The Human Costs to Staff from Closure of a General Hospital: An Example of the Effects of the Threat of Unemployment and Fragmentation of a Valued Work Structure

Abstract

There must be an understanding of the human costs on staff and patients when hospital closures are contemplated.

A Comprehensive Approach to Effectively Engage Physicians during a Hospital Closure: Using the Physician Engagement Model

“…Previous research has shown the negative impact of closures on physicians, particularly when they have not been involved in the decision-making process. 1,3,[6][7][8][9][10][11][12][13][14][15][16][17][18] Blair reports that fewer than 10% of the medical staff at Shaughnessy Hospital, located in Vancouver and closed in 1993, felt that the closure was handled well. 16 Blair also indicates that the closure "caused long-lasting divisions among MDs" as the physicians were not able to express their views through the process and were not welcomed or supported by physicians at other hospitals.…”

“…ince the late '80s, hospitals worldwide have been closing. 1,2 In Canada, as a result of recent provincial health care restructuring, there have been hospital closures, particularly in Ontario, [3][4][5] British Columbia, 6 Saskatchewan 7 and Newfoundland and Labrador. 8 These closures have negatively affected staff and the community, for example, stress and burnout have been well documented in staff after a closure; [9][10][11] therefore, obtaining further input from these groups has been acknowledged.…”

“…9,10,[12][13][14][15] There is, however, a paucity of research on the impact of closures and consolidation of services on physicians. 1,3,[16][17][18] What has been shown is that hospital closures cause demoralization, stress and anger in medical staff, particularly when they are not included in the change process. 1 This in turn can affect professional efficacy, quality of work and patient outcomes.…”

“…1,3,[16][17][18] What has been shown is that hospital closures cause demoralization, stress and anger in medical staff, particularly when they are not included in the change process. 1 This in turn can affect professional efficacy, quality of work and patient outcomes.…”

The Future of Consultation–Liaison Psychiatry

“…The wisdom of persisting with these components of C−L activity has been much debated [81], but there is renewed support for them. They are seen as being counters to the reductionism of the prevailing economic rationalist approach [82]. There is evidence of cost‐offset benefits of C−L psychiatry activity [83], but it is time to study this more broadly, including an examination of the cost benefits to the institution and community of having better functioning patients, doctors and other health professionals [6].…”