{"id":13414,"date":"2016-04-13T06:00:22","date_gmt":"2016-04-13T10:00:22","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=13414"},"modified":"2016-04-15T10:36:12","modified_gmt":"2016-04-15T14:36:12","slug":"muskoka-left-out-in-the-cold-when-it-comes-to-stroke-rehabilitation-beds-says-doctor","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/muskoka-left-out-in-the-cold-when-it-comes-to-stroke-rehabilitation-beds-says-doctor\/","title":{"rendered":"Muskoka left out in the cold when it comes to stroke rehabilitation beds, says doctor"},"content":{"rendered":"
<\/broadstreet-zone><\/strong><\/div>\n

About 150 people in Muskoka suffer from a stroke each year and depending on the severity of the stroke, some will need to be relocated elsewhere. That\u2019s because despite the best intentions of local healthcare providers, there are no designated stroke rehabilitation beds in our community.<\/p>\n

Patients in need of intense stroke rehabilitation are relocated
\n<\/strong><\/p>\n

Dr. Mackenzie Brooks, a psychologist from BC, encountered the issue first hand when she flew to Huntsville to care for her sister, who suffered a stroke last month.<\/p>\n

\u201cI\u2019ve seen and learned a few things here,\u201d she said.<\/p>\n

Anybody who knows a stroke victim, the sooner they\u2019re assessed and put in rehab in a familiar environment with access to their family, the better their chances at recovery. That\u2019s not seemingly happening here, whatsoever.Dr. Mackenzie Brooks<\/cite><\/p><\/blockquote>\n

Brooks said she was disappointed to learn that proper rehabilitation services were not available for her sister in her own community. She was told her sister would be transferred to North Bay but on the same day the transfer was scheduled to take place she was told the bed was no longer available. She said Huntsville staff tried to cast a net to find her a bed elsewhere, areas such as Toronto, Hamilton and Barrie, but they were not sure when one would become available and she was told it could take weeks. In the meantime, she said, her sister was already three weeks into her stroke.<\/p>\n

\u201cHuntsville Hospital, they\u2019re amazing here. They spent I don\u2019t know how many hours of staff time case managing and planning a strategy for her and then at the last minute having it pulled out from underneath her,\u201d said Brooks who went to the media with her concerns. She contacted the Toronto Star\u2019s health reporter who she said made some calls.<\/p>\n

\u201cA bed magically became available the very next day by 10:30 a.m.,\u201d she said.<\/p>\n

There is something going on in Northern Ontario that\u2019s very concerning\u2026 If they don\u2019t get into rehab quickly it increases the chances that they\u2019re going to be institutionalized, which is very costly. They\u2019re dependent on the system\u2026 it has life-long consequences for a stroke victimDr. Brooks, who wondered how many others experience similar situations
\n<\/cite><\/p><\/blockquote>\n

Huntsville is considered a district stroke centre but there are no dedicated beds here<\/strong><\/div>\n

 <\/p>\n

We asked Natalie Bubela, CEO for Muskoka Algonquin Healthcare, which manages both the Huntsville and Bracebridge hospitals, for input on the issue. She confirmed that Muskoka is part of the Central East Stroke Region, one of 11 established by the Province to co-ordinate stroke care. And while Huntsville is considered a district stroke centre, it has no dedicated rehabilitation beds.<\/p>\n

\u201cWe do not have designated acute rehab beds. We\u2019re not funded in the organization to provide that, however we do have on any given day patients that are recovering from a stroke in our acute care beds and we look after them,\u201d said Bubela.<\/p>\n

Huntsville hospital is considered a stroke centre for patients who wind up in its emergency department because it is able to provide services that are required to look after patients who suffer from strokes. It also provides services like speech language pathology, physiotherapy and occupational therapy. The problem occurs when patients require more intensive rehabilitation.<\/p>\n

From time to time though, the type of care or the intensity of what the patient requires is beyond what we\u2019re capable of providing. So if someone needs very detailed physiotherapy that is very active, so potentially a couple of hours a day in services, we\u2019re not equipped to provide that here\u2026 we then attempt, after we\u2019ve assessed the patients and what their deficits are and what their needs are, to match them to the appropriate stroke rehabilitation centre and then we get them in there MAHC CEO Natalie Bubela<\/cite><\/p><\/blockquote>\n

Bubela said wait time for a rehabilitation bed averages about 10 days.<\/p>\n

Stroke patients, duration of hospital stays and those relocated by the numbers<\/strong><\/p>\n

She said in 2013\/2014, MAHC saw 147 stroke-related cases. The average length of stay for those patients was approximately 9.15 days and 12 were referred elsewhere for rehabilitation services, the majority to Penetanguishene. In 2014\/2015 Muskoka had 137 stroke-related patients. Their average hospital stay was 10.5 days and 26 of those patients were relocated elsewhere, the majority to North Bay.<\/p>\n

More recently, between April 2015 and January 2016, MAHC has seen 136 stroke patients. \u201cI think if you extrapolate that to the end of our fiscal year we will be in line with what we did back in 2013\/2014, maybe a little higher,\u201d said Bubela. She said the average length of stay is currently at 10.73 days and so far 20 patients have had to be referred elsewhere for rehabilitation services with the majority going to North Bay.<\/p>\n

The promise of beds put on hold<\/strong><\/p>\n

Attempts have been made to get funding for rehabilitation beds in Huntsville, but to date those attempts have been unsuccessful.<\/p>\n

The North Simcoe Muskoka Local Health Integration Network (LHIN), which distributes and co-ordinates health care funding dollars in the area, considered creating rehabilitation beds at three different hospital sites in the area.<\/p>\n

\u201cAt one point they were actually looking at three areas in this LHIN to have those designated beds,\u201d said Bubela. The sites were Huntsville, Orillia and Barrie. That proposal put forward between 2012 and 2013 was put on hold on what she presumes was the advice of the Ministry of Health.<\/p>\n

Pilot project could see results here?<\/strong><\/p>\n

\u201cThey are doing a pilot right now in the Barrie corridor to just understand the cost and what the actual staffing and operation requirements are needed to actually have these stroke rehab beds. Our hope is that when the pilot is done in the Barrie centre that they move ahead with designating Huntsville and Orillia to have stroke beds,\u201d she said.<\/p>\n

It is not certain just how long the pilot project will take to complete, \u201cit could be any time now,\u201d said Bubela.<\/p>\n

Not everyone is hopeful<\/strong><\/p>\n

Dr. Timothy Lapp, who specializes in physical medicine and rehabilitation in Huntsville lamented that it has taken this long for those beds to materialize.<\/p>\n

\u201cThere was a proposal made that was thought to be very cost effective for new stroke rehabilitation beds to be provided in a number of hospitals not just south. So there would\u2019ve been more beds in Orillia and in Huntsville and we were supposed to receive approximately 10 beds and with that there would be funding for specialized nursing, specialized physiotherapy, specialized occupational therapy, specialized speech and language pathology, an intensity that would allow us to perform our own rehabilitation here in Muskoka. The government didn\u2019t accept that proposal and is now in the midst of deciding how this might work,\u201d said Lapp.<\/p>\n

There\u2019s a pilot project underway involving patients from Collingwood and Barrie to look at this more intensive rehabilitation method but as it stands right now Muskoka has been shut out of that so we\u2019re left with again doing the best we can with the resources that we have and I don\u2019t see any likelihood in the near future for us to get any funding for dedicated rehabilitation beds. Dr. Timothy Lapp<\/cite><\/p><\/blockquote>\n

He argued that research out of London aptly demonstrated the cost effectiveness of an integrated stroke unit to manage stroke patients \u201crather than haphazardly managing on other floors with non-specialized nursing and therapy staff.\u201d<\/p>\n

He said the stroke council, which he sat on, agreed with the position that the creation of rehabilitation beds would be a cost effective way to go about managing stroke victims in North Simcoe Muskoka. \u201cThe government didn\u2019t accept that explanation and felt they wanted to rework the numbers and needed more evidence before they considered funding it. \u201cIt\u2019s very disappointing, I can tell you that.\u201d<\/p>\n

There\u2019s no question that Muskoka in particular \u201cappears to provide substandard, inappropriate stroke care despite the best intentions of the people involved who are working pretty hard at this but it\u2019s beyond their capacity,\u201d said Lapp.<\/p>\n

Cheryl Moher, Regional Director for the Central East Stroke Network explained in a written statement, \u201cThere is an ongoing need for rehabilitation system change particularly to improve access to hospital-based outpatient rehabilitation and CCAC (Community Care Access Centre) services.\u201d Click here to see her full response (PDF)<\/span><\/a>.<\/p>\n

She said the pilot project underway is expected to \u201cinfluence implementation in the other parts of the LHIN.\u201d<\/p>\n

CAO argues for a new hospital model<\/strong><\/p>\n

In the meantime, Bubela also made a pitch for developing one brand new hospital for Muskoka.<\/p>\n

\u201cIf we were to get the (stroke) beds tomorrow we would have difficulty bringing them in because we don\u2019t have the room,\u201d she said.<\/p>\n

We would shift people around and do our best to accommodate the beds but that would then influence our infection control practices where we try to have people in single rooms, etc. It would be a challenge and a stretch for us because we don\u2019t have a big physiotherapy area here for the rehab like a big purpose-filled gym… that\u2019s the appeal of a new hospital build . Bubela<\/cite><\/p><\/blockquote>\n

Bubela noted that staff is doing a phenomenal job at dealing with stroke patients at the acute care level. She said the hospital has started placing all stroke patients together in one unit within the past three weeks and has developed outreach educational programs for stroke patients and their families in the past year.<\/p>\n

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