Case Study: Deep River and District Hospital

While the Deep River and District Hospital (DRDH) has always understood its place as a vital service provider to the community, it only began specifically embracing the concept of a health hub in 2010. Today, its notion of a hub is based as much on co-location as it is on community partnerships. Its health campus includes the North Renfrew Physiotherapy Centre, the North Renfrew Family Health Team, the Four Seasons Lodge, North Renfrew Family Services, and the Deep River and Area Food Bank, and it recently launched an integrated community services council. A significant aspect of DRDH's approach can be found in its work connecting with the wider community, where it has forged relationships with the local food bank and nearby Canadian Forces Base Petawawa. The resulting partnerships saw the food bank move into the hospital basement and the military build a helicopter landing pad (a joint project where the hospital paid for the materials and CFB Petawawa engineers designed and built it). In a northern setting, proximity matters DRDH sees co-location as a significant part of its role as a health hub. The health campus is located on ten acres of wooded property. It occupies approximately 50,000 square feet of that property. Currently, the health campus consists of the hospital proper and an outpatient clinic. The hospital building houses a 16-bed medical floor and 14-bed long-term care home, a 24/7 emergency room, diagnostic imaging (including Ontario Breast Screening Program), the Eastern Ontario Regional Laboratory Association (EORLA) lab, a non-profit physiotherapy clinic, telemedicine services, administration and hospital foundation offices, laundry and support services, as well as an auxiliary gift shop. The Community Care Access Centre (CCAC) also has an office in the hospital and is staffed by a CCAC nurse who is a care coordinator, that assists with discharge planning in acute care and meets regularly with staff at the family health team. An outpatient clinic building is physically attached to the hospital by a full-purpose walkway and ambulance entrance. It houses North Renfrew Family Services (a community based counseling and social service agency), the North Renfrew Family Health Team and the offices of two community doctors. Partnering with the community to bring services into the hospital space Deep River and District Hospital Ontario Hospital Association 2 DRDH's telemedicine platforms are a resource shared with others in the community whenever possible. Staff members from nursing homes share in educational events, and even the staff of the local dental office uses the equipment for learning needs. It is a regional resource that not only increases patient access to a wider community of specialists, it is also integrated with regional programs such as diabetes and stroke rehabilitation. It is significant to note that LHIN funded, non-LHIN-funded, and community-sponsored organizations are all located on DRDH's health campus. When these providers work together, regardless of funding sources (some from different ministries), the North Renfrew community is better served by a wider array of support services. This strategy recognizes not only the diverse needs of the area, but also the fact that socio-economic factors have an enormous impact on health. Integrating services to leverage economies of scale Service integration is a significant part of the health hub vision. The hospital provides information technology services to downtown doctor and dentist offices as well as to the North Renfrew Family Health Team and the North Renfrew Long-Term Care Home. It also provides laundry services to the North Renfrew Long Term Care facility and local hotels, a massage and chiropractic office, as well as a summer science residential camp. The hospital's sponsorship of the family health team means that the human resources and financial reporting are shared functions. This enables the family health team to recruit and retain professionals it might not have been able to attract as a stand-alone employer. Both the hospital and the family health team contract the services of a pharmacist from a tele-pharmacy company. Expanding the health campus and its reach DRDH plans to expand its health campus, starting with the construction of a county-funded ambulance bay that will form the northwestern boundary of the property. In keeping with the Champlain LHIN's Integrated Health Service Plan 2013- 2016 (""[build] a strong foundation of integrated primary, home and community care""), the hospital is also developing its vision for a primary care facility on the grounds. The proposed 12,000-square-foot building will be a stand-alone, single-story structure with its own mechanical and HVAC systems. It will be physically connected to the hospital by a covered walkway. Approximately 8,000 square feet will be occupied by the North Renfrew Family Health Team and the rest of the space by three community doctors. DRDH expects to further enhance its position as a senior-friendly hospital and a primary care hub by housing these community doctors and their patients in this up-to-date facility that meets all accessibility standards and connects to ancillary services through the closed walkway. This is significant because stable primary care relationships are important for the effective management of chronic disease. Developing an integrated community services council to build on its community integration, DRDH extended a public invitation to a strategic planning workshop (as part of its 2012-2013 Strategic Plan). Well attended by members of the community, strategic partners, hospital staff, and local doctors, the workshop helped develop the idea of an integrated community services council. In the spring of 2013, a council was formed and started to build interagency relationships. DRDH expects the council will be able to advocate for community needs and inform regional planning projects using local data. To begin its work, it will analyze data on patients who access the services most and put a plan in place to help address any gaps in the services provided by its agencies."

The situation analysis of DRDH presents how Deep River and District Hospital has transformed into a one-stop health center that provides facilities that tap into other sectors for the benefit of North Renfrew in Ontario. DRDH has moved beyond the basic hospital services through collaborations with local agencies and having other services within the health campus. Besides, it increases the accessibility of extensive healthcare solutions and responds to the context of SE factors by offering more numerous opportunities for support services.

 Key Points of the Case Study:Key Points of the Case Study:

 Health Hub Concept: In emphasising the health hub concept, DRDH accepted the centrality of co-location and the partnerships with the communities. It is essential to their work of delivering, extensive service by accommodating different services such as North Renfrew Physiotherapy Centre, Family Heath Team, and the local food bank within the compound.

 Community Integration: It has also contracted good relations with local stakeholders such as Canadian Forces Base Petawawa who assisted in construction of a helicopter landing pad within the hospital compound as well as the food bank which is housed in the hospital basement. The integration also enables the hospital provide the needed services in addressing the variety of needs in the community.

 Service Integration: Apart from offering medical services, the hospital adds Business IT support, laundry service for other institutions such as family health team, long term care homes and businesses within the community as an added service.

 Expansion Plans: DRDH’s campus will grow even larger in the coming years because the practice is still growing and has its sights on not only a primary care building but also a county-funded ambulance bay. Such changes are consistent with regional plans for the development of the health service and are planned to increase the role of DRDH as a specialised hospital for the elderly as a primary care provider.

 Community Services Council: Subsequent to the strategies it has designed on community integration it has, DRDH has created an integrated community services council. This council has the responsibility to represent and negotiate for the community needs and be involved in the planning of the services in the region to effective meet the needs of a community.

 Conclusion:

 The above-discussed DRDH case presents the way in which an outlying hospital may broaden its function as a healthcare center and perform the functions of an integrated health and social service provider in a community-oriented facility. DRDH has benefited from creating links and integrating service delivery for the provision of comprehensive solutions to the North Renfrew residents as well as for improving health system planning and delivery in the broader region. The above model can then be followed by other healthcare providers in other rural settings who are interested in enhancing the delivery of their services and clients’ health status.