02/01/2023
Country Hospital Community Conversation
January 31, 2023
What We Heard Summary
On January 12, Alberta Health Services (AHS) hosted a community conversation to discuss the temporary closure of the Big Country Hospital’s 10 inpatient beds and restricted hours for the Emergency Department (ED). Over 500 community members from Oyen and the surrounding area gathered to express their concerns and provide input to AHS representatives.
Current Situation
We know the importance of maintaining a hospital in your community given its geographical location and have no plans for closing the facility.
As a result of significant staffing challenges, AHS made the difficult decision to temporarily close the Oyen Big Country Hospital emergency department daily from
7 p.m. to 7 a.m. which began on January 16.
The ED is open from 7 a.m. to 7 p.m. with nursing staff on site and a physician on call.
The lack of nursing staff also resulted in the temporary closure of the 10 acute care beds at the facility. Inpatients were either discharged or transferred to another facility.
This is a temporary measure and AHS is working to ensure local residents continue to have access to the care they need during this time. Nursing staff will remain on-site overnight providing care for long-term care residents. AHS will reopen the ED and acute beds as soon as we are able to do so safely.
As communicated at the engagement session, we now have an interim site manager in place and the previous site manager will not be returning to the role. We have begun the recruitment process for a new permanent site manager.
AHS will continue to communicate with the residents and families, and will be connecting with community leaders and agencies.
By working together, we remain optimistic that we will be able to secure the staffing needed and reopen the ED and acute care beds as soon as possible, and to have them remain open for many years to come.
An apology to the community
We understand that there have been longstanding issues at the site, and I’ve been reflecting on how we got here.
Over the last decade, as we have settled into becoming the South Zone within Alberta Health Services, we’ve had a number of leadership change at the various levels above our site manager. With this, has brought inconsistencies and a lack of continuity contributing to the current situation.
Please accept my sincere apology. We strive to do better. You deserve better.
Our hope is that we can move foward together.
We know we have work to do. I’m committing to you that we’re going to put in the work with your support to get to a better place.
Thank you for being here, for being passionate about your community, and for working with us to get Big Country Hospital services re-opened as soon as possible.
Linda Iwasiw, Chief Zone Officer, AHS South Zone
What We Heard – Oyen Big Country Hospital Community Conversation
Updates
A public service announcement was issued last week sharing that we have collaborated with our local physicians and EMS teams to support patients locally, when possible, between 7 p.m. and 7 a.m.
Following a 911 call during these hours, EMS teams will work collaboratively with the on-call physician in Oyen to determine the patient’s needs and whether they can be treated locally and released or transported to another emergency department.
Concerns we heard
Temporary closure
Q: Weareconcernedthatthisclosurecouldbecome
more permanent. We have seen other programs, such as labour and delivery, shut down and reopen multiple times in this community over the past 20 years. Is this going to be the case with the hospital?
Q: Howtemporaryisthistemporaryclosureexpectedto be?
A: We know the importance of maintaining a hospital in your community given its geographical location and have no plans for closing the facility. It is our goal to safely reopen as quickly as possible. Timing is dependent on staffing levels.
Access to care
Q: Wearealongwayfromeverywhere.Ittakesalong time to access care.
Q: Aren’totherEDsunderthesamestrain?Canwebe guaranteed we won’t be turned away?
A: Facilities in the region around Oyen are prepared to see and treat patients as needed. The ED averages 30 visits per month between 7 p.m. and 7 a.m. or approximately one visit each night.
Workplace culture
Q: Whydidittakesolongtomakethesechanges?The staff and community have been calling for change for a long time.
A: We take full responsibility and accountability for the situation that has evolved at the Big Country Hospital and apologize for the time it took to make changes.
Q: There has been lots of hurt, and the management changes have been long in coming. What efforts will AHS leaders and the new management take to rebuild staff confidence and trust? How can staff be assured that, going forward, their concerns will be taken seriously?
Q: WillAHSreachouttothenurseswhohaveleft? Retired nurses and former nurses who quit or left the hospital should be contacted.
A: In order to better understand the hospital environment our interim site manager, supported by our Rural Director and Human Resources, is in the process of connecting with current staff and extending an offer to former
Contact us:
AHS Community Engagement
E: community.engagement@ahs.ca
Accessing care during the service disruption
AHS is committed to providing care to residents during this temporary service disruption at the Oyen Big Country Hospital.
• Patients are asked to call 911 if they have a medical emergency. EMS calls will be re-routed to another ED to ensure residents have access to the emergency services they need.
• Following a 911 call between
7 p.m. and 7 a.m., EMS teams will work collaboratively with the on-call physician in Oyen to determine the patient’s needs and whether they can be treated locally and released or transported to another emergency department.
• Patients seeking care during the closure in Oyen can access emergency services anytime at: o Hanna Health Centre
o Coronation Hospital
o Provost Health Centre o Brooks Health Centre o Medicine Hat Regional
Hospital
These facilities are aware of the situation in Oyen, and are prepared to accept patients from the area.
• Residents can also call Health Link at 811, which is available 24/7 for non-emergency, health-related questions. Individuals requiring non- emergency medical care are also encouraged to call their family physician.
2
What We Heard – Oyen Big Country Hospital Community Conversation
employees, offering the opportunity for an exit interview to discuss their previous concerns and advise for better future.
Recruitment challenges
Q: Howmanyvacanciesarethere?Howmanystaffneedtobeinplacebeforethehospital can open again? How long will this take?
A: For the ED and Acute beds, we are recruiting for five part-time Registered Nurses (RN) and one Licensed Practical Nurse (LPN). In long-term care, we are recruiting for one full-time and two part-time RNs, along with one full-time Healthcare Aid (HCA). Once stabilized staffing is in place, the Big Country Hospital services will be reopened asap.
Q: Whyareyouadvertisingpart-time?Shouldn’ttheserolesbefull-time?
A: Our leadership and human resources team are willing to adjust the number of hours should an interested party want full-time hours.
Q: Whereareyouadvertising?Howcanpeopleapplyforpositions?
A: All opportunities available for interested applicants on the AHS Careers webpage. We also encourage you to reach out to the interim site manager directly at andrea.ames@ahs.ca.
Q: Howareyourecruiting?Areyoujustlookingfornurses,orotherhealthcareworkerstoo?
A: AHS is actively recruiting for all healthcare disciplines locally, provincially, nationally and internationally. Here are a few of the strategies that we are currently using:
• AHS has created a provincial posting for LPNs and RNs with a focus on rural recruitment.
AHS’ Talent Acquisition has created a rural landing site on the AHS Careers webpage to
highlight opportunities in rural communities.
• AHS commenced in September of 2022 a Health Care Aide (HCA) initiative province wide
where we will provide a person the education and training to get their HCA designation while
working.
• AHS meets regularly with post-secondary institutions. Our Talent Acquisition teams
participate in career fairs at colleges and universities across the province, Canada and internationally. Talent Acquisition speaks to all Alberta post-secondary graduating nursing classes to highlight rural nursing opportunities.
• AHS has a comprehensive recruitment campaign to attract and retain internationally educated nurses.
• Agency Nurse utilization is a short-term strategy for critical shortage areas.Oyen has, and continues to utilize, agency nurses to enable the facility to remain open and running while we recruit to permanently fill our lines.
We currently have two agency nurses providing staffing support at the hospital and have requested up to three additional agency nurses to assist with stabilizing our staffing situation. We have put in a request for internationally educated nurses currently being recruited by AHS, although we do not anticipate a start date prior to the fall.
• AHS is also working with government to build our nursing workforce overall, including signing new collective agreements this year for RNs (UNA) and LPNs (AUPE). Those agreements have established Rural Capacity Investment funds (RCIF) that will be jointly administered by AHS and the unions to address rural recruitment and retention challenges.
The RCIF will support recruitment and retention initiatives to grow capacity and nursing staff at rural sites, such as Big Country Hospital. So far over $17 million annually has been committed to support recruitment, retention and relocation to sustain our workforce over the long term in the North, Central and South Zones.We look forward to working with our unions through the RCIF to build capacity and improve recruitment and retention in our rural and remote units, sites and programs.
Contact us:
AHS Community Engagement
E: community.engagement@ahs.ca 3
What We Heard – Oyen Big Country Hospital Community Conversation
Q: NoonewantstocometoOyen.Itneedstobeknownthatnewmanagementisinplaceand that Oyen is a good place to work. How are you going to rebuild the Oyen Hospital’s reputation?
A: AHS is committed to working with the Big Country Hospital staff and physicians to improve the working environment and positively profile and promote the site with our partners.
Q: Weneedtogrowourown.Highschoolclassesthatwerepreviouslyinplacehavebeen cut. Will AHS advocate for this program to be reinstated?
A: We believe in the strength of collaborative training programs with high school students. As of Sept. 1, 2022, AHS offers a training program for uncertified HCAs (in permanent full or part time positions in rural or remote areas of Alberta) to become certified. Through the program, newly hired uncertified HCAs will receive orientation and support to enroll in a licensed HCA education program. The program enables HCAs to continue working while earning their certification. The program takes about 8-12 months to complete, and the tuition is covered by AHS. If you’d like to become a HCA and earn your certificate while you work, click on the link below to explore our job postings. If you have questions about the program, please view the HCA Training Program Primer or contact hca.info@ahs.ca.
Q: Onechallengewehaveheardisthattherearenoaccommodationsforrecruits.Howto address this? What incentives are being offered to bring healthcare workers to our community?
A: We are working closely with community leaders to ensure accommodations will be available to those who are not from the region.
EMS coverage
Q: Withtheclosureofthehospital,weareconcernedthatlocalEMSstaffwillberequiredto take on an even heavier workload.
A: We are closely tracking EMS calls since the temporary closure began Jan. 16. The ED averages 30 visits per month between 7 p.m. and 7 a.m. or approximately one visit each night.
Q: Whataboutambulanceswehavetwobutonlyoneoperational–willAHSbelookingfor more EMS staff? Is there a guarantee there will be an ambulance in the community?
A: EMS is committed to the full staffing in Oyen in the coming months and keeping an ambulance
stationed in the community.
EMS is also doing all it can to find and hire paramedics: Since January 2022, EMS has hired 457 new staff members (from January 1, 2022 – December 31, 2022) including 341 paramedics. Looking over the longer term, 2,763 paramedics were employed by AHS as of December 2019. As of December 2020, AHS employed 2,844 paramedics and in December 2021 2,991 paramedics were employed. As of December 2022, 3,075 paramedics are employed by AHS. From 2019 to now, this is an 11.2 per cent increase.
Communication
Q: Whenandhowwillyoubecommunicatingwiththecommunity?
A: AHS leadership will be providing regular updates to community leaders about the ongoing status of services at Big Country Hospital. When we have updates, we will be sharing with community via the channels that we have shared this What We Heard document.
Contact us:
AHS Community Engagement
E: community.engagement@ahs.ca 4
What We Heard – Oyen Big Country Hospital Community Conversation
Thank you and Next Steps
On behalf of Linda Iwasiw, Chief Zone Officer and Dr. Aaron Low, Zone Medical Director, we want to thank the residents of Oyen and surrounding area for your continued committment to healthcare.
We want to remind you that the closure of the ED and acute care beds is a temporary measure. It remains our goal to safely reopen as soon as possible, and the timing is dependent on staffing levels.
AHS is actively recruiting RNs, LPNs, an HCA and a site manager, and working on retention strategies to address challenges in rural communities. We will continue to meet with current and past staff to learn more about what we can do to improve the site.
A shared commitment
Alberta Health Services, the Town of Oyen, the Special Areas and the MD of Acadia #34 have committed to continue working together, through this service disruption and beyond.
Through this collaboration we will regularly come together to foster and build upon what we already have in the community, maintain a sustainable workforce and keep the Big Country Hospital open and available to the communities within this region.
