Cover

‘A great group rising to the challenge’

Brian Bergman June 5 2000
Cover

‘A great group rising to the challenge’

Brian Bergman June 5 2000

‘A great group rising to the challenge’

HEALTH REPORT The Annual Rankings

Communities with Medical Schools

The Edmonton health region provides residents with the best services in its select category

EDMONTON: Teamwork in action

In response to a rare meningitis outbreak early this year, Edmonton’s Capital Health Authority launched a massive immunization campaign. With medical and administrative staff from across the region pressed into service, 170,000 children and teenagers received vaccinations over a two-week period in February. Last week, Sheila Weatherill, chief executive officer of the Edmonton authority, cited the immunization drive as an example of the teamwork that has put her region in the top rung of the Maclean's health-delivery rankings for the second straight year. “It was a case of a great group of people once again rising to the challenge,” says Weatherill. “It was just amazing to be part of such an effort.”

Last year, Edmonton came out on top of the 16 major centres included in the inaugural Macleans ranking. In this year’s more exhaustive review of 50 regions, Edmonton heads the list of “communities with a medical school”—a category that puts Weatherill’s region up against the centres she regards as benchmarks of success. “To be ranked first among centres with such prestigious organizations as Toronto’s University Health Network and the London Health Sciences Centre,” she says, “fills me with an enormous sense of pride.” Edmonton’s success is qualified only by the fact that it ranks slightly behind the top three centres in the next category, “other major communities.”

The Capital Health Authority was created five years ago as part of an Alberta-wide move to merge some 250 hospital and healthcare boards into 17 regional and two provincial authorities. The Edmonton-based board oversees seven major hospitals in the city and surrounding area, as well as almost every other aspect of health services in the region. The authority also acts as the major referral centre for far-flung northern communities in Alberta, British Columbia and Saskatchewan as well as the Northwest Territories. On any given day, about 30 per cent of its patients have travelled into the region for treatment. Those visiting patients don’t affect the ranking, which considers services available to the regions’ residents. But they are evidence of a high level of expertise, which would clearly benefit locals as well as outsiders.

Rank by region

Rank last year

1 Edmonton

2 Ottawa

3 Saskatoon

4 Toronto

5 Calgary

6 London, Ont.

7 Hamilton

8 Vancouver/Richmond 9* Quebec City

9* Winnipeg

11 Halifax/Dartmouth

12 Sherbrooke, Que.

13 Montreal

14 Kingston, Ont.

1

10

6

2

12 83.4

83.2

13

Overall

Scores

85.3

84.9

84.7

83.5

82.9 82.5 82 82 80.4

79.9

il

1

79.3

78.9

Overall

ranking

4

5

6 8 9

10

11

13

15*

15*

24

25*

29

30*

OUTCOMES

Life

expectancy

10 6 12 8 9

28* 28*

3* 23* 23* 23* 35* 23*

37

Indicates a

PRENATAL CARE

Low birth weight

44*

32*

15*

47*

50

15*

43

19*

19*

38*

34*

49

38*

25*

Caesarean

section

18

13*

8*

32*

11

3

23*

41

6

15*

29

1

25

40

m 3

Births after c-section

5

24*

32*

2

6*

14*

30*

6*

14*

10*

1

20*

35*

COMMUNITY HEALTH

Hip

fractures

12

14

26

16*

33

42

18

34

15

28

38

22*

19

44*

Pneumonia and flu

18

24

19

11

17

8

13 16

4

14 32* 22

6

38

ELDERLY SERVICE;

Hip

replacements

24

37

4 36 30

5

12

40 42 22 14

41 48

6

Knee replacem

21

31 10

32 32

7

12

41

45 19

8

46 48 15

tie

Among other things, the Capital Health Authority ranks well in preventable hospital admissions, keeping those numbers low by treating people on an outpatient basis whenever possible. At the height of this year’s flu season,

the region dispatched home-care nurses to emergency rooms to help people avoid admission to hospital. Another successful initiative sees nearly 300 elderly and frail residents bused regularly from their homes to three central facilities where physicians, nurses and therapists attend to their needs. That program has halved the amount of time its clients spend as hospital patients.

The Capital Health Authority fares badly in just one ranking category, recording a high number of births of low-weight babies. That, Weatherill says, may be due to the relatively high proportion of poor people in the region, which exceeds the national average. At the same time, Edmonton boasts a state-of-the-art neonatal unit, allowing physicians to deal with high-risk obstetrics cases. Among other things, the unit features digital radiography at every bedside, providing instant X-rays of the tiniest and frailest patients.

Like other jurisdictions across Canada, the Edmonton region struggles with a chronic shortage of hospital beds. The authority’s own projections call for almost 500 new acutecare beds by 2008—and a staggering 1,800 additional longterm beds to be phased in over the next decade. The Alberta government, which drastically cut health-care funding in the 1990s and forced the closure of hundreds of beds, is now pouring money back into the system. But one of the biggest stumbling blocks to opening new beds, says Weatherill, is a nationwide shortage of nurses and physicians. “I usually have a list of about five things I should be worrying about each day,” she adds. “Almost always at the top of that list is how we can recruit and retain staff.”

While the challenges are sometimes daunting, Weatherill believes that she and her colleagues are on the right track. “The health restructuring was very difficult in this province,” she says. “But the government made the right decision in creating integrated regions.” With hospitals and a wide range of community services—including everything from immunization to restaurant health-code inspections—consolidated under one umbrella, she adds, managers are able to move personnel and resources quickly as circumstances warrant. “Because of the huge diversity of services,” says Weatherill, “I can’t imagine having a better job than this.” As the Macleans rankings reconfirm, it is one she is doing exceedingly well.

Brian Bergman