Strait-Richmond Hospital facility manager Cathy Chisholm outlined priorities for the Evanston facility to the Richmond County Seniors’ Council at the Riverdale Community Centre on May 11.

EVANSTON: The administrator of a local hospital says big plans are in works for the facility.

During a meeting of the Richmond County Seniors’ Council on May 11 at the Riverdale Community Centre, Strait-Richmond Hospital facility manager Cathy Chisholm told the group that the Evanston facility was constructed for the needs of physicians, patients and staff in the 1980s and is now starting to show its age.

As a result, hospital administration identified priority areas for improvement to meet the needs of the 21st century.

The first was in ambulatory care. Patients requiring specialists like surgeons – who typically see 50 patients per day – have to go through the hospital’s emergency department.

“There’s days that our emergency department is so blocked that we’re taking these specialists and trying to find a place in the corner for them,” Chisholm noted.

When physicians are at the hospital, they see patients in a room in the emergency department set up for patient care, not patient visits, she said.

In 2016-2017, Chisholm said the hospital had 10,549 emergency room visits and 1,742 clinic visits in an area of the hospital that has only nine stretchers and one chair.

“A lot of times, we have patients in those beds waiting to get on our medical unit, so it’s very difficult to provide service in that environment,” Chisholm said.

The second priority area is the lack of washrooms in the emergency department for nursing staff and patients.

“You have to come out of the emergency department across the hall,” Chisholm pointed out. “Sometimes nurses cannot leave the department to take patients and we know our population is getting older and more feeble, and sometimes people need assistance, they’re not well and that’s why they’re in the hospital in the first place. Unfortunately, people are unsafely going across the hall to the washroom.”

Another problem identified was in the area of triage. Rather than seeing a nurse, patients at the Strait-Richmond Hospital first see a member of the clerical staff to register. The standards for health care facilities dictate that the location of the triage should allow for the fastest identification of emergency patients by the medical team, including Registered Nurses, Licensed Practical Nurses and physicians.

Work stations were also noted as problem areas in the hospital. Chisholm pointed out that many desks at the hospital are older and became cluttered when the facility switched to a computer-based system a decade ago. There is also a lack of ergonomic work spaces for staff, and there is a lack of storage space in the hospital, Chisholm said.

The lack of wheelchair accessibility was also highlighted by administration.

“If somebody did come into our department now in a wheelchair, we can’t even see them if you’re sitting at the counter,” Chisholm said.

Another area of concern surrounds the lack of easy access to an ice machine. Chisholm said ice is necessary to preserve specimens.

“Right now, to get somebody a cup of ice, the nurses need to leave that department and go down to the nursing unit,” she said.

The deteriorating condition of the in-patient nursing station has also been discussed, including the lack of air conditioning.

“The wood is all chipped and cracked, the floor has holes in it,” Chisholm explained. “This was put there when the building was originally built in the 1980s. So from an infection control perspective, it’s a nightmare.”

Chisholm said administration was focused on the structure of the building in identifying deficits. The hospital received funding in the last fiscal year from the Nova Scotia Health Authority (NSHA) for a preliminary design undertaken by Archibald & Fraser. Hospital administration then held several meetings with the design team.

In addressing the priority areas, it was decided that since all laboratory services are already shipped to St. Martha’s Regional Hospital, the Cape Breton Regional Hospital or Halifax, then better uses can be found for that space, Chisholm said.

“We no longer provide any diagnostics in the Strait-Richmond Hospital and haven’t for several years now,” Chisholm noted. “We have a big lab space that’s there that’s not being utilized so that space can certainly be used much better.”

Chisholm said major considerations of the upgrades surround infection control, preliminary cost estimates, construction regulations, maintaining services during construction, and the overall impact of construction on the hospital.

One of the main goals for administration is the development of an ambulatory care space that accommodates current clinics and attracts future clinics, Chisholm stated.

“So those visiting specialists, when they come, will have clinic rooms for them,” the facility manager said.

Currently, chemotherapy patients requiring blood transfusions, people who need to have their dressing changed and those on IV medications all have to wait in the emergency department along with other patients, Chisholm said.

“Those are vulnerable people because they’re getting chemotherapy, and they’re sitting there with ER patients who are there because they’re sick and they’re bringing in whatever viruses and sickness they have,” Chisholm said. “We’re putting an unwell population at risk by having them there.”

Other goals identified by hospital administration include improving the flow in the emergency department to shorten current wait times, creating a divide between sick patients who require emergency services and clinic patients who are well but vulnerable, and beefing-up security for staff and patients using the emergency department.

“You can walk straight into our emergency department,” Chisholm pointed out. “If you’re listening to the news of late, that’s a risk. Anybody can walk in at anytime with any weapons.”

Another goal is to centralize all registration at the front desk, by renovating and expanding the current lab and x-ray registration areas, and considering the consolidation of all registration services.

In addition to financial support from the NSHA for the preliminary design, the Strait-Richmond Hospital Foundation was also the recipient of a $300,000 donation from Joe Shannon. The foundation has agreed to match that donation. Chisholm said the foundation has also received interest from another private donor, whose donation is contingent on a financial contribution from the NSHA.

Although she acknowledged that they are many other facilities in equal or worse condition around the province, and there is only so much money to go around, Chisholm is hopeful the health authority will contribute.

“I am very, very confident and optimistic that there is going to be money put in by the NSHA,” Chisholm told the meeting.

“This project is on NSHA’s radar and it’s in scope.”

Before proceeding with a final design, the hospital needs a signed financial agreement between the NSHA and the hospital foundation, Chisholm said, noting that the estimate of $2.3 million from 2017 has already increased.

To make the construction a reality, Chisholm said that the Strait-Richmond Hospital will need the support of the community in the form of donations and volunteers to conduct fundraising through the hospital foundation. She added that a variety of stakeholders have been invited to a meeting of the foundation on June 5 at the Riverdale Community Centre.