North York General Hospital telephone town hall summary

On Wednesday, July 24, North York General Hospital (NYGH) hosted a telephone town hall to discuss health care needs in the community and ask residents to help inform the hospital’s plans to create a better, more unified health system.

Close to 30,000 randomly selected residents in the North York community were contacted, with almost 4,000 residents participating for the full hour. President and CEO Dr. Joshua Tepper was on hand to answer questions and gather feedback from the community. NYGH Patient and Family Advisor Steve Wolinsky, a resident of North York, also joined Dr. Tepper as part of the telephone town hall.

For community members who were unable to attend, you can find a brief summary of the event's topics, as well as information provided by Dr. Tepper.

Learn more about how North York General Hospital is planning for the future.

Town hall at a glance

• The telephone town hall was held on July 24, 2019 from 7–8 p.m.
• Approximately 4,000 residents participated in the call.
• All questions during the event were posed live (17 in the time allotted); 11 follow-up questions were left in the town hall voicemail to be addressed).
• The most raised topics during the discussion were: 1) emergency department wait times, 2) mental health care, 3) closing the Branson Ambulatory Care Centre, 4) efforts to ensure all patients are being treated with empathy and respect, 5) promoting health care services available to patients and families, and 6) addressing hallway medicine.
• 91% of those who responded to our poll felt the telephone town hall was helpful.
   

Topics raised by residents:

Dr. Tepper: Everyone working in health care can appreciate that some wait times for appointments, tests and procedures are too long.

Our hospital is a busy place and getting busier. That said, North York General strives to ensure all patients receive high-quality, timely care. The North York community has one of the fastest growing populations in Ontario — and one of the oldest. The hospital is facing very high patient volumes and demand for services in a 50-year-old facility.

We are addressing wait times in a number of different ways including how we increase our capacity to serve more people as needs in the community grow. We are also looking at where we can offer more services in the home, throughout the hospital locations and out in the community.

It is important to know that critical patients will be seen first, whether they arrive on their own or via ambulance. In simple terms, the sickest patients will be seen most quickly. We do our best to ensure that we have the highest number of staff available to provide care at peak periods and we are careful to plan in advance for such things as seasonal pressures and flu volumes. We know waiting is not ideal and we do appreciate your patience as we care for our most vulnerable.

One of the biggest challenges we have at the hospital is finding enough space to meet the needs you have. It is why you sometimes have to wait for service.

We must have services and spaces in place to care for the patients we serve today and those who will live here in the future. In response to these challenges, we’ve started planning for future physical growth by developing a new Master Plan. We will also soon be opening two new locations, which we recently announced — 2 Champagne Drive and 243 Consumers Road. Both locations are accessible by public transit, will be newly built spaces and designed specifically to meet the needs of the programs. Spaces will be fresh, bright and accessible for all of our patients, visitors and staff.

For a long time, mental health was not considered part of the health care system or an aspect of care that received a lot of attention.

North York General is recognized for offering a wide range of mental health services that meet the specific needs of individuals of all ages and their families. Through our inpatient, partial hospitalization, outpatient and outreach services, we offer excellent continuity of care. 

In June, we opened Phillips House for our Child and Adolescent Mental Health and Adolescent Eating Disorders Outpatient Services. This unique space provides outpatient mental health services in a home-like setting.

A key component of the strategy to help us address the needs of patients with mental health and addictions is the creation of the new Ontario Health Teams (OHTs), a new model of organizing and delivering services in local communities.

North York General and several health care partners have been approved to move forward to the next stage of planning for an Ontario Health Team.

As a partner in our OHT, we want to build capacity in the system by providing 24/7 care coordination and access to system navigation so that patients and families receive seamless transitions in care.

The goal of the Ontario Health Teams is to ensure great care for every person who lives in North York Central. We know that there are certain members of the community that use the health care system more often and these groups are an early focus of our efforts. These groups include: senior citizens, people with mental health and addiction issues and those approaching end of life. We are trying to think about how we can provide high-quality care for these groups as close to home as possible and around the clock.

Dr. Tepper: Services and programs at the Branson have been relocated to the General site and to our newly redeveloped Phillips House location, which provides outpatient mental health services in a home-like setting.

It is important that there are a range of health services in the community; we don’t want people to only be able to get care at the hospital. This is why we are opening several new sites in the community.

It’s also important that we work more closely with primary care providers in the community, such as family doctors and nurse practitioners. There are over 700 family doctors in the North York community. We are looking at how we support them, build their capacity and leverage the care they provide.

Dr. Tepper: We know that it is important to patients and their caregivers to be able to access their health records electronically.

Implementing a patient portal is a priority at North York General Hospital and we are starting to build a portal whereby patients can access their results right away.

In addition to creating a patient portal, we are also working on connecting different parts of the hospital with providers in the community, such as family doctors, to speed up the time they receive information and test results for their patients.  

Electronic health systems need to talk to each other — we are increasingly solving this problem by building better communication channels within the hospital and with care providers in the community.

Dr. Tepper: We have an amazing set of nurses and staff members who are dedicated and devoted to each individual patient and the community at large. We appreciate that, for those on the front lines in health care, their work can be very difficult.  It is also critical for us to recognize that when patients and families come to the hospital they are often feeling stressed and scared, and need our empathy and respect. We know our staff and physicians strive to provide exceptional care during every interaction with patients and families, but we may not get this right 100% of the time and we are committed to always doing better.

That’s why we started using Communicate with Heart, a training program that teaches effective communication and relationship building for everyone in the hospital.

Communicate with Heart consists of two programs that we provide to our staff, physicians and volunteers: S.T.A.R.T with Heart (Smile and greet warmly, Tell your name, role and what to expect, Active listening and assist, Rapport and relationship building, Thank the person) and Respond with H.E.A.R.T. (Hear, Empathize, Apologize when a concern is voiced, Respond, Thank).

Since we launched our service standards in September 2017, 1,421 staff, physicians and volunteers have been trained in the Communicate with Heart program.

All new employees receive training on our patient- and family-centred care approach and service standards, Communicate with HEART.

Dr. Tepper: The communications team at NYGH takes an active role in educating the public on the various health care services and resources available at the hospital and in partnership with the community.

North York General publishes many articles on a wide variety of topics including the flu, cancer screening, and our various services. We use the experts in our hospital to lend their expertise to these articles. We also provide information on our website, in the media and on social media.

A good example of the type of public education we do is advance care planning, which involves letting people know what kind of health and personal care you would want in the future if you were unable to speak for yourself. This is a critical aspect of care that we can help educate patients and families about. It is important to have these conversations early and not wait for a crisis.

North York General has a variety of ways of communicating information, articles and resources to the public:

• The North York General website (www.nygh.on.ca)
• The Pulse, North York General’s community newsletter is sent to you 10 times per year (subscribe now)
• Social media (Twitter: @NYGH_News, Facebook: @northyorkgeneralhospital, YouTube: NYGHNews, Instagram: northyorkgeneral and LinkedIn: North York General Hospital)

 

Dr. Tepper: Hallway medicine is one of the most challenging problems in our health care system. NYGH and many other hospitals in the city struggle with this. Hallway medicine is a complex problem that many hospitals throughout the city are struggling with and it is being tackled in several different ways. First and foremost, we need to help people avoid coming to the hospital if the care they need is best provided at home or in the community. For those that require hospital care, we need to help move patients along their care journey safely, smoothly, and efficiently. Once hospital care is no longer needed, patients should be transitioned back to the most appropriate setting.

To achieve this, we have implemented a number of innovative models that involve partnerships with community partners, long-term care, home care and primary care to better navigate patients through the system.   

The solution to hallway medicine is not easy one and requires many different solutions coming together.

Greater emphasis needs to be placed on what happens after you leave the hospital. People are living longer — that’s a great thing and we need to change the way we think about patients when they are discharged from the hospital — because you never really leave the health care system and care needs to be coordinated both inside and outside the hospital. This goes back to the Ontario Health Teams — which bring together the health care providers you see before, during and after your hospital stay.

There is a lot of evidence that shows health care is best received in the home or as close to home as possible. We need to do everything we can to make that happen. There are many different ways that we are doing this — either through virtual technology, home care, or other types of remote technology.