Dr. CEO: Interior Health Authority President and CEO sits down for a check-up with the Rossland Telegraph
By Allyson Kenning
Last week, IHA President and CEO, Robert Halpenny, did a three-day tour of the Kootenay-Boundary region, with stops in Nakusp, New Denver, Kaslo, Nelson, Grand Forks, Castlegar, and, finally, Trail, home of our own Kootenay Boundary Regional Hospital. The purpose of the visit, which he makes biannually, was to gain an understanding of the physical structures of the sites and programs and to talk with health care staff, physicians, elected officials, and auxiliaries. During his stop in Trail, Halpenny received a tour of the KBRH facility and then sat down with media representatives to answer questions.
Many issues close to the hearts of those of us who live and access different kinds of health care here came up. The first one raised on Wednesday’s meeting with the media concerned a press release put out that day by IHA announcing an increase of funding of $5.9 million to improve care in publicly funded residential care sites. The increased spending will go into more care hours provided to patients by RNs, LPNs, care aides, and activity and rehabilitation staff.
“What we’re trying to do is standardize care, in both our public and private facilities” Halpenny stated. “One of the things we’re trying across Interior Health is [create] standards and equity from site to site. The issue has to do with the number of hours of care. It’s much easier for us as IH when we own the facilities to reach those targets, and we have to work with those private facilities in order to reach those standards.” Care hours at these facilities will be increased to 3.15 hours per patient, in order to equalize these hours throughout IH. Some facilities had 2.85 care hours per patient. “The complexity of the patients going into a residential care facility has gone up. Very often we have complex patients who have either dementia or Alzheimers. Very often they have chronic diseases and very often they have lost the ability to walk, so it’s having the correct care so that either they can improve, and certainly so that their health status doesn’t diminish.” More care hours will mean that health care staff will be able to deal more effectively with these complex issues. Some sites in the Kootenay-Boundary region will see this increase in care hours by the end of the spring.
Another important issue to rural communities such as ours is doctor shortages. Halpenny acknowledges that this is a challenge because recruiting physicians to a rural area is difficult. IHA is coordinating with physicians, communities, and various organizations, as well as utilizing different web sites, like Health Match BC and Better Here in order to recruit doctors. One thing Halpenny believes will increase recruiting to the area significantly is a new medical school starting in Kelowna this year. Every year, it will start training 36 new medical students.
“We’ll start to distribute those 36 students out across the health authority to get their extra training, then the potential to recruit them goes up considerably.”
Recruiting lab technicians and ultrasound technicians, of which there is also a shortage in rural areas, is also a priority, and Halpenny says he is working with colleges, universities, and other training facilities to see how training can be improved and increased.
The topic of the ultrasound controversy in Castlegar did come up. On that very polarizing issue, Halpenny said, “I come back to the theory of the common good and the whole idea that we have to protect those services that provide the most common good and those that have the critical care component. So the issue of the ultrasound in Castlegar is an example of where that machine would be better used in this location [i.e. KBRH] as a regional centre for those patients who need a higher level of care. The radiologists are here, the higher trained techs are here, we would have much better use of that machine in this location. Now some people understand that in that community [i.e. Castlegar], and some people see it as a loss for that community, rather than saying ‘oh gosh, I get better service at the regional centre.’ So it comes down to community perspective. My goal is what’s best for patients in the common good perspective.”
Halpenny went on to say that consolidation of services is important in rural areas because there are only a finite amount of ultrasound techs or specialists available, and not every site is able to have one on staff. “We have to consolidate, and communities perceive this as loss, rather than saying ‘I have access to higher specialties than I had in the past.’ It’s a perception.”
With regards to the future of of health care in the Kootenay-Boundary region, Halpenny addressed local talk about a new, bigger regional hospital that would replace the current, aging KBRH. The answer he gave was fairly non-committal, but he did cite many challenges inherent in planning for such a facility to come into fruition. Amongst them were taking into account population projections vis a vis the needs of the community, and the difficulties of projecting too far ahead into the future due to how quickly changes to health care come about.
“If we’re going to do a broad-based master site plan, [we have] to say what does the population look like, what is the population projection, and in that projection what are the different age groups, and what are the services people are going to need - before we can say we need a new hospital. We used to project five to ten years out, sometimes up to 15, but now if we can project three to five years out, we’re doing well.” Halpenny said discussions about these projections and the costs of maintaining older facilities versus building new ones, and all the trickle down effects of both scenarios, are happening with communities, but he states, “there are so many things coming in health care - genetic formulations for drugs [for instance] - we may not need as many beds as we thought we needed in the future. To sink hundreds of millions of dollars into something...this is going to be a fairly detailed process if and when we start. It’ll be interesting.”
Robert Halpenny is a doctor himself and practiced in Kelowna and Vancouver before earning a Masters Degree from the University of Colorado in Health Administration. In 2002, he became the VP of Medicine for Fraser Health and then accepted the position of Provincial Executive Director Cardiac Services at the Provincial Health Services Authority. He became the President and CEO of Interior Health in January 2010, and is an avid golfer, hockey player, and skiier. Interior Health has an annual budget of $1.7 billion and employs approximately 18,000 people who serve a population of roughly 750,000.