Company Report: Bethesda Hospital
Exceptional patient care Healthcare Digital learns that as Manitoba experiences double-digit population growth, Bethesda Hospital remains committed to its mission of treating patients in a safe environment

In only 10 years, the population surrounding Steinbach in Canada’s province of Manitoba has grown by nearly 50 percent. The influx of 8,500 new potential patients has inspired South Eastman Health/Santé Sud-Est’s Bethesda Hospital to become creative in performing its mission of providing exceptional patient care in a safe environment.

To address the increase in population, major expansions and improvements to meet the surge in demand have already begun.  Patti Fries, Facility Manager, concluded after the new state-of-the-art birthing center opened in January 2008, “if you build it, they will come.”

“Building the bricks and mortar is easy, sustaining it poses a human resource challenge,” Fries points out. “To address this challenge, our Regional Health Authority is always working to secure additional staffing. Our mission and philosophy is very much about patient safety and meeting quality standards. Staffing is part of that equation.”

CENTER FOR STROKE CARE
Bethesda Hospital is the largest of four acute care facilities in South Eastman Health/Santé Sud-Est, a regional health authority that serves 65,383 residents and covers 10,000 square kilometers from the Trans Canada Highway in the north to the American border in the south, from the Red River in the west to Ontario in the east. The region is divided into four districts with Bethesda Hospital situated in the central district, 45 minutes southeast of the province’s capital of Winnipeg.

Defined by its secondary services such as surgery, obstetrics, cancer care, rehabilitation, cardiac care and a 24/7 emergency department that sees up to 25,000 visits each year, Bethesda Hospital is an 84-bed acute care facility (plus 60 personal care home beds in the attached Bethesda Place) on a continuous quest to improve and expand the scope of its services.  The recent implementation of the regional stroke prevention program at Bethesda – in partnership with the Heart & Stroke Foundation of Manitoba – is testimony to this.

Stroke patients are immediately referred to Bethesda Hospital, which is the only hospital with CT scanning, ultrasound and advanced diagnostic support at its disposal in the South Eastman region. Since June, as part of the stroke strategy, a neurologist from Winnipeg and a newly hired stroke case manager run a stroke prevention clinic for patients who have suffered a stroke and require close monitoring during the following 90 days when the risk of a second stroke is high. The hospital is, however, in need of consistent radiology/neurology support to read the scans as patients come in.

“We’ve had some success stories where the clot-busting drug, tPA, has been administered,” Fries relays. “A patient who came in with extensive stroke symptoms would have been left paralyzed, but thanks to tPA, we were able to reverse it and the patient left the hospital walking. It’s amazing.”

POPULATION BOOM
Many services are put to the test by the pressures of a growing population. The central district of South Eastman has experienced the brunt of the growth with approximately half being new immigrants from Germany and other overseas countries. The increase in population puts pressure on the Medical Unit where 31 beds rarely cover the need and, as a result, patients overflow into the Surgical/Obstetrical Unit and the 20-bed Rehabilitation Unit.

“With the ever increasing population growth, we’re not meeting bed demand and struggle with bed utilization and effective discharge processes,” Fries says.

Built in 1963, Bethesda Hospital saw no major expansion until 1986-1987 when a new ER and improved Diagnostics area in addition to the Rehabilitation Unit and Physiotherapy/Occupational Therapy Departments were built. In 2007, a new Chemotherapy Unit opened, moving cancer care out of the basement and into two examination rooms and eight treatment areas on the main level adjacent to a healing garden. The new birthing center premiered shortly thereafter with a hydrotherapy room, four large birthing rooms and a treatment room for newborns in need of stabilization. Although not LEED certified, the additions comply with the majority of green building requirements.

BIG PROJECTS PLANNED
The 2,300sf emergency department serves 24,000 clients a year and is in dire need of more space. A new  $14 million-plus ER, five times as large, is scheduled to go to tender in the new year – which includes a four-bed observation unit and a special care unit. The new ER will be “awesome from a patient perspective and client-centered care,” Fries says.

“It will improve patient flow with two patient care streams and waiting rooms for major and minor problems,” she says, further praising a pilot project recently completed to test whether nurse practitioners can manage care in the ER, and indirectly offset some of the demands on physicians. “Any time we can take the pressure off of physicians is good. We always look at who’s the right person for the job or who can best meet the patient’s needs.”

Next in line is another big capital project, outlined in last year’s feasibility study and annual Health Plan: a new west wing that will house a surgical suite, and 20 surgical beds in addition to medical and palliative care units. The current operating rooms are, according to Fries, “very dated.”

“I’d like to say ‘hear us now,’” Fries says, “but the funding approval process does take a while. Until it happens, we’ll have to be creative in how we manage the load and deliver services.”

The interim bed policy takes awaiting placement patients to other locations until local beds are vacant. Fries and her staff prefer an approach of problem solving to address challenges.

“I work for the staff and need to give them the resources and tools they need to do their job,” she emphasizes. “Evidence and patient safety guide our decision making each and every day and the region is committed to being transparent with our staff and other stakeholders regarding the challenges we face.”

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