The Drive Magazine - Special Report

The

DRIVE CONDITION

CRITICAL

Why Our New Hospital is on Life Support

S P E C I A L

R E P O R T

POWERFUL IMAGES FOR A

HEALTHIER FUTURE Bringing 3D Digital Mammography Close To Home Is Essential

3D Digital Mammography creates a three-dimensional picture of the breast using X-rays.

(Conventional mammogram creates a two-dimensional image)

This means improved accuracy of breast cancer screenings and reduced false positive tests.

Windsor Regional Hospital has performed over 85,000 breast screening exams over the past 5 years. Our need for state-of-the-art Mammography equipment is essential. Our fundraising commitment is $500,000 in order to bring this technology close to home and to create a healthier future for all of us.

TO DONATE NOW PLEASE VISIT: www.wrh.on.ca/WRHFoundation

YOUR NEW HOSPITAL WELCOME TO THE FIRST “SPECIAL REPORT” BY THE DRIVE "Condition Critical" articulates the current state of our hospitals and the campaign to replace them.

We commissioned a team of seasoned journalists to do a “reality check” on the hospital and acute-care in general, giving you the depth and breadth of coverage that has become a rarity in local news. The DRIVE has made this investment because the hospital affects us all, and our families, for generations to come.

Our goal is to Inspire, Inform, Educate and Engage. In this edition we place a spotlight on the real issues, human issues, surrounding the continued delay and political turmoil of our new hospital.

TWO HALVES DO NOT MAKE A WHOLE...

Dr. Wassim Saad, Chief of Staff at Windsor Regional Hospital describes the current state of our two acute hospitals as just that.

The fact is that we do not have two hospitals; we have two partial hospitals that when put together still have several assets missing to make up a fully functioning, proper care providing healthcare system. They are in a desperate state of decay and the campaign to replace them is at a stand still. It has impeded attempts to introduce cutting-edge and life saving technology, raised infection risk, undermined talent recruitment and demoralized staff.

Currently, we are all pawns in a purgatory that we cannot afford. Political influence and a protracted zoning fight have pushed the timetable for a new hospital into uncertain territory. As taxpayers into one of the best public healthcare systems we deserve the same care that is being welcomed into other municipalities across Ontario.

Enjoy the read. It is a departure from what you would normally expect from our pages and vital for all of us to fully understand the state of the union for our hospitals.

We welcome any and all feedback at haveyoursay@thedrivemagazine.com

On the cover: Dr. Wassim Saad, Windsor Regional chief of staff.

Photo Credit: Rob Gurdebeke

Special Report; graphic design, layout and pagination: Shawna Beecroft

Ken Stewart, Managing Director – The DRIVE Magazine

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BEHIND THE STORY THE WINDSOR WRITERS GROUP

In the last seven months of his life, Micah Hackett was in perpetual motion between the two campuses of Windsor Regional Hospital because neither unit alone could provide the life-saving care the teenage cancer patient required. Why, in a county of nearly 400,000 people, does Windsor-Essex not have a 21st Century care facility like those taken for granted in most similar sized regions? The Hacketts and countless families like them deserve better. Micah deserved better. This special report by the Windsor Writers Group, a team of journalists led by former Windsor Star publisher and editor-in-chief Marty Beneteau, explores the dilemma through the eyes of those most affected.

Principal writer Jennifer O’Brien is a Windsor native nationally recognized for her more than 20 years of news reporting with Canadian Press and the London Free Press.

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Photographer Rob Gurdebeke was picture editor at The National in Abu Dhabi, UAE, deputy picture editor at the Daily Telegraph in Sydney, Australia and is a former Windsor Star photojournalist and photo editor.

Project manager and co-writer Marty Beneteau is a nationally recognized journalist who enjoyed a 36-year career at The Star as a reporter, copy editor, newsroom leader and executive.

Building on quality services, people and facilities The University of Windsor is fully invested in the health and wellness of all of the residents of Windsor and Essex County.

Our commitment to a healthier region - with the best possible care - is front and centre right across all of our disciplines and faculties at the University of Windsor. Our exceptional graduates also play key roles on the frontlines of local health care. And our health-related research and service – often working with community partners – is an important investment for better health care in our region.

We also believe the foundation of a vibrant health care system must be built on quality services, people and facilities. A state-of-the-art hospital coupled with strong education and training programs will therefore ensure the best care for our children, our families - for everyone. It will also provide needed and improved support for our initiatives at the University of Windsor.

Windsor-Essex has an opportunity – and responsibility – to move forward as quickly as possible with plans for a new regional hospital.

Micah’s Journey WHAT’S WRONG WITH OUR HOSPITALS? Teen’s harrowing cancer battle illustrates shortcomings

By Jennifer O’Brien

Micah Hackett in Mexico one month before his first cancer symptoms emerged. Photo courtesy of Jon Ouellette

Weeks after 19-year-old Micah Hackett was diagnosed with terminal cancer, his family faced a devastating choice.

bed as kids and nights were spent talking and giggling.

‘‘

Did they want doctors to treat the cancer that was killing Micah?

Or did they want doctors to treat the symptoms that included violent seizures, paralysis, confusion and headaches?

They couldn’t have both.

What they wanted was the best available care in 2019.

But the best hospital care in Windsor during the dying teenager’s seven-month cancer battle was split between two buildings four kilometres apart, and Micah was incapable of travelling.

“It’s just frustration,” says his dad Brent Hackett.

“Would he have lived longer if everything was in one hospital? Maybe a few more days, maybe not – cancer’s stupid,” he says. “But, you are under stress when you know that the services that could be given to your family member are at another hospital."

An aggressive cancer in Micah’s spinal cord and cerebral meninges caused seizures and intracranial pressure that required a shunt. That meant he depended on critical services at Windsor Regional Hospital’s two sites: the neurology department at its Ouellette campus downtown and the oncology department at its Met campus in South Walkerville.

For weeks, his care included being transported between the two facilities, depending on which medical need was a priority at the time. Those transports alone had family members “always on edge,” worrying about what could go wrong as Micah and his medications were passed from hospital to hospital, department to department.

Then, as Micah’s condition worsened and he relied on more medications and equipment to keep him alive, it became clear that he was too weak to be transferred between hospital campuses.

His family decided on Met, because the SPECIAL REPORT I THEDRIVEMAGAZINE.COM

Photos courtesy of Hackett family

I loved him with my whole heart

’’

Back then, Micah talked about being a travelling preacher, but as he grew older, he decided he wanted to stay close to home and be a pastor in his own community.

He and Lucas would drive to Bible conferences around Southwestern Ontario and Michigan. He loved his faith and became increasingly focused on studying the Bible and biblical languages, spending his free time writing books about the Bible. He launched two websites and since his death, his family has found two books he wrote.

After Micah’s fourth trip to the hospital last winter, Lucas took a leave from work so he could be with his brother. “I didn’t want to be anywhere else – I wouldn’t want to be at home or at work, knowing he was sitting there in a bed.”

...

In November 2018, Micah and Lucas went to Mexico for a friend’s wedding. They had a great time, says Lucas. Then, after cancer was the root of Micah’s problems, they returned to Windsor, Micah started but that meant he could not have magnetic feeling tired and sick. resonance imaging (MRI) done, which was the best way to determine how that cancer It started with fatigue, a nagging was growing. Magnets could impact the headache and Micah generally feeling shunt that was decreasing the pressure under the weather. After a couple of weeks, on Micah’s brain. After an MRI, the shunt it started to seem like the flu that wouldn’t would need to be reprogrammed, a service end — nausea, vomiting, headaches — it only available at Ouellette. just kept getting worse. He worked at Forest Glade Fireplaces, but he was missing shifts.

“We had no idea what was going on He felt so sick. inside of him (after that),” says Micah’s older brother Lucas. “You needed an MRI to treat The first seizure was Dec. 21, 2018 – the the symptoms. day after he turned 19.

—Lucas Hackett

“We had to fight the cancer, but it Micah’s parents followed the ambulance was aggressive.” to Windsor Regional’s Ouellette campus, ... and arrived to find doctors had already done Micah died Wednesday, July 17, 2019. a lumbar puncture on Micah to determine Every Wednesday since, Lucas has gone to if he had meningitis. sit by his brother’s grave.

Before February, the teenager had had “He was the person I laughed with and four major seizures – one of them seven he was the person I talked to. Now I don’t minutes long. Doctors in the neurology have that,” says Lucas, 26. “I loved him department at the Ouellette campus had with my whole heart – more than I can say.” done three lumbar punctures, and surgery to place a shunt in his brain. They tested for Home-schooled, the four Hackett kids cancer, but it wasn't detected at that point grew up as siblings, classmates and best friends. Mornings were for school work, Between hospital stays and ambulance afternoons for Lego, imaginary play and the trips, his family tried to keep things as trampoline. Micah was the bravest. “He’d normal as possible. They went out for do crazy flips that would freak me out,” dinner Feb. 7, an event documented in a says Lucas. The brothers shared a bunk journal the family started to keep track 7

of Micah’s symptoms, treatments hospital at 7:30 a.m. to find Micah in bed, and medicines. with blood and drool on his pillowcase and a nurse trying to wake him.

Micah loved Swiss Chalet. He ordered double fries. He couldn’t finish them.

That day, paramedics transferred Micah back to Met, where he was assessed and “That’s the last time he ever went out admitted “like a brand-new patient again,” for dinner. The whole family was there,” says Brent. The doctor did an assessment says Brent. “I was just thinking about and informed Brent that Micah appeared that yesterday.” to have meningitis, according to a detailed log kept by the family. After some back and After another seizure and long period of forth, Brent explained his son’s diagnosis confusion, doctors sent Micah to London’s and the emergency room doctor looked University Hospital for more tests. It was Micah up in files, where he found informathere that an MRI found a blood clot and a tion about the rare cancer. rare form of cancer on Micah’s spinal cord.

Still, due to that day’s seizure, Micah Cancer meant Micah would need an was transferred out of the hospital with an oncology team at the Met campus, but oncology department and back to the intenthe ongoing seizures and other symptoms sive care at Ouellette for neurology to keep meant he still relied on the neurology an eye on him. department at Ouellette.

“We were always on edge: ‘Is he going “It was really a distressing time because to have a seizure because of being transyou didn’t know where you needed to ported?’” says Micah’s sister Nicole. She be,” says Brent. “They didn’t know if he recalls the steps required to transfer Micah’s should be a neurological patient or a file to the other hospital, the paperwork and cancer patient.” While at Ouellette, Micah re-admission. Each time, she says, hospital was under the care of the neurology staff would re-enter all the information department and also a “hospitalist,” or about the medications he needed. “There is internal medicine doctor. a lot of room for errors.”

The ambulance rides and other transfers It was April when doctors said the transbetween hospitals increased. fers were becoming too much for Micah. He was hooked up to a breathing ventilator One week – between March 27 and April machine, with a tube down his throat to 3, 2019 – Micah was transported between his trachea. hospitals five times. “Each time meant a new chart, a new assessment, a new interThey told the Hacketts he should remain pretation,” says Brent Hackett. “The swabs, on one site and that should be where all the testing all over again.” oncology specialists could treat the cancer.

Problem was he needed MRIs to monitor One transfer took so long, Micah didn’t the cancer growth and see what was going receive his seizure medication at the proper on, but magnets can change the pressure time. Two days later his dad arrived at the setting in shunts – and Micah’s shunt was

critical to easing the otherwise unbearable pressure on his brain. Normally, after an MRI, his shunt would need to be reprogrammed by a neurosurgeon, but that was not available to him at Met, Brent says.

“So from then on, they couldn’t see where the cancer was or what was happening in his head. They could not see in detail what they needed to see. I asked many times, ‘Can’t we do an MRI?,’ and they said ‘We can’t. He has a programmable shunt and he’s too weak to transfer over to Ouellette to get it done.’”

He recalls doctors saying things would have been easier if neurology and cancer services were in the same facility. “With the current set-up you have to make a choice,” says Brent.

“That’s the problem. Everything is split between two locations.”

Micah’s doctors did not respond to requests to participate in this article, but hospital officials have confirmed that Micah would not have been able to have his shunt reprogrammed while at Met. Not that doctors didn’t try. While in cancer care, Micah suffered at least one major seizure that put him out of commission for three days and led to paralysis. At one point, an on-call oncologist ordered an emergency MRI, but it could not be done as shunt reprogramming can only be done at Met. “We have half a hospital at the Ouellette campus and half a hospital at the Met campus,” says Dr. Wassim Saad, Windsor Regional chief of staff. “They provide different services. They are one hospital

Micah with his grandmother, Alma Hackett at her 80th bithday party.

Micah holds his niece Georgina in bed, Dominic and Virginia, standing next to him.

organization but they are kilometres

“Before, all I cared about was as long as an ambulance can get to the hospital, it doesn’t matter where it is,” he says. “You never care about it until you need it.”

...

Micah’s older sister can still hear him laugh, in that distinct way he had. It was contagious.

Brent Hackett discusses his son’s seven-month cancer battle.

apart. Services are spread out. They are woke up and said, ‘When are they coming fragmented.” Many of the problems “will to videotape me?’” recalls Brent. “Then he disappear under one roof” if the new acute- asked, ‘Oh, did I do good?’” care hospital is built, he says.

Micah returned to Met hospital June 12, In May, five months after his first seizure and died five weeks later. ... and two months after his cancer diagnosis, Micah’s medical team said the teen Lest anyone think that the family blames would benefit from palliative care and he the medical team, a month after Micah went home. died, his dad emailed hospital CEO David Musyj praising hospital staff, especially While he was home, members of the nurses for the “A+” care. Not only did they family’s church would often stop by to do everything they could to help Micah, visit and pray, while prayers came in from they listened to the family with compasaround the world to a Facebook group sion and cried with family members when Nicole set up. The family still had hope. he passed away.

“When you have a history of faith, you’re looking for miracles,” says Brent.

At the end of May, a film crew came to videotape Micah talking about his faith and his life. In the six-minute video he appears upbeat and accepting of what is happening and calls his death “a shortcut to heaven.”

“He seems so together during the video.

But after they were done he fell asleep and

The sadness comes and goes, for Nicole, 30, who has three kids ages eight, six and two. “Having the kids around keeps my mind off it, but then you go to bed at night and close your eyes and all you see are the IVs and all the machines around.

“It was the most traumatic seven months of our lives…. You’re always hoping for that miracle.”

Micah was a spiritual person who “cared deeply about everyone who he came in contact with,” always seeking knowledge, which he loved to pass on to others, says Nicole.

“He was definitely an unusual teenager – selfless and willing to go help anybody at the drop of a hat. He had a listening ear.

He’d cut grass and do yard work for seniors from the church.”

And he adored his nieces and nephew.

Even when he was sick, his face would light But the purpose of the email, says Brent, up when he saw them. was to provide the hospital with “actual comments from patients in support of the While he was in the hospital, the family new mega-hospital.” would pray for Micah to be healed every night. “After he passed away, I said ‘God Before his son was sick, Brent knew answered our prayer and healed Micah, but about Windsor-Essex’s plans for a new he healed him in heaven instead of here on acute-care hospital that would put all earth,’” says Nicole. “And they were happy. services under one roof in state-of-the-art To them he’s healed, he’s walking again surroundings, but didn’t give the issue in heaven. much thought.

“I wish I had their simplicity.”

EXCERPT FROM A BRENT HACKETT EMAIL TO WRH CEO DAVID MUSYJ: It's been a long, tough haul. But the support from everyone in the hospital was great. When we were on 4W at MET, we would still get messages from the 8th floor at Ouellette asking how my son was doing. A lot of the nurses followed my son's Facebook page to keep up to date on how things went. It was a real family atmosphere. Even the porters who wheeled my son down to get his radiation and other tests were great (Brad loved taking my son, as my son's memory wasn't too good due to his seizures, so Brad got to tell the same jokes all over again). The cleaners too would poke their heads into the room and ask how things were each day. And when we had to come back to the hospital, they would stop and ask what was wrong when they saw us again. I might as well add that the kitchen staff was great too. When we were at Ouellette, they got to know us by our voices, and how my son liked his tea or coffee. Then when we moved to Met, they connected who we were by my son's tea and coffee choices.

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BACK

OF THE

LINE

POLITICS, LOCATION BATTLE BLAMED FOR PLUMMET ON PROVINCIAL RANKING

By Jennifer O’Brien and Marty Beneteau

Seven years into the campaign for a new hospital in Windsor-Essex, it’s time for a reality check: the project is on life support.

Caught up in a rancorous legal fight over its location and politically outgunned at Queen’s Park, the $2 billion Windsor-Essex Hospitals System proposal now finds itself at the bottom of the Ontario government pecking order, staring up at a sea of Tory blue competition.

Rival hospital projects – many in ridings boasting Progressive Conservative MPPs and cabinet ministers – now rank ahead of Windsor Regional Hospital on the province’s timetable for hospital construction. Some leapfrogged it after Doug Ford’s Tories swept to power in June 2018 and the Windsor area elected three New Democrats.

Once in the top six, Windsor Regional is listed last among hospital projects on the latest Infrastructure Ontario market update, based on the date it is expected to receive final approval – after 2024.

That means that while patients and hospital staff here deal with two aging campuses unable to adapt cuttingedge technology, other Ontarians can look forward to construction starting on their high-tech health hubs as early as 2022.

Consider a redevelopment proposal by the Ottawa Hospital. Estimated at $2 billion, like Windsor Regional’s, it was nowhere to be seen on the 2017 Infrastructure Ontario market update. On that update, Windsor’s project was scheduled to start its formal search for construction contractors in 2021.

Now, on the most recent update, issued in September, Ottawa is slated to start that same search in 2022 and start construction as early as 2023, while Windsor Regional’s request for proposals and projected financial close are both “greater than five years” away.

The Ottawa region is home to four Ontario cabinet ministers.

“They started their capital planning project after we did, and recently they just moved ahead of us,” Dr. Wassim Saad, Windsor Regional’s chief of staff, told an October rally of 42 Forward, a group in favour of the proposed County Road 42 site. “Are people in Ottawa more important than the people in Windsor-Essex? No, they are not.”

Mega-hospital supporter Bev Valliquette helps to rally the crowd at an October rally organized by 42 Forward, a group backing the County Road 42 site.

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Noting that Ottawa’s hospital project has leapfrogged Windsor’s, WRH chief of staff Dr. Wassim Saad asks: “Are people in Ottawa more important than the people in Windsor-Essex?”

Speaking to former patients and families who shared heartfelt stories about their hospital experiences, Saad described how deficiencies at Windsor Regional’s Ouellette and Met campuses are burning out staff and hurting talent recruitment.

“For our patients, for our community, for clinicians … who want to care for you and your loved one in the right place at the time you need it, we need to move forward.”

Why is the hospital stalled? Has the nearly five-year dispute over its location given Queen’s Park an excuse to idle it, as Mayor Drew Dilkens, County County Warden Gary McNamara and others suspect?

The debate goes back to 2015. When a site-selection committee recommended a farm field near Windsor Airport, it sparked a headline-grabbing battle that touched social themes ranging from the environment to accessibility and urban sprawl.

The chosen location, touted as a geographical compromise to provide equal access for nearly 400,000 city and county residents, drew outrage from some Windsorites concerned about losing health care to the suburbs. The most vocal was CAMPP (Citizens for an Accountable MegaHospital Planning Process), which posted lawn signs imploring the govern-

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ment to “re-think the mega-hospital.”

“We expect a long fight,” CAMPP, whose CAMPP said the proposed site would make appeal is supported by three business care less accessible for Windsorites. improvement areas, says on its website.

After Windsor council approved a motion to rezone the site to make it possible to build a hospital there, CAMPP formally appealed that decision. The appeal led to a three-day hearing before the province’s Local Planning Appeal Tribunal (LPAT) in October. Adjudicator Scott Tousaw reserved judgment and a ruling is expected by January 2020, nearing the eighth anniversary of the hospital campaign.

If CAMPP wins, and the city does not appeal, it’s anyone’s guess how long selecting a new site would take.

A dismissal of the appeal could shoot Windsor up the province’s construction list. But not necessarily.

Either side can appeal to Divisional Court, according to the LPAT Act, and the site opponents are well funded. A GoFundMe campaign organized by CAMPP spokesperson Philippa Von Ziegenweidt had exceeded $80,000 of its $100,000 goal in November.

In an interview, Von Ziegenweidt said her organization supports a new single-site hospital located “where people live today.”

CAMPP is adept at garnering media attention and its social media execution is prolific and pointed. The group has churned out more than 5,600 posts since joining Twitter in 2014. CAMPP had 667 Twitter followers in November and 230 donors to the GoFundMe campaign. By comparison, Dilkens poses an important question: 42 Forward had six Twitter followers and Why would the province approve a six posts. $2-billion expenditure which is at risk of going back to the drawing board if zoning In a Sept. 15 post, CAMPP defended is killed? The province would include zoning itself against critics who said it is putting among what it calls “early planning work” the hospital in peril, saying, “Stop the that puts the onus on the lead agency – in fearmongering (sic) about losing this this case WRH – to resolve local issues investment. Stop vilifying vocal, deeply before the project moves forward. concerned residents.”

“We don’t think it’s being held up at all by discussion over the location. People think it’s a matter of getting shovels in the ground. Everybody assumes (the delay) is about the location, but nobody has ever said that. It could be for any number of reasons.

“They still need to decide on all care in aging hospitals that no longer sorts of functional matters before they meet modern health-care standards,” can proceed.” said Nesbitt.

She said hospital supporters should welcome the “independent oversight process” occurring with the LPAT appeal.

“For such a major expense that we are incurring, I don’t see why anybody wouldn’t want to have those checks and balances before proceeding. I think that’s a very important step in the process that we should all be welcoming.”

He said “early capital planning work” to “determine the programs and services to be delivered” is “not being impacted” by deliberations over the site.

Could the Windsor area’s lack of provincial representation in an austerity-minded government impact the hospital’s fate? Dilkens and others think so.

Dilkens draws a direct line between the “Everyone here understands that we site selection dispute and the hospital’s lack don’t have a voice around the government of progress. table,” said Dilkens. “Trying to pursue a budget item of $2 billion is a challenge in “The appeal process does give the the best of times.” province a reason to delay,” he said. “The province legitimately has a way to say we The Ford government has been looking like your proposal, but why will we give you for cost efficiencies in its attack on so-called $9 million today?” The latter is in reference hallway health care. In Grimsby, reports to the province announcing $9 million last that his hospital would lose key services summer to push Ottawa to the next stage. such as obstetrics, surgery and endoscopy caused West Lincoln Memorial Hospital’s McNamara, his county counter- chief of staff to resign. One month later, part, noted that all eight municipalities, Ford visited Grimsby, represented by Tory including Windsor, have approved the MPP Sam Oosterhoff, with chequebook in location. “We don't want to be in a position hand. to give the provincial government any type of opportunity to deny a much-needed acute He announced “shovels in the care hospital that is desperately needed ground by 2022” for a new hospital and in our region,” said McNamara, mayor of pledged an immediate $8.5 million for Tecumseh. “It is unfortunate that there are emergency upgrades. squabbles about the location. What we are hearing (in the community) is, ‘Let's move Seven of the 12 hospital projects listed on, stop the rhetoric. It's been done fairly.’” ahead of Windsor on the 2019 Infrastructure Ontario report have strong PC repreThe DRIVE made repeated requests to sentation, particularly Ottawa and Queeninterview Ontario’s Minister of Health sway Health Centre in Etobicoke, which is Christine Elliott. She did not respond. adjacent to the premier’s riding. Tourism, Interview requests also were submitted Culture and Sport Minister Lisa McLeod to Premier Doug Ford and Infrastructure has been vocal in her support of the Ottawa Minister Laurie Scott, without success. A project near her Nepean riding, telling the health ministry spokesperson responded Ottawa Citizen in December 2018, “We are to a series of questions about the apparent still on track and it is a priority for me and change in direction on Windsor Region- my government. We need a new hospital.” al’s plans for a new hospital. Asked why Windsor’s scheduled start was pushed back On the 2017 market update, Windsor to more than five years away, the spokes- Regional was included on a list of eight person, Mark Nesbitt, described the project Infrastructure Ontario projects expected as “still in the early stages of planning,” to start procuring vendors by 2021. and said “it’s important to get this early planning right.”

“Many patients and families across the province, including Windsor, are receiving

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Two of those projects – Queensway Health Centre in Etobicoke and Niagara Falls Hospital – once in line with Windsor Regional, are now slated for “financial close” in 2022. That means the province expects financing to be in place to design, build, finance and maintain those facilities, before Windsor Regional even issues its first request for proposals. The 12 projects listed ahead of Windsor would cost more than $10 billion.

“It appears Windsor is being left behind,” said Lisa Gretzky, New Democrat MPP for Windsor West. “Pushing this off with a ‘greater than five years’ is not acceptable for our community. We waited long enough. We’ve done our fair share and we need the government to step up and honour its commitments.”

The province’s hallway health care initiative places an emphasis on rapidly growing communities. Gretzky said that while slower population growth in Windsor-Essex could be a factor, that doesn’t negate the need. “We have aging infrastructure, we need the investment in infrastructure, and people in this community deserve it. They pay taxes like everyone else, and we are seeing investments to other communities. It is our turn.”

Gretzky recalled the chilly, sun-kissed day in December 2017 when then health minister Eric Hoskins stood before a packed atrium at the Ouellette campus and announced Windsor Regional was moving to Stage 2 and an unspecified infusion of government cash. “The problem is the Liberal government never forwarded the funding. They made the announcement and it sat.”

Six months later, the Liberals lost to a Conservative machine pledging to reduce spending by four per cent. Provincial funding stopped at Stage 1b – $6.8 million, or less than one-quarter of what local taxpayers have contributed so far through municipal levies.

The vast majority of our region and elected officials and health care providers all agree the location issue has been settled.

As an elected official, my role was to allow that process to unfold without politicizing it and I think that was the same tact all elected officials took at every level and when you look at the location, it’s a compromise location. We have to realize it is a regional hospital and not everyone is going to be happy with its location.”

– MPP Taras Natyshak, NDP - Essex

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THE STONE IN DOUG FORD’S

SHOE MPP Taras Natyshak (NDP - Essex) is a prolific Doug Ford tormenter, regularly challenging the Premier on issues ranging from cronyism to his means of business travel. As reported by The Toronto Star:

February 26: Natyshak labels a passenger van for which Ford sought $50,000 in taxpayer-funded modifications “a souped-up man cave on wheels.” Calling it a “lack of respect for taxpayers,” he asks: “Can the premier explain how equipping a van with a minifridge, a 32-inch television with a Blu-ray player and a leather power-reclining sofa is a cost-cutting measure for the taxpayers?”

March 18: When Natyshak asks the OPP to investigate allegations of unregistered lobbying by close friends and advisors to Ford, the Premier calls him out: “The member from Essex walks around here like he’s a real tough guy. He thinks he’s a big tough guy, but why doesn’t the big tough guy walk outside and make those accusations outside this door if he’s so tough. He’s not tough. He knows he doesn’t have a good enough lawyer to walk outside those doors. He walks around as a tough guy, but he’s nothing but a coward.” To which Natyshak replies: “I guess we know why the Premier wanted his buddy to head up the OPP so badly.”

July 17: Ford’s release of his cell phone number to the public was “a farce to begin with,” Natyshak says.

“I think Doug was trying to play the populist card and hand out his cell phone to everybody that wanted to chat with him. Inevitably, when he started getting calls that actually asked some hard questions the phone line went dead.”

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Photo courtesy of Snap'd

August 28: “No one yet knows how many Ford friends and insiders may be stowing away on the gravy train, clinging to their golden tickets,” Natyshak says in a statement after Ford names former Toronto Sun executive Jamie Wallace his chief of staff, replacing Dean French after French left in a cronyism scandal. “It’s time for Doug Ford to drop this charade and let the standing committee on government agencies publicly inspect the tickets he’s been handing out.”

November 5: Natyshak accuses Ford of crass opportunism over a fundraising campaign to mend a country “divided” by the federal election. “Canadians heard some shocking news from the Premier ... the fabric of the nation is at risk unless we send him a toonie,” Natyshak says. “If the premier was remotely serious about this, he wouldn’t be trying to fundraise off of it.” Natyshak called for Ford to apologize and reimburse donors.

In an interview with the DRIVE, Natyshak called his noteworthy back-and-forth with the Premier, the “nature of politics,” and said he is confident the province understands Windsor-Essex's campaign for a new hospital.

“The nature of politics is that we don't always agree on policy and that certainly has been the case with New Democrats and Conservatives on a whole host of issues including cuts to education and health care and spending to communities," he said. "My disagreement is with those policy initiatives and I don't think that has any bearing on the need or viability of the hospital project in this area. There is no doubt the current government understands the need for a new 21st century hospital in southwestern Ontario and Essex county. They are aware of our position down here in terms of what our needs are.

This is an expenditure the government has committed to and they've indicated they are committed to continuing with the project.”

WE’RE NO.

Kingston

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NOTEABLE: The hospital renovation enjoyed strong support from the previous Liberal government, but no sooner had Kingston elected a Tory MPP in the Ford government than Hillier was sacked from caucus for alleged insensitive remarks. Hillier was accused of saying “yada, yada, yada” to a parent of a child with autism during question period. He later claimed he was heckling the NDP, not the parents.

The upheaval did not result in Kingston losing its place atop Infrastructure Ontario’s hospital timetable.

Bowmanville Lakeridge Health Bowmanville redevelopment Less than $200 million request for proposals winter 2021 Financial close 2022 Political influencers; MPP Lindsey Park, PC, Durham

HOSPITAL PROJECTS ON THE INFRASTRUCTURE ONTARIO FALL 2019 MARKET UPDATE, IN ORDER OF THEIR PROJECTED FINANCIAL CLOSE, AND THEIR REGION’S QUEEN’S PARK REPRESENTATION

2

NOTEABLE: “I’ve been championing it sort of since I got elected,” Park told Clarington This Week in September.

“I’ll be standing with the community in support of this project every step of the way.”

Etobicoke Trillium Health Partners – Queensway Health Centre redevelopment $500 million-$1 billion Request for proposals spring 2021 Financial close 2022 Political influencers; MPP Christine Hogarth, PC, Etobicoke-Lakeshore.

3

NOTEABLE: The neighbouring riding of Etobicoke North is represented by Premier Doug Ford. His nephew, Mike Ford, is Toronto’s Ward 1 councillor in Etobicoke North.

Niagara Falls Niagara Falls Hospital $500 million-$1 billion Request for proposals summer 2021 Financial close 2022 Political influencers; MPP Wayne Gates, NDP, Niagara Falls

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1

Kingston General Hospital renovation $500 million-$1 billion Request for proposals summer/fall 2020 Financial close winter/spring 2021 Political influencers; MPP Randy Hillier, Lanark-Frontenac-Kingston, Independent; MPP Ian Arthur, NDP, Kingston and the Islands.

4 15

Grimsby Hamilton Health Sciences – West Lincoln Less than $200 million Request for proposals spring 2021 Financial close 2022 Political influencers; MPP Sam Oosterhoff, PC, Niagara West

5

NOTEABLE: One month after its chief of staff resigned amid reports that obstetrics, surgery and endoscopy would be moved out of West Lincoln Memorial Hospital, Premier Doug Ford visited Grimsby to announce there would be “shovels in the ground’ by 2022 for a new hospital. “We’re going to build you the hospital that you need,” Ford was quoted as saying by CBC. “This will happen on our watch.”

Ford also announced an immediate $8.5 million for emergency upgrades.

Mississauga

6 7 8

Trillium Health Partners – Mississauga Hospital Site redevelopment More than $2 billion Request for proposals fall 2021 Financial close 2022 Political influencers; MPP Natalia Kusendova, PC, Mississauga Centre. Others in nearby ridings include MPP Kaleed Rasheed, PC, Mississauga East-Cooksville and MPP Rudy Cuzzetto, PC, Mississauga-Lakeshore.

Toronto Centre for Addiction and Mental Health – Phase 1D Redevelopment $500 million-$1 billion Request for proposals winter 2022 Financial close 2023 Political influencers; MPP Chris Glover, NDP, Spadina-Fort York.

Ottawa

‘‘

We’re going to build the hospital you need.

11 This will happen on our watch —Premier Doug Ford, November 28, 2018,

’’

on a new hospital in Grimsby

11

The Ottawa Hospital – Civic Redevelopment More than $2 billion Request for proposals summer 2022 Financial close 2023 Political influencers; Minister of Tourism, Culture and Sport Lisa MacLeod, PC, Nepean; Minister of Long-term Care Merrilee Fullerton, PC, Kanata-Carleton; Municipal Affairs and Housing Minister Steve Clark, PC, Leeds-Grenville and Minister of Natural Resources and Forestry John Yakabuski, PC, Renfrew-Nipissing-Pembroke.

NOTEABLE: Health Minister Christine Elliott announced in July a $9 million cash injection for the next phase of Ottawa Hospital’s civic campus project, raising the total provincial contribution to $12 million.

13 16

Toronto

THE POLITICAL LANDSCAPE

North York General Hospital $500 million-$1 billion Request for proposals fall 2023 Financial close 2024 Political influencers; MPP Vincent Ke, PC, Don Valley North

POLITICAL INFLUENCERS IN THE REGIONS OF HOSPITAL DEVELOPMENTS Conservatives Liberals NDP

Brampton

Independent

9 10 11 12

William Osler Health System – Peel Memorial Less than $200 million Request for proposals summer 2023 Financial close 2024 Political influencers; MPP Prabmeet Singh Sarkaria, PC, Brampton South.

Other neighbouring MPPs include Amarjot Sandhu, PC, Brampton West; Kevin Yarde, NDP, Brampton North.

1 Kingston 2 Bowmanville 3 Etobicoke 4 Niagara Falls 5 Grimsby 6 Mississauga 7 Toronto 8 Ottawa 9 Toronto 10 Brampton 11 Moosonee/ Moose Factory 12 Hamilton 13 Windsor

Moosonee/ Moose Factory

Weeneebayko Area Health Authority $200 million-$499 million Request for proposals winter 2024 Financial close 2025 Political influencers; MPP Guy Bourgouin, NDP, Mushkegowuk-James Bay,

Hamilton 8 1 2 9 3 7 12 10 6 5 4

Hamilton Health Sciences – Hamilton redevelopment $500 million-$1 billion Request for proposals spring 2024 Financial close 2025 Political influencers; MPP Andrea Horvath, NDP Leader, Hamilton Centre; MPP Monique Taylor, NDP, Hamilton Mountain; MPP Paul Miller, NDP, Hamilton EastStoney Creek.

Windsor *

T-13

Windsor Regional Hospital More than $1 billion Request for proposals more than five years Financial close more than five years Political influencers; MPP Percy Hatfield, NDP, Windsor-Tecumseh; MPP Lisa Gretzky, NDP, Windsor West; MPP Taras Natyshak, NDP, Essex

*Proposals by the Hospital For Sick Children (Toronto), Scarborough Health Network and a broader redevelopment of Lakeridge Health are also listed as more than five years to financial close.

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17

A HOUSE House Divided

DIVIDED TWO-SITE HOSPITAL ‘UNFAIR TO EVERYONE,’ DOCS SAY

Windsor Regional Hospital oncologist Dr. Caroline Hamm

Dr. Caroline Hamm already had a busy day ahead of her.

Her cancer clinic at Windsor Regional Hospital’s Met campus was booked back-to-back.

Then she got the call. Doctors at the Ouellette campus needed her to help identify what appeared to be acute leukemia in a patient in intensive care. If their fears were proven correct, the patient needed immediate treatment or he could die within 10 days.

Hamm raced out to the parking lot, drove to Ouellette, assessed the situation and did a biopsy. When she returned to Met nearly three hours later, there were nine patients in the waiting room.

“These are not earache patients,” says the medical oncologist. “They are cancer patients, here for a very important visit and they stress about these visits for weeks.

“They don’t know, I might be telling them that the chemo is not working…. But I have to leave them for hours to go to the other site to deal with this more critical patient,” she says.

The patient at Ouellette did have acute leukemia.

Three years later he is cancer free and comes in for regular check-ups, says Hamm.

“Now he has to wait when I’m away at the other site,” she says.

It’s something that happens about three times a year, she says. And not just to her patients.

“All of us deal with this. Every cardiologist, every oncologist, every hematologist, every surgeon, every neurosurgeon,” says Hamm.

‘‘

“It’s so unfair to everyone. Mostly to patients.”

It scares people away

’’

Today’s medical students will graduate with the world at their feet – in high demand at hospitals across Ontario.

And with so many other options, the prospect of co-ordinating care for patients across two different locations is a deterrent to medical students who have trained at Windsor Regional, says Dr. Larry Jacobs, associate dean for the Schulich School of Medicine & Dentistry’s Windsor campus.

SPECIAL REPORT I THEDRIVEMAGAZINE.COM

“It scares people away from wanting to work in the community,” he says. “They already see the stress on the patient, families and physician and nurses involved in the care.”

Jacobs’s doctors in training have already experienced the struggle of trying to determine the best site for a patient with complex needs and trying to track down a specialist in the other building kilometres away.

“You’re trying to show them how great it is here, but you’re also showing them, ‘By the way you’re going to be with this kind of stress where you can’t take care of people at one site,’” he says.

Recruitment has been difficult in Windsor as a whole, says Dr. Wassim Saad, the hospital’s chief of staff.

“A lot of it has to do with the fact we are operating out of two sites,” he says. The hospital doesn’t keep statistics that confirm Saad’s claim, but he points to his experience interviewing potential candidates to fill important specialist positions.

Candidates are often “shocked” they would be required to cover two separate sites, says Saad. It is difficult to replace surgeons who retire or move, and when Windsor Regional is down a specialist that has a direct impact on patient care, he says.

Earlier this year, the hospital could only provide acute cardiology services at the Ouellette campus while it tried to recruit a cardiac surgeon to replace one who had left.

“It’s hard to recruit someone if you tell them ‘When you’re on call for an entire week you are going to have to be driving back and forth covering two sites of one hospital’,” he says.

“It’s a hard sell.”

He’s not surprised, knowing the hoops medical staff jump through on a regular basis to get patients services from the other site.

“It’s nothing but frustration and time-consuming phone calls,” he says, adding earlier in the week it took 48 hours for a patient with a brain bleed to get from the Met emergency room to the operating room at Ouellette.

To arrange for the elderly patient to be transported, re-assessed and admitted, then seen by a neurologist at the other campus, the doctor had to make six phone calls, says Saad. “If we were at a single site, it would’ve been one phone call to the neurology department.

“It’s a daily thing.”

19

YOU CAN'T GO HOME WINDSOR PATIENTS SPEND TOO MUCH TIME IN TRANSIT

After life-saving cancer surgery, doctors at London Health Sciences Centre’s Victoria campus wouldn’t allow Saydeh Daher to return to Windsor for nearly a month because it wasn’t safe.

“London wouldn’t let her come back because we don’t have dialysis at the same hospital,” says Hamm. “Rather than have her in a critical state, going back and forth across the city, she stayed in London for the whole month.” Normally, a patient The dialysis which Daher needed returns to Windsor within days after a three times a week takes place at Windsor stem-cell transplant.

Regional Hospital’s Ouellette campus, which is four kilometres away from the The extended separation from her family cancer clinic at Met campus, where added to what was already a stressful situaDaher would be recovering. Leaving tion. “My family was on the highway back the clinic so frequently would increase and forth all the time,” says the Windsor her risk of infection, says her oncologist grandmother. “I was worried about them.

Dr. Caroline Hamm.

I was really upset, but there was nothing I 20

could do about it. I had to stay there.”

Every year, about 1,500 patients are transported between Windsor Regional’s two campuses. It’s a by-thenumbers reality for a hospital divided by its specialized services.

And each trip puts a patient at risk for infection, physical injury and missed medical doses according to researchers at the Canadian Patient Safety Institute (CPSI).

Transfers of care pose one of the highest

risks to patient safety, according to the you are being transported. It’s not optimal to another location because the hospital Ottawa-based organization. care for that patient or the family. they are in doesn’t have what they need.

It doesn’t make sense having two different For someone who is ill, they increase “Health care is a really scary environ- hospitals in one city.” potential exposures to life-threatening ment,” says Kossey. “If you don’t fully know infections. And patient handovers between what’s going on, where you are going or for hospitals include a transfer of information what purpose and it causes a lot of distress – whether electronically or on paper – that in the patient care team.” leaves more room for medication errors, such as missed doses.

Windsor Regional doctors and nurses But for now, transports are necessary. say transfers are inconvenient, time- If a cancer patient at Met has a heart “From a general safety perspective, consuming and stressful for medical staff, attack, needs a shunt reprogrammed or transfer of care is one of the highest patient who no longer “have eyes” on their patient. develops renal failure, the patient must go safety risks. Transfer of care, handovers or to Ouellette. If a patient at Ouellette has a handoffs between care providers, settings “This is not good for patients. They are pregnancy related complication, it’s a ride and teams creates opportunities for gaps in so weak and some of them are dying. These by ambulance or transport shuttle to Met. care, teamwork and communication break- patients are suffering,” says Dr. Padmaja downs,” says Sandi Kossey, a senior director Naidu, a hospitalist – or internal medicine The hospital pays about $550,000 a year with CPSI. “There are standardized precau- doctor – at the Met campus. “Imagine your for the private shuttle transfers. Ambulance tions that sometimes can break down when loved one being critically ill and shipped transports are a separate cost.

It becomes a ‘‘paperwork trail. ’’

WHAT’S DONE AT MET, OUELLETTE BOTH CAMPUSES: EMERGENCY, AMBULATORY CARE, MEDICINE AND SURGERY

METROPOLITAN CAMPUS

OUELLETTE CAMPUS

Regional Cancer services

Complex Trauma

Paediatric Services

Renal Dialysis

Family Birthing Centre

Cardiac Care

Neonatal Intensive Care

Stroke and Neurosciences Acute Mental Health

WINDSOR MAYOR DREW DILKENS FEELS FOR THE HOSPITAL STAFF “You have great people doing the best they can with the facilities they have, but there is no denying – you have a room where there are five beds and the washroom is down the hall. We know that infection rates higher than in newer facilities with private rooms,” says Dilkens.

“This is about providing modern service to the residents here.”

ALL TECH’D UP NOWHERE TO GO

BECAUSE THERE WAS NO ROOM AT MET CAMPUS, A NEW $3.5-MILLION PET/CT SCANNER OPERATES OUT OF A TRAILER. In August 2019, Windsor Regional Hospital received a long-awaited $3.5 million PET/CT scanner that was paid for by the province and Cancer Care Ontario.

The new equipment was welcome news because it is considered critical for locating early-stage cancers using a form of nuclear medicine imaging called positron emission tomography/computed tomography. But while the technology is state of the art and serves about 600 patients a year, there was no room for it in the hospital’s Met campus building.

Windsor Regional planned to expand the Met campus for the PET/CT at an estimated cost of $4.5 million. The design was modified and the price lowered to $2.5 22

‘‘

The thing that stresses physicians the most is when you can’t deliver the care you want to give

’’

—Dr. Sindu Kanjeekal Windsor Regional oncologist

million. To save money, the hospital put the scanner in a trailer outside the building at a cost of $425,000. Patients are now treated inside the building, then taken to the trailer via a makeshift wooden ramp for the scan.

The arrangement is what Kevin Marshall, Windsor Regional’s director of corporate services and capital planning, calls “not ideal” and “problematic from an infection control point of view.”

“Windsor deserves to have this new evolving technology. We need space for that new technology,” says Dr Sindu Kanjeekal, an oncologist at Windsor Regional.

“Right now our PET (scanner) is outside.

We use it perfectly, but it’s in a trailer.”

No place for a cath lab At Windsor Regional’s Ouellette campus, the basement is where instruments are sterilized, linens are cleaned and food is prepared. It’s also where some heart procedures are done. Because there was no room on the fifth-floor cardiac unit when the hospital first got the technology to do angiograms, the cath lab is in the basement.

To get to the lab from the cardiac unit – which sometimes needs to happen in a hurry – patients must be wheeled across the hospital, down elevators and through the basement hallways for angioplasty, ablation surgery or to have a pacemaker installed. Then recovery takes place in the fourth floor coronary care unit.

“Our cath lab is archaic,” says Dr. Wassim Saad, Windsor Regional’s chief of staff, referring to its placement in the basement. “It was put there because we couldn’t make new space for it (upstairs) when we started doing angiograms.

Dr. Sindu Kanjeekal, WRH oncologist

“In other centres, the cath lab is on the same floor as the (critical care unit).”

In 2014, the then-Liberal provincial government announced $18 million to renovate the cardiac unit and provide a second cath-lab table, but the money never came. Now Windsor Regional officials, staff and patients must wait for a state-of-the-art cath lab planned for the new hospital.

Ramp to MRI trailer

CODE STROKE

The good news is great news: Stroke patients in Windsor-Essex are recovering at a higher rate than ever before, due to a region-wide Code Stroke protocol the hospital first implemented in 2015. The goal is to decrease “door-to-needle” time for stroke victims – so the stroke team can deliver clot-busting medication or remove the clot as soon as possible. That’s important because the sooner the clot is gone, the greater chance of survival and recovery.

But it means that if someone comes into an emergency department showing symptoms, the neurologist needs to be on site within 30 minutes to assess that patient and decide whether they can be a candidate for clot-busting “thrombylotics,” or to actually extract the clot. With one neurologist covering both campuses while running a patient clinic at Ouellette for people at-risk of strokes, days get busy fast.

Last year, Windsor Regional Hospital received 523 patients with stroke symptoms. Sometimes a stroke patient arrives at one emergency room while the neurologist is dealing with one at the other, say doctors.

“It really does consume what we do – we take a high degree of concern for those patients,” says chief neurologist Dr. Michael Winger. “To look after our stroke patients, it would be better if we had everybody under one roof – that’s a time factor. We want to make everything as efficient as possible, and moving to one hospital cannot come soon enough.”

“We need that more than anything.”

23

“The community needs to move past this preoccupation with where the acute-care hospital is going to be situated,” says Hotel-Dieu Grace Healthcare president Janice Kaffer

MENTAL HEALTH PLAN IN

LIMBO STOP OBSESSING OVER LOCATION, HOSPITAL PRESIDENT SAYS

24

It has been called the most significant Right now, people are often triaged from plan to reform mental health care in a emergency departments to mental-health generation. services at Windsor Regional Hospital’s Ouellette campus, which is an acute-care It could be a game changer in Windsor hospital and not intended for long-term, and Essex County – where far too many ongoing recovery relationships that are people are struggling with mental illness often required in the treatment of mental and addictions. illness, says Kaffer.

But the plan to integrate mental health services – and make it less confusing for patients to get help through one access point to the system – has “gotten lost” in the public debate over the mega-hospital location, says Janice Kaffer, president of Hotel-Dieu Grace Healthcare.

Integrating those services at one hospital focused on mental health and addictions would “redefine” health care for those people, says Kaffer.

But it requires transferring about 60 beds – as well as staff and resources – for mental-health services and addictions “The community needs to move past to Hotel-Dieu Grace from the Ouellette this preoccupation with where the acute- campus. care hospital is going to be situated, and concern themselves with the benefits of this Integrating mental-health services plan,” she says. at Hotel-Dieu Grace would give people experiencing mental health or “It’s about more than a mega-hospital. addictions a “single-access point” to enter This opportunity to transform the mental- the hospital system and remain within the health care system is once-in-a-lifetime.” organization. Right now, the most common point of access to the hospital system for While the mega-hospital has dominated mental-health clients appears to be the headlines, it is only one part of what is nearest emergency department, she says. officially known as the Windsor-Essex Hospital System proposal, which includes Having the beds at the Tayfour campus integrating mental health services so that will allow mental-health clients to receive the Hotel-Dieu Grace Healthcare’s Tayfour better “continuity of care,” says Kaffer. campus will be the single access point for mental health and addiction.

“The whole experience would be within

one or two organizations with the same philosophy,” she says. “From a patient’s lens, they don’t care who provides the care as long as it is seamless. Mental illness needs continuity and long-term care relationships.”

But those beds aren’t going anywhere until the province moves forward with the Windsor-Essex Hospitals System – something that appears to have stalled during a legal zoning battle that could impact the location of the mega-hospital.

Last year, at least 37 people in Windsor and Essex County died by suicide, and mental-health workers say they continue to see high rates of stress, anxiety and depression in the region.

“This has been incredibly frustrating,” says Kaffer. “The biggest frustration is that the change in mental-health service is tied to decision making around the new acute-care hospital. We could be doing that work now.”

‘‘

“This community is fixated on the location. Imagine if all of the people signing petitions about location were signing petitions saying let’s move mental-health services forward?”

It’s about more than a mega-hospital.

This opportunity to transform the mental- health care system is once-in-a-lifetime.

’’

— Janice Kaffer, Hotel-Dieu Grace Healthcare

Hotel-Dieu Grace’s portion of the proposal was about $130 million, which included the cost of building new space for the services. The organization is now looking at ways to bring down the cost by working within the existing infrastructure.

Separate from the Windsor-Essex Hospital System plan that has been submitted to the province, Hotel-Dieu Grace is planning for a mental health assessment centre that would be accessible to all mental-health and addictions clients if they are not overdosing.

“People in Windsor and Essex know we have a mental-health issue and an addictions issue,” says Kaffer. “It’s time we have a hard conversation about what we are prepared to do. Are we prepared to keep losing members of the community to suicide and overdoses?”

COMMUNITY WELLBEING IS OUR SOLE FOCUS

• Mental Health and Addictions Programs • Resources

• Comprehensive Primary Care Services • Health Promotion, Illness Prevention, Disease Treatment and Recovery

windsoressex.cmha.ca SPECIAL REPORT I THEDRIVEMAGAZINE.COM

• Mental Health Awareness, Education and Training • Fundraising • Advocacy

1400 Windsor Avenue Windsor, Ontario N8X 3L9

519-255-7440

25

DELAY, DECAY, DISMAY WORN-OUT BUILDINGS IMPEDE CUTTING-EDGE CARE

When the buckets come out at Windsor Regional Hospital, chances are it’s raining outside.

Leaky roofs at both the Met and Ouellette campuses mean it’s not unheard of to have operating room surgeons navigate around pails on the floor during a heavy shower.

They also have to worry about rainwater getting behind a wall, causing mould and compromising patient safety.

Facilities staff work on high alert to prevent worst-case scenarios, such as a wet drywall ceiling giving way in the operating room.

It would cost $2.8 million to replace both roofs, but because Windsor Regional is planning to move into a new building, the 20-year investment makes no sense.

Instead, staff prowl the rooftops in search of breaches, patching as they go. In 2018, $183,000 that could have been spent on patient care went to roof leaks, says the hospital’s capital planning boss.

Seven years after agreeing to forego substantial capital investments in exchange for a one-time replacement hospital, such is the patchwork state of acute care in Windsor. It’s in critical condition.

26

hospital’s 15 boilers and chillers – million-dollar machines crucial to not only atmospheric comfort but sterilization and infection control – are nearing or past their best-before dates.

A boiler failure impacts “medical device reprocessing,” which means instruments can’t be cleaned and surgeries can get cancelled. Chillers bring cooling fluid to the air conditioning unit, which maintains temperature and humidity control and is critical for operating teams performing surgeries and for infection control.

In 2016 Windsor Regional cancelled and postponed about 300 surgeries due to failures in its sterilization systems at both campuses. The biggest issue occurred at Ouellette campus after aging-related problems in the 54-year-old piping that brings steam from the hospital's powerhouse to the autoclaves which sterilize the instruments. "That was due to the age of the piping system," says facilities manager John Faber.

“It’s not just about comfort. These are very critical pieces of equipment.”

“The issue is we have this really old infrastructure that we have to invest in just to keep the place going,” says Kevin Marshall, Windsor Regional’s director of corporate services and capital planning. “That’s money we aren’t spending on direct patient care.”

It is estimated it would take $90 million to $100 million to address urgent issues ranging from roofs to drafty windows and boilers. This year, following a needs assessment by the province, Windsor Regional received $1.1 million under the Facility Condition Assessment Program.

Leaky roofs aren’t the only big-ticket item. The

Staff prepared a priority list and selected 20 of the

Facilities manager John Faber says aging equipment such as boilers and chillers are “critical” to patient care. “biggest headaches and (said) this is what we can afford,” within the allotted four-month period to spend the money, says Faber. The upgrades focused on patient safety. The list ranged from elevators at Ouellette ($72,000) to the nurse call system at Met ($144,000).

No bells and whistles In 2015, an inspection found the fire alarm at Ouellette needed a substantial upgrade. Windsor Regional started a three-year project to replace the system at a cost of $2.1 million, but because of insufficient ceiling space the hospital could not include equipment needed for cutting edge features found in most modern hospitals.

“We couldn’t even go to the newest system,” says Faber. “No bells and whistles, no new features. You still just pull this lever and it still makes the bell ring. For $2.1 million.”

Some of the deficiencies may seem borderline comical.

At Ouellette, where most of the patient rooms date back to 1962, there are hallways where an average-height adult can reach up and touch the ceiling. They have been dropped over the years to fit modern infrastructure, including ductwork and wiring needed to incorporate new technologies.

In some Windsor Regional wards, there aren’t enough outlets to plug in computers needed to meet SPECIAL REPORT I THEDRIVEMAGAZINE.COM

today’s paperless standards.

‘A patchwork’ The buildings themselves are what Dr. Wassim Saad, chief of staff, calls a “patchwork” which date back decades. “Some of our hospital is between 80 and 100 years old,” says Saad. “Expansion is something we cannot do at either site because they are landlocked.”

Met was built in 1928. The first hospital at the Ouellette campus was built in 1888. Most of the patient rooms there were built between 1952 and 1962.

The hospitals have been maintained, repaired, expanded and renovated over the past century, including a major expansion at Met in 2004 and another at Ouellette in 2001 (expanding emergency services, operating rooms and the diagnostic imaging department).

But many features are still outdated – including windows and floors.

The clinical teaching unit at Ouellette was originally a pediatric unit. The rooms were meant for one child each. Now those same rooms house three adult patients at a time. “If I’m sitting in the middle of that room, I can almost touch all three beds at the same time,” says Saad.

The problem is most glaring when a patient is in 27

crisis and an emergency or “code” team must rush into the room with a large cart full of supplies. It’s too crowded.

Hospital staff need to get other patients – who are also very sick – into a hallway during the urgent situation, he says.

‘‘

Staff and patients cope with cramped Hospital acquired infections quarters and an aging Patient beds in semi-private rooms at infrastructure, which Ouellette campus are 90 centimetres apart, about the width of a microwave oven, which makes adapting new is a concern to Windsor Regional’s manager of infection prevention and control. technologies difficult.

’’

“It’s close quarters,” says Erika Vitale.

“When you start adding an IV pole, a chair, a visitor’s chair, it’s very difficult. We have had outbreaks of influenza and Norwalk virus. Those can spread easily because of In at least 20 per cent of the cases the close quarters.” only known risk factor was that the patient shared a room with someone else who had Between April and September, more the bug. It’s a difficult statistic to control in a than 200 Windsor Regional patients facility where 80 per cent of ward rooms are contracted antibiotic-resistant bugs. shared by at least two patients. The Ontario While most people carried the bug without standard for new hospitals is 20 per cent. becoming sick, 19 ended up with what are called “hospital acquired infections,”says While hospital officials won’t guess how Vitale. the new building for the Windsor-Essex

A bucket captures runoff from a leaky roof on the fifth floor of the Ouellette Campus.

Hospitals System will change things, they expect the numbers to go down. The plan is for 80 per cent of the rooms to be private and all of the bed spaces to have dedicated bathrooms, so the risk of exposure will decrease significantly, says Vitale.

The same goes for preventable outbreaks that have forced Windsor Regional to cancel surgeries in the past, says Vitale.

In 2018, Windsor Regional had to postpone 29 surgeries due to four outbreaks of the flu – two at the Ouellette campus and two at the Met campus.

Outbreaks occur when patients who are already in the hospital become infected by exposure to other patients. In 2018, four patients and six staff members were infected at Met campus, and nine patients and seven staff members at Ouellette, Vitale says.

The logistics at the old hospitals increase the risk of patients acquiring infections, because most patients share bathrooms, she says.

“When you have an enteric illness – vomiting, diarrhea – it’s very contagious. If you are sharing a bathroom with somebody, that’s how people pick it up. In the new hospital every patient would have their own toilet facility.”

Plumber Rick Lachance of Vollmer Mechanical repairs a leaky drain pipe in a section of Ouellette campus that dates back to 1938. “It’s what’s behind the walls that’s scary,” says WRH CEO David Musyj.

28

BY THE NUMBERS Typically chillers and boilers life

15-25 YEARS

9

of Windsor of Regional’ Hospital’s 15 chillers and boilers are more than 20 years old, including two that are nearly 28.

The rest are at least 16.

$680,000 was spent on chiller/boiler repairs over the past five years, including

$145,000 $300,000

$183,382

after a 2017 chiller failure at Met and

after a 2018 chiller failure at Ouellette.

Cost to remove and replace all boilers and chillers, more than

$14 MILLION

7,000 scheduled preventative maintenance tasks by facilities staff a year and more than 8,000 unplanned fixes ranging from plugged toilets to broken beds.

Roof patches and replacements in

Cost to replace the needed sections of both Met and Ouellette roofs

$2.8

MILLION

Annual maintenance budget, including utilities and natural gas

$10 MILLION

WHEN IT BREAKS •

The inability to control extreme heat and humidity can play havoc. This past summer, $75,000 worth of disposable equipment was lost due to humidity in the Ouellette campus cystoscopy room.

•

Anesthetic machines at the Ouellette campus operating room were ruined in 2014 by an outside water backup caused by an old, inundated system with a malfunctioning sensor and no redundancy. The replacement cost was $1.2 million.

•

Operating room delays have been caused when equipment must be transferred between campuses and re-sterilized.

“What these numbers show is that these hospitals need investment just to maintain the status quo. But even if we had a blank check to invest in everything on the list, we are still operating in old, tired buildings, in two landlocked facilities, where patient privacy and infection control is a constant challenge. We need to move forward so our patients can have access to modern health care. The longer this project is delayed, the more money we will have to spend on projects that do nothing to improve the quality of care we are able to offer our patients.”

– Windsor Regional Hospital CEO David Musyj

WHAT

COULD BE NEW HOSPITAL MEANS NEW SPECIALISTS, PROCEDURES Q. What new services would be offered that now require travel to London or the U.S.?

Q. What is acute care?

A. Trauma/emergencies, cardiac, cancer, dialysis, critical care, neurosurgery, A. Transcatheter aortic valve replace- neonatal intensive care, obstetrics, ment: Needing a heart valve replacement pediatric, inpatient medical and surgical units, acute specialist clinics. used to mean open-heart surgery, but now doctors are doing it in a minimally invasive way. A new heart valve procedure Q. Where else will care be offered?

A. Mental health, addiction and rehabiliknown as TAVR involves inserting an tation will be at Hotel-Dieu Grace artificial aortic valve through an artery Healthcare on Prince Road. in the neck, leg or between the ribs, and placing it inside the patient's diseased heart valve while the heart is still beating. Q. What are some highlights of plans for the acute-care facility?

Advanced arrhythmia treatments: A. 1.6-million-square-foot, 10-storey, Procedures for common arrhythmias hospital with room for 700 beds on a such as atrial fibrillation (AFib) and 60-acre property at the southeast corner implantable devices beyond pacemakers, of County Road 42 and Concession 9. such as automated implantable cardioverter defibrillators (AICDs). This would Q. How will the new building be a require a new cath lab dedicated to electrophysiology, but specialists in this healthier environment? area are plentiful and could be recruited A. 80 per cent single-patient rooms for with the right setup. Cardiac bypass: A improved comfort, privacy and infeclarger cardiac care unit capable of doing tion control. Private bathroom for each bypasses, seen by Windsor Regional as an patient. All acute-care services under one evolution of the coronary care unit coming roof, so fewer transports – and therefore five years after the new hospital opens. less exposure to infections.

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Q. How will this impact talent recruitment?

A. Increased opportunities to work with the Schulich School of Medicine & Dentistry’s Windsor program, and conduct research and clinical trials. Modern infrastructure strengthens recruitment, retention of physicians, specialists and support staff.

Q. What about downtown?

A. The Windsor-Essex Hospital System plan calls for an “Urgent Care/Satellite Emergency Facility,” to replace the emergency department at the Ouellette campus once the mega-hospital is built.

Hospital officials say that while the site would not be open 24 hours unless there is demand, it would be more than a typical urgent care clinic, because it would be a state-of-the-art facility staffed by emergency room doctors and nurses, trained to handle traumas and stabilize patients. The difference between the “satellite” facility and an actual emergency department is that there are no beds for admitting people into the facility, according to Windsor Regional.

People who need to be hospitalized would be transported to the acute-care facility.

They compare the future site to an urgentcare centre at Peel Memorial hospital, and have posted a video explaining how things work there on the Windsor Regional website at: windsorhospitalsblog.org

LEAP OF FAITH CITY, COUNTY RESIDENTS ANTE UP Windsor and Essex County residents have been putting their money where their mouths are, anteing up nearly $30 million to date, or 15 per cent of the $200 million their councils agreed to contribute to the new hospital. The $200 million is 10 per cent of the projected capital cost as mandated by the province.

So far, Windsor has collected $16.4 million and the county $13.5 million through taxpayer levies.

The city’s one-per-cent levy is projected to continue annually through 2029 or earlier based on interest earned. The levy will be topped up with “additional sources of funding” beginning in 2020, and then again in 2023, which will increase the annual contribution by approximately $7.1 million to a total annual amount of $10.975 million, according to the mayor’s office.

The county in 2015 and 2016 placed funds in a hospital reserve when other external funding commitments expired. A minimum 0.5-per-cent levy until 2027, and debt financing over the following 10 years, will account for the remainder of its contribution, according to the chief administrative officer.

‘‘

We were so committed down here that we were in the ‘if’ phase and we started collecting our money. That was a huge leap of faith from both city and county council to do that.

’’

—Windsor Mayor Drew Dilkens To date, the province has contributed $6.8 million.

On Jan. 24, 2016, Then-Essex County Warden Tom Bain, left, MPP Percy Hatfield, Windsor Mayor Drew Dilkens and MPP Taras Natyshak signed a letter to Ontario’s health minister pledging support for the new hospital. Photo courtesy Windsor Regional Hospital

SEVEN YEARS TWO GOVERNMENTS

ONE ZONING BATTLE

Eric Hoskins, then the Ontario Liberal government’s health minister, announces in December 2017 that Windsor’s acute-care hospital is moving forward.

Photos courtesy Windsor Regional Hospital

2012

April 2012

July 2012

On the third tee at Beach Grove Golf and Country Club, Ontario Finance Minister Dwight Duncan (L—Windsor-Tecumseh) suggests to his playing partner David Musyj, president and CEO of Windsor Regional Hospital, that rather than spend billions fixing Windsor’s aging two hospitals, a campaign begin to replace them with a single-site, acute-care hospital. Duncan publicly announces the plan to the first convocation of the Schulich School of Medicine and Dentistry’s Windsor program.

Duncan appoints a tri-partisan task force to assess the community’s appetite for the new hospital, tapping Liberal MPP Teresa Piruzza (Windsor West), former provincial NDP health minister Dave Cooke and Tom Porter, a lawyer, former Tory candidate and former city councilor. In December, the panel concludes there is strong support for the hospital and recommends Queen’s Park move forward.

February 2013

January 2013 The Ontario government commits to providing $37.5 million to cover the first two phases of the mega-hospital plan, to address governance, programming and design. It's anticipated the hospital will take 10 to 12 years to complete at an estimated cost of up to $1.6 billion.

Duncan announces his retirement from Ontario politics. Windsor Regional Hospital and the city’s faith-based hospital, Hotel-Dieu Grace Healthcare, announce a reorganization that will see Windsor Regional operate the proposed new hospital. In October, Windsor Regional takes over trauma and acute-care services at the Ouellette site formerly known as Hotel-Dieu. Hotel-Dieu Grace Healthcare takes over the Tayfour campus of Windsor Regional (formerly I.O.D.E) on Prince Road for mental health, addiction and rehabilitation.

2013

July 2015 Following a 15-month study that included public consultation and a fairness advisor, a 10-member site selection committee recommends building the 10-storey, 500-bed hospital on a farm field at County Road 42 and Concession 9 near Windsor Airport. The plan also calls for redevelopment at Windsor Regional’s Ouellette and Met campuses, a four-storey, stand-alone emergency department on the former Grace Hospital site and expansion at the non-acute care Hotel-Dieu Grace Healthcare on Prince Road. The cost is estimated at nearly $2 billion.

2014

March 2014 The hospital project moves to Stage 1B of the provincial approval process, including site selection, architectural plans, an implementation schedule, how services will be integrated at the new hospital, how existing facilities will be used and funding/ financing plans.

The recommended location comes under fire from a new watchdog group, Citizens for an Accountable Megahospital Planning Process (CAMPP), which says the airport site will reduce access to healthcare for Windsorites and contribute to urban sprawl.

2015

SPECIAL REPORT I THEDRIVEMAGAZINE.COM

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December 2015 Windsor and Essex County councils approve their share of a $200-million local levy to help pay for the hospital and acknowledge that they will help shoulder an additional $200 million to $300 million in road and infrastructure work to improve access to the site.

Percy Hatfield @PercyHatfield Thank you Dr Eric Hoskins for moving us into Stage 2 planning for our new hospital #we"r"ready" indeed

2016

2017

November 2016 Organized by former Windsor mayor and current WFCU Credit Union president Eddie Francis and his wife Michelle Prince, the Starry Night gala raises $1 million for the hospital campaign, unofficially kicking off community fundraising.

CAMPP @WindsorCAMPP Why is Windsor Regional Hospital advertising a long dead deal?

November 2017 Infrastructure Ontario lists the hospital among six new health care projects to move forward by 2021. It lists the project as a "Design-BuildFinance-Maintain" model, which means the responsibilities for designing, building, financing and maintaining the project will be transferred to private sector partners. Requests for construction quotes would be issued in 2021.

The following month, Health Minister Eric Hoskins visits the area to reaffirm the hospital is moving forward.

2018 August 2018 City council approves rezoning for the hospital site following a marathon nine-hour meeting in which community activists step up their campaign to overturn the site selection.

June 2018 Doug Ford’s Conservative Party sweeps to power in the Ontario election.

April 2019 Following a case management conference, the province’s Local Planning Appeal Tribunal (LPAT) orders an appeal of the County Road 42 location to proceed to a full hearing in October.

2019

July 2019 Following months of inactivity when the operations of fundraising consultant KCI are suspended, Mayor Drew Dilkens announces plans to meet Premier Doug Ford in an effort to revive the stalled hospital project.

September 2019 Windsor-Essex once again appears on the Infrastructure Ontario market update, only this time the list has swelled to 16 hospital projects and Windsor is ranked tied for last based on anticipated date of financial approval.

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October 2019 Following a three-day hearing, an LPAT adjudicator withholds judgement. A CAMPP lawyer predicts it could take up to three months to rule on the appeal of the proposed hospital site. .

TS N E M T S INVE E H T T R A PO WE SUP TUNITIES THAT OR AL AND OPP ODERN HOSPIT DM NEW AN ON OUR ENTIRE VE WILL HA D ECONOMY. AN REGION

FIND OUT WHY @ WEBackThePlan.ca