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.