We don‘t have to look too far back in the records to see the dramatic change. Only four years ago OTMH was operating with 333 acute care Gone are the days of extended hospital stays for minor procedures. Even those who do undergo surgery are, in most cases, encouraged to begin rehabilitation immediately following surgery. With improved technologies, advanced drugs and sophisticated professional staff, the outcomes of most hospital visits are more positive, less painful and less stressful. How has Oakvilleâ€"Trafalgar Memorial Hospital (OTMH) fared amidst the closures, layoffs and other doom and gloom news? Many patients and families expect things to be the same as "When | was here 10 years ago." The truth is that things are not, and will never be the same again. here‘s no denying it, health care in Ontario is changing. The increased focus on shorter lengths of stay, reduction in acute care beds and the financial squeeze that all hospitals are facing are all contributing factors to this change. Improving the quality of health care A Total Quality System measures the quality of the delivery of health care and improves the level of performance and interaction with patients and their families in all of the Hospital‘s departments and services. ) ) ) ) ) > > p » > > p p Total Quality is a comprehensive system of managing and moving an organization toward excellence. In striving to achieve 100 percent quality, OTMH will increase patient satisfaction through a better method of health care delivery. This will mean better patient perception of the health care which they are being provided. In light of the Hospital‘s new focus in obtaining total The use of interdisciplinary teams "We are in the business of caring," said Mary Ellen Nicholsonâ€"Vidette, Administrator of the Total Quality System. "Anything less than a commitment to high quality performance by ourselves is a disservice to all our patients and particularly to those patients who place themselves in our hands every day." Ms Nicholsonâ€"Vidette recently joined Oakvilleâ€" Trafalgar Memorial Hospital to introduce, implement and administer a Total Quality Improvement System. _ is that Oakvilleâ€"Trafalgar Memorial Hospital is developing and implementing a Total Quality Improvement System. The good news for Oakville and Clarkson Total Quality Improvement means that all hospital staff, when undertaking a task, must strive for 100 percent quality in their performance. is essential to Total Quality Improvement. Health care today has changed As part of the recovery process, patients are encouraged to do as much as they can for themselves ie. a patient who is comfortable and able to be mobile without help, should be able to keep track of his own intake and output. Other practices, such as a full bath every day for every patient "whether they need it or not" are neither necessary or practical. One individual may require washing several times a day for comfort or skin care, while another requires only a partial bath. One of the areas reflecting the dramatic changes in technology is the change between inpatient and outpatient procedures. Four years ago the ratio between inpatient surgical procedures and outpatient procedures was 60/40. Today, the ratio is 30/70. beds; today we are functioning with only 277 open beds. Four years ago, we admitted 14,000 patients and recorded 95,000 patient days. Today, while we have admitted 15,000 patients, our patient days have decreased to 83,000, which reflects the decreased length of stay for most patients. The answer lies in teamwork. All members of the health care team at OTMH will be called upon to assist in reducing repetition of effort, inefficiencies and sometimes cumbersome managerial systems. Problems which recur time and time again will now be tracked and dealt with in a manner which will prevent recurrence. The Ontario Ministry of Health‘s new quality service, OTMH has been accepted by the Canadian Council on Health Facilities Accreditation to participate with a small group of other Ontario hospitals in a Quality Improvement pilot project. It is certainly a privilege for the Hospital to be included in this project. There is no denying that health care is in a state of transition. How can this major refocus be achieved with shrinking health care dollars? What about the patient? What about the family? The focus of the health care system is shifting towards less hospitalization and more outpatient procedures: from treating disease to promoting ° wellness. The challenge for hospitals and for the public they serve is to work together to make the health care system, with its admitted problems, work for them. OTMH will be at the forefront in the double goal of increasing the quality of patient care while reducing operating costs. We have accepted an ambitious challenge, but with our dedicated team of Hospital medical staff and employees, we are quite confident of meeting the challenge of Total Quality Management. Families‘ involvement with patient care makes relatives feel they are doing something useful and helpful for someone they love. It usually means more involvement with the nursing staff as well. This can lead to more sharing of information and a better appreciation by the staff for what the patient is like when fully recovered. reforms demand a reduction in hospital costs. At the same time, hospitals are striving for Total Quality Improvement. They know that the quality of health care is important to their patients and they have reacted by placing quality of care at the top of the list of goals for the health care industry in the 1990s. Visiting hours are more liberal and families are encouraged to assist with feeding, walking and sitting with patients. The family visits are now perceived as a healthy influence and a major contributing fact to the return of wellness for the patient. In the past, nurses may have been responsible for making families feel they were "in the way" Now, nursing staff take a different approach. members can be of help, especially with the elderly patients, who may become confused while in hospital. What of the future?