By Chris Marchand
While a townhall meeting to discuss the need for local dialysis services drew a capacity crowd in February, little has been heard since of efforts that continue behind the scenes to define the scope of the project.
Those efforts, described as a multi-year timeline by Ontario Renal Network Northwest Region Director Aaron Skillen, involve mostly high-level planning to this point.
“I think things are going very well with the planning to enhance the dialysis services in Dryden generally since the February townhall meeting,” said Skillen. “We’ve certainly been working closely with Doreen (Armstrong-Ross) and Kim (Vares) in that regard. We’re monitoring our patient numbers and contemplating what types of services we could enhance in Dryden and area, including an in-hospital satellite site like neighbouring communities Sioux Lookout, Fort Frances and Kenora. What kind of care model would be appropriate there and what would the staffing requirements be to ensure patient safety and an appropriate level of care for that level of service.”
Skillen says he and Sioux Lookout-based Nephrologist Dr. Paul Watson have raised the matter of dialysis in Dryden with the Ontario Renal Network leadership in March and June meetings in Toronto. Skillen and Watson also travelled to Dryden in early June to talk with local hospital staff and check out the hospital.
Patient numbers have been a recurring sticking point in the effort to move the issue forward in the community over the years. At the February meeting, local health officials claimed Dryden’s renal patients in need of in-centre hemodialysis numbered less than six — an assertion that was difficult to reconcile with the first-hand experience of renal patients and family members from the broader catchment area who had driven from as far as Ear Falls, Ignace and surrounding First Nations to attend the February meeting, and who often drive two-to-three hours one-way to receive treatment in Sioux Lookout up to 156 times per year.
On the question of patient numbers, Skillen says any program in Dryden, like other dialysis services in the region, will grow into sustainability as the patient numbers become more clear. Satellite dialysis units in Ontario typically demand 12-18 patients to get started.
“It’s probably premature for us to say whether the ORN is satisfied (on sustainable patient numbers), if you will — I think that’s part of an endorsement process for any capital project that might be proposed in that regard,” said Skillen. “What we do know is that this would not be what one might call a traditional in-facility dialysis unit. Our satellite sites in Fort Frances (capacity of 28), Sioux Lookout (capacity of 24) and Kenora (capacity of 20) are quite well established and would be considered a traditional satellite site here in Ontario. If Dryden were to have that in the future, it wouldn’t start with 20-28 patients, that wouldn’t be the case at the onset. It would need to be at a small scale. We’re open to anything that would support high quality care and be operationally viable in the long-run.”
Dryden Regional Health Centre VP of Patient Care Services Doreen Armstrong-Ross says the challenge before them is to create a model of service that remains viable under lower patient numbers.
“We are going in with number that’s a lot below the threshold for a traditional type of dialysis unit, so we have to be creative and looking outside the box about what would work here with the relatively small number of dialysis patients we would have,” said Armstrong-Ross. “We have some extra factors here that they don’t have in Southern Ontario: it’s a good hour-and-a-half to Sioux Lookout. We have to look at things differently than you would in the greater Toronto area. We have the opportunity to do something very different here that works for Dryden.”
Citizen’s group the Dryden Dialysis Committee, co-chaired by Lori Miles and Greg Gamble, have been consulted on the activities this past week.
Skillen says he hopes that the first steps of putting forth a capital project would happen within this calendar year.
“That said, it’s typically a multiple-year journey if that’s indeed what we’re looking to pursue here in Dryden.”