Hamilton Psychiatric Hospital

REVIEW OF 1998/99

In the Fall of 1998, the Mood Disorders Program was awarded the Gold Award for Excellence in Clinical Care and Treatment from the American Psychiatric Association. The melding of academia, research and clinical care has been recognized as contributing to the program developing into a Centre of Excellence with world-wide recognition.

In January 1999, HPH received the Minister of Health's approval to proceed with implementation of the Health Services Restructuring Commission's advice to transfer governance and management of HPH to St. Joseph's Hospital.

In May, 1999, the Hospital Administrator, Mary Sutherland retired from the Ontario Public Service. Bob Cerniuk, who was an Assistant Administrator, has been appointed as the new Hospital Administrator and along with the Senior Management Team will lead the organization through the transition process and shift of governance and management to St. Joseph's Hospital. The Senior Management Team includes Assistant Administrators Ron Dolson and Pauline McKinley; Clinical Director, Dr. Gary Chaimowitz; and Psychiatrist-in-Chief, Dr. Richard Swinson.

Comprehensive Assessment Project: As part of the Ministry Implementation Team-System's activities, HPH is conducting a comprehensive assessment of the current level of functioning and support/service requirements of all HPH inpatients and a representative sample of outpatients. The information will be used for planning purposes at the MIT-System table.

In a further demonstration of our community involvement, over 60 staff represented HPH on many community boards and committees and over 40 staff were involved in planning short-term and long-term joint ventures and collaborative projects with nearly 100 community agencies and businesses.

Since 1996, there has been a moratorium on further bed reductions while the growth in outpatient activity continues. This year, the Ministry asked us to include the number of Staffed Beds (the number of beds that can be staffed immediately without moving staff from other programs) as well as the number of Set-up Beds (number of beds ministry refers to for budgeting purposes)

Following is a snapshot of patient activity at HPH on the same date for past four years and annual patient statistics for the past four years.

Table #2 Snapshot of Patient Activity November 30^th each year

Snapshot of Patient Activity	1995	1996	1997	1998
set-up beds	211	211	211	211
staffed beds	NA	NA	NA	157
# of inpatients	160	165	151	142
# of patients on leave of absence (LOA)	37	30	26	10
# of registered outpatients	772	963	1094	1218

* Despite the fact that HPH has 211 Set-up Beds our 1999 census of 157 Staffed Beds in utilization shows movement to the community-the resources-difference between 211 and 157 beds is being utilized for community initiatives. By definition, we are obliged to retain the 211-bed figure until the funding formulas are adjusted to recognize HPH's significant shift to community services.

Table #3 Four-year Overview of Annual Hospital Statistics: Patient Activity between April 1, 1998 and March 31, 1999

PATIENT ACTIVITY	1995/96	1996/97	1997/98	1998/99
# of patients admitted	553	566	543	458
# of patients discharged	584	547	560	483
Average length of stay (days)	173	156	144	128
# of direct contacts-includes registered and non-registered outpatients	53,562	75,197	77,378	73,673

The trends shown on these tables support HPH's shift to community-based services. The hospital shows shorter length-of-stay, fewer admissions, an increased proportion of discharges and an increase in outpatient registries and contacts-direct and indirect. (Outpatient contacts may be understated due to failure to report statistics). The statistics also speak to the increased number of services available to this population in the community and the work being done by HPH staff to assist community service providers in preventing in-hospital stay.

The following table breaks down annual patient activity in 1998/99 by District.

Table #4 Annual Hospital Statistics: Patient Activity by District-HPH catchment area 1998/99

1998/99 HPH Patient Activity by District	Brant	Haldimand-Norfolk	Halton	Hamilton-Wentworth	Niagara	NFA*	Other*	TOTAL
# of Inpatient admissions	15	10	18	265	89	19	19	458
# of new Outpatient Registrations	3	17	26	330	72	1	30	479
# of patients discharged	17	12	16	307	77	28	26	483
# of outpatient terminations	7	17	33	235	41	8	16	357

* NFA = No fixed Address

* Other = address outside of catchment area

* Outpatient Terminations includes 13 patients discharged from inactive status.

The detailed Clinical Program Section of this plan contains the number of clients from each district receiving services in 1998/99 from specific programs.

The following two tables show a snapshot by district of the number of registered inpatients and outpatients on March 31, 1999.

Table #5 Registered Inpatients by District-Snapshot March 31, 1999

Program	Brant	Haldimand-Norfolk	Halton	Hamilton-Wentworth	Niagara	NFA*	Other*
Community Liaison Program	0	0	2	17	3	4	0
Schizophrenia Service	0	0	4	38	13	14	0
Mood Disorders Program	0	0	0	5	8	0	0
Geriatric Psychiatry Program	1	0	2	10	3	0	0
Forensic Program	2	0	1	4	6	11	0
Acquired Brain Injury Program	0	2	0	2	0	1	1
TOTAL	3	2	9	76	33	30	1

Registered inpatients include 21 Leave of Absence (LOA's)= Brant-1, Halton-1, Hamilton-Wentworth-7, Niagara-9, NFA-3.

Table #6 Registered Outpatients by District-Snapshot March 31, 1999

Program	Brant	Haldimand-Norfolk	Halton	Hamilton-Wentworth	Niagara	NFA*	Other*
Community Liaison Program (includes Exit Team)	0	1	1	6	1	0	0
Schizophrenia Service	3	3	0	56	7	1	0
Mood Disorders Program	13	42	60	357	132	0	77
Forensic Program	1	1	1	16	5	0	1
Acquired Brain Injury Program	0	0	0	0	0	0	0
Mental Health Services for Adults with Developmental Handicaps	0	0	0	13	2	0	0
Other Community-based Services/Programs	0	0	0	0	0	0	0
# of outpatients registered to Rehabilitation Services *	0	1	0	77	1	0	1
Community Schizophrenia Service	6	9	1	328	18	2	3
TOTAL	23	57	63	853	166	3	82

Clients registered to Rehabilitation Services are not registered to another program in the hospital.

Registered patients also receive Rehabilitation Services through their respective clinical programs.

Geriatric Outreach Programs' clients are not registered outpatients of HPH. They are counted as Direct Contacts. These clients are normally registered with other community agencies/facilities.