The Remedy to Québec Health Care

Dr. Lawrence Rosenberg leverages his experience as a hospital executive, researcher, and practitioner to help the province’s new Integrated Centre of Care deliver improved patient outcomes while cutting costs

Québec’s health-care sector began a major transition this past April when a bill transformed most single-standing health-care facilities into the Integrated Centre of Care (also known as CIUSSS or CISSS, depending on whether there is a university designation), which consists of multiple complementary-care institutions. As the newly appointed president and CEO of Montréal’s Integrated University Centre, Dr. Lawrence Rosenberg, formerly the executive director of Jewish General Hospital, the largest institution in its network, is tasked with easing the transition to the new system and ensuring that the vision of the Integrated Centre is successfully realized in improved patient outcomes and efficiency in Québec’s health system.

“The new legislation will invariably change what we do at Jewish General as well as how we do things. Now that we have community partners and are part of the same organization, we can put into place a continuum of care for our patients that is long overdue.”

“Québec has been slowly moving in this direction for many years,” Rosenberg says. “It’s the next logical step and the right thing to do. I believe it will result in a better way of delivering health care.” The idea behind grouping institutions with complementary services is to ensure that the patients will receive a continuum of care through any given health issue and across their lifetime. The new structure, which includes Jewish General Hospital, also contains organizations that provide primary care services in the community, long-term care, elder care, and rehabilitation services, as well as services for those with physical or intellectual deficiencies. No matter where a patient needs health care, they can expect to receive services from one regional centre.

FACTS & FIGURES

$23M

Deficit Rosenberg helped eliminate to balance the budget at Jewish General Hospital

50%

Reduction in ER wait times, even with a 20 percent increase in patient volume

60%

Reduction in patient boarding time in the ER

50%

Reduction in average turn-around times between OR patients

95%

On-time starts for the first case at the operating theatre, up from 56 percent

Implemented correctly, the Integrated Centre will result in reducing in the fragmentation of care and duplication of services that plague a system with several freestanding health-care providers. “Essentially, we will be better able to give the right care in the right place to the right patient at the right time,” Rosenberg says.

Getting to that point presents several immediate challenges. As the structures change, the staffing will change, which can create upheaval in an organization. All senior management in the partner institutions had to reapply for their jobs in the new structure, and several positions were cut in order to create a more efficient system. “There will be some initial budget issues in terms of budgets shrinking and structures getting leaner as the senior layers of management shift and consolidate,” Rosenberg says. But he believes the new management structure will create opportunities as well.

Rosenberg counts himself as only one among many who will be instrumental in successfully managing the new care structure. He was nominated and confirmed as president and CEO of the new Integrated Centre after he, too, had to reapply for a position in the new system. He is uniquely suited for his new leadership role by virtue of his broad range of health-care expertise. Not only does he have health-care CEO experience, but he also conducts diabetes research at the university and has practiced as a surgeon until he began as director general. Because of that experience, he understands firsthand the importance of creating an environment that promotes dignity and respect for each patient with high-quality, cutting-edge care. Rosenberg plans to ensure open communication between each partner in the new system to provide multiple areas of expertise for each patient’s personalized health care while also improving patient access and reducing wait times.

“The challenge is to meet the goals of the legislation,” Rosenberg says of making sure there is a continuum of care with easy access to high-quality treatment for the entire population. “All that will take time.”

A major part of the Integrated Centre’s success will depend on community support and physician buy-in. “A lot of the change will come about as part of a bottom-up approach,” Rosenberg says. Patients will need to be flexible as the structures change and coalesce into the new system, but ultimately it will lead to improved care and the betterment of Québec’s population.