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The Huron Expositor, 1971-09-16, Page 12additions to the staff BO the hospital is now delog a' greeteT amount of what was formerly MS- frict referral work, One might- question whether this. should he encouraged in such a, hospital without certified anaesthetists and the back-up of a wide range of diagnostic and treatment staff and facilities. On thbotherhands if the hospital is to provide an active treatment role for the area, which includes an accident referral centre through its emer- gency department, then it is most advantageous to have a skilled surgical teem available. Th10 change in staff may affect the hospital bed need through wider utilization in the area even though the population itself Is not in- creasing. Another couple of features should-be mentioned in reference to the role of this hospital. One is the low use of the chronic care beds. This is apparently the de- cision of the medical staff todls- eharge patients to other types of accommodation rather than leave them in the chronic care beds as- 0 0 11111111111111011 E ARE BU' ING WHIT BEANS We now h ave a FAST NEW elevator an d intake. We have the' quickest and most modern un- loading facili ties avail° ble for ou r Bean a nd Corn Growers ALSO, STORAGE F For Courtesy & Service Come . to W. G. Thompson & Sins Limited MITCHELL 1 14 Miles West of 'Mitchell on Highway 8 PHONE 3488433 SEE --- DRIVE and BUY The New '72 Models RUPP SNOWMOBILES at Wm. Beuerman • RUPP SALES and SERVICE • Five miles North of Dublin and1/2 -mile`West or six miles East of Winthrop. . — Immediate Financing Arranged — PHONE: 345-2950 BANGHART, KELLY, Dom & Co. Chartered AccoOntants 476 Main St. S., EXETER 235-6120 C R. W. REID, C.A. and who should be included in „_ the plan. Because of this con- fusion it appears that a valid expression of producer opinion cannot be obtained at this time. The belief that only a Public Enquiry could clarify the situa- tion prompted the request and recommendation, According to the Minister the general terms of reference would authorize the Commissioner to enquire in total into the egg industry in Ontario. This would include the developments that have taken place In the industry in terms of increased produc- tion facilities, processing and grading facilities, and producer credit and income. Theproposed plan for marketing eggs in Ontario, including policies re- lating to quotas, distribution through grading stations, and pricing and pooling policies, would be examined, together with the relationship of the marketing of Ontario eggs to the proposed national plan: The Commissioner would be authorized to make re- commendations in respect to the marketing of Ontario eggs which, in his opinlon,•would promote the stabilization of egg marketing in Ontario and, in concert with other provinces, the marketing of eggs in Canada. Btucefield Club Meets Brucefield II Butterdups met at the home of Mrs. Doris Can- telon with ten members present. Milk in various forms available was discussed and Faye Cantelon and Linda Coleman demonstrated cheese pizza and Kathy Tomkins and Kathy Lawrence served. At a second meeting at the home of Linda Coleman dis- cussion centred on the nutrients sof milk and yogurt. Kathy Law- rence, Peggy Richardson and Karen Whitmore brought ingre- dients and demonstrated cream •of potato soup and yogurt dip. Now you can get 50% off the cost of your winter wheat insurance. If you know the right people... — The Crop Insurance Agents in'irqur area. So call your local Agent today — he'll be happy to tell you all about the new special Winter-Kill coverage — the new quality coverage — and the new system whereby your guaranteed winter wheat production can, increase year by year — at no increase in premium cost per acre. He'll also show you how you get 50% off —so you can buy this comprehensive crop insurance for only half the actual other premium The Provincial and Federal governments pay the So act now get your application in before the deadline. Call your loc'al Crop Insurance Agent — he's listed,below. William Wilson, R.R. i1, Brumfield, Ph. 527-1757 Lorne E. Hay, Box 165, Hensall, Pb.. 262-2133 Peter A. Roy, Gen. Ins., 17 Gibbing's St., Clinton, Ph. 482:9357 Geo. A. Watt, Blyth, Ph. 52379217 THE CHOP INSURANCE COMMISSION OF ONTARIO Pai•ilament Ettlildingq, Toronto 5, Ontario;, J1-111E" H,PRON EXPOSTOR, SEAFORTH, ONT., SEPT 16 1971 Suggests Seaforth Hosgita -1 -1 Potential s"Sgt, ;00 shifty Carried Out by ssArsOWs Peeldiare and Associates bPSPItal planning Consul- • ?WA, vet* respect to the iteePitiale. tit Huron and P erth , 64.8% in 1969. The figure fore Logan Township was exactly the same in both years at 42.4% of the hospitalizations to Seaforth. if this pattern shows a larger increase in 1970, and continues so each year, then the hospital community populatiiin will obvi- ously have to be increased. The number of beds required 'would then have to relate to that figure. The active treatment bed size will need to be kept under review each year. Since the medical staff has altered considerably In —ltigt past couple at years, the 1970 statistics should be analyzed in reference to determination of the size of hospital area in that year. Since the age grouping is high throughout this region, the number of active treatment beds permitted is higher than the stan- dard of 4.0, 4.5, or 5.0 bed formula would suggest above. If the percentage of population served throughout the district has Increased substantially in 1970 and repeats this in 1971, there will be some justification for increasing the number of active treatment beds. At the present time, on the basis of the 7,500 population in the ser- vice area and the low use of the chronic care beds, it is not possible to Make such a receM-: mem:1311M It is reetenniended that annual review of the hOSpItal 'service area for Seaforth be made, since there is Indication that this is increasing le each recent year. The number of active treatment beds is now at the peak of uti- lization but, unless the hospital service area increases in its percentage, and unless the chronic care beds are used more extensively, it is impossible to recommend additional beds at this time. The situation appears to be changing and requires an- neal review. The other factor which would affect 'hOspital bed needs would be a change In the role of the Clinton Public Hospital. Should this be accepted and come into effect, there would be additional pressures on Seaforth Hospital as well as onGoderich because of the proximity to their service area. Some of the Clinton doctors would possibly prefer to practise in Seaforth or have at least a ortion of their practice there C145500. the potential of Seaforth entornenity Hospital and sug- 0*(4 steps to enlarge the service the hospital provides the community. Excerpts from the study fellOWe There has been a hospital in ,Seaforth for many years, in the typical pattern of a converted house. lir 1965, however, this hospital moved to an entirely new building on a corner of a spacious 83-acre site, partly in the town and partly In the township. The location is excellent and there is ample potential for growth if and when required. There is no peril- cuter reason to anticipate growth in the area in the next decade; unless something unusual hap- pens 'in the 'development of in- dustrial or commercial activity, the area will do well to hold its current population size. The hospital is located just inside-Huron County, so its ser- vice area is fairly equally divided between Huron and Perth County residents. It will be noted that Tuckersmlth Township and the .Town of Seaforth show a utiliza- tion, of 197 discharges per 1,000 in• 1'969 and a use of 2,306 patient days per 1,000 population. This is somewhat higher than the aver- age for the county and .con- siderably higher than that of Southern Ontario which is appro- ximately 150 and 1,530. On the other hand," the Township of iticKillop receives most of its hospital care in Seaforth and utilization there is towel. than the provincial average at 140•diss charges and 1,184 days of care per 1,000 population per year. This-is- an-Interesting slifferen- tial, which is a fairly typical pattern; small towns and villages have a very 'high utilization of 'hospital care, whereas the rural area has one that is less than average in many cases. This would seem to be the situation here. This le an inter- esting differential to ponder in terms of ,establishing equitable use of hospitals for all citizens. Hibbert Township is also a major user of this hospital and utiliza- tion is again high at 193 and 1,789. Interestingly enough, this ap- pears to indicate a high number of admissions but a fairly short 'average stay. Perhaps this re- flects the pattern of care prac-s tised by a particular physician In this area. ,A similar pattern as with the townships above ap- pears to exist with Logan TOwn- ship, where almost half of the people obtain their care in Sea- forth; their admission rate is very low, or at least below the provincial average at 147 per , 1,000 and again a short average stay is indicated, by 1,256 days of care per 1,000 only., Thus the utilization for the area has a pattern of very high users, and very low hospital 'users, which balances somewhat, but would be interesting to provide further study. ' The townships in Huron County tend to refer more work to London than to Stratford. The reverse is true for the townships in Perth County, as might be espected. In fact these townships show what might be, considered a fairly ideal pattern of use with the majority of their work being handled in the local community hospital, the next largest figure 'being referred to the district hospital in Stratford, and the smallest portion being referred on for the more difficult investi- gative and treatment procedures in London. At least one assumes that these are the referral reasons. The hOspital had ten chronic care betis and, although they were used fairly well in the first year of operation at the new hospital (69.4%) this immediately dropped to 'an average census of one . . or two patients, and the hospital has been re-classified to four chronic care beds and 41 for active treatment. 'AC-Wally,. they have made a further recent change in order to gain a post- anaesthesia recovery room next to the surgical suite. The hos- pltalsnow operates as 44 beds for inpatient admission instead of 45. The overall acfree. Tree:Orient occupancy has been extremely high, although one has to balance this with the chionlc care figure. Even so, the use of beds has been consistently high. The nu tuber of admissions has continued to climb although the full utilization. was a limiting factor until the length of stay was reduced in 1969. This length of stay is now, at 9,2 days average, a more reasonable 'figure for a hospital of this type. The admis- sion and discharge committee of the medical staff is obviously {tieing an active job. In departmental utilization the hospital is certainly becoming more and more of an active treat- ment centre. The number of surgical procedures has In- creased remarkably, having doubled in four years. This Is Presumably a reflection, in the past year particularly, of `a certi- fied surgeon located in Seaforth plus another surgeon and some work being done by certain of the family practitioners as -well. In fact, . all of the staff members act as general practitioners. The emergency visits have increased a great deal, having doubled be- tween 1968 and 1969, presumably partly a result of an improved ambulance service with a dis- patch centre from the hospital. An increase in radiographic prO- cedures would be expected and .has occurred. Bed Needs: The medical stiff is anxious to have more active treatment beds. They have been using most of the chronic treatment alloca- tion and have made this official recently; even so, they feel 'the need for more and more beds partly for general practice and partly fer an increasing surgical load related to the location of another qualified surgeon in the community. On a population to bed ratio equivalent, there is no justification for More beds. Ac- cording to the percentage of people cared for from the area, on an actual utilization basis, the hospital population is approxi- mately 7,500. A community hos- pital allocation of 4.0 beds per 1,000 suggests that only $0 active treatment beds are deeded. Dis- trict allocation, counting oremore referred work, would give 34 beds at 4.5 beds per 1,000. A regional referral hospital, the .equivalent to London, would give five beds per 1,000 population which would be 38 bade. The hospital already has, by reallocation recently, 41 active—treatment -beds., It 1s,.., therefore,' difficult to find any method of justifying a greater number of beds at this time. The other method of being able to-gain more beds, assuming that the ratio system is a reason- able one (and in most cases it.is) the hospital would need to justify greater .growth by serving a larger population. This will need 10' be observed from year to year to determine where people at- tend hospital in that region. We have figures for 1968 and 1969, which do not offer a conclusive indication of wider utilization. It has been shown that 71.2% of the people from McKillop Town-, ship who went to a IsaSpital in 1968 were admitted to the Sea- forth Community Hospital, in 1969 this had increased to 78,0% which would Indicate a trend, However, the population of Mc- Killop is very small at less than 2,000. In the larger Township of Tuckersmith including sea- forth, there was also an equiva- lent upward trend from 55,3% of the hospitalizations' in 1968 to 59.7% in 1969. Same was true for Hibbert Township with an increase from 57.6% in 1968 to TODAY'S CHILD BY HELEN ALLEN "POPULAR AT SCHOOL" Eric is a handsome lad of French and Irish descent, with dark eyes, brown hair, and dark' skin. A husky, healthy boy, he enjoys vigorous outdoot activities, especially swimming and baseball. At 10 years,' Eric has many friends and is popular with his schoolmates. Perhaps because he is a quiet lad,, not very assertive, he prefers to play with children younger than himself. Even with them he is not bossy, playing a friendly big-brother role. Eric is a pleasant boy to have around, because he is co- operative ,and creates no discipline problems either in school ox in his fosteenome. He is.not a great scholar, but he tries hard. Eric's athia.ble disposition will make him a happy addition to a warm, relaxed family. He needs a home where he will receive a great deal of, affeCtIon, where the 'father will share his interest in sports and where there is no pressure for academic achievement. To inquire about adopting Eric, please write to To-day's Child, Department of Social and Family Services, Parliament Buildings, Toronto 182. For general adoption information, ask your Children's Aid Society. Minister of Agriculture and Food, W. A. Stewart, has an- nounced that a Public Enquiry will be conducted into the egg Industry in Ontario. This ac- tion is being taken in response to an official request from Thee' Ontario Egg and Fowl Producer's Marketing Board through the Farm Products Marketing Board that such an enquiry be conduc- ted. The Farm Products Market- ing Board has also recommended such action. There have been many con- flicting points of view presented regarding the opesration of the proposed egg marketing plan, Announce Public Enquiry rather than in Goderich. This signed to the hospital. Yet other would probably be essential from similar sizes- of hospital with the point 'of view, of proximity similar age breakdowns, use all for the patient to his orher home. or more than all their chronic Should this role alter, then the bed assignment and thereby per- bed be adjusted accordingly and im- need in Seakorth will need to cover- mediately. their hospital insurance mit these patients to benefitfrom age.' Should nursing homes be Physical Facilities: covered under the insuranceplan eosin, this. would offset such a differential. We assume that patients needing the facilities and care offered in the general hospital are kept there ' ald the medical staff state this is so. This is obviously a situation which can change and the pos- sibility of re-evaluation of this aspect of the hospital role should be remembered.. The other feature of the role of the hospital relates to obste- trics. There was an average The increased vidunte Of vSotk --census-.-ef-s2.9 service, with a capacity of six beds. 'There is a danger in trying to maintain an obstetrical service with such small volume, both for the mother and the baby. It is also. an uneconomic unit .to ope- rate, plus the extra problem of needing Whatever' obstetrical load can be obtained for the education - of student nurses in a larger centre. obstetrics is still, a part of community medical prac- tice, hoWever, in this area and thete is little ,local sympathy for referring maternity work to a, larger centre. In fact, there is some resentment when Stratford obstetricians take over the care of a patient unless requested to do so. Reducing the obtAstrical win-probably not happen here location for this service and the role treatment room is also needed. anexdcewpte-owvepraled laoentghpaevreiethdeofneitiZ).• The radiology use continues to pgeraokw eafn ida,ealfothroaugehaerrot onmeaLithtee, to recommend it. Should the inte- rests of the medical staff continue' to change, however, this subject it is awkward to provide for emergency and routine work should receive further review, while the radiologist is there We do not believe that this fugri nag the mobile ro o int; a ePheirphea pwsoanuidarfielal district centre, because of the hospital should become a major the answer, as is done in many limited size of population which 1 it can serve. It is true that, should places. There is , no maintenance, • the role of the Clinton Public Hos-. pital change and become less workshop. Anything done in this regard has tb be performed In oriented to active treatment, should have a workshop, even 11 the boiler roome Any hospital there would be more justification for doing so here in Seaforth. in an adjacent building. Meanwhile, we urge that' this The original plan obviously hospital continue to do what it _did not include enough_spane for is now doing in being a first- nursi ng ,administration, a typical mistake in hospitals of .this size. As a result there has been some, juggling of rooms and the admini- strator now works .from the quiet room by the front door without a secretary or a meeting area. This is far from Weal. Generally speaking, the fag).- Mies are. excellent although it Would be much better if at least some of these features`could be remedied before long. Role and. Recommendations: This appeals to us as a fairly ideal typical commiinity hospital, serving the needs of its population extremely well. The surgical load is increasing becabse of recent • In general these are excellent and only minor comments are re- quired. The growth of work in the emergency department has _indicated the need for a recovery or observation area; a• eparate cast room would' also be useful and will become more necessary if the volume of work continues to, grow. Patient accommodation is satisfactory with the possible exception, of arilsolationnursery, although this is not an essential. in the surgical suite has sug- gested the need for an anaesthesia recovery room and a single room has been taken for that purpose. This should work fairly well. There is no intensive care or coronary care unit and a large service cannot be justified here. However, consideration should be given to some provision for this service. There is no physiotherapy de- partment and .'a general hospital of this type should have one. Work is now referred to Stratford or Clinton. There has been some move to provide a small physio- therapy department in a treat- ment room; we think this would be a mistake since it is a poor class corniest-Fe trsafes-hbeeetsals It should develop a coronary care room with' medical staff and nursing staff skilled in looking after such patients, and with the equipment to' provide such ser- vice. It should continue to im- prove its emergency service for the area of ,coverage, and some additional physical facilities should be provided to permit this to happen. more,explicitly, a recovery room should be added iI plus a cast room and a room for a mobile x-ray machine. A physiotherapy department should be added. The hospital should urge development of the home care plan and participate actively in it. ' Involvement with public health work is no* substantial and commendable. It sti'ould con- tinue to develop, with a mental health clinic if staffing is at all possible. The hospital should seek accreditation, de is now being done, and if this is not re- ceived, the changes should be made immediately in order to bring it up to the recommended Standard. It should be remem- bered that accreditation stan- dards are considered as minimal only and any hospital should seek' to surpass them. . This hospital Would be ideally suited to develop- a true health care •complex surrounding the hospital. A medical clinic office building should be encouraged for direct .association with the hospital and use 'of joint parking facilities as well as the diagnostic services. Room should also be made in the hospital for voluntary health service organizations as well as the existing public health offices.' This would be an ideal community project and a model for the other hospitals and com- munities in the province. It Is recommended that Sea- forth Community Hospital con- tinue to develop its role as a first- class community hospital and limit its role as a district centre to the range of work now done. The hospital needs a small expan- sion program to improve its emergency service with a recovery room, a cast room, a mobile x-ray room and the need for a physiotherapy department.' It also requires a rooen for treat- ment Of coronary care. A medical clinic 7 'building "should be en- - couraged for collocation. 11r # a aM 0