A $65 million ambulatory center for outpatients in downtown Toronto-a first for Canada-actually was conceived of four years ago as a 260-bed acute-care hospital.
But that was before the healthcare financial crisis rolled across Canada, flattening budgets and projects in its wake.
The new Doctors Hospital will include a referral detoxification center for women; outpatient mental health services; birthing rooms; a walk-in center for injuries that aren't life-threatening; and day surgery, including gynecological and pediatric procedures.
It won't include an emergency department, major-surgery facilities or virtually any acute-care services requiring overnight stays. Nor will it accept seriously ill patients who need complicated operations that call for lengthy hospital stays. Serious emergencies will be referred to neighboring hospitals. Physicians and nurses will go into the community, visiting patients at their homes while they wait for surgery that has them in and out within a day, and while they recuperate from such procedures.
Ontario's Ministry of Health is providing $45 million toward the cost; the hospital has raised the other $20 million. The original 150-bed acute-care Doctors Hospital will be demolished upon completion of the new six-story center in 1995. Its design and numbers of beds will be determined by a review panel that combines professional and community opinion.
"It should save money and provide good quality care," said Carol Clemenhagen, president of the Canadian Hospital Association.
Dennis Timbrell, president of the Ontario Hospital Association, said the shift from acute to ambulatory care is part of a trend to more day surgery and shorter hospital stays, prompted by economic difficulties and improved medical technology.
Hospital President Brian McFarlane described the new center as a "more effective use of healthcare dollars. We want to make sure we are building a hospital for the 1990s and beyond. Hospitals a re no longer measured in terms of beds. They are measured in terms of programs and services."