Midwives returning to roots, building the future

The Lincoln Community Midwives are coming home to West Lincoln Memorial Hospital (WLMH).

As announced last week, the midwifery team will be returning to practice at the site on October 3, when the birthing service officially resumes in a 24/7 care model.

“We are all really excited to be coming back to WLMH. It feels like we are returning to our roots while being able to build the future of the program at the same time,” says Pilar Chapman, midwifery site lead for WLMH.

The WLMH obstetrics program has been temporarily redirected to Niagara Health a few times since 2019 as a result of necessary safety upgrades needed at the site, staffing shortages and response to the COVID-19 pandemic. The current redirect has been in place since December 2021, when the fast-moving Omicron variant spread across the site closing all but a few beds to new patient admissions.

Caring for the community

For a time during the program’s redirect, the midwives worked between both WLMH and Niagara Health providing care for patients. However, as the temporary pause lingered, the team made the difficult decision to stay at Niagara until the program could return 24/7.

“We tried working between the two hospital sites for a while, but it was not working well. There are logistical challenges when working between two different hospitals [sites and systems] each with their own processes. There are also concerns around moving patients in labour or with the possibility of being in labour when the changeover between hospitals happened. Most importantly, patients were stressed about the situation and we just decided to stay at Niagara Health until we could come back 100-per-cent of the time,” said Chapman.

The midwifery service has a long history at WLMH, dating back more than 25 years. WLMH was one of the first hospitals in the region to open its doors to midwives. At the time, the hospital had just one obstetrician practicing and the midwives brought additional support and growth to the program. Midwifery practice makes up an integral part of the interdisciplinary team at low-risk-birthing units working closely with obstetricians, family physicians and nursing colleagues.

“WLMH has traditionally offered a low-risk birthing focus. Midwifery care is a great complimentary service as it primarily deals with normal, low-risk births. We’ve had a great relationship with providers at the hospital for a long time,” said Chapman, noting that prior to the recent service changes, midwives delivered 15-20 per cent of all babies at WLMH.

New hospital, new opportunities

Chapman was quick to express gratitude toward Niagara Health and the team at its St. Catharines’ General site for welcoming them into the fold.

“Our team is very thankful for Niagara [Health] opening their doors to our practice during this period. They were very welcoming and our team has a great relationship with their labour and delivery unit.”

Being at the St. Catharines’ site also helped the seven-person Lincoln midwifery team appreciate the benefit of working in a newer hospital, increasing excitement about the soon-to-be rebuilt WLMH and the opportunities it will hold.

“We look forward to continuing to build a program focused on low-risk, normal births. As a teaching hospital, it holds the opportunity for incorporating further research and evidence into our practice. But we will also be able to teach other obstetrical care providers about this important care model, which can help low-risk birthing units thrive in smaller communities,” said Chapman, who also offered that there are very few Level 1B birthing units – WLMH’s designation – remaining in Ontario.

The midwives aren’t the only ones who are eager for the service to return. Many across the hospital community are counting down the days until the midwives resume practice at WLMH.

“We all are looking forward to a new beginning for our WLMH site,” said Dr. Joan Bellaire, WLMH site medical lead. “It is so momentous for us to welcome our midwives back to the WLMH family and to benefit from their knowledge and skill while working together with our obstetricians, family physicians and our nurses to guide our department towards a centre of excellence for low-risk obstetrics. Their decision to come back was critical in the program being able to return at this juncture.”

Teamwork delivers OBGYN; obstetrics program returns to WLMH

If it takes a village to raise a baby, then it took a hospital community to bring baby services back to West Lincoln Memorial Hospital (WLMH).


Last week, the hospital announced that the obstetrics program would reopen to expectant mothers at the site on October 3 with a 24/7 model of care. The birthing service has been temporarily redirected to Niagara Health since December 2021, when the fast-moving Omicron variant spread across the site closing all but a few beds to new patient admissions.


“Returning the program needed a lot of moving parts to come together,” said Dr. Bryon DeFrance, chief of obstetrics and gynecology at Hamilton Health Sciences, providing medical leadership to birthing programs at McMaster University Medical Centre (MUMC) and WLMH. “Bringing the program back took longer than I think anyone really wanted or expected, but there were some necessary pieces which needed to be in place before that could happen. Specifically, we didn’t have a full team of obstetricians and gynecologists.”


The program had been operating with two full-time OBGYNs, which is about two-thirds of the minimum needed for around-the-clock coverage. When fully operational, the WLMH birthing program has been delivering upwards of 900 babies per year. Four full-time OBGYNs is the magic number in terms patient population size, sharing operating room hours and after-hours call responsibility. For comparison, MUMC has 16 OBGYNs for 4,000 annual deliveries.


Recruitment efforts for two full-time OBGYNs have been underway for months. Multiple candidates have expressed interest, however they would need to complete their existing commitments. That means summer 2023 is the earliest the next full-time OBGYN can start.


Bridging the gap


It became clear that short-term coverage would be needed. Hiring a “locum” – which is health-sector speak for a physician hired on time-limited contract – is quite common. Recruitment quickly turned in that direction. Postings went out across Ontario and nationwide. But something was missing.


“People come to WLMH and fall in love with the culture, but they first need to get in the door,” said Dr. Joan Bellaire, medical lead at WLMH. “A particular challenge that smaller community hospitals can have when recruiting specialized positions is a limited pool of qualified candidates nearby. This role requires the candidate to be a short-distance to the hospital when they are covering call overnight and on weekends, which needed some extra thinking on our end.”


The solution? Providing temporary housing accommodation near the hospital to remove that concern for potential candidates. And for help, the hospital turned to its trusted partner.


“We are completely aligned in our role to support the entire hospital with what it needs,” noted Pamela Ellens, executive director at West Lincoln Memorial Hospital Foundation (WLMHF). “With respect to the obstetrics program, we have given close to $600,000 over the past five years based on the hospital’s equipment requests.”

“It was only natural that we would continue to support this vital program, so the WLMHF Board approved a grant to help with recruitment efforts,” said Kevin Antonides, WLMHF Board chair. “A provision for on-demand accommodations when overnight call coverage is needed is being generously provided by a WLMHF Board member who owns a nearby hotel. We know how important this program is to the site and the entire community. We were proud to be able to help out in this way.”


Babies coming back


The collective effort and hiring strategy was successful. The job posting received interest from candidates, and resulted in a commitment from a talented physician who is currently practicing at a hospital north of Toronto. Their skills and expertise will be beneficial to expectant families and women seeking care, but also to start rebuilding the program for long-term success.


“We are very encouraged by the result. Two physicians cannot cover all of the potential deliveries around the clock all week, it’s just too many hours to cover. This added bench strength means we can bring the program home to the site in a safe and sustainable manner,” said DeFrance.


Over the next two years, the plan is to add two additional full-time OBGYNs to the program, bringing the total to four. Operating a team of four full-time OBGYNs will be the largest physician complement in the program’s history at WLMH.

HHS obstetrical nurse training program a labour of love

In-house partnership “builds the teams we want and need” amid WLMH service pause, global staffing crisis

Nursing positions within the West Lincoln Memorial Hospital (WLMH) obstetrics program have historically been hard to come by. The program’s reputation and culture make it a place where many staff often start out of school, and then stay for their entire career.

When a spot opened up in August 2021, Courtney Davis didn’t miss the opportunity to throw her hat in the ring.

“It was hard to get in because nobody ever left,” said Davis, a registered practical nurse who spent the previous four years working at the site on a general medicine unit. “When I was hired in medicine at WLMH, the obstetrics program had a great reputation. I’d always considered working here.”

The birthing service has been temporarily redirected to Niagara Health a few times since 2019 as a result of necessary safety upgrades needed at the site, staffing shortages and response to the COVID-19 pandemic. The current redirect has been in place since December 2021, when the fast-moving Omicron variant spread across the site closing all but a few beds to new patient admissions. Last week, the hospital announced that the obstetrics program would reopen to deliveries at the site on October 3 in a 24/7 care model. The reopening follows months of necessary work to rebuild the program.

Recent hires into the program need to add or enhance their existing obstetrical skills in preparation for the fall return. But with limited volumes at WLMH due to the redirect, a unique in-house training program has been developed in partnership with the labour and delivery team at Hamilton Health Sciences’ McMaster University Medical Centre (MUMC), which is attached to McMaster Children’s Hospital.

The team at MUMC deliver approximately 4,000 births a year, many of which are high-risk.

Specific skill set needed

“When hiring a nurse to work in the obstetrical service, I’m really looking for a few things,” said Angela Leslie, clinical manager in WLMH’s obstetrics department. “First, do they have general nursing experience? Then, there are specific skills needed to be successful in the role like fetal heart monitoring, perinatal certificate and neonatal ressucitation.”

The in-house training is beneficial to the WLMH nursing team, and is also welcomed by the McMaster team as well.

“The advantage of having McMaster in our system with its volumes and nurses with such expertise is a fantastic learning opportunity. But it also benefits the McMaster team as well, bringing skilled nurses and a few extra sets of hands into the delivery rooms to help with those volumes has also been well received,” Leslie pointed out.

Caring for adults and babies


Even for experienced nurses like Davis, making the transition to caring for newborns has a learning curve as the role requires a 50/50 split in assessing and treating moms and babies.

“All of the assessments are different and all of the vital signs are different. Over eight years of nursing I’ve developed a ‘nursing intuition’ about things. Now we’re adding some specific skills needed to safely care for these little patients,” Davis noted.

Shyma Prince agrees. Originally trained as an obstetrical nurse in India, Prince brings significant operating room nursing skills to the WLMH obstetrics team, which she honed while most recently working at a hospital in Alberta.

“Since being hired we have mostly done c-section deliveries at West Lincoln. We have had the opportunity to work with the team at McMaster to assist with high-risk deliveries as well as upgrading post-partum care skills, caring for mothers as they heal from the delivery,” said Prince, a registered nurse who was hired in February 2022.

Team critical to success

According to Shasta Cividino, clinical manager in labour and delivery at MUMC, there are many experiential learnings beyond skills development which can also be gained through training opportunities like this partnership.

“Being a regional centre, staff get exposure to wide variety of normal low-risk and high-risk care. But they also have the opportunity to experience emergencies which will happen in every birthing centre. In those situations, developing the wherewithal to understand how the team can come together and work through a situation is very important,” she said, adding that there are many unique situations and cases a nurse will see only once in a 30-year career.

Another benefit of spending time in different clinical settings is the chance to build a community of practice with other nurses. A result Cividino calls the “phone-a-friend” mentality.

“Mentorship in health care can be sometimes hard to achieve, especially given the current generational shift going on. We have a wealth of people in that intermediate to expert range to talk and vent to and deconstruct scenarios with. This is great for workplace wellness. You can’t bring these conversations home because of confidentiality and privacy, which is where like-minded colleagues can really help you through those situations,” she said.

Hiring in a global staffing crisis

Finding experienced obstetrical nurses – or any specialty nursing position – is increasingly challenging in the current climate. Health care professionals are in short supply after what many sources attribute to two years of pandemic chaos across the sector. According to Leslie, training programs like this will be increasingly important.

“It’s extremely competitive out there trying to find staff,” she said. “For the obstetrics roles, we are looking at all angles to reach candidates where they are and where they are looking for work. We get candidates for every posting but most don’t have the complete skill set we need. We are fortunate to have in-house training opportunities to help build the teams we want and need.”

The intensity of hiring has also increased. Candidates have many options so they don’t wait too long for a hiring manager to respond to their inquiries. Fortunately, the promise of the new hospital continues to attract great candidates.

“The biggest selling point is the new hospital. Everyone wants to work in a state-of-the-art, smart hospital in a beautiful and growing community. It will allow us to further incorporate research and education into practice. We have a very bright future,” Leslie noted.

Over at MUMC, Cividino – who has held roles during her career at WLMH – believes the new hospital and the program’s reputation will be a perfect storm bringing many expectant mothers to the site to deliver.

“When the new hospital opens its doors, the team can anticipate a much busier obstetrical program with the attraction of a new site, exceptional care delivery standard and a growing community in West Niagara.”

Photos: Tearing down, building up

If you’ve been by the West Lincoln Memorial Hospital site lately, you will probably notice that it doesn’t look quite the same anymore. Work continues to roll along at West Lincoln Memorial Hospital to prepare for construction on the new hospital. If you haven’t been by recently, don’t worry, we’ve got you covered.

Workers are renovating the emergency department (ED) platform. The awning has been removed and a giant retaining wall is being built to increase the space outside of the ED.
View from the ED. The purpose of this work is to allow enough space for ambulances to turn around and then return to the street down the ED driveway, as opposed to exiting out the east parking lot exit.
Speaking of the east parking lot exit, a construction access pathway has been created. The access on the west side of the building will also be used as an access point.
Construction trailers – three to be exact – have moved onto the front lawn. These will provide space to the construction teams to conduct meetings without taking over space inside the hospital.
Roughly 35 trees across the site were taken down in preparation for new hospital construction. Efforts are being made to protect all trees which are at high risk of exposure to construction activity. More than 120 trees will be planted throughout the redevelopment project.
A walkway connecting WLMH with Deer Park Villa is being taken down. The walkway is directly in the path of construction. It’s location is very close to where the new hospital’s front entrance will be.
Soon, the area in the forefront will be excavated and formed for the hospital’s basement and footings.
With the loss of parking due to construction, off-site parking has been arranged for staff. So has a shuttle to the lot.
General rules of engagement for the project: safety always first!

Obstetrics services resuming October 3

Program rebuilding includes return of WLMH Midwives

The below is an abbreviated version of a staff and physician message shared on August 17, 2022

Starting October 3, the labour and delivery program will return to West Lincoln Memorial Hospital (WLMH) site, operating in a 24/7 model of care. This is the result of many months of work and significant recruitment efforts by multiple departments at the site and across Hamilton Health Sciences (HHS), to bring the service back in a sustainable manner. This was also made possible by significant partner contributions, including the WLMH Foundation and Niagara Health.

Specifics include:

• Physician coverage will be enhanced by a new obstetrician and gynecologist who will join the program on a six-month contract, with the possibility of extension for an additional four months.
• Following months of aggressive recruitment efforts, program staffing is currently sufficient to return based on expected near-term patient volumes. Recruitment will continue to ensure further coverage as volumes grow over the coming months.
• WLMH’s operating room team is also growing with the addition of new procedures and surgeries being delivered at the site, which will allow for a 24/7 call schedule to support urgent after hours obstetrical cases.
• As part of a return to 24/7 coverage, we are excited to welcome the WLMH Midwifery team back to the site. WLMH Midwives have been practicing at Niagara Health, and will provide care to expectant mothers, families and babies at WLMH starting October 3. Their presence will be an essential piece of the program’s transition back to the site by adding ongoing low-risk obstetrics mentoring to the nursing team, as well as for the long-term success of the program.

In addition, recruitment has progressed toward hiring two additional full-time OBGYNs to the program. Interviews will take place this fall. A team of four FT OBGYNs – the largest physician complement the program has ever operated – will add stability and predictability to the program, enabling long-term growth.

This period of temporary redirect has been longer than anyone expected or wanted. We are optimistic that the foundational rebuilding mentioned above represents the start of the program’s next chapter.

Thank you to our staff and physicians who remain committed to serving patients at the site and in this program, despite the many changes over the past few years. We would also like to acknowledge the WLMH Foundation which graciously provided the hospital with a grant to assist with OBGYN recruitment, in addition to its ongoing financial support of the program. Finally, we thank our partners at Niagara Health in caring for WLMH mothers and babies during this time.

Preparing the new hospital site for success

Early site works well underway at WLMH

With the ground officially “broken” on the new West Lincoln Memorial Hospital (WLMH), attention has quickly turned toward prepping the site for the build.

Early site works, which generally refers to activities required to prepare the site for construction, have been taking place since the end of April. This includes removing trees which were in the path of construction (35 were removed, with 122 new trees to be planted over the course of the project), locating and moving existing mechanical systems, and decommissioning some physical spaces connected to the existing hospital.

RELATED: New WLMH a done deal

“Depending on the site, there can be significant work needed to make it a safe, blank slate for excavation,” said Kelly Campbell, VP, Corporate Services and Capital Development at Hamilton Health Sciences. “The WLMH build site is pretty open, but it has a relatively small footprint so there is some demolition work that needs to be done ahead of construction. From the street, it may not look like much is happening at the moment, but there is a lot of work going on behind the scenes and on site.”

Notably, there is a service corridor connecting the existing hospital and Deer Park Villa located at the north end of the property. This enclosed walkway, which includes the WLMH kitchen used by hospital Nutrition Services, will be need to be removed ahead of construction. A new home for Nutrition Services – the team and area responsible for feeding inpatients – has been created inside the hospital and the walkway will soon be hoarded off and taken down.

Another early works change happening at the site will involve an alternate plan for some site parking. Parts of the existing lot will be converted to construction access, and hoarding is planned to be erected during the coming month. To offset parking demand at the site, HHS has struck a partnership with a nearby church for staff and physician parking through the week. Parking spaces at the site will be reserved for patients and families, and a small number for emergency on-call physicians.

“We knew from the beginning that access to the build site and parking would be something we need to address. With the support of our church partner, we’ve created a suitable off-site parking arrangement for our staff and physicians during the construction period,” said Campbell, noting that once the new hospital is built and the existing hospital is removed, on-site parking at WLMH will grow considerably.

Probably the biggest change in the coming weeks will be the addition of construction office trailers at the front of the hospital. While not an early site work per se, nothing screams progress like a build team setting up a field office on-site. Once positioned, the trailers will be surrounded by hoarding and wrapped with project signage, creating a safe space on-site for project meetings to take place outside of the existing hospital building.

So, when will ground actually be broken on the new hospital?

“Early works will continue over the summer and into the beginning of fall, at which time excavation and construction can start. This will continue through to fall 2024, when we can start moving furniture and fixtures in and commissioning the building. Substantial Completion is targeted for early 2025 and patients will be able to receive care in the new hospital shortly after that,” said Campbell.

WLMH key to HHS’ innovative surgical plan

Plan made possible through Surgical Innovation Fund

Three Hamilton Health Sciences (HHS) hospital sites are partnering to tackle wait times for certain spine, knee and eye day surgeries.

These surgeries currently have wait times longer than the provincial targets. This plan, made possible through $450,000 from the province’s Surgical Innovation Fund, will help reduce wait times overall.

This plan will see some day surgeries for adults currently performed at Hamilton General Hospital (HGH) and McMaster Children’s Hospital (MCH) move to West Lincoln Memorial Hospital (WLMH) in Grimsby.

Read the full story here.

New West Lincoln Memorial Hospital is a done deal!

Now its time to build!

Shovels are about to hit the ground on the new West Lincoln Memorial Hospital (WLMH)!

The Government of Ontario approved the start of construction to begin on the new Hamilton Health Sciences (HHS) site following the closing of the project contract between EllisDon Infrastructure Healthcare (EDIH) and HHS on April 29, 2022.

Related: read the full news release

The next day, local elected, hospital and community leaders gathered to celebrate.

Here are a few pics from the day.

A message to the WLMH community

Last year, we started this message off by noting how remarkable a year 2020 was.

It’s safe to say that 2021 has followed a similar path.

Over the past 12 months, our teams across Hamilton Health Sciences, including those at West Lincoln Memorial Hospital (WLMH), have continued to demonstrate resilience, dedication, and courage serving patients with unwavering compassion in the most challenging of times. Staff and physicians continue to rise to each occasion and meet every difficult endeavour head on.

At WLMH, we saw many staff bring their highly specialized skills to other hospital sites, helping out in the hardest hit patient care areas, and others volunteering their skills at vaccination sites. Some programs at the site saw twists and turns as the hospital followed the government’s direction in response to the unrelenting virus, changing the way our providers deliver and patients receive care.

All of that turbulence did not stop progress on major WLMH initiatives.

For the first time in the site’s almost 75-year history, patients can now get timely and critical computed tomography (CT) scans in West Niagara. This momentous achievement was the result of many years of work by many hands – in the hospital, the Foundation, the community and at Queen’s Park. The site is now also home to two new x-ray machines and a new mammography suite, allowing more opportunity for preventative screening close to home.

As we head into 2022, we are just months – yes, months – away from construction being able to start on the new hospital. Getting here has taken immense effort, energy and emotional investment. It has been a long road travelled, but when shovels finally break ground on this long-overdue project, we think we will all agree that it was time well spent.

On behalf of Hamilton Health Sciences, we would like to wish our staff, physicians, volunteers, families, donors, community and supporters a very happy, healthy and safe holiday season, and what promises to be a very exciting New Year.

Rob MacIsaac, President and CEO, Hamilton Health Sciences

Leslie Gillies, VP, Community Medicine & Population Health, & Exec Site Lead, WLMH – Hamilton Health Sciences

This message was originally drafted for the West Lincoln Memorial Hospital Foundation annual Trees of Healthy Wishes campaign.

Teams submit technical RFPs for new WLMH

Financial submissions due January 2022

The West Lincoln Memorial Hospital (WLMH) Redevelopment project moved a little closer to becoming a reality as the technical Request for Proposals (RFP) period closed.

Technical submissions include individual plans for the design, layout and execution of the future facility. Hamilton Health Sciences (HHS) and Infrastructure Ontario (IO) will now begin a rigorous evaluation of the technical submissions.

The financial component of the RFP is expected to close in January 2022, after which time HHS and IO will be able to select a preferred proponent and negotiate a contract with that team.

“As we turn the corner into the New Year, we will very soon be able to determine and share who will build the new West Lincoln Memorial Hospital and what it will look like,” said Kelly Campbell, Vice-President, Corporate Services & Capital Development at HHS. “We thank each of the teams for the time, effort and energy they have invested into developing their technical proposals for this project. Very soon, we will have the exciting yet challenging task of selecting one winner from the high-quality and unique submissions.”

It is anticipated the successful team will be announced in spring 2022, and construction will begin shortly thereafter.


The RFP was posted at the end of June 2021. The three shortlisted teams – which were determined through an open Request for Qualifications (RFQ) process earlier this year – were invited to respond to the RFP for the new hospital. The RFP package included more than 5,500 technical requirements set by HHS, in partnership with the Ministry of Health and IO, which each team must satisfy in its submission.

“This is an exciting next step towards the build of the new West Niagara hospital the community has been working towards for many years,” said Sam Oosterhoff, Niagara West MPP. “This legacy community healthcare infrastructure will provide care and treatment to many patients in our community for years to come, and I wish to thank all those who have worked so hard to get the new build to this point. The Government of Ontario is committed to working with Hamilton Health Sciences and the whole community in getting the new hospital built as soon as possible.”

Q&A: Leadership lessons learned

For the last four-plus years, Cindy MacDonald has been the Director of Community Programs and Site Administrator at West Lincoln Memorial Hospital. She recently announced her retirement which is set for the end of December 2021. She graciously (and humbly) agreed to sit down for a Rapid Fire Q&A session to share some of insights from her career and advice for younger health-care workers looking to take the leap into management.

(Dear Reader, please note that the feature photo shared with this story was taken long before the COVID-19 pandemic. Cindy, like all members of our team, diligently follow public health guidelines, including masking and physical distancing.)

Q. Best piece of advice you’ve been given about leadership?

A. My mentor told me a long time ago: “surround yourself with bright lights,” meaning other people who are committed to excellence and kindness. Bright lights bring people together and help others grow and evolve.

Q. What would you say to someone who wants to get into health-care management?

A. First thing I would ask is “why”? What do you want to achieve in your career? What’s your definition of leadership? If you’re coming into a leadership role for any other anything other than wanting to provide leadership to those around you and support patients and the organization, you may not be successful. Leadership is not about you as an individual but how you can support others to be successful. It can be a very challenging at times and you have to be in it for the right reasons. If your heart is at the bedside, you can be a leader in compassionate and evidence based care, teamwork, advocacy – there is a need for bedside leadership as well.

Q. Most important skills health-care leaders should have to be successful?

A. Communication is very important. The challenge of communicating in a digital world is that email isn’t always the best way to get a message across. How do you ensure people are informed and have what they need to do their job? How to you bring information to people as opposed to thinking they’ll seek it out on their own?

Q. Best piece of advice about being staying grounded in a management role?

A. Part of being a good leader is reflecting and learning, but you’ll never achieve everything you want to do in a role. It’s about doing the best job you can do and making positive change for those around you.

Q. Any leadership myths you’d like to dispel?

A. People sometimes think when you take on leadership positions that you need to change, but you don’t. What you do need to be is authentic and stay true to yourself.

Q. Best part about your time at WLMH?

A. The team who come in every day and provide the best care possible for patients. I’m thankful for the opportunity to work in a community hospital for the first time in my career. I’m honoured to be of service to the community, and grateful for being part of the exciting conversations about the new hospital.

Q. Plans for retirement?

A. Lots. But after 36 years of working full time in health care, I’m looking forward to what life wants to show me next.

“Perfect time” to get screened

New WLMH mammography machine up and running


The latest upgrade to diagnostic services at Hamilton Health Sciences’ (HHS) West Lincoln Memorial Hospital (WLMH) is new state-of-the-art mammography equipment that provides routine 2D mammography as well as 3D imaging, also called tomosynthesis.


Mammography technologists at WLMH started using the new machine — a GE model called the Pristina — earlier this month. It replaces the hospital’s aging mammography machine, and is part of upgrades through Managed Equipment Services (MES).


The HHS Juravinski Hospital and Cancer Centre’s CIBC Breast Assessment Centre (BAC) in Hamilton received three of the same model of machines.


“WLMH now has a top-of-the-line mammography machine with all the bells and whistles to perform screening mammograms, diagnostic studies in people with breast concerns and tomosynthesis,” says Dr. Kavita Dhamanaskar, an HHS radiologist with expertise in breast imaging. Dhamanaskar was part of the MES team that was instrumental in bringing the new machines to WLMH and the BAC.


The new machines provide traditional 2D digital mammography for routine breast screening as well as leading-edge 3D technology. With 2D mammography, two x-ray images are taken – one from the top of the breast and one from the side. The 3D mammography provides a more detailed look by obtaining a set of breast images at different angles.
Radiologists recommend tomosynthesis views when a person is recalled for further evaluation of abnormal findings on routine mammogram. This more advanced 3D scan can also be used for screening people with dense breasts.


Improved experience for patients and staff


Until this month, WLMH patients needing detailed assessment or extra views were sent to the BAC. “Now these patients can have complete diagnostic assessment right here in Grimsby instead of travelling into Hamilton,” says WLMH clinical manager Bethany Hancocks, whose responsibilities include diagnostic imaging.


Patients have shared that they’re pleased with the new machine, which is designed to provide a more comfortable experience, says WLMH mammography technologist Natasha Brandel. It’s also more user friendly for technologists, provides higher-quality scans than its predecessor, and is faster.


It has been a big year for diagnostics at WLMH, with a new CT scanner added in summer and now the new mammography machine. It’s all part of a plan to replace and upgrade most of the site’s diagnostic imaging fleet.


Ontario Breast Screening Program


WLMH is home to an Ontario Breast Screening Program (OBSP) site, serving West Niagara and Hamilton residents. The OBSP offers free mammograms to people ages 50 to 74 as part of their routine health care. It’s recommended that most women in this age group get a mammogram every two years since early detection can catch breast cancer when it’s small and is easier to treat.


Anyone in the 50 to 74 year age group who’s due or overdue for a mammogram is encouraged to book their own appointment by phone at an OBSP site that’s most convenient for them. A referral is not necessary, although appointments can also be booked through a person’s primary care provider.


This year, due to delays caused by the pandemic, women aged 75 can also book their own appointment. Outside of the provincial breast screening program, women over 75 and under 50 can book through their primary care provider if screening is deemed necessary due to personal circumstances such as a family history.


“Now is the perfect time for people who are due or overdue to book their mammogram,” says Dhamanaskar.

WLMH welcomes Dr. Mosher, OBGYN

For Dr. Andrea Mosher, coming to West Lincoln Memorial Hospital is a bit of a homecoming.

“This opportunity at WLMH is somewhat full circle for me,” said Dr. Mosher, WLMH’s newest obstetrician and gynecologist. “I grew up in Niagara Falls, did my undergrad at Queens University, went to medical school in Calgary, and took my residency in Hamilton. I am excited for this opportunity to come back to the Niagara community.”

At a young age, Dr. Mosher set her sights on a career in medicine. Influenced by a family friend who was a physician practicing obstetrics in a low-risk birthing environment, she started considering a similar path for herself.

“Being a doctor was always a dream of mine. When I was in medical school I did rotations in obstetrics and I was then matched into the residency program. It’s an honour to be part of families’ birthing experiences and help them welcome a new life into their family and world,” she said.

Dr. Mosher is currently practicing at St. Joseph’s Healthcare Hamilton. She officially starts at WLMH on October 1. The community medical model in place at West Lincoln will be a change, but a welcomed opportunity to practice in a different care environment with new colleagues.

“The model is unique as it allows you to interact with many other providers from the hospital and community. This presents a great opportunity for continued collaboration and growth because it always keeps you learning and encourages experience sharing with each other. It’s very important to me that I’m always advancing but also helping others advance as well,” noted Dr. Mosher.

In addition to her expert clinical skills and experience, she brings another personal yet critical element to her practice which enhances her interaction with patients during their journey to parenthood.

“I’m a mother of two young boys. This is an important piece of who I am but also how I engage with my patients. Having my children let me learn what it was like from a patient’s perspective and where appropriate, I bring this into my work. While it’s definitely not a requirement for practicing obstetrics, personally, I feel like it helps me connect with new and expecting moms and parents,” she explains.

Dr. Mosher is also a practicing gynecologist and will continue this work at WLMH. Through her appointment at McMaster University, Dr. Mosher’s current research focuses on endometriosis – a common but underdiagnosed condition where endometrial tissue grows outside the uterus – with the goal of expanding knowledge of the symptoms toward earlier diagnosis and treatment.

When asked if she had a preference between her two specialties, she gave a considered chuckle before responding.

“I like to say: I came to the specialty for the obstetrics and stayed for the gynecology,” she said. “I really love them both and I think they complement each other well. I am excited to see that gynecology has significant [operating room] time allocated at WLMH and it will be great to get in there work through some of the backlog caused by the pandemic. Being able to help fill a clinical need for a community is humbling.”

The obstetrics program has been temporarily redirected to Niagara Health following a provincial directive earlier in the year which paused scheduled care and facilitated the redeployment of hospital staff to critical care and other clinical areas hard hit by the COVID-19 pandemic. WLMH staff who contributed to this response have since returned to the site.

Separately, in the past year, two of the site’s three obstetricians have departed to pursue professional opportunities abroad. Dr. Nwachukwu [ChuChu] Nwebube who leads WLMH’s obstetrics and gynecology department has remained steadfast in his role and has been the sole obstetrician/gynecologist on site for a number of months.

From an operations perspective, there are three essential pieces needed to run an obstetrics and gynecology program: operating room (OR) staff and OR availability, obstetrics staff, and obstetricians/gynecologists. Dr. Mosher’s arrival is a big step toward fulfilling the physician complement and resuming obstetrical care at the site starting October 5.

“We’re grateful to staff who took on different roles to help out across Hamilton Health Sciences sites during the pandemic, but we’re also really glad to have them back at the site,” said Cindy MacDonald, director of community programs and WLMH site administrator. “Our OR and obstetrical staffing has been stabilized. Dr. Mosher is passionate to work in the community and her arrival is an opportunity to rejuvenate the program. We’re excited for her to start, and at the same time we’re all incredibly thankful to Dr. Nwebube for his dedication and commitment to our patients and the program.”

Arguably, no one at WLMH is more eager for Dr. Mosher’s arrival than Dr. Nwebube.

“Over the last year, we’ve worked through the loss of two obstetricians and it’s very promising to welcome Dr. Mosher to the team,” he said. “She brings great expertise and talents to the program and to our patients. Her contributions will be important as we serve patients in the current building, but also as we transition to the new hospital and restore the program to its former glory and beyond. In addition to her clinical practice, she’s also an accomplished researcher and we’re looking forward to her bringing this important element to the care we provide.”

With the birthing program set to resume, consideration needs to be given that the COVID-19 pandemic is still very unpredictable in the community and the government-driven response which may be needed in the coming months is yet unknown. However, most people at the site are now looking a little farther down the road; to the opening of the new hospital.

“The promise of the new hospital holds a lot of potential,” said Dr. Mosher, who noted the prospect of a rebuilt WLMH played into her decision to accept this role. “It’s exciting to have the opportunity to work in a new facility which is being built with community growth in mind and patient care at the centre of everything. Also, the new hospital will let us further grow the obstetrics program and provide long-term stability for patients in the community.”

The WLMH redevelopment is currently in Stage 4 of the planning process, with the Request For Proposals (RFP) currently out to tender. Shovels are looking to hit the ground in June 2022.

Obstetrics services resuming October 5

Obstetrics services at WLMH will resume starting October 5, supporting deliveries from Tuesday morning to Friday afternoon.

Outside of these hours of operation, women in labour or requiring assessment will be redirected to deliver at the St. Catharines site of Niagara Health (NH).

This is the same model that was in place prior to the provincial directive earlier this year which temporarily paused scheduled care to allow hospital staff and physicians to support clinical areas hardest hit by the COVID-19 pandemic.

Our obstetricians and family physicians will retain their privileges at both hospitals, allowing continuity of care for patients. In situations where WLMH physicians are not able to attend a delivery, the patient will be under the care of the NH obstetrician on call


Midwifery care will be provided at NH only.

EXPECTING FAMILIES: this handout is for you.


Once again, the obstetrics service resumption will be assessed on an ongoing basis to determine if and how it can be extended. The goal is to provide as many hours of obstetrics services as possible, as long as its sustainable from a staffing and resourcing perspective to do so.

Hamilton Health Sciences is grateful for our ongoing partnership with NH and its team who continue to make this service arrangement possible until obstetrics services can fully resume at WLMH. We also appreciate the flexibility and professionalism our staff and physicians have demonstrated during this period of transition.

“Exciting part of the development process”

Work continues on rebuild project

The Request for Proposals (RFP) was issued at the very end of June, meaning the three teams vying for the project have all of the requirements needed to complete their bids.

For the redevelopment team which has been working furiously throughout the planning phases to get this project over the finish line, it’s a chance to take stock of all their efforts.

“This is an exciting part of the development process,” said Bart DeVries, director of redevelopment at Hamilton Health Sciences. “Our team has spent the better part of two years consulting and planning for the new hospital. Now we’re at the stage where we get to see that hard work materialize in the plans being developed by the design-build teams competing to win the project.”

Working behind-the-scenes

While this is a relatively quiet period in terms of public milestones and updates, lots of work is happening behind the scenes.

“Together with Infrastructure Ontario, we meet with each bid team on almost a weekly basis. Some of these meetings are a few hours in duration to cover their progress on schedules, IT and equipment planning, etc. In August, September, and October there are all-day meetings with each team where they share their current design iterations and walk us through their plans at each stage,” said DeVries, noting that each meeting is attended by an impartial “fairness monitor” to ensure that any information provided by the hospital to one bidder is shared equally with the others.

These meetings are an important part of the development process. They allow each design-build team to receive feedback on its designs in real time and have dialogue with the hospital. The meetings also provide the opportunity to raise red flags if there are potential issues or concerns on either side of the table.

“The RFP includes over 5,500 specific and unique requirements associated with the project. Documentation is provided to the bid teams after each design presentation session outlining which requirements have been satisfactorily met, and those that have not. As you can imagine, many questions come up throughout the process. Between regular meetings with the bidders, and request for information (RFI) requests, all parties have the ability to interact with our requirements and ultimately identify solutions, even though their design is unique from others. Where warranted, we revise some of our requirements to respond to innovations and other changes that will benefit the project,” said DeVries.

“With all projects, especially those which move as fast as the WLMH rebuild is moving, it’s always better to address matters up front so that teams can progress their designs quickly and allow us to minimize what needs to be resolved in the end,” he added.

Building relationships

The regular dialogue also lets the hospital’s team get to know each of the potential design-build teams. The new hospital will take between two and three years to build. It’s important to start building relationships and understanding each team’s dynamics.

“The relationship between the design-build team and the hospital and its planning, design and conformance (PDC) team is critical for the success of any project. Building rapport starts on day one and it’s nice for both sides to get to know each other early on,” noted DeVries.

Meetings with design-build teams will continue until late October 2021. Technical (“design”) submissions for the RFP are due at the end of November 2021. RFP financial (“cost”) submissions are due early January 2022. Evaluation of each will take place and the successful proponent will be announced sometime in March 2022. Shovels are expected to hit the ground by June 2022.

Q&A: Update on the new WLMH

Q. The Stage 3 submission was sent to the Ministry of Health in late March for approval. Where does that currently stand?

A. Our team has been engaged in discussion with the Ministry about the submission. This is normal. Everyone is working toward the same goal of planning and building a great hospital. All parties are working as fast as possible to achieve that goal.

Q. When do we anticipate Stage 3 approval?

A. Approval is expected imminently.

Q. What happens after the Stage 3 submission is approved?

A. Refining the RFP documents has continued since the Stage 3 plan was submitted. The Stage 4A (Approval to Request for Proposal) was submitted to the Ministry on May 28. Final revisions and reviews will continue into mid-June, and we are also preparing for the tendering period.

Q. When will the RFP for the design-build team be posted?

A. Ministry direction is to post the RFP on June 28, which is almost a week earlier than originally scheduled.

GRAPHIC: Countdown to Construction

Q. What happens in Stage 4?

A. The three design-build team candidates will receive the tender documents on June 28. This launches us into formal design presentations from each team as they develop their proposals. Those presentations are followed up with design documents which will be checked for compliance and feedback, and then returned to the teams to progressively elaborate on their designs. This will continue until the proposals are received late fall 2021 at which point there is an extensive evaluation and negotiation process with the preferred proponent, leading to a contract to design-build-finance the project.

Q. What happens during the RFP period? Is there any contact between the hospital and the bidding teams?

A. There are regular touchpoints between the hospital, Infrastructure Ontario (IO) and the three individual teams while the RFP is posted. These conversations will inform the teams’ bids. The procurement process will be overseen by a third-party to ensure transparency and confidentiality are maintained.

Equipping the new WLMH for success

When people think about building a hospital, the shiny new building from a project’s renderings often come to mind. Construction-related comments like “shovels in the ground” or “opening the doors” are tossed around in casual conversation.


Less attention is paid to the thousands of critical items which make the hospital function. Operating tables, IV pumps, task chairs, stretchers, ultrasound machines, waiting room seating, scalpels. In the hospital sector, these items are referred to as furniture, fixtures and equipment, or commonly just “FF&E” and are absolutely essential for the care that’s provided.


Figuring out FF&E

Calculating the FF&E needed for a new hospital is complex, but is also similar to how a family would figure out the décor in their home.


“Think about your living room and all the items in it. You have a couch, chairs, coffee table, maybe a lamp or two, some shelves, possibly a TV, area rug, artwork, books. If you were to move, you’d look at your furnishing and based on their condition and the space in the new house, which should be kept or replaced. That’s essentially what needs to be done when planning for every room in a new hospital,” said Bart DeVries, HHS director of redevelopment.


Knowing what we’ll need starts with knowing what we currently have and what can be transferred to the new building. To help with this process, hospital redevelopment teams lean on industry experts.


“Our team went in last June and did a complete inventory of the existing assets. Each item was tagged, barcoded and logged so we could conduct an assessment for transferability to the new building. Each asset is evaluated individually looking at its age, service history, compatibility in the new space and its current condition,” said Larry Rook, an advisor from Colliers Project Leaders.


Did you know? Approximately 3,500 items were tagged in this process at WLMH.

Once the cataloguing and assessment is done, the team needs to determine what is missing and what needs to be purchased, taking into account the needs and spaces in the new hospital.


For example, the current WLMH has two operating rooms. The new hospital will have four. Even if every item from the existing operating rooms were transferred (and much of it is new so it will be) outfitting would be needed for the two new rooms regardless.

Other factors play into the decisions as well. Timing is a big one.


“You can’t move the contents of an entire hospital to a new building overnight. There will be a period of overlap when the new hospital opens and both hospitals are still operating. The emergency department, for example; if you arrive at 5:59 a.m. at the old site on ‘move day’ you are cared for there and then transferred to the new hospital later. The new site opens at 6:00 a.m. on move day so all patients after that time are seen there. The result is that some items will be bought new to ensure continuity of operations,” noted Rook.

Covering the cost


FF&E for a new hospital can carry a hefty price tag. The multi-million dollar question becomes: who covers this cost? It depends on whether the items are considered “fixed or loose.”


“Generally, fixed items are anything that wouldn’t fall out of the building if you were to pick it up and turn it upside down. Ceiling-mounted surgical lights are a good example. Those are considered to be part of the building and are captured in the construction costs because structural supports need to be provided by the contractor and they have hard-wired electrical connections. Everything else that would shake out are considered loose and the Ministry doesn’t pay for those,” said DeVries.

Related: Take it to the Finish…Building a Healthy Community campaign website


The loose items are funded through the “local share of financing” for the new hospital. In Ontario, new hospitals are cost-shared between the Ministry of Health and the local community which the hospital serves. The local share is the portion the community is required to cover. For more on that, read this.

Related: Local share of financing lands at $50M


The more equipment that’s transferred means less will need to be bought new to open the hospital.


“FF&E costs are a big part of the local share of financing. For the WLMH redevelopment, we’ll be able to transfer almost 40 per cent of the total equipment required, which, compared to other hospital projects, is a considerable amount,” said DeVries, noting that all of the furniture in the new hospital will be bought new.

Three Teams on Shortlist to Build New WLMH


Process for full submissions opens in July, successful team will be announced spring 2022

Today, Infrastructure Ontario (IO) and Hamilton Health Sciences (HHS) announced that three teams have been prequalified to design, build and finance the West Lincoln Memorial Hospital (WLMH) redevelopment project.


Teams were prequalified based on criteria identified in a request for qualifications process that began in November 2020. Selection criteria included design and construction capability, experience, qualified personnel and financial capacity to undertake a project of this size and scope.

The prequalified teams and their prime team members are:


AMICO SACYR ALLIANCE
• Applicant Lead: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Design Team: IBI Group Architects Canada
• Construction Team: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Financial Advisor: Operis Business Engineering Limited


ELLISDON INFRASTRUCTURE HEALTHCARE

• Applicant Leads: EllisDon Corporation
• Design Team: Parkin Architects Limited
• Construction Team: EllisDon Corporation
• Financial Advisor: EllisDon Capital Inc.


POMERLEAU HEALTHCARE PARTNERS
• Applicant Lead: Pomerleau Inc.
• Design Team: Cumulus Architects Inc, WalterFedy
• Construction Team: Pomerleau Inc.
• Financial Advisor: Pomerleau Inc.


A request for proposals (RFP) is expected to be issued to these prequalified teams in summer 2021. Once submissions are received, IO and HHS Sciences will evaluate the proposals, select a preferred team and then negotiate a final contract. The successful team is expected to be announced in spring 2022. A fairness monitor will oversee the entire procurement process.

Quotes

“The WLMH RFQ generated interest from leading private-sector teams who want to bring this exciting project to life. Together with Infrastructure Ontario, we are encouraged by the quality of submissions received and look forward to seeing the full proposals from the shortlisted teams in the coming months. By this time next year, the successful design-build team will be selected; one of the final pieces before getting shovels into the ground.”
Kelly Campbell, VP Corporate Services and Capital Development, Hamilton Health Sciences

“The selection of three highly qualified teams to move on to the request for proposals stage is a significant project milestone. Through IO’s P3 process, we are confident these teams will submit competitive bids that will result in the delivery of a state-of-the-art hospital to serve West Niagara for years to come. We are delighted to once again partner with Hamilton Health Sciences as we set our collective sights toward breaking ground in spring 2022.”
Angela Clayton, President, Project Delivery, Infrastructure Ontario

“This is good news for Niagara West residents who have worked hard with HHS and WLMH team to ensure that this new facility moves forward. The Ontario government is committed to delivering this important project for Niagara West; and investing in healthcare across our region. My thanks goes to all who have put so much work into getting to this point, and my congratulations goes to those who have pre-qualified for this infrastructure build. I will keep supporting this build in any way I can!”
Sam Oosterhoff, MPP, Niagara West

Additional Resources


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SNEAK PEEK: New WLMH renderings

The WLMH redevelopment project once again entered unprecedented territory last week with the Stage 3 submission being sent to the Ministry of Health for approval: the final stage before the project is approved for tender in July!

This submission builds on the Stage 2 approval received in January and summarizes all the details required for the bidders to deliver a concept, design and price to construct the new hospital.

It also means we’re able to develop updated illustrative design renderings for the project! These renderings show what the hospital could look like, based on many of the requirements we’re putting forward to build teams to include in their bids for the project.

Bidders will apply their own innovations and solutions to meet the project’s needs, so these illustrations may still change somewhat.

Graphic: Evolution of Design-Build-Finance Project Design

The images illustrate the final plan with the former WLMH buildings removed; replaced with parks and parking. Due to the constraints on the site and robust specifications that will be in the tender package, it is very likely that the new WLMH will replicate many of the site and building characteristics shown in these renderings.

Stage 3 illustration of new WLMH: view from Main St.
Stage 3 illustration of new WLMH: view from current parking lot on east side of site.
Stage 3 illustration of new WLMH: aerial view of the proposed site (notice the proposed park space along Main St.!)

Reflecting on a remarkable year

What a remarkable year 2020 has been.

As a global pandemic took hold in the community, our team at West Lincoln Memorial Hospital (WLMH) has shown incredible resilience and dedication to keep the hospital open and our patients safe.

Inside the hospital, we’ve invested heavily to upgrade the aging mechanical systems to make the building safer, until we can open the new one. The most significant safety upgrade at the site occurred in the operating rooms and endoscopy reprocessing area. Our site team and the contractor worked tirelessly during the surgical shutdown that occurred in response to the pandemic in order to renovate and reopen the operating rooms on time.

We’re also further down the path than ever before to rebuild WLMH. This year started with the government approving a detailed service plan for the new hospital, which meant we could start designing how those services will function in a brand new building. At the end of October, that plan was sent to the Ministry of Health for review. We’re now looking for a team to design and build the future hospital. This project is moving at unprecedented speed. Our goal is to keep it going.

Through it all, our community, neighbours, families, patients, staff, physicians, volunteers, partners and donors have stood beside us. We thank you for your unwavering support and generosity this and every year. Because of you, WLMH’s future has never been brighter.

On behalf of Hamilton Health Sciences, we would like to wish you a very happy, healthy and safe holiday season.