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Medical Organization Structure and Services

Overview

The medical organizational structure and delivery of medical services within Western Health reflects its large geographic region and the population centers within the region, as well as the long established traditional medical referral patterns and service delivery arrangements.

The Vice President of Medical Services, Dr. Dennis Rashleigh, works from the administrative headquarters in Corner Brook. The Vice President position is one of nine executive positions that reports to the President and Chief Executive Officer. The Vice President, as a member of the Executive team, is responsible for all matters relating to medical services within the region, attends board meetings on a regular basis, and reports on medical services and related issues within the region.

Medical Staff Organization

The Medical staff structure in the Western Region is comprised of appointed Chiefs of Discipline who are the medical staff leaders for each of their respective services.

The following are the Clinical Disciplines with Western Health:

  1. Children and Women's Health
  2. Emergency/Ambulatory Care
  3. Family Practice
  4. Medical Imaging
  5. Medicine
  6. Pathology and Laboratory Medicine
  7. Perioperative
  8. Psychiatry
  9. Surgery

In addition to the above Clinical Disciplines, Western Health has a Division Head for Pediatrics.

Along with the Chiefs of Discipline, the Organization appoints Chiefs of Staff for each of the six health facilities as follows:

Chief of Staff, Western Memorial Regional Hospital, Corner Brook
Chief of Staff, Sir Thomas Roddick Hospital, Stephenville
Chief of Staff – North, Bonne Bay Health Centre, Norris Point and Rufus Guinchard Health Centre, Port Saunders
Chief of Staff – South,  Calder Health Centre, Burgeo and Dr. Charles LeGrow Health Centre, Port aux Basques
 

Each of the six health facilities noted above have a Local Medical Advisory Committee (LMAC) chaired by the Chief of Staff.  These LMACs normally meet on a monthly basis and deal with medical issues in their areas.  Issues of regional relevance that cannot be resolved locally, as well as policy matters, are referred to the Regional Medical Advisory Committee (RMAC) and as necessary, to the Senior Team for recommendation and resolution.

The RMAC membership is comprised of all of the above positions, as well as an appointed Chair for the Committee.  The RMAC is also attended by the CEO, VP Medical Services, VP Patient Services, and VP Rural Health.  The RMAC meets minimally 8 times per year at the call of the Chair.

Service Delivery

Western Health operates 20 community-based offices, 22 medical clinics, and nine health facilities within the region. The medical clinics are dispersed throughout the region and provide primary health care services to residents in their respective catchment areas. These services are provided by physicians and nurse practitioners in a cooperative and consultative manner under established provincial protocols. Physicians may be required to enter into affiliation agreements with nurse practitioners in their area of service, or in adjacent areas.

Six of the nine health care facilities offer a variety of medical and diagnostic services including acute care and in-patient beds. These facilities receive and care for patients in their direct catchment areas. Four health care facilities provide primary in-patient and out patient medical care and diagnostic services:

Charles L. LeGrow Health Centre, Port aux Basques
Calder Health Centre, Burgeo
Bonne Bay Health Centre, Norris Point
Rufus Ginchard Health Centre, Port Saunders.

These centres have in-patient long-term care and palliative care beds. Minimal obstetrical and surgical services are also provided at the Charles L. LeGrow Health Centre.

Sir Thomas Roddick Hospital, located in Stephenville, is a newly constructed 44 bed acute care facility which serves a population of approximately 24,000 residing in  Stephenville and the surrounding Bay St. George area. The facility provides a full scope of primary health care in-patient and clinical services as well as general internal medicine, surgical (including general surgery, obstetrics/gynecology and ophthalmology), psychiatric, and anesthesiology services.

Western Memorial Regional Hospital in Corner Brook is the referral centre for the region. In addition to its 182 acute care beds, the facility offers specialized services in a wide variety of disciplines.

Patient Referral Patterns

Referral patterns for specialty level services from medical clinics and facilities throughout the region are to the Western Memorial Regional Hospital. As well, some patients from the Charles L. LeGrow and Calder Facilities are occasionally referred to Sir Thomas Roddick Hospital in Stephenville. Referral of patients outside of the region is carried out for tertiary level services not offered at Western Memorial Regional Hospital. Patients requiring these services are usually referred to tertiary care facilities in St. John’s.

Quality

There is a strong emphasis on quality within Western Health. The organization has a Vice President of Quality Management and Research who works closely with the Vice President of Medical Services to ensure physician involvement and input into quality initiatives and clinical patient safety issues. There are various initiatives ongoing within Western Health under the leadership of quality improvement teams.

Teaching

Western Health operates the Western Regional School of Nursing which offers a baccalaureate in nursing. There is an affiliation agreement with Memorial University of Newfoundland’s Faculty of Medicine, under which provision is made for medical students and residents to rotate as part of their clinical training throughout the Western region in disciplines such as Family Practice, Pediatrics, Orthopedics, General Surgery, Anesthesia, Palliative Care, and Geriatric Care.