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SJHH / Our Stories/ Fiscal Sustainability


St. Joseph’s Healthcare Hamilton is maintaining access to quality care during budget saving strategies

St. Joseph’s Healthcare Hamilton is proud of the care we provide every day to patients in Hamilton and this community. We’re also proud of the people doing that care.

So it’s with very careful consideration that we make decisions about changes to care. We have had to do that as we balance our budget for March 2017.  Rest assured, quality patient care is our number one priority and you will continue to have access to required hospital services.

We will be making changes in how care is delivered, where it is delivered, and who is providing care. Our staff and our doctors are here for you.

Please read further about how we will continue to provide quality care while ensuring we are a cost-efficient hospital.

Financial pressures on hospitals are an Ontario-wide issue

Healthcare takes up about 42 cents out of every dollar of the Ontario budget. As a result, for the past four years hospitals have not been receiving any increases in base operating funding to compensate for inflation. We anticipate the same for next year.

Hospital costs rise each year due to increases in wages, benefits and costs associated with running facilities, such as heat and hydro. Hospitals must find a way to pay for those increases each year, and this creates a funding gap.

Additionally, hospital funding has changed in recent years, so that, based on a number of factors such as population growth and type of hospital service provided, many hospitals have also experienced changes in funding.

There has also been a movement in Ontario to change the model of care from one that is hospital-based to one that is community-based.

St. Joseph’s Healthcare is seeking $26 million in cost-savings to balance its budget for March 2017

St. Joseph’s has an annual total budget of $550 million. Due to inflation and changes to funding, we have a gap in funding that amounts to $26 million. Most hospitals, including St. Joe’s up until this year, work on a one-year budget plan. This year we are working on 2 years instead of 1 so that we can plan for a longer term. We are doing thisbecause the degree of change required to achieve sustainable savings requires careful forethought, planning and time to implement.We are seeking $26 million in cost savings for 2015/16 and 2016/17.

We make decisions by putting our patients first

Our job is to take care of patients. We make changes by trying to find the best way to take care of patients in a safe and cost effective manner. You may experience a change in the way you get care, or you may be cared for by another qualified professional, or the location of your care may change.  You will continue to get quality patient care from expert doctors and staff for all services required by our hospital.

We have tried to minimize the impact on our staff

Cost saving strategies will affect 136 staff. St. Joseph’s Healthcare Hamilton workforce has 5,528 staff and physicians. We have tried to minimize the impact on our staff through a number of measures. We will be making early retirement offers, managing vacant positions and working with unions to try to ensure most of the affected staff who want to stay at St. Joseph’s will remain here. We believe the final impact on staff will be 30-40 people or less. Every one of our staff makes a valued contribution to St. Joseph’s.

We first sought cost-saving measures that would not impact people or programs

We first looked at ways of finding cost savings that would not impact any services or staff. We looked to increase revenue, reduce avoidable expenditures, renegotiate supply contracts with vendors, and reduce duplication of efforts and services.

For example, we will be renting rooftop space on buildings at our West 5th and King Campuses to place solar panels to generate revenue.

We asked staff and physicians for ideas on cost savings and they generated ideas such as less expensive supplies that are of equal quality.

An example of this is the Operating Room staff who identified that the use of metal nozzles to administer sprays of local anesthetic to the back of patients’ throat cost $21 for a package of 2. A plastic version of the spray nozzle was sourced which costs $1.84 each. The overall savings is $200,000 annually.

In addition, we have been renegotiating contracts with vendors, creating significant annual savings.

We’re making changes in where care is provided, who is providing care, and how care is provided

Changes that we’re making include:

Right caregiver for the right patient at the right time – We’re hiring 38 registered practical nurses where appropriate to provide care for patients in the right setting. These are qualified, trained nurses appropriate for the patient population they are serving. The nurse to patient ratio will remain the same in inpatient areas where we have made this change. Registered nurses and registered practical nurses are part of a healthcare team in a hospital, all there to play a role in patient care.

Changing the way we provide care - Where it makes sense as a method of delivering quality care and finding cost efficiencies, we are changing how we deliver care. Patients will experience changes in care delivery but the quality care will remain the same.

An example of this our Respiratory Rehabilitation Program which will be changing from an inpatient program to an outpatient program. This is a model used in other hospitals.

Examining the use of best resources - We need to ensure we are using our limited resources on services that need to be provided in hospital, and require our resources. For example, we will no longer be operating a Day Therapy Program. While important work was done, this service is generally not provided in hospitals and services are available in the community. This fits with new models of community-based care.

Patient and staff safety is a priority for St. Joseph’s Healthcare

Patient and staff safety remain a priority at St. Joseph’s Healthcare Hamilton. There is nothing in this budget that will in any way reduce the safety of our patients and staff.

To help ensure this remains the case, these budget strategies will be monitored and measured to ensure St. Joseph’s continues to maintain quality care and a safe environment.

Please talk to your healthcare provider if you have any questions about these changes.