A message from the HHHS Board of Directors

• HHHS has experienced a significant number of near Emergency Department closures due to health human resource shortages
  • There is formal protocol for reporting physician shortages, and over 20 reportable near-miss closures offered at the Haliburton site.
  • However, many, many more near closures have occurred as a result of nursing shortages at both EDs, but these aren’t recorded the same way
    • Both doctors and nurses are required to keep an ED open
    • This is primarily about the nurses, not the doctors
       
• Nursing shortages globally make recruitment of qualified staff incredibly difficult
  • Nursing staff attrition rates are high due to many nurses leaving the profession as a result of stress and burnout, or more lucrative offers elsewhere or retirement/change of careers and these challenges continue to accelerate
     
• Existing hospital staff are stretched beyond limits
  • The constant environment of always “fighting fires” has increased stress to unbearable levels
    • The toll on our existing nursing staff has become untenable
       
• Near misses on ED closures occurred over this past winter, not just last summer and were becoming more frequent in nature
  • It would likely be impossible for an ED closure not to occur this summer in peak season without some pre-emptive action being taken
     
• The physician coverage model is different between the two sites
  • The Minden doctors made it very clear that if the Haliburton ED were to close, the Minden ED would close as well because of safety concerns due to their staffing model
    • If no action was taken immediately, we would be without any ED in all of Haliburton County this summer – with no notice
       
• All hospitals in Ontario, including HHHS, are bound by the Ministry of Health (MOH) funding rules
  • Funding for core hospital operations, including all forms of compensation for nurses can only come from MOH
  • MOH only funds regular nursing salaries and provides no funding for higher rates charged by nursing agencies which provide temporary nursing staff; these agencies were increasingly being relied on to provide nursing staff in order to avoid ED closures
  • Fundraising is not a solution to this crisis, as funds raised from community donations can only be used for capital equipment and non-core services
    • No amount of community fundraising support could be used to attract additional nurses, salaried or agency, through higher compensation or bonuses
       
• Consolidating the two sites does result in efficiencies, allowing for lower overall staffing requirements, especially during non-peak hours overnight when both sites typically see minimal visits
  • No job losses will occur because the staffing reduction will result in using fewer agency nurses and HHHS staff working at the Minden site will be redeployed
  • An ED is required that has access to in-patient hospital beds, and the in-patient department in Haliburton needs access to an on-site physician in case of medical emergencies
  • The Minden site is much smaller and has no in-patient beds; even with extensive and costly renovation, the site would not be able to meet the required capacity
  • The Haliburton ED is more central to our county and is better positioned to serve all county residents & visitors
    • Between the two sites, closing the Minden ED is the responsible action to take to stabilize and reduce the risk of having no emergency department services in Haliburton County
       
• Planning regarding all variations of potential ED closures has been going on since 2021 at HHHS
  • The team knew how to do this effectively
• There are lots of interesting and potentially viable options for the Minden site, which could serve the needs of the local community
  • However, they all require time and a full assessment by knowledgeable teams, as well as necessary approvals from the Ministry of Health
  • We will take the time to fully assess those options and to enlist stakeholder feedback
    • That can’t happen while all energies are focused in the short-term on ensuring a successful transition of ED services, and,
    • Many of the options will still require qualified nursing staff and, as noted above, the recent shortages we have experienced mean that we do not have sufficient staff currently available to support these options
       
• This is a crisis time for healthcare services across the province in general and for our community in particular
  • The risk is not going away in the near term, even with this decision
  • Unfortunately, we will likely see more crises occur before the system has recovered
  • We need to mitigate the risks in whatever way we can to ensure we continue to have a hospital with an ED and other services in our region

This has been a very difficult decision for the Board, leadership, and the staff at HHHS, and we know it has been difficult for the community as well. Our focus will continue to be on the delivery of safe, quality, reliable care for all of Haliburton County.

Thank you to all those in the community who are quietly supporting HHHS.

HHHS Board of Directors