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In a Meeting


**UPDATE** from the Physician Town Hall March 30, 2023 regarding major changes to service at JH

Dear Colleagues:

The time is coming when the medicine service at the Juravinski Hospital will change to a new model. Maybe that doesn't sound like much; but it is!  It's not just about changing names and providers.  Everything is changing. A new acute medicine hospitalist service comprised of McMaster GIM faculty and staff internists will provide the care to IM patients previously under the GIM CTU. The current hospitalist service will become a Multispecialty Hospitalist Service. The two services will be reached differently, will work differently, and will need to collaborate differently with all other services at the hospital.  They will need to be reached through Epic differently. Although this big change affects the Juravinski Hospital, you can already see that other services coming to JH to provide care will liaise with this new service differently than they did before.  Additionally, the service will look different in the day than it does at night. Internal Medicine residents will not be covering on-call overnight work at the JH on medicine beginning July 1, 2023.

In response to educational requirements of the residency programs of medicine and general surgery, the working group announced this change almost a year ago. A multidisciplinary working group comprised of medical leaders from different specialties and administrative leaders from quality, communications, project management and organizational development, has been working feverishly since that time to define what has to change, how it has to change, and how to best effect that change without compromising patient care. They have engaged those who are involved in the care from the internists to residents to nurses, allied health care workers and those on other services who interact with medicine frequently.

On March 30th, at the MSA town-hall event, members of the working group described how care is currently provided by the medicine service and how the provision of care will change. The panel showed us all how involved this change will be. About three dozen new staff physicians will provide care.  There will need to be Epic training, new ways of communicating, new ways of providing care and many more teams providing care. Additionally, to meet the accreditation needs for our training programs, we will see 20-30 residents rotating through the site instead of 90-100. Teaching at the JH will change. There are many things that are not changing in the model, such as the indications to call another specialty, code Blue and the RACE team.  More engagement will be required from all of us, in addition to the gratitude that we should have for the vast amount of thought and work that has gone into the change so far. 

Much work has been done.  Much is yet to do.  Some can't be done till last minute, as the providers have yet to land and be credentialed -- recruitment has been robust. Some things have already been changed and they are being worked into the current model. The teams are working to enable changes that could include rapid access clinics to avoid admission and post-discharge monitoring and surveillance.  The new process will come with metrics to look at admissions, discharges and quality indicators. Epic will come in handy for the data that we need to monitor our success and to find out what needs to change and how. Once again, this is where we can all contribute to improvements. 

At the presentation, we learned how the new model will work when we look at oncology, surgery and medicine patients. We heard questions that challenged the team to continue to work on some areas that are still not finalized. We heard that members of the team are not dropping their work on July 1 -- they are looking for your input, your help, your ideas. At the end of the presentation, there was less trepidation and more excitement, not only because we have seen so much of what is to come,  but because we are embarking on a new way to work and to serve our patients. Those of us who are looking to show ourselves capable of greater responsibility (find opportunities to practice leadership) can take on small, discrete projects in this change that they can lead to completion. 

In summary, Thursday’s presentation, well attended with about 80 attendees in the audience and on zoom, was the first big public rollout to physicians. Congratulations to the team on a job well-done so far and good luck to all. For those of you who were not able to join the event, presentation material and FAQ’s will be available on the Hub online.  Please check this web resource frequently for ongoing updates.

Keep your ears open, and look out for what you can do to partner with this work and show your stripes. 

Let's make this change another reason that we are proud to work at HHS.

Dr. Deepak Dath

President, Medical Staff Association

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