Shuswap Lake General Hospital is suffering from a chronic lack of funding and prioritization in the region that is threatening the ability to provide quality critical care.

Dr. Scott McKee, head of the internal medicine department at the Salmon Arm hospital, brought this candid message to city council on May 23.

He explained that he and five colleagues, all internists (physicians who specialize in the internal organs), are responsible for emergency and critical care at the hospital on a 24/7 basis. Critical care is what is done in the ICU B次元官网网址� the intensive care unit, and it is in jeopardy, he said. The unit is also called the CCU B次元官网网址� critical care, cardiac care or coronary care unit, or the HAU B次元官网网址� high acuity unit.

McKee told council itB次元官网网址檚 important as politicians that B次元官网网址測ou be aware we are at risk of losing not a minor bit of our service but a major bit of our service.B次元官网网址�

While critical care can live through lean times in terms of some resources, B次元官网网址渢here was a real concern last fall that we were going to lose this service altogether. And we had to begin to actually plan about what that would look like. How would it affect our other departments? How would it affect namely our operating rooms and our emergency rooms?B次元官网网址�

Although he said things have eased slightly since autumn, he outlined the ongoing issues. And he asked for councilB次元官网网址檚 help.

B次元官网网址淚B次元官网网址檓 not here today to ask you to help solve our operational problems or get yourself involved in the delivery of health care in Salmon Arm; thatB次元官网网址檚 clearly not the councilB次元官网网址檚 role.B次元官网网址�

McKee said his hope is that council could help to keep the health-care needs of the growing community at the forefront for Interior Health, the Ministry of Health and the board of the North Okanagan Columbia Shuswap Regional Hospital District.

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McKee noted Shuswap Lake General Hospital (SLGH) was built in 1958 and, in 2006, the emergency room was modernized and the radiology department was expanded. At the same time the renovations were completed, a master site utilization plan was submitted by the hospitalB次元官网网址檚 planning group with a growth plan and future hospital expansion. It was specifically for the critical care unit, the medical wards and the surgical operating rooms.

Post 2006, he said a few minor renovations were done B次元官网网址渂ut there was really no attempt to adapt the hospital to our demographic growth, to our tourism infrastructure,B次元官网网址� he said, pointing out the hospital sees a lot of B.C., Alberta and Saskatchewan visitors.

B次元官网网址淭hat site plan was never escalated, was never funded; we went to meetings once a year, we heard that it was there, that it was waiting to be prioritizedB次元官网网址� Other projects got accomplished and ours did not get any attention at all.B次元官网网址�

In 2017 the medical staff were concerned, he said, so a modernization plan that included primarily the operating rooms was funded outside of Interior Health. The initiative was led by an operating room doctor.

McKee pointed out that although his focus is mainly critical care, it is closely tied to the surgical service B次元官网网址� B次元官网网址渨e need one another.B次元官网网址�

He said the plan cost about $60,000 and was submitted within a year to Interior Health capital planning for prioritization. The plan was for what was called the OR Redesign Project.

After a year, good news was received that the plan had been bumped up and was #3 on the regionB次元官网网址檚 capital priority list.

B次元官网网址淭hat meant to us that things were going to happen imminently,B次元官网网址� McKee commented.

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In 2020 the pandemic struck, but coming out of that in the summer of 2022, the hospital received news from Interior Health that it had been approved for $1 million for a formal planning phase of the OR Redesign Project from five years earlier. Medical staff leaders were notified, asked to plan time off to participate in the meetings, B次元官网网址渁nd we thought this was going to be our opportunity.B次元官网网址�

Within a couple of months, McKee said, word was received the funding was being withdrawn.

B次元官网网址淭he bottom line was, we were told itB次元官网网址檚 not Salmon ArmB次元官网网址檚 timeB次元官网网址�B次元官网网址�

Money was left for some operating room renovations but all other complementary projects were cancelled. Those included all the components of the original OR Redesign Project B次元官网网址� the critical care space, the medical device reprocessing or sterilization unit, and the ambulatory care space designed to accommodate people who are suitable for B次元官网网址渓umps and bumps type surgery,B次元官网网址� keeping them out of the expensive operating rooms.

More negotiations occurred, leading to what McKee called the new Site Utilization Plan. However, he said they were told it would take three to five years to complete.

B次元官网网址淚n our world, that means maybe never, and we havenB次元官网网址檛 really got our arms around how weB次元官网网址檙e really going to get through those next three to five years.B次元官网网址�

The ICU

McKee included a photo of the ICU in Salmon Arm taken a week prior.

ItB次元官网网址檚 a three-bed unit, with two beds on one side and a third bed behind a curtain on the other. ThereB次元官网网址檚 patchwork duct taping on the plastic walls and the plastic doors. He said vents were rigged up at the time of Covid to create a pseudo negative pressure space that vents outside the window on top of the emergency room bay.

B次元官网网址淚tB次元官网网址檚 an archaic failing space,B次元官网网址� McKee described the unit, adding the hospital is also a site for the UBC internal medicine training program. He said the Salmon Arm program is at risk because the hospital can no longer really accommodate the trainees with a functional working space.

B次元官网网址淪o this speaks to the need for the structural modernization of this ICU space that has really been untouched since maybe the B次元官网网址�80s.B次元官网网址�

McKee said critical care is now sometimes carried out in other parts of the hospital such as emergency rooms with critical-care facilities, or the recovery room, which can mean mismatched skill sets in terms of medical staff.

B次元官网网址淓mergency department backlogs speak for themselves. We have 14 beds at the best of times in our ER. Many days we will have nine or 10 or 13 of them filled with admitted patients. Many of them are ward patients, but sometimes theyB次元官网网址檙e critical- care patients that need hour-by-hour monitoring and intervention.B次元官网网址�

Salmon Arm sometimes must transfer critical-care patients to larger hospitals if it canB次元官网网址檛 manage them.

B次元官网网址淭hey tie up a bed in Kelowna and they still wait three or four days for their procedure in an ICU or a step-down bed in a tertiary hospital. ThatB次元官网网址檚 not good for anybody.B次元官网网址�

He said there is no simple solution with an aging building and skyrocketing construction costs.

B次元官网网址淭hereB次元官网网址檚 not a revolution here, thereB次元官网网址檚 not a magical solution weB次元官网网址檙e going to snap out of the skyB次元官网网址�

B次元官网网址淲eB次元官网网址檝e been complaining just long enough and just loudly enough lately, that everyone has visited our campus. They understand what weB次元官网网址檙e up against. We have letters of support from other regional partners. But we need to find a way to get Salmon Arm out of the danger zoneB次元官网网址� before we irretrievably lose these services or something happens to our ICUB次元官网网址� and itB次元官网网址檒l close and we wonB次元官网网址檛 have anything to do but wait for many more years and then hope that we can recover the staffing resources that we need.B次元官网网址�

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Allison Howatt, chief of staff at SLGH, added what she described as clarifications to McKeeB次元官网网址檚 presentation.

She said there is still a master plan and a secondary plan.

B次元官网网址淣othing was cancelled, but nothing was approved. So we didnB次元官网网址檛 have anything taken away, we were just never given anything we thought we were going to get,B次元官网网址� she said.

B次元官网网址淲e have a set amount of money to do something at Shuswap Lake. It was not enough to cover all the things we had wanted. ThatB次元官网网址檚 why the project got skinnied down to just the surgical redesign. And that project is underway, albeit slowly, but itB次元官网网址檚 underway. With the hope that those renovations will start in the fall of 2024. But weB次元官网网址檙e in the planning stage.B次元官网网址�

Howatt said the HAU (ICU) is a priority, B次元官网网址渂ut our entire hospital space allocation is an issue. We have way more things we need to do with our space than we have space to do it. ThatB次元官网网址檚 the huge issue.B次元官网网址�

B次元官网网址淭here are many services that are at a tipping point, as they are all across IH,B次元官网网址� she said. B次元官网网址淥ur maternity services are grossly underfunded and theyB次元官网网址檙e at a tipping point. Our emergency services, in terms of our person power for both nursing and staff and ER docs, is at a tipping point.

B次元官网网址淚f we donB次元官网网址檛 get any improvements to our site, then it becomes less and less easy to attract people to come to Salmon Arm despite it being a pretty nice place to live.B次元官网网址�

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Howatt also pointed to inequities in funding for SLGH.

The hospital is funded for the Salmon Arm community, but she estimated that 50 per cent, if not more, of patients from Enderby come to Salmon Arm. However, Enderby is 100 per cent funded to receive health care in Vernon.

She also pointed out that Salmon Arm has a B次元官网网址渧ery robust group of family doctorsB次元官网网址� who look after patients from Enderby, Armstrong, Kamloops, Chase and other areas, yet the financial support goes to bigger hospitals in Vernon or Kamloops.

Coun. Kevin Flynn said Salmon Arm council reps on the Columbia Shuswap Regional District board go twice a year to the North Okanagan Columbia Shuswap Regional Hospital District board meeting. He said they B次元官网网址済et told our taxpayers as a group will pay 40 per cent of this, this, this, this and this. And IB次元官网网址檝e been here 18 years and IB次元官网网址檝e felt that that process is a rubber stamp and I really appreciate you saying that we need to be more vigilantB次元官网网址�

B次元官网网址淚 think we as a council need to figure out what our steps are. I think we as a hospital district need to figure out what our next steps areB次元官网网址�B次元官网网址�

B次元官网网址淭hat tower in Vernon, the two extra rooms, the psych ward being talked about in Vernon, I canB次元官网网址檛 argue that those arenB次元官网网址檛 important to all of us, but I can argue that Shuswap Lake has been under-servedB次元官网网址�B次元官网网址�

B次元官网网址淭hereB次元官网网址檚 been lack of communication and I really have to thank you (Dr. McKee), and Coun. Lavery, for opening up this discussion because itB次元官网网址檚 time for the residents of the Shuswap to speak upB次元官网网址�B次元官网网址�

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Flynn also noted that city taxpayers will see a hospital district tax on their city tax notices. That goes to the province and Ministry of Health, not the city. He said any hospital improvements in the regional hospital district are funded 40 per cent by the hospital district.

The North Okanagan Columbia Shuswap Regional Hospital District consists of Salmon Arm, Revelstoke, Sicamous, Enderby, Spallumcheen, Armstrong, Lumby, Coldstream, Vernon and CSRD Electoral Areas B, C, D, E and G and RDNO Electoral Areas B, C, D, E and F.

In response to council questions, McKee remarked: B次元官网网址淲eB次元官网网址檙e not proposing that we march on the streets or have a special save-the-hospital dayB次元官网网址� WeB次元官网网址檙e all trying to stay away from drama and hyperbole. These are practical real-world problems. There are hard-working people on both sides of the coin. We need to work together and find a way to help them keep our particular hospital afloat. WeB次元官网网址檙e not talking about an expansion or growth or some new unit. WeB次元官网网址檙e just trying to maintain a quality service and hope that it grows from there as the community grows as well.B次元官网网址�

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Coun. Tim Lavery outlined how Dr. McKee approached him, Mayor Alan Harrison and Coun. Flynn just after the election. They had further meetings with MLA Greg Kyllo, SLGH administration and Interior Health. However, it was too late as the regional hospital district had its budget meetings early in the year.

B次元官网网址淭he issue has been raised with them; the criticism is that folks thought there was a plan. Medical staff thought there was a plan to proceed, it was taken off the table and no one knew.B次元官网网址�

Lavery said McKee has highlighted B次元官网网址渋ncredibly well that the ability to retain the service, to retain and attract staffing is at a critical level. He would not be here without that.B次元官网网址�

Lavery termed it a regional issue and asked that McKee take his presentation to the Columbia Shuswap Regional District (CSRD), which Flynn chairs. He noted that while the regional hospital district is not just the CSRD, B次元官网网址渨eB次元官网网址檙e hearing loud and clear a message about prioritization for here, and we need to advocate on that.B次元官网网址�

Mayor Alan Harrison began his comments by saying he hears all the time from residents how much they value the human care and compassion they receive at the hospital B次元官网网址� and the discussion is not about that but about physical structure.

Both he and Lavery thanked McKee for his courage in bringing the issues forward.

B次元官网网址淚t seems to me that the North Okanagan regional hospital board doesnB次元官网网址檛 work. That process doesnB次元官网网址檛 work for us,B次元官网网址� Harrison said, emphasizing meaningful input isnB次元官网网址檛 happening.

Harrison said while there is a lot of talk about plans, B次元官网网址測ou have to have a financial plan to pay for the result of the plan. And that part seems to be missing.B次元官网网址�

He said council needs to become more vigilant.

B次元官网网址淲eB次元官网网址檝e lost faith in the process of the system bringing capital improvement to our hospital. The best way to make that happen is to make residents aware.B次元官网网址�

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