Shuswap Lake General Hospital is suffering from a chronic lack of funding and prioritization in the region that is threatening the ability to provide quality critical care.

Dr. Scott McKee, head of the internal medicine department at the Salmon Arm hospital, brought this candid message to city council on May 23.

He explained that he and five colleagues, all internists (physicians who specialize in the internal organs), are responsible for emergency and critical care at the hospital on a 24/7 basis. Critical care is what is done in the ICU 害羞草研究所� the intensive care unit, and it is in jeopardy, he said. The unit is also called the CCU 害羞草研究所� critical care, cardiac care or coronary care unit, or the HAU 害羞草研究所� high acuity unit.

McKee told council it害羞草研究所檚 important as politicians that 害羞草研究所測ou be aware we are at risk of losing not a minor bit of our service but a major bit of our service.害羞草研究所�

While critical care can live through lean times in terms of some resources, 害羞草研究所渢here was a real concern last fall that we were going to lose this service altogether. And we had to begin to actually plan about what that would look like. How would it affect our other departments? How would it affect namely our operating rooms and our emergency rooms?害羞草研究所�

Although he said things have eased slightly since autumn, he outlined the ongoing issues. And he asked for council害羞草研究所檚 help.

害羞草研究所淚害羞草研究所檓 not here today to ask you to help solve our operational problems or get yourself involved in the delivery of health care in Salmon Arm; that害羞草研究所檚 clearly not the council害羞草研究所檚 role.害羞草研究所�

McKee said his hope is that council could help to keep the health-care needs of the growing community at the forefront for Interior Health, the Ministry of Health and the board of the North Okanagan Columbia Shuswap Regional Hospital District.

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McKee noted Shuswap Lake General Hospital (SLGH) was built in 1958 and, in 2006, the emergency room was modernized and the radiology department was expanded. At the same time the renovations were completed, a master site utilization plan was submitted by the hospital害羞草研究所檚 planning group with a growth plan and future hospital expansion. It was specifically for the critical care unit, the medical wards and the surgical operating rooms.

Post 2006, he said a few minor renovations were done 害羞草研究所渂ut there was really no attempt to adapt the hospital to our demographic growth, to our tourism infrastructure,害羞草研究所� he said, pointing out the hospital sees a lot of B.C., Alberta and Saskatchewan visitors.

害羞草研究所淭hat site plan was never escalated, was never funded; we went to meetings once a year, we heard that it was there, that it was waiting to be prioritized害羞草研究所� Other projects got accomplished and ours did not get any attention at all.害羞草研究所�

In 2017 the medical staff were concerned, he said, so a modernization plan that included primarily the operating rooms was funded outside of Interior Health. The initiative was led by an operating room doctor.

McKee pointed out that although his focus is mainly critical care, it is closely tied to the surgical service 害羞草研究所� 害羞草研究所渨e need one another.害羞草研究所�

He said the plan cost about $60,000 and was submitted within a year to Interior Health capital planning for prioritization. The plan was for what was called the OR Redesign Project.

After a year, good news was received that the plan had been bumped up and was #3 on the region害羞草研究所檚 capital priority list.

害羞草研究所淭hat meant to us that things were going to happen imminently,害羞草研究所� McKee commented.

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In 2020 the pandemic struck, but coming out of that in the summer of 2022, the hospital received news from Interior Health that it had been approved for $1 million for a formal planning phase of the OR Redesign Project from five years earlier. Medical staff leaders were notified, asked to plan time off to participate in the meetings, 害羞草研究所渁nd we thought this was going to be our opportunity.害羞草研究所�

Within a couple of months, McKee said, word was received the funding was being withdrawn.

害羞草研究所淭he bottom line was, we were told it害羞草研究所檚 not Salmon Arm害羞草研究所檚 time害羞草研究所�害羞草研究所�

Money was left for some operating room renovations but all other complementary projects were cancelled. Those included all the components of the original OR Redesign Project 害羞草研究所� the critical care space, the medical device reprocessing or sterilization unit, and the ambulatory care space designed to accommodate people who are suitable for 害羞草研究所渓umps and bumps type surgery,害羞草研究所� keeping them out of the expensive operating rooms.

More negotiations occurred, leading to what McKee called the new Site Utilization Plan. However, he said they were told it would take three to five years to complete.

害羞草研究所淚n our world, that means maybe never, and we haven害羞草研究所檛 really got our arms around how we害羞草研究所檙e really going to get through those next three to five years.害羞草研究所�

The ICU

McKee included a photo of the ICU in Salmon Arm taken a week prior.

It害羞草研究所檚 a three-bed unit, with two beds on one side and a third bed behind a curtain on the other. There害羞草研究所檚 patchwork duct taping on the plastic walls and the plastic doors. He said vents were rigged up at the time of Covid to create a pseudo negative pressure space that vents outside the window on top of the emergency room bay.

害羞草研究所淚t害羞草研究所檚 an archaic failing space,害羞草研究所� McKee described the unit, adding the hospital is also a site for the UBC internal medicine training program. He said the Salmon Arm program is at risk because the hospital can no longer really accommodate the trainees with a functional working space.

害羞草研究所淪o this speaks to the need for the structural modernization of this ICU space that has really been untouched since maybe the 害羞草研究所�80s.害羞草研究所�

McKee said critical care is now sometimes carried out in other parts of the hospital such as emergency rooms with critical-care facilities, or the recovery room, which can mean mismatched skill sets in terms of medical staff.

害羞草研究所淓mergency department backlogs speak for themselves. We have 14 beds at the best of times in our ER. Many days we will have nine or 10 or 13 of them filled with admitted patients. Many of them are ward patients, but sometimes they害羞草研究所檙e critical- care patients that need hour-by-hour monitoring and intervention.害羞草研究所�

Salmon Arm sometimes must transfer critical-care patients to larger hospitals if it can害羞草研究所檛 manage them.

害羞草研究所淭hey tie up a bed in Kelowna and they still wait three or four days for their procedure in an ICU or a step-down bed in a tertiary hospital. That害羞草研究所檚 not good for anybody.害羞草研究所�

He said there is no simple solution with an aging building and skyrocketing construction costs.

害羞草研究所淭here害羞草研究所檚 not a revolution here, there害羞草研究所檚 not a magical solution we害羞草研究所檙e going to snap out of the sky害羞草研究所�

害羞草研究所淲e害羞草研究所檝e been complaining just long enough and just loudly enough lately, that everyone has visited our campus. They understand what we害羞草研究所檙e up against. We have letters of support from other regional partners. But we need to find a way to get Salmon Arm out of the danger zone害羞草研究所� before we irretrievably lose these services or something happens to our ICU害羞草研究所� and it害羞草研究所檒l close and we won害羞草研究所檛 have anything to do but wait for many more years and then hope that we can recover the staffing resources that we need.害羞草研究所�

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Allison Howatt, chief of staff at SLGH, added what she described as clarifications to McKee害羞草研究所檚 presentation.

She said there is still a master plan and a secondary plan.

害羞草研究所淣othing was cancelled, but nothing was approved. So we didn害羞草研究所檛 have anything taken away, we were just never given anything we thought we were going to get,害羞草研究所� she said.

害羞草研究所淲e have a set amount of money to do something at Shuswap Lake. It was not enough to cover all the things we had wanted. That害羞草研究所檚 why the project got skinnied down to just the surgical redesign. And that project is underway, albeit slowly, but it害羞草研究所檚 underway. With the hope that those renovations will start in the fall of 2024. But we害羞草研究所檙e in the planning stage.害羞草研究所�

Howatt said the HAU (ICU) is a priority, 害羞草研究所渂ut our entire hospital space allocation is an issue. We have way more things we need to do with our space than we have space to do it. That害羞草研究所檚 the huge issue.害羞草研究所�

害羞草研究所淭here are many services that are at a tipping point, as they are all across IH,害羞草研究所� she said. 害羞草研究所淥ur maternity services are grossly underfunded and they害羞草研究所檙e at a tipping point. Our emergency services, in terms of our person power for both nursing and staff and ER docs, is at a tipping point.

害羞草研究所淚f we don害羞草研究所檛 get any improvements to our site, then it becomes less and less easy to attract people to come to Salmon Arm despite it being a pretty nice place to live.害羞草研究所�

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Howatt also pointed to inequities in funding for SLGH.

The hospital is funded for the Salmon Arm community, but she estimated that 50 per cent, if not more, of patients from Enderby come to Salmon Arm. However, Enderby is 100 per cent funded to receive health care in Vernon.

She also pointed out that Salmon Arm has a 害羞草研究所渧ery robust group of family doctors害羞草研究所� who look after patients from Enderby, Armstrong, Kamloops, Chase and other areas, yet the financial support goes to bigger hospitals in Vernon or Kamloops.

Coun. Kevin Flynn said Salmon Arm council reps on the Columbia Shuswap Regional District board go twice a year to the North Okanagan Columbia Shuswap Regional Hospital District board meeting. He said they 害羞草研究所済et told our taxpayers as a group will pay 40 per cent of this, this, this, this and this. And I害羞草研究所檝e been here 18 years and I害羞草研究所檝e felt that that process is a rubber stamp and I really appreciate you saying that we need to be more vigilant害羞草研究所�

害羞草研究所淚 think we as a council need to figure out what our steps are. I think we as a hospital district need to figure out what our next steps are害羞草研究所�害羞草研究所�

害羞草研究所淭hat tower in Vernon, the two extra rooms, the psych ward being talked about in Vernon, I can害羞草研究所檛 argue that those aren害羞草研究所檛 important to all of us, but I can argue that Shuswap Lake has been under-served害羞草研究所�害羞草研究所�

害羞草研究所淭here害羞草研究所檚 been lack of communication and I really have to thank you (Dr. McKee), and Coun. Lavery, for opening up this discussion because it害羞草研究所檚 time for the residents of the Shuswap to speak up害羞草研究所�害羞草研究所�

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Flynn also noted that city taxpayers will see a hospital district tax on their city tax notices. That goes to the province and Ministry of Health, not the city. He said any hospital improvements in the regional hospital district are funded 40 per cent by the hospital district.

The North Okanagan Columbia Shuswap Regional Hospital District consists of Salmon Arm, Revelstoke, Sicamous, Enderby, Spallumcheen, Armstrong, Lumby, Coldstream, Vernon and CSRD Electoral Areas B, C, D, E and G and RDNO Electoral Areas B, C, D, E and F.

In response to council questions, McKee remarked: 害羞草研究所淲e害羞草研究所檙e not proposing that we march on the streets or have a special save-the-hospital day害羞草研究所� We害羞草研究所檙e all trying to stay away from drama and hyperbole. These are practical real-world problems. There are hard-working people on both sides of the coin. We need to work together and find a way to help them keep our particular hospital afloat. We害羞草研究所檙e not talking about an expansion or growth or some new unit. We害羞草研究所檙e just trying to maintain a quality service and hope that it grows from there as the community grows as well.害羞草研究所�

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Coun. Tim Lavery outlined how Dr. McKee approached him, Mayor Alan Harrison and Coun. Flynn just after the election. They had further meetings with MLA Greg Kyllo, SLGH administration and Interior Health. However, it was too late as the regional hospital district had its budget meetings early in the year.

害羞草研究所淭he issue has been raised with them; the criticism is that folks thought there was a plan. Medical staff thought there was a plan to proceed, it was taken off the table and no one knew.害羞草研究所�

Lavery said McKee has highlighted 害羞草研究所渋ncredibly well that the ability to retain the service, to retain and attract staffing is at a critical level. He would not be here without that.害羞草研究所�

Lavery termed it a regional issue and asked that McKee take his presentation to the Columbia Shuswap Regional District (CSRD), which Flynn chairs. He noted that while the regional hospital district is not just the CSRD, 害羞草研究所渨e害羞草研究所檙e hearing loud and clear a message about prioritization for here, and we need to advocate on that.害羞草研究所�

Mayor Alan Harrison began his comments by saying he hears all the time from residents how much they value the human care and compassion they receive at the hospital 害羞草研究所� and the discussion is not about that but about physical structure.

Both he and Lavery thanked McKee for his courage in bringing the issues forward.

害羞草研究所淚t seems to me that the North Okanagan regional hospital board doesn害羞草研究所檛 work. That process doesn害羞草研究所檛 work for us,害羞草研究所� Harrison said, emphasizing meaningful input isn害羞草研究所檛 happening.

Harrison said while there is a lot of talk about plans, 害羞草研究所測ou have to have a financial plan to pay for the result of the plan. And that part seems to be missing.害羞草研究所�

He said council needs to become more vigilant.

害羞草研究所淲e害羞草研究所檝e lost faith in the process of the system bringing capital improvement to our hospital. The best way to make that happen is to make residents aware.害羞草研究所�

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