The Challenges We Face and Our Priorities
Scarborough Health Network (SHN) is the third largest community health network in Ontario that cares for more than 800,000 people in our catchment area at three different hospitals — Birchmount, Centenary and General. We provide exceptional care to our patients and delivering provincially, nationally, and internationally recognized programs. SHN is taking the lead in delivering accessible, world-class and inclusive healthcare to one of Canada’s most vibrant and diverse, yet vulnerable communities.
Yet despite our leading efforts, SHN has been the least funded health network in comparison to other hospitals with no major infrastructure funding received in the last 20 years. At more than half a century old, our aging hospitals are falling behind and creating obstacles for our patients, physicians, staff, and community. To overcome these obstacles, continue our high quality of care for Scarborough’s patients, and become Canada’s leading community teaching health network, SHN needs investment.
SHN Foundation recently launched the Love, Scarborough marketing campaign, encouraging the rest of Toronto to back us up. The campaign, launched in January, 2022, is an open letter to Toronto and sheds light on the healthcare inequities we face in Scarborough. Like the fact that although we make up 25% of Toronto’s population, our Scarborough hospitals get less than 1% of hospital donations.
SHN serves a “diabetes hotspot” in Scarborough. With our community’s unique demographics, there is a heavy demand for dialysis and other CKD treatments. Couple this with the fact that Scarborough has the lowest average family income in the GTA, and it’s clear that our vulnerable community is facing a significant health challenge.
Existing spaces where care is provided are being outgrown, and across the Network, we are already at full capacity – or beyond. Many of our dialysis units are in urgent need of attention to not only increase capacity but to provide a better, safer patient experience and mitigate risks posed by our aging facilities.
With CKD on the rise in our catchment area, SHN must not only expand but employ innovative, cutting-edge models of care delivery that prioritize education, prevention, and disease management. These services are essential to changing how the community reacts to the disease by focusing on prevention and promoting a sustainable change in lifestyle, with the intention of driving a decrease in CKD rates. Also, as a community health network that prides itself on strong partnerships with like-minded organizations, a collaborative, integrated model would allow SHN to engage with the Scarborough community while offering patients and families, particularly those in vulnerable circumstances, greater access to more comprehensive care closer to home.
Currently, diagnostic imaging services are scattered across five different locations within the General hospital, impacting the patient experience.When meeting with our Patient Advisory Council, patients voiced their concerns over the wayfinding at the General—it is difficult to know where to go when the various diagnostic imaging services are at five different hospital locations. Patients come for testing to the General and are confused because there isn’t a designated waiting space for dedicated area for pre- and post-procedures. Instead, patients need to navigate between multiple locations to get the testing and care they need.
The challenge is that the current diagnostic imaging space is based on the original 1956 building design so the room sizes are undersized compared to modern technology requirements. This also means there are not accessible washrooms or changing cubicles, and there are very limited waiting areas so patients are redirected to a chair in the hallway. It is also not possible to separate different patient groups, such as inpatients and those at the General for an appointment, for greater efficiency.
Due to these challenges, SHN is forced to expend significantly more resources and funding to order to achieve the necessary levels of care for our patients. The out-of-date technology and cramped spaces also demonstrate a disparity in health equity, with Scarborough receiving care in far less adequate facilities than the rest of Toronto.
A new Diagnostic Imaging Concourse has been a priority at SHN since 2000, and successive governments have continued to overlook the importance of this critical infrastructure need.
Scarborough has grown far beyond the capacity of our existing facilities, while our capabilities are being surpassed by modern medical technology that could drastically improve the patient experience.
At more than 200% of their intended capacity, our aging EDs at Centenary and Birchmount provide inadequate infrastructure for patients and physicians alike:
- Waiting rooms are cramped and under-furnished;
- Patient privacy and comfort is lacking; and,
- Space is not optimal for doctors, nurses and staff to properly manage patient care
The other critical factor that has exacerbated the need for upgraded EDs are the learnings we have had dealing with the COVID-19 pandemic. SHN dealt with the second-highest number of COVID-19 patients throughout the five waves of the pandemic. The most recent Omicron wave showed us that we need to redesign the emergency so areas are not siloed, are more continuous, and spaces can be flexible to cope with changing circumstances. We have to be able to maximize the available staff in the department and be able to cope with shortages in staff due to illness – like the shortages we saw during the last wave of the pandemic. Line of sight is critical, along with minimizing travel steps.
New emergency departments – with an expanded footprint and additional capacity for modern technology and innovative models of care – are essential if we hope to deliver on our priority of transforming the patient experience and caring for our growing Scarborough community.
SHN is home to the second-largest community hospital-based mental health and addiction program in Ontario and currently operates two satellite outpatient clinics in the Scarborough community. However, lack of funding for mental health initiatives in Scarborough has led to these satellite sites being in less than ideal spaces. The current sites are not easily accessible for our staff, patients and community members, often located on the second or third floors of buildings with back alley entrances and difficult to reach by TTC.
The Scarborough community is 59% new Canadians, 74% visible minorities and has the lowest average income in the GTA. Due to limited government funding in capital infrastructure over the last 12 years, our community is receiving care in less-than-ideal and aging facilities, like our mental health satellite sites.
With our community growing and evolving each and every day, we must also evolve and transform to meet current capacity and prepare for more. To set the stage for the leading role we aim to play among Toronto’s hospitals, SHN needs investment to update and expand its facilities and, ultimately, close the growing gap to ensure equitable healthcare for all of Scarborough.