“One call does it all”

Multi-year overhaul of diagnostic imaging equipment benefits from MES agreement

Change has been a consistent theme at West Lincoln Memorial Hospital over the past few years.

From an equipment perspective, the diagnostic imaging (DI) service has arguably seen the greatest amount of change during this time period. With the operating room renovations in 2020 came the new C-arm machine. Then the site’s first-ever computed tomography (CT) scanner opened for patient care in mid-2021. Immediately after, work got started on upgrading the mammography and two x-ray suites.

“We have all been so excited for so long to get two x-ray rooms open,” said Mindy Chmielewski, senior CT technologist at WLMH. “Prior to the renovation, we had two rooms and machines, but one of the machines could only perform a limited amount of procedures. That machine was also very old and the quality of images was not good. It was stiff and difficult to maneuver, which was a challenge for staff and posed significant risk for injury.”

The first renovated x-ray room opened in fall 2021. The second room became operational on February 14, essentially completing the multi-year DI overhaul at the site.

More machines, more efficiency

“Now that we have two fully functional rooms and machines, we can be far more efficient with patient care. We don’t have to wait for the other technologist to finish, we can just do our exams and get patients on their way,” said Amy Tousignant, senior x-ray technologist.

Chmielewski agrees. “When the emergency department was full and we knew we had a lot of patients requiring x-rays, it seemed like a really daunting task to coordinate in a timely manner with one machine. Now, it’s really easy and reduces stress in our day.”

Renovations, upgrades enhance safety

The x-ray suites themselves also got a makeover. The renovation included safety updates to the paneling inside the walls required to contain the radiation. The team also took the opportunity to reconfigure the space to improve overall function and safety, like adding a control room in between the two suites which lets staff monitor both rooms and easily assist colleagues in either when they need a hand.

“You can tell that function was definitely considered when they planned these renovations,” said Chmielewski, who added that the renovated rooms have received many “oohs and ahhs” from patients.

The new x-ray machines are fully automated meaning limited physical force is needed to operate.

“The ergonomic elements alone are amazing. Technologists are susceptible to injury from repetitive motions, particularly upper back injuries. These rooms and equipment are safer for staff and therefore safer for patients,” added Tousignant.

The renovation also repurposed an existing hallway into a staff room which Chmielewski, Tousignant and their colleagues call, “the team room.”

In June 2021, WLMH’s first-ever computed tomography (CT) scanner opened at the site.

CT scanner serving the community

The CT scanner saw its first patients in June 2021. Since then, the demand for the service has grown steadily. Currently, it is fully booked pretty much every day.

“We get tons of positive feedback from patients, largely about receiving care closer to home and decreased wait times for service. Patients also love the space and compliment us on the suite and facilities,” said Chmielewski. “We have received thank you cards from patients which I’ve never seen before in my career. It is a very rewarding place to work.”

All of the recent DI equipment has been procured through the landmark Managed Equipment Services (MES) agreement that Hamilton Health Sciences (HHS) made with Siemens Healthineers in early 2020. One of the most innovative pieces of the agreement is the built-in service component, which streamlines maintenance and limits machine downtime.

“MES has been really good. Each piece of equipment is labelled with a device ID number and a phone number for tech support. If anything goes wrong, we can easily get a hold of tech support around the clock to troubleshoot or schedule a maintenance call. One call does it all,” said Chmielewski.

Hospital under construction

All of this progress does not come without challenges. The noise and unavoidable chaos which comes with construction has been part of daily life at the site for many years.

“Working in a hospital under construction has been difficult. However, when I started here six years ago, it was clear how bad a state the hospital was in and how much work was needed. Yes, it can be a pain to hear the noise and have your workflow disrupted. But knowing that better things are coming, like the two new x-ray rooms, helps you get through it,” said Tousignant, who was quick to add that the construction team has been extremely courteous and respectful throughout the renos.

Diego Gomez knows this challenge all too well. As the project manager responsible for delivering all MES projects across HHS, he has worked closely with the construction team to sequence the projects at WLMH to minimize disruption while sticking to schedules.

“The feedback we have received about our contractors from staff and end users across the site has been excellent. It takes a lot of coordination from contractors, consultants, Siemens and site staff to execute these projects, but I feel like this is an example of great teamwork achieving great results,” said Gomez, pointing out that every project was completed on time and on budget.

Looking to the future

All of the DI equipment will carry over in to the new hospital. The future has been a shining light for many staff at the site.

“I’ve worked at different places but I’ve never had such a sense of team as I’ve seen here. It’s a positive environment and great atmosphere. We all know that things are going to get better in the new hospital and that the challenges of this building are now temporary. We’re a pretty resilient bunch,” said Tousignant.

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.

What’s Up @ WLMH: August 2020

WLMH ORs Reopening September 14

Critical safety upgrades required in the WLMH operating rooms (ORs) are now complete. Activity in the ORs will gradually resume, starting the week of September 14.

Patients will soon be able to receive high-quality procedures closer to home, in an environment that meets standards for safety and infection control.

Which services will be provided?

Services resuming in the coming weeks include:
• Endoscopy procedures
• Gynecology and general surgery cases, addressing the backlog created by the province-wide COVID-19 surgical shutdown
• Elements of obstetrics services, such as scheduled cesarean births

We continue to focus on building up OR nursing staff levels to increase on-call capabilities at WLMH and support more surgical services over time.

What does this mean for patients?

Patients will be contacted by their health-care provider about scheduling their procedures.

Additional information for obstetrical patients is available here.

We appreciate everyone’s ongoing patience and resilience while these necessary safety upgrades were taking place.


What’s coming up this fall?

Work is progressing on a number of priorities at the site. Here’s a look ahead to what’s happening in the coming months:

September

  • Surgical activity gradually resuming in WLMH ORs
  • Construction starts on CT scanner suite

October

  • Building a New WLMH – Stage 2 submission on track to share with Ministry of Health for review and approval

November

  • Two-Year infrastructure project wrapping up – three months ahead of schedule!

What’s Up @ WLMH: May 2020

Hospital services starting to gradually resume in Ontario

Earlier this week, Hamilton Health Sciences’ (HHS) plan to gradually resume clinical services was approved by Ontario Health. Many services, including surgeries and other procedures, were paused during the initial response to the COVID-19 pandemic. Here’s the message we shared with our staff.

This approval means we will now start gradually booking appointments for some procedures, prioritizing care for patients based on the severity and urgency of their medical needs. Patients will be contacted directly by the hospital or their doctor about the timing of their care, when an appointment for them is available.

West Niagara residents will continue to receive procedures at other HHS sites. The operating rooms at West Lincoln Memorial Hospital are undergoing critical safety upgrades and are scheduled to re-open this fall.

We will provide further updates as this process moves forward, but you can also stay up-to-date here.

Progress on important safety upgrades at WLMH

Completed:

  • Laboratory upgrades, like electrical, lighting and millwork
  • Parking lot resurfacing completed; lighting is being installed

Upcoming:

  • Work on Endoscopy Reprocessing starting June 1
  • Operating Room/Intensive Care Unit work starting June 15

West Niagara municipal Councils show continued support for the new WLMH

This month, local municipalities (Grimsby, Lincoln and West Lincoln) each passed a motion of commitment to the local share financing required for the construction of a new hospital. This commitment is a critical part of the hospital planning process. We thank each of the Councils and Mayors for their continued support of this important project.

During the coming weeks, staff and physicians at WLMH will help develop detailed plans for the new hospital. Their input will help to ensure that that future health care service delivery needs are translated into the design and construction of the new hospital by providing clinical, technical, operational, programmatic, and equipment information.

Check out our newly released feature sheets to help keep you informed about the road ahead. Find out how new hospitals are financed in Ontario and the government’s process for building new infrastructure.