CHEO
is looking at moving paper medical records out of storage at the hospital and introducing hybrid work for some employees as part of a “creative” effort to find more desperately needed space to treat patients.
The hospital’s
new president and CEO, Dr. Vera Etches
, said having enough space is a growing concern at the children’s hospital, especially when it comes to moving patients from the busy emergency department to wards.
In an interview to talk about her first weeks on the job at CHEO, Etches said finding creative ways to repurpose space in the
50-year-old hospital
is among her first priorities on the job.
The area currently occupied by medical records at CHEO is one example of space the hospital is looking to repurpose for clinical use, she said.
“The medical records area is currently underneath the emergency department. We are quite interested in that. We would be able to move all of the paper documents out and hopefully create space where patients could be seen.”
She also said the hospital is looking at hybrid work schedules for some employees whose work does not involve direct patient care.
“We do have roles that are not direct patient care or support services. Right now, many of those teams are partly on-site, partly off-site, and so it’s about taking a really deliberate approach to that. People need connection, they need to feel they are part of the team here, but we may not have enough space for everybody to be here all the time.”
Those plans to repurpose space for clinical and educational uses are still at the discussion stage, she said, and would have to be done without dedicated provincial funding.
CHEO is currently undergoing redevelopment, the first part of a plan that eventually includes a new tower at the hospital, which would have more beds and spaces for patient care
—
but that is far down the road, Etches said.
The current phase includes the construction of a new 200,000 square foot children’s treatment centre. Michael Parsa, Ontario’s minister of children, community and social services, was in Ottawa this week to break ground on the building that will be the centre of a new model of care for children and youth with developmental needs. It is expected to open in 2028.
Space, and the lack of it, has become one of Etches’ priorities in her first weeks on the job as president and CEO of CHEO. Etches took on the role at the beginning of March. She left her job as Ottawa’s medical officer of health in January. She takes over from Alex Munter who headed CHEO for more than two decades.
Munter was a vocal advocate for “right-sizing” pediatric health care in Ontario, saying it had long been underfunded, not keeping up with inflation, population growth or the realities of pediatric medicine in the 2020s.
The Ontario government responded with new intensive care and critical care beds as well as funding to help ease pressure in the emergency department following a respiratory season that overwhelmed CHEO and other pediatric hospitals in late 2022. Meanwhile, the first phase of redevelopment is moving ahead, and there will be some space added to the emergency department, Etches said.
Those investments are important, said Etches, but they have not solved immediate space issues at the hospital, especially when it comes to general medicine beds. One challenge is that the hospital was built 50 years ago, before the current standard of single rooms in hospitals. Often, during the busy respiratory season, beds can’t be used because a patient in the same room has an infectious illness and is in isolation.
Etches noted that there are growing pressures around infectious diseases. Although Ottawa has not seen any measles cases during the current outbreak in the province, like other hospitals, it is prepared.
The space shortage, she said, “affects the movement through the emergency department into the wards upstairs, so people have to wait for a bed to be open.” Although adults sometimes have to be treated in hallways because of hospital crowding, Etches said that is something CHEO does not want to have to do with children and youth.
There are future plans to expand the hospital. “We’ll get there one day, but we really can’t ignore the current day problems.”
The hospital also has plans to hire a flow coordinator for the emergency department, whose sole job will be to make sure space is being maximized, she said.
Etches said the need for more space, not only for clinical care but also for education sessions, hit home when she spent an overnight shift at the hospital to better understand her new role as head of CHEO.
She spent part of the overnight shift with the hospital’s clinical operations manager
—
who ensures efficient and effective patient care delivery
—
to get an overview of the operations at night. Etches also visited wards to talk to nurses about how they manage the shift and spent time in the emergency department.
“It’s a 24/7 operation. I wanted to understand what that’s like for the team members that work overnight and also for those who need to be in the emergency room overnight.”
That experience, in the early weeks in her new job, reinforced for her that having enough space for patients in the hospital and keeping the emergency department operating effectively is a constant challenge and one that is not getting easier.
Etches is also bringing her public health lens to her job at CHEO. The hospital has begun collecting postal codes of patients to better understand some of the factors that impact their wellbeing. It echoes work done by Ottawa Public Health during the pandemic to look at wellbeing by neighbourhoods.
“There are many things that can challenge a family’s wellbeing or a child’s wellbeing and that may sometimes be tied to where you live,” she said.
“I cannot avoid thinking about things through a public health lens. It’s who I am, and that is a beautiful thing about CHEO. It has that more-than-a-hospital mindset and approach … which is more than care. (It is also) how do we help people, families, children, and youth have what they need?”
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