March 17, 2023: A total of 15 joined this ASK Salt Spring gathering for all or part of the time to welcome , Erin Price-Lindstrom, recently replacing Sara Gogo, (now leading the Tofino hospital) as the Site Director of Lady Minto Hospital, (https://ladymintofoundation.com/news/the-road-ahead-lady-minto-hospitals-new-site-director-discusses-challenges-and-opportunities/). After our Territorial Acknowledgement, Erin spoke briefly of the challenges and opportunities in her multi-hat position, stretching to include, the operational oversight of our hospital, the outer Gulf Islands, and ensuring critical liaison with Island Health initiatives. Beginning with her first day, in September 2022, this position has been marked by change as well as the recognition that her leadership through much more change ahead is needed. 

Erin described the strength of Lady Minto being the dedicated team of interdisciplinary staff who have continued to navigate many challenges through the pandemic and, more recently, through health-care worker staffing challenges that are occurring locally and across the country. Such challenges inspire a system-wide re-evaluation of how our local and regional health care teams need to adapt and work together differently to deliver consistent, high quality health care services for Salt Spring patients and families. 

She and her team are beginning that process of questioning long standing ways of doing things, seeking, instead, to cultivate an integrated site model and a resilient team ready to provide seamless, patient-centred care for our families. While this focus is often upon front line health care professionals, Erin reminded us that this team also incudes facilities, housekeeping, laundry, and dietary workers as well as the staff providing administrative support for the full team. All team members are critical to success.

Erin comes to the role following a 15 year clinical career as a Registered Midwife and several years spent leading policy teams in the Population and Public Health Division, BC Ministry of Health. We learned from her that midwifery is one of the world’s oldest professions as well as one of BC’s newest regulated professions, having been regulated since 1998. With years of clinical experience in many rural communities and the Fraser Valley, as well as several years delivering babies here on Salt Spring, Erin is well-prepared and invested in taking on the many challenges of providing accessible, high quality care in our small, rural community. 

Acknowledging many care providers working under different contracts with different organizations, Erin seeks a more integrated and easily-accessible system for all healthcare needs. A possible vehicle for the seamless care is a Primary Care Network (https://pcnjobsbc.ca/?gclid=Cj0KCQjwn9CgBhDjARIsAD15h0AHc4avJI1eWezsYR9gyK2G6HpmT-yEuJi5fmvVBbdnPzOm4f0XJpsaAvv7EALw_wcB). Comprised of an integrated team of professionals, Primary Care Networks (PCNs) focus on providing each patient with a more seamless, patient-centred network of care. Markedly different from what can often be experienced currently as a siloed range of services, getting there requires a serious rethinking of how we better coordinate and deliver care.

While rethinking the logistics of our health care system is complex, Erin sees great possibilities. She envisions a model that provides clear and seamless referral pathways and support for patients and families navigating the system. Having an integrated team provides increased opportunities for patients to access continuous care based on patient/caregiver relationships. This team would understand what level of care is needed, reducing the need for patients (or families) to try to find that appropriate level of care themselves. Patients and families would not have to explain the problem over and over again to a series of different health care professionals. The promise of PCN, in Erin’s opinion, offers improved continuity of care, as well as a broader reach of care and opportunities for patient attachment than in our current system. 

Will Salt Spring get a PCN? Possibly, but it’s too early to say. There is significant work underway to support the development of a local PCN in conjunction with community partners and the Ministry of Health. Erin noted that much still needs to be done before integrating a PCN in our community. While an exciting initiative, Erin described that this is a long game with much work to do to build this more integrated service model on Salt Spring. 

Passionate about this opportunity to rethink our health care delivery, Erin also has so many other critical responsibilities, including participating in the oversight of the major renovation of our Lady Minto Emergency facility. We learned that completion of this exciting project is expected by this summer with opening expected in October 2023. This is exciting news and a culmination of the good work of the Hospital Foundation and the generosity of Salt Springers. 

Erin addressed a concern from a hospital volunteer: While acknowledging the caring and competent care patients are given, this volunteer noted that that a number of the acute care beds in the hospital appear to be occupied by patients who may be better served in an assisted living or long-term care environment. Erin agreed. Appropriate level of care for long-term patients is a challenge province-wide. This does not exclude Lady Minto Hospital. 

To try to cope with this challenge, Erin told us about plans this year for a Minto Makeover, with support of the Lady Minto Hospital Foundation and the Lady Minto Hospital Auxiliary. This is a project to brighten up and add comfort to patient- and family-oriented hospital areas, with an emphasis upon refreshing the lounge areas for patients, families, and volunteers, especially for those requiring an extended length of stay at Lady Minto Hospital.

Erin reminded us of another unanticipated role for Lady Minto due to primary care challenges: As a result of the many Salt Spring families who have no doctor, our hospital is serving as their only source of medical help. Despite this added pressure on our hospital, we learned from Erin that our local emergency room wait times continue to be significantly shorter than most other sites.

While staffing is an on-going challenge, there is some good news: Lady Minto Hospital continues to hire new health-care workers and efforts are underway to recruit and retain more. While the nursing shortage remains headline news, it is important to note that Lady Minto and all health care relies on a broad team that includes administrative support staff, laundry, food preparation, and housekeeping. Anyone interested in a career in health care can find a position on Salt Spring.

A participant wondered how many in our community knows that anyone wanting to become a health care aid can get free training (https://www2.gov.bc.ca/gov/content/employment-business/job-seekers-employees/find-a-job/health-care#HCAP). While many in our community may not know of this opportunity, Erin was very familiar with it, telling us that several in this training program are currently at our hospital. Pass the word! We were reminded that we, as a community, need to better acknowledge and appreciate the value of the dedicated work done by Health Care Aides at Lady Minto. 

Concerning job training, a participant reminded us that WorkBC, located in Community Services, is available to help with training and job seeking (https://workbccentre-fulford-ganges.ca/). As Erin said: please put the word out-We are always hiring!

LMH also benefits from the generous support of hospice and Lady Minto Hospital Auxiliary volunteers, which were services that were greatly impacted and reduced during COVID. These important, hard-working groups would greatly benefit from an increase in volunteers.

Recognizing the scarcity of housing as a major deterrent to filling vacancies, Lady Minto Hospital does a number of things to address this hurdle: 

• A full-time administration position has been created at Lady Minto Hospital to help newly recruited and short-term staff to navigate housing issues. 
• A resource list matching available rentals with hires is maintained and supported by the Lady Minto Foundation
• Working with owners, several housing units are maintained to support short-term staff housing needs, and
• The Lady Minto Foundation’s purchase of the Seabreeze Inne will eventually offer housing for 18 permanent hospital staff members. (While some would have liked to further discuss the current challenges surrounding Seabreeze, we were reminded that it is work led by the Foundation and not something Erin is in a position to discuss.) 

As 1:00 was approaching and a number had left to address their other responsibilities, we spent the last 15 minutes together talking casually. We learned about a participant’s experience with some amazing home support in a larger, urban area, and discussed the need for increased home care supports on Salt Spring. Another participant wondered whether the recent increase in doctors’ salaries (https://vancouver.citynews.ca/2022/10/31/bc-health-new-pay-model-doctors/), also applies to hospital privileges, and, if not, would this make it harder than ever to recruit doctors for work in our hospital? And, we even had a moment of levity, acknowledging that wonderful series, Call the Midwife(https://en.wikipedia.org/wiki/Call_the_Midwife#Episodes)!

Applauding Erin for her optimism, aplomb wearing so very many hats, hard work, commitment to team building, and willingness to take up that challenge of rethinking how we locally network to better deliver health care, we left with appreciation for Erin and all her good work. (Thanks, Erin!)