N.B.'s Horizon Health will remain in red level, maintain masks and visitor restrictions for a while yet

The CEO of Horizon Health Network in New Brunswick says there will be measures that will never go back to the way they were prior to the COVID-19 pandemic.

Dr. John Dornan said during an in-person Horizon board meeting – and after to reporters – the virus is still having a big impact on hospitals, although numbers are moving in the right direction.

“We’re on the right side of that peak, we believe,” he said. “We’re not certain that things won’t get worse but they probably will continue to improve.”

The hospital system is “a long ways away” from being able to move from its most restrictive red level, he said. Horizon has been in the red level since December.

“The higher the prevalence, the higher the probability that you bring this in and it infects one of our staff or infects the patient that you're visiting. So this has driven us to a red level and we’re a long way away from being at an orange or a yellow,” he said.

“Because the disease is so virulent and new variants are coming on that are equally virulent, at some point in time, there will be a fraction of our society that has had it and doesn't have it anymore and is at a lesser risk of getting it in the future… Regardless, it’s not going to go back to the way it was pre-COVID, in terms of the way that we protect ourselves and our patients from getting another infection.”

Dornan says masks will remain for a long time within hospitals.

He also told the board that Horizon used to have a liberal, “free for all” visitation policy, prior to the pandemic.

However, because of what the system has learned from COVID-19, that policy will likely never return.

Today, designated support persons, often family members or close friends who assist patients when in hospital, are allowed to visit – but social visitors are not.  

“What we have found through our experience with COVID, is that it's really important to distinguish between designated support persons - so those very close family members - and a social visitor,” said Margaret Melanson, the vice president of Quality and Patient-Centred Care.

“Probably, when we do have the point where infection control allows us to restart social visiting, social visiting may very well continue to be during that two to eight p.m. time-frame, and the expectation that those individuals would come in during that time-frame, not early morning and not late at night, that that would be times that there be more designated support person availability.”

Melanson said that would allow for better infection control, and give patients more time to rest. The change hasn’t happened yet, but officials say it’s likely once hospitals move to orange or yellow levels of restrictions.

NEW APPROACH TO RECRUITMENT, RETENTION OF PHYSICIANS

During the meeting, Dr. Susan Brien, who just returned to New Brunswick last year to take on the role of vice president medical, academic and research affairs at Horizon Health, presented a look at what the network is doing about physician recruitment.

She said Horizon and the province may need to discuss what the right targets are for New Brunswick. In 2021, Horizon recruited over 100 doctors alone, when the provincial target is 90.

Recruiters are currently at or planning to attend several medical conferences and a new recruitment employee has been hired for the Fredericton region - a region that’s been struggling to retain physicians.

“Fredericton, interestingly I’m told, has half of the patient connect waitlist – and there are some real challenges recruiting people from Fredericton. I’m trying hard to understand that. I’m actually from Fredericton,” she said.

“So, with a small team, we’ve been doing a deep dive, I’ve been doing exit interviews and talking to coordinators to really understand what are some of those challenges that we need to fix to make sure that when people come to New Brunswick, particularly Fredericton, that they feel they belong to the community.”

Brien says, in the past, they have “not done the best job we can do to promote New Brunswick,” so they’re now using more social media and promotional strategies to recruit. She also said there are myths about billing numbers from doctors outside the province – myths they’re working to erase.

Eighty-five per cent of residents who train in New Brunswick, stay in New Brunswick, she said - an angle they want to work harder at targeting. And hospitalists will be added to alleviate the strain on current doctors.

“We will be moving to a new standard model of hospitalist care. So, hospitalists are generally the family physicians who look after patients who are in the hospital,” she said.

“A financial model has been negotiated and we will be standardizing this model throughout Horizon. The first hospital to kick off will be May 2… We have heard. We have listened to physicians. Many physicians cannot do it all. They cannot be in the ER, be in the OR, be in their offices, be with patients, so we feel that looking and exploring and financing this new model of care is a way for us to support recruitment in new ways.”

The first hospitalists will begin May 2 in Miramichi, N.B.