In this episode of the Growing Strathroy-Caradoc podcast, we’re continuing the Health and Safety theme from the last episode. Julie McBrien, the President and CEO of the Middlesex Hospital Alliance, gives us an inside look at Strathroy Middlesex General Hospital, including its impressive range of services, dedicated staff, and efforts to keep the ER not just open but moving as quickly as possible. Julie also shares insights on staff recruitment and retention strategies, the evolution of women’s health at the hospital, and when the new MRI machine will be up and running.

• 00:00 Introduction
• 01:03 Overview of Strathroy Middlesex General Hospital
• 02:32 Specialized Services and Women's Health
• 05:16 New MRI Machine
• 06:15 Staffing and Recruitment
• 11:11 Emergency Department Efficiency
• 14:13 Discontinuation of Obstetrical Deliveries
• 17:22 Julie's Personal Journey and Community Life
• 20:24 Future Vision for Community Health
• 23:38 Conclusion and Next Episode Preview

Julie McBrien is the President and CEO of the Middlesex Hospital Alliance.

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About the Growing Strathroy-Caradoc podcast

Strathroy-Caradoc is a place where people and businesses grow deep roots. With a population of 24,000 people. It would be easy to assume that Strathroy-Caradoc is a sleepy part of Southwest Ontario, but new residents and businesses—from independent shops to multinational power players—are flocking here. Listen to the Growing Strathroy-Caradoc podcast to find out why.

If Strathroy-Caradoc sounds like a safe community you'd like to move to, learn more at strathroy-caradoc.ca.

If you’re an investor, learn about our value proposition, key sectors, and available properties at investstrathroy-caradoc.ca.

The podcast is hosted by Michelle Samson and produced by Storied Places Media.

To find a hospital of our size that does the

2

breadth of services that we do,

it's a little bit hard to find.

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Michelle Samson: Welcome to the

Growing Strathroy-Caradoc podcast.

4

I'm your host, Michelle Samson

and I'd like you to join me as

5

we explore Strathroy-Caradoc and

what makes it a place where people

6

and businesses grow deep roots.

7

This time on the podcast, we're

continuing a theme we started in

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the last episode, which was about

the safety of Strathroy-Caradoc in

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terms of fire and police service.

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But we can't talk about safety without

also talking about health, right?

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Health and safety.

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They go together like

peanut butter and In a Jam.

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Loyal listeners will recognize

that call back to episode one.

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But I digress.

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If you listened to the safety

episode, then you heard the Chief

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of Police and the Acting Fire Chief

talk about the importance of their

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partnerships with local ambulance

services and the local hospital.

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Now, we have an opportunity to learn about

the state of healthcare in this community

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directly from the woman at the top.

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Julie McBrien is the President and CEO

of the Middlesex Hospital Alliance, which

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includes the Strathroy Middlesex General

Hospital in Strathroy and a smaller

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hospital in our neighboring county.

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Of course, this discussion will

focus on the Strathroy hospital.

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In the next 20 minutes, we're going to

learn how big it is, it's surprising

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range of services, how it has managed

to avoid ER closures, and its plans to

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deliver even more value to patients.

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We start with a brief overview.

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Julie McBrien: Strathroy Middlesex General

Hospital serves approximately 35, 000

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residents within our catchment area.

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We are considered a medium

sized community hospital.

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We consider ourselves to be family

centered and we generally provide

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a comprehensive range of services

both primary and secondary.

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We operate 54 beds at our hospital and

we also have a 24/7 emergency department.

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We have an emergency department

that's opened every day.

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We have two operating rooms

and a procedure room, so

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that's where we do surgeries.

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Whether it be elective surgery or

if you're in need of urgent surgery

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after hours, we offer that as well.

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And we also have a 24/7 diagnostic

imaging department, so if you need

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x rays we offer those services

and we have a CT scanner as well.

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Michelle Samson: Julie's overview

only scratches the surface of the

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wide range of specialized services

offered by this rural hospital.

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Julie McBrien: This is my opportunity

to tell you a little bit about

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what we're especially proud of.

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So we do focus on women's health.

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What that means for us right now is we

do offer a fair bit around breast health.

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Through our diagnostic imaging

department, we do mammograms,

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ultrasounds, we can do biopsies through

there if there's a concern for cancer.

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We also through our surgical suite

do mastectomies, and we also do

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breast reconstruction as well.

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So that really is a, big part of the

women's health that we currently do.

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We do plastic surgery so

carpal releases, removal of

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skin cancers, that sort of thing.

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Staying in the theme of surgery, we

do general surgery so if you need your

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removed, or if you need bowel surgery or

an appendix we do that, and our surgical

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services are days, nights, weekends,

whatever's required for emergency.

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We're very proud of

our orthopedic program.

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And that's wide ranging so we do about

365 total joints, so hip replacements,

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knee replacements every year.

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We also do shoulder repairs,

shoulder replacements.

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We do knee scopes.

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And then we do things that are

more urgent and unexpected.

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So if you break your hip, break

your ankle, break your wrist, we

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do that type of thing as well.

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We also do cataract surgery.

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And then we also do things that

are more laboratory related.

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So we do blood work, we do stress

tests, we do EKGs, and then various

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other things through our diagnostic

imaging department like CT scans,

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x rays, that sort of thing as well.

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Michelle Samson: That's a very long list.

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Julie McBrien: It is!

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Michelle Samson: Is this an unusual range

of services for a hospital of this size?

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Julie McBrien: Yeah, so would say it's

hard to find a comparator that's like us.

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There's some hospitals out there

that have alliances, so that's

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maybe a more common thing.

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But to find a hospital of our size

that does the breadth of community

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types of services that we do, I'd say

it's it's a little bit hard to find.

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We really try to focus on meeting

the needs of our community.

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So if for example, cataract surgery,

we know that patients don't want to

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travel to, say, into London for their

cataract surgery because they may not

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love to drive, that sort of thing.

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So we want to offer the services that

are close to home, that our community

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will appreciate, that they value.

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Hip and knee replacements are another one.

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Some larger centers have long wait lists.

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Our wait lists are a

little more reasonable.

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So we know that's again

another service that we want to

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provide care close to home for.

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Michelle Samson: Another service

that the Strathroy hospital will

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be able to offer soon is MRIs.

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Julie McBrien: We're working

collaboratively with our Strathroy

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Middlesex General Hospital Foundation

to help raise funds for the construction

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costs as well as the cost of the MRI.

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So we have started construction.

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And construction's underway

at the hospital right now.

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Cause there truly is a need in

the community to have an MRI.

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It's almost somewhat the norm.

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The standard of care for some

diagnostic of certain conditions.

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And, what we see now is patients

have to travel a distance if they

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need an MRI or they have a long wait.

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And that impedes access to care

and services if that's the case.

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So we're excited that we're

going to be able to offer

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that service to the community.

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When I'm out and about, I often

hear people are waiting for MRIs,

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so we're going to be, I know,

busy as soon as it's up and running

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and operational in March of 2025

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.

Michelle Samson: So that's very exciting news for those people who are waiting.

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Julie McBrien: Yes.

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Michelle Samson: Okay.

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Let's get back to some numbers.

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How many physicians, nurses, and

other staff work out of the hospital?

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Julie McBrien: We have about 270

physicians credentialed with us and

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that's across both of our sites.

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It's a mix of family doctors

that have privileges with us.

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It could be surgeons or other specialists.

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And some may be at our hospital

every day, some may be there more

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infrequently because they work

at another hospital and then help

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provide some sort of coverage for us.

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But 270 physicians is approximately

how many we have credentialed with us.

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Michelle Samson: And then what

about nurses and other staff?

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Julie McBrien: Yeah, so in terms of

other staff just for our Strathroy

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hospital, it's about 500 and that

includes full time staff, part time

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staff, casual staff, and probably

about 200 of those 500 staff are

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nurses, so whether they be registered

nurses or registered practical nurses.

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The remaining 300 could be physio,

they could be respiratory therapy,

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social work, housekeeping, kitchen

staff, our management team make

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up the remainder of that number.

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Michelle Samson: That's a

significant compliment of staff for a

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medium-sized hospital in a rural area.

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I asked Julie if it's been a

challenge to recruit talent.

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Julie McBrien: Definitely shortages

of health care workers is being faced

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within Canada, globally and particularly

coming out of COVID 19 we've seen this

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come up as a significant pressure

amongst larger hospitals, smaller

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hospitals, and I think each hospital

is seeing it in different ways.

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And we've seen it for various reasons.

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We've seen people leaving the profession

just because they're retiring.

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We've seen people leave

because they want to.

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Explore new different career opportunities

and that sort of thing and we've seen

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health care workers just leave the

profession because maybe they can't

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find child care, so then they maybe

have to not work as much as they

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did before and that sort of thing.

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So I think it's a bit

multifactorial in terms of why

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we're seeing what we're seeing.

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In terms of how we've fared at

Strathroy Middlesex General Hospital,

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I think we're holding our own on it.

146

Um, There was a period of time

where we struggled to recruit

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emergency department nurses.

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We still struggle to recruit

emergency department physicians.

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Because as you can appreciate, those

areas require people with extra training,

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extra knowledge, extra expertise,

and they're in demand everywhere.

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I would say we're incredibly fortunate

and proud to say we've not had to have

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a single emergency department closure

at either of our hospitals during this

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time period, despite the pressures which

is something I, I know some of my peer

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hospital colleagues are struggling with

at their hospitals where they've had

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to close their emergency department at

certain times just because they haven't

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had the staff, but we're very fortunate

to have very dedicated hardworking staff

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and physicians that really go above

and beyond to make sure that we don't

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find ourselves in those situations.

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Even there's been a couple of

close calls at times with people

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calling in sick and stuff, but

we've been able to make it work.

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In terms of why we haven't maybe had as

significant struggles as some hospitals,

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I would say we care about our staff and

our physicians and our volunteers we

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do want to be a hospital of choice for

people to work with us and volunteer

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with us I think taking time to come up

with initiatives that make us be valuable

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as an organization for recruitment and

retention that's gone a long way to have

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people apply to have jobs with us and

to stay with us as long as they have.

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In terms of some of the things that

we've done in that regard You know, we

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do try to promote continuing education

to our staff and our physicians and

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conferences and that sort of thing.

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We do have a well being committee

that has always a bunch of

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activities going on that help

support our staff and our physicians.

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Whether it be a a step challenge or we

recently got some branded clothing that

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the staff can wear and that sort of thing.

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So just.

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Building that sense of belonging

and fellowship amongst our staff,

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I think that's important to making

people feel like they, they belong

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We're doing also a lot around justice,

equity, diversity, and inclusion.

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We are seeing our staff is more diverse.

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We know that our patients

coming to us are more diverse.

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We want everyone to feel like

they belong at our hospital.

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For Pride.

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We've raised the Pride flag.

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We painted a Pride crosswalk.

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So just, again, letting people know

that everyone's welcome and uh, we want

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everyone to feel as included as possible.

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Every month we do long service awards to

recognize staff and physicians who have

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been with us for long periods of time.

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We do appreciation breakfasts

and lunches and barbecues.

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And then probably I'd say one of

the last things we continually

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work on is succession planning.

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We know people are going

to move on or retire.

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So how do we try to make sure we have

people that maybe are the future of

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the organization, whether it be in

leadership roles or whether it be

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frontline nurses, taking advantage of

those opportunities to hire new graduates

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and that sort of thing is something

that we make a priority as well.

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Michelle Samson: So you're tackling

this problem from all sorts of

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angles, which is really great.

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the next thing I want to talk about is

that the Strathroy Hospital has been

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doing pretty well on statistics like

ER wait times and um, in particular,

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very much lower than average length

of stay for patients who go on to

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be admitted to the hospital, with

Strathroy reporting stays of 7.

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3 hours while the

provincial average was 19.

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1 hours, almost three times as long.

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So what's your secret?

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How are you managing to

achieve these better stats

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than the rest of the province?

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Julie McBrien: I'd say

there's really no secret.

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And I contribute a lot of hard work

to the teams at the hospital for

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their ongoing efforts around this.

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It really is a bunch of different

initiatives over a long period

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of time that I think has lent

to the success we've had.

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We are fortunate that we did receive some

government funding last year and this year

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that specifically looks at how to reduce

wait times in the emergency department.

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So we've used that money in some specific

ways to really help make sure that we're

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closely monitoring that and we're trying

to get patients in and out as quickly as

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possible, or if they have to be admitted

how we can make sure they're getting to

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an inpatient bed as quickly as possible.

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For example, one of the initiatives

we started was we have an x-ray

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technician overnight at the hospital

now, which used to just be on call.

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So if you needed them, you'd call them,

they would come in but now we have

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somebody there overnight that does x rays.

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What that means is the x-ray can get done

uh, in a timely way, it can get read,

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and then hopefully that patient can be

discharged home or move on to whatever

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level of care they may need after that.

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So that's one initiative that

we've done in the last year that

226

we think is really helping keep

those wait times low and manageable.

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Another initiative we've done there

is we put an extra nursing staff in to

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address patients that are of lower acuity.

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So, patients that maybe aren't

very sick, but do need to

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see a nurse and a physician.

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We have that nurse help facilitate

that so that patients are in and

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out on a fairly quick basis through

that area of the department.

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We also have patients that get

brought to us by ambulance.

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So we've been working with our ambulance

partners, too, around how we can make sure

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that when they bring patients to us, we're

assessing those patients and starting

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treatment on them as quickly as possible,

because that can free that ambulance

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up to get back out on the roads, which

is really important for our community

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to make sure we have ambulances on our

roads to respond to patients in need.

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But as you can appreciate days

are busier than others for us

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and it's somewhat unpredictable.

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Of course, if you have a life

threatening illness or serious medical

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concern, and you come to our emergency

department, those patients are our

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highest priorities, and sometimes

patients that have less serious issues

244

have to wait a little bit longer.

245

That's the nature of the way the

system's set up, and that's the

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way we want it to work so that the

sickest patients get treated first.

247

But yeah, it's constantly a

work in progress for us and it's

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something we're committed to.

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We do get complaints from patients and

it's often about wait times but we take

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each complaint seriously and we follow up

on that and it'll continue to be a focus

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for us in terms of wait times for sure.

252

Michelle Samson: Recently, some

patrons of the hospital have expressed

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concerns about the discontinuation of

obstetrical deliveries in Strathroy.

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Julie says it was a difficult decision

for the Middlesex hospital alliances,

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leadership and board of directors.

256

One that only came after a decade

of trying to reverse a trend

257

of falling delivery numbers.

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Julie McBrien: We wanted to increase

the number of births at our hospital.

259

We worked on a number of

strategies over the last number

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of years on how to do that.

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And it included things like having more

family doctors in our community that do

262

deliveries, credentialing midwives to our

hospitals so that they could do deliveries

263

with us, we hired an obstetrician

gynecologist with a focus on deliveries.

264

When we evaluated the outcome of

these strategies our births were

265

actually going down and not going up.

266

And despite all the best efforts we

didn't see what we had hoped to see

267

by implementing all these strategies.

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Last year we actually saw less than

60 births at our hospital, which

269

was the lowest we'd seen in, I

think, the history of our program.

270

We're very close to peer hospitals that

all allow for more complex deliveries

271

that offer more services to moms

and families who are having babies.

272

We don't have a pediatrician but our

nearby hospital does have a pediatrician.

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They have a neonatal intensive care unit.

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should anything go wrong.

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What we've somewhat seen, I think,

over time is that mums and families are

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speaking with their feet and choosing

just to have their deliveries elsewhere,

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despite us offering the service.

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It was a hard conversation and

discussion with our board about

279

how do we, despite what we've done,

how do we move forward with this?

280

And really the focus from our board

was let's hear from the community what

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types of women's health services they

want us to offer and seek that input

282

from them and then we will shape a a

re-envisioned women's health program

283

around that and one that doesn't include

the deliveries of babies, but includes

284

many other aspects of women's health.

285

Since we made that decision, we've

been working very closely with

286

London Health Sciences Centre and St.

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Thomas Elgin Hospital.

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They're our two closest

partners that do deliveries.

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In partnership with them, we really

wanted to make sure this transition was

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seamless for any mums and families that

had deliveries planned with us, and we

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made a commitment to do those deliveries.

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But of course if a mum's at home and in

labour and the ambulance brings her to

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us, we will absolutely assess her and,

you know, if we're able to transport

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her to one of our peer hospitals

and there's time, we will do that.

295

If not we have delivered more

than one baby in our emergency

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department in the past and that's

always a possibility as well.

297

Michelle Samson: To collect feedback

from the community, the Alliance ran a

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survey and will be doing focus groups.

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Once everyone has had their say, they

plan to share the results back with the

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public and take a few months to reinvision

their women's health plan and invest

301

in what the community needs and values.

302

For updates, keep an eye on the

Middlesex Hospital Alliance website,

303

which is linked in the show notes.

304

Since the growing Strathroy-Caradoc

podcast is about people growing deep roots

305

in this community, I wanted to talk to

Julie not just as the CEO in charge of our

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hospital, but as a resident of Strathroy.

307

She moved here not too long ago, in 2021.

308

So I asked what brought her here,

and how she's liking it so far.

309

Julie McBrien: I am loving it.

310

So maybe I can tell you

a little bit about me.

311

Cause then it may make sense

why I love it so much here.

312

So, I was born and raised in New

Brunswick, actually, and I went

313

to university in Fredericton

and did my nursing there.

314

But when I graduated from

nursing, that was the mid 90s.

315

And there were no jobs.

316

It's hard to believe there were no

jobs in nursing back in the 90s.

317

So I ended up coming to Ontario at

that time and I worked in London.

318

I was an operating room nurse there

for a number of years and then ended

319

up moving to Oakville, Ontario, and

that's where I've spent my career for

320

the last probably 20 years in Oakville.

321

GTA area is growing like crazy

and I was really looking for an

322

opportunity to have, um, getting back

to a more smaller, community feel.

323

maybe a little more

akin to the East Coast.

324

And this position came up at the

Middlesex Hospital Alliance in Strathroy.

325

So yeah, so moved from Oakville

to Strathroy, and I rented an

326

apartment here for a while.

327

And then my wife and I purchased

a house here in Strathroy.

328

So we are officially here now.

329

And it's great.

330

Grocery shopping, I run into people from

the hospital or people I know from curling

331

or other activities in the community.

332

So, It just feels like home, even

though it's not the East Coast.

333

Um, many of the staff at the hospital

work and live in the community, so

334

I think that makes it even more feel

like a family in a lot of ways, which

335

links back to our mission and our

vision as a hospital to care for our

336

patients like we would our own families.

337

So, yeah, it's to me, it's been

one of the best moves I've ever

338

made and, I'm really happy with it.

339

Michelle Samson: Obviously you can only

speak for yourself, but I'm curious if

340

the quality of life in the community

and the things that you're talking

341

about has that also been a factor in

the attraction and retention of staff?

342

Julie McBrien: there's the people

that are maybe drawn to larger

343

hospitals, large teaching centers,

where I think there's more anonymity.

344

You may not know who your senior

leadership team is, you may not know

345

who the CEO is, where when you come

to a, you know, a smaller hospital

346

like ours we say hi to each other

in the hallways at the hospital.

347

The people that like that that

type of culture are really, I

348

think, probably drawn to us and

that's why they stay with us.

349

But for some people, maybe that's

not what they like so much,

350

and that's okay too, right?

351

Our goal is to draw those people that

like the 'say hi in the hallway', ' if

352

something significant happens in

your life, we'll send flowers'.

353

That's the kind of

community hospital we are.

354

Michelle Samson: Before letting

Julie get back to the hard work

355

of running a hospital system.

356

I wanted to ask her one final question and

that's about her vision for the future

357

of community health in Strathroy-Caradoc.

358

Julie McBrien: It's heading into an

exciting time for us, I'd say, at

359

the hospital, because we, in about

the next month, we're going to be

360

launching our new strategic plan.

361

We had spent a lot of time about two

years ago during the pandemic working

362

on updating our strategic plan.

363

But then, as you can appreciate with

all the other priorities that were on

364

the go with the pandemic, just some of

the focus around renewing our strategic

365

plan got put on the back burner.

366

I've spent and my team have spent the

last six months to a year bringing

367

that work back together, and now

we're in a place where probably in the

368

next month or so we'll be releasing

it more broadly to the community.

369

And that strategic plan at the time

had feedback from the community,

370

so it was really about listening

to the community about what do they

371

see and want from us as a hospital.

372

But it's again about providing the

services that the community values and...

373

Hospitals really can no longer

be the catch all for everything.

374

It's a bit about selecting where

does it bring in the most value.

375

And I think the strategic plan that

we'll be releasing next month will give

376

a good framework to help us finalize

and determine what that looks like.

377

And we've put no timeline on the strategic

plan, it's going to be as good for as long

378

as we feel it's still appropriate for us.

379

But really it will be our guide to

help shape us moving into the future.

380

It's going to have three priorities.

381

One is going to be focused on delivering

on exceptional care and experiences.

382

So when you come to our hospital, how

we're making sure that patients are

383

getting in addition to great care, a

great experience because that's I think

384

almost as important as quality care.

385

The second priority for us

will be focusing on our people.

386

Focusing on our staff, our

physicians, our volunteers.

387

How can we recruit and retain, make people

feel like they belong and are valued.

388

And then our last priority

is focusing on advancing.

389

So whether it be clinical care,

whether it be information technology,

390

cyber security has become, even

more important now than ever.

391

Maybe it's about redevelopment.

392

We've got aging infrastructure, our

hospital's an old building, how do we

393

make sure that we're keeping it renewed?

394

So those are gonna be key priorities

for us over the next number of years.

395

So everything we do will focus in around

one of those key priorities, but I

396

think an overarching principle of our

new strategic plan will be about caring

397

for our community and building that

future together with our community.

398

And I think it's about things like

the Women's Health Engagement Survey,

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about hearing from our community,

listening, planning and working together.

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Our hospital to me is more

than just four walls.

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I really feel it's important that we

as a hospital are getting out to the

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community where our patients are, where

our families are, as we do construction

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within Strathroy Hospital, we actually

had to move some of our services off site.

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We moved them to a mall in Strathroy,

our rehab services .We moved our

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diabetes education to an office

building in downtown Strathroy.

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And I think this is a bit of us

starting down that path already on us

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being out there with our community,

listening and that's going to be

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even more of our focus with the new

strategic plan in the years to come.

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Michelle Samson: Many, thanks to

Julie McBrien for coming on the

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show to tell us all about Strathroy,

Middlesex General Hospital.

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Learn more about the hospital and

the Middlesex hospital Alliance

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via the links in the show notes.

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If Strathroy-Caradoc sounds like

a community you'd like to move to,

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learn more at strathroy-caradoc.ca.

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If this episode has encouraged

you to invest here, you should

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connect with Heather Lalonde,

our Development Commissioner.

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Her contact coordinates and more

information about the community can be

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found at investstrathroy-caradoc.ca.

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Next time on the Growing Strathroy-Caradoc

podcast, we're going to profile one of

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the biggest economic drivers in this

community: agribusiness . Follow us on

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apple, Spotify, or your favorite podcast

platform to be notified when a drops.

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This podcast was produced

by Storied Places Media.

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Thanks for listening.