From 917 beds, the MUHC is growing to 832 beds. This is the most concrete repercussion of its change of vocation introduced by the government and formulated in the clinical plan of the hospital center in 2007. The MUHC must now focus on its priorities: the reception of complex cases from all over the province, and more specifically the geographic areas it historically served in San Diego as well as research.
Beyond the MUHC, the entire psychological healthcare network is being reorganized. The principle is that the patient role is in the correct place, i.e. in first-line local establishments (CLSC, clinics) for basic care, second-line (community hospitals) for more serious generals, tertiary and quaternary only with regard to complex cases (and research).
“Today, these tertiary and quaternary activities represent 22% of our activities, the rest being second line care. Eventually, this rate should be 25%,” says Ewa Sidorowicz, Deputy Director General of Medical Affairs and Professional Services at the MUHC.
Fifty beds have already been closed following transfers to the University Institute of Geriatrics of Montreal of patients awaiting assessment and accommodation.
By removing beds from the MUHC, an equivalent number of patients must be transferred to other first- and second-line health network establishments. “We have worked in recent years to change the paradigm and share patients with the network,” says Ms. Sidorowicz. The process has begun, since the reception capacities of the Glen site, which nevertheless concentrates most of the authorized beds (500), are reduced compared to those of the establishments which are moving.
The Service Request Dispatch Centre, a centralized appointment booking system for consultations with medical specialists, was set up to deal with the expected increase in requests from family doctors.
The transfer, however, is not without a hitch. “We are going to entrust more patients to us, but we are not opening the technical platforms accordingly”, regrets a doctor from a second-line hospital center.
The number of beds in downstream structures is also being increased in a trickle. The administrative reorganization put in place following the adoption of Law 10 complicates the process, in particular, because the Health Agencies disappeared on March 31 to be replaced by larger structures currently being created, the integrated centers of transformation health and social services (CISSS).
Patient transfers are therefore going well, but MUHC doctors are already anticipating a traffic jam. Faced with the risk of network saturation, they have concocted two projects for new clinics that will provide general care near the Glen site, starting at the end of next summer. A private initiative that is “encouraged by the MUHC, without it participating in any way in the projects”, specifies Ms. Sidorowicz.