New Baffin Hospital chief vows to strengthen patient care

Dr. Mark Lachmann, the new chief of staff at the Baffin Regional Hospital, faces a daunting task: improve patient care, create “more Inuit influence” and figure out how to keep the Government of Nunavut’s new staff housing policy from driving away its precious nurses.

Lachmann started his new job only three weeks ago, on Oct. 1, but at a press conference last week he was ready to set out his vision for medical services in Nunavut’s largest region.

At the top of his to-do list, Lachmann said, is to carry out recommendations contained in a series of internal reviews on Nunavut hospital services, not yet released to the public, that show patient care falls below Canadian standards.

To accomplish that, Lachmann told reporters he’s got three goals:

* improve patient care standards at the Baffin Regional Hospital up to Canadian standards;
* find ways of getting and keeping more staff, to cope with “a profound shortage of nurses” that will hit Canada within the next 10 years, while dealing with the biggest problem that Nunavut nurses have right now: staff housing; and
* transform the BRH into a “community hospital,” with more Inuit involvement.

Lachmann, an assistant professor of medicine at the University of Toronto, who has worked in Nunavut since January as a family doctor and geriatrics specialist, also said he wants to increase the hospital’s autonomy within the system.

“We would like to see the hospital separate out from the department of health and social services so that it’s not a mini-department, but an independent institution that’s able to respond to its own issues,” Lachmann said.

On patient care, Lachmann openly admitted that a big part of his job is to provide his political masters with the information they need — and then press the GN Department of Health and Social Services for more resources.

“What I see my role as being, is to set a certain standard of care and say to the people of Iqaluit and Nunavut that we need to have a certain standard of care here, and that it’s up to the Department of Health and Social Services to implement that,” he said.

But that means solving one of the department’s longstanding problems: finding and keeping staff.

“At the current time, we simply do not have the human resources within the acute care system to meet patient care needs. We do not have enough nurses and we do not have enough support staff to do that effectively,” Lachmann said.

He said, though, that he believes the GN’s health department now supports the goal of improving patient care.

“The most encouraging thing is that the department is very committed to having the hospital and the rest of the acute care system meet Canadian standards,” Lachmann said.

A key to better patient care standards is the recruitment and retention of nurses. And right now, the GN is not dealing with the biggest factor that is driving nurses away from Nunavut: staff housing.

“I only raise it [housing] as an issue because it’s a real issue. A nurse who graduates from any part of Canada, including the excellent nursing program at Arctic College, those skilled professionals can go anywhere in the country and Nunavut has to be made an attractive place for them to come. I worry about that. If there are no nurses here, there is no hospital.”

In its new staff housing policy, announced last month, the GN will start raising staff housing rents this January, and stop providing staff housing in Iqaluit by 2010. It’s not clear yet if this policy will hurt the GN’s health staffing efforts.

But Lachmann said the new policy has already done visible damage to staff morale at the Baffin hospital.

“When the article came out in the local newspaper about housing… all of a sudden, people didn’t have a reason to be here. I don’t know how to address that but that’s a real concern for the functioning of the hospital.”

As for more involvement from Inuit in the running of the hospital, Lachmans said that’s not an expensive thing to do, but just a question of changing attitudes.

“Being the chief of staff, this is still not my hospital. This is your hospital. This is the hospital of people who live in Iqaluit, Baffin Island and Nunavut. One thing that I think would be very exciting would be to have people who actually live in the area brought in to tell us what they want.”
GN staff still expect that the Baffin region’s replacement hospital will be ready for use by April 1, 2007. The contractor, SNC-Lavalin, will likely turn it over to them in late 2006, or early 2007.