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					Bluewater Health Community Survey

            Presented to:
          Dr. Kevin Smith

             May 2007
Table of Contents

                                                 Page

Research Background and Methodology               2

Key Findings & Recommendations                    6

Health Care in the Local Community                10

General Impressions of Bluewater Health           25

Awareness of Issues Regarding Bluewater Health    35

Usage of Bluewater Health                         50

Media Usage and Preferences                       61

Suggestions for Improvement                       65




                                                        1
Research Background & Methodology

   As the provincially-appointed investigator for Bluewater Health in Sarnia, Dr. Kevin Smith
    commissioned POLLARA to conduct a public opinion research poll of residents in the
    communities served by Bluewater Health.
   The main objectives of this research were to:
     – Investigate the public‟s perceptions of the local health care system;
     – Determine impressions and usage of Bluewater Health; and,
     – Understand the public‟s usage of various media sources.
   Results are based on a telephone survey conducted with 502 adult residents in
    Bluewater Health‟s catchment area, namely, Lambton County.
   Overall, these results are considered accurate to within ±4.4%, nineteen times out of
    twenty.




                                                                                             2
    Research Background & Methodology

    The survey was designed to ensure a representative sample of the population was
     attained. At the data analysis stage, the data were weighted to ensure they are fully
     representative of the population in Lambton County.
    The following table shows the number of interviews conducted in the community, and the
     corresponding margins of error:

                                     Actual # of         Weighted # of           Margin of
                                     Interviews           Interviews              Error
    Lambton County –
                                         247                  246                  ±6.2%
    North of Hwy 402
    Lambton County –
                                         255                  254                  ±6.1%
    South of Hwy 402
    TOTAL                                502                  500                  ±4.4%




                                                                                              3
    Research Background and Methodology –
    Analyses Conducted

   Frequencies have been reported for each question from the survey.
   Each question was cross-tabulated against the following variables to identify any differences:
     – Impressions of the overall quality of care;
     – Preferred hospital;
     – Perceived quality of care at Bluewater Health;
     – Awareness of issues regarding Bluewater Health;
     – Usage of Bluewater Health medical services; and,
     – Demographic groupings including: region of residence, age, gender, education,
       household income, household composition, main community newspaper read, and
       opinion leader status.
   Where relevant, analyses of significant differences are presented in the report.




                                                                                                4
    Note on “Opinion Leaders”


   Throughout this report, reference is made to the views held by “Opinion Leaders”.
   “Opinion Leaders” are defined as those citizens who are actively involved in the social and
    political life of their communities. These individuals have done at least one of the following
    activities in the past year:
     – Made a public speech;
     – Written a published article;
     – Written a letter to the editor of a newspaper or magazine;
     – Served as an officer for a club or organization;
     – Called a radio or TV talk show; or,
     – Volunteered for a political party or candidate.
   These residents can be regarded as influencers on other residents and are more likely to be
    vocal about social and political issues than other residents. They are at the forefront of public
    opinion.
   “Opinion leaders” are most likely to:
     – Have lived in the community for more than 25 years (49% vs. 44% of the general
          population);
     – Have attained a higher level of education, either university (24%) or post-graduate level
          (15%), versus 19% and 11% of the general population, respectively;
     – Have a household income of $100,000 or more (22% vs. 17% of the general population).
                                                                                                   5
Key Findings & Recommendations




                                 6
    Key Findings & Recommendations


Perceptions of Health Care System in Local Community
    Residents of Lambton County appear to be well aware of the management issues at
     Bluewater Health. While a lack of doctors tops the list of health care concerns for residents
     (20%), management issues and conflicts between hospital administrators and doctors follow
     closely behind (14%).
    Overall ratings of the quality of local health care are mediocre (5.8), suggesting that the
     public thinks that the issues facing the local health care system (lack of doctors,
     management issues) have begun to affect the quality of care.
    In addition, almost two-thirds (61%) of residents think the quality of care in their community
     has worsened over the past few years – a trend primarily attributed to a lack of hospital staff
     and longer wait times.
 Efforts need to be made to improve the impressions of quality of care available to
  residents in Lambton County. In particular, issues surrounding the shortage of
  doctors and staff, the long wait times, and the conflict between management and
  doctors need to be addressed.
 A communications strategy will be necessary to alleviate the concern expressed by
  residents about their local health care system. This strategy should highlight the
  initiatives that have been, or will be, undertaken to address the issues.


                                                                                                   7
 Key Findings & Recommendations

Perceptions of Bluewater Health
 While Bluewater Health is the first choice hospital for many residents (46%), this preference
   is driven primarily by the convenience of the Hospital‟s location and the lack of alternative
   options, not because of the quality of care received.
 In fact, the quality of care received at Bluewater Health is viewed by a plurality (35%) of
   residents as “worse than average” (vs. 29% who say it is “average”). This is despite the fact
   that 60% of visitors to the Hospital say their experience there “met” their expectations.
 Residents are well aware of the issues regarding Bluewater Health and point to poor
   management (27%), resolution of conflicts (9%), and restoring public confidence (4%) as the
   biggest challenges facing the Hospital today.
 Impressions of the Hospital‟s Board of Directors are poor (generating an average rating of
   2.9 on a 10-point scale), especially in comparison to the more favourable ratings given to
   the Hospital‟s volunteers (8.2), nurses (7.8), and doctors (7.2).
 Similarly, trust in the hospital administrators to effectively manage the community‟s health
   care resources is low (4.0 on a 10-point scale).
 Efforts need to be made to restore the public’s confidence in Bluewater Health. The
   management issues and conflict between the Board and doctors need to be resolved
   as quickly as possible.
 Communications with the public are also required to highlight initiatives that are
   underway to improve the local health care system and how the resolution of the
   management issue will positively impact the quality of local health care.
                                                                                             8
    Key Findings & Recommendations


Communications with Public
    Not surprisingly, the community is deeply concerned about the issues facing Bluewater
     Health and many residents want to be kept up-to-date on the initiatives that are being
     implemented to resolve the issues.
    Three-in-ten (30%) residents think the best way for the Hospital to improve its image in the
     community is to increase communications with members of the public, while one-in-four
     (23%) think the Hospital‟s management should be replaced.
    Residents express a preference for being kept informed about the progress at the Hospital
     through community newspapers or mailings from the Hospital.
 Frequent updates on the progress being made at Bluewater Health should be
  provided through local media outlets, particularly through local newspapers (e.g., the
  Sarnia Oberserver) or through direct mail from the Hospital.




                                                                                                 9
Health Care in the Local Community




                                     10
  Most Important Health Care Issue in Community



                                      Lack of Doctors                    20%
                                   Poor Management                 10%
         Closing Hospitals/Accessibility/Space                      9%
                                                                                    One-fifth (20%) of residents
                                  Waiting Lists/Time                                 believe that the lack of doctors is
                                                                   9%
                                                                                     the most important health care
                             Building New Hospital                8%                 issue facing their community
                                                                                     today.
                                   Quality of Service            6%                 In addition, approximately one-in-
                             Condition of Hospitals              6%                  seven (14%) residents mention
                                                                                     either poor management (10%) or
      PR Relationship Between Admin & Staff                      4%                  the relationship between hospital
                                                                                     administrators and staff (4%) as
                        Diseases/Health (General)               4%                   the most important issue.

                                                   Other             13%
                                Don’t Know/Refused                 9%
                                                           0%        20%        40%       60%      80%     100%


Q1: What do you think is the most important health care issue facing your local community today?
    (OPEN-END; ACCEPT ONE MENTION ONLY)                                                                                    11
  Rating of Health Care Services in Local Community

   On average, residents rate the health care services in their community as 5.8 on a 10-
    point scale where 1 means “very poor” and 10 means “excellent.”
   Just over two-in-five (42%) residents report that health care services in their local
    community are „excellent‟ (5%) or „good‟ (37%).

           80%
                                                                                                          Mean: 5.8

           60%




           40%                          37%               37%


           20%
                                                                             12%
                       5%                                                                       6%
                                                                                                               3%
            0%
                   10 Excellent        7-9 Good           4-6 Fair          2-3 Poor        1 Very Poor    Don’t Know/
                                                                                                            Refused
Q2: Overall, how would you rate the health care services in your local community? Please use a scale                     12
    from 1 to 10, where 1 means “very poor” and 10 means “excellent”.
Rating of Health Care Services in Local Community,
by Genderation

   On average, impressions of the quality of local health care services become less
    favourable with age among both men and women.



                                                Average Rating
                                                      #
                           Total                      5.8
                           Male                       5.9
                           Male 18-34                 6.4
                           Male 35-54                 5.6
                           Male 55+                   5.9
                           Female                     5.7
                           Female 18-34               6.9
                           Female 35-54               5.6
                           Female 55+                 5.5




                                                                                       13
Rating of Health Care Services in Local Community,
by Region

   Residents living south of Highway 402 rate their impression of local health care services
    significantly higher than their northern neighbours (6.1 vs. 5.4, respectively).


                                                       Average Rating
                                                             #
                    Total                                    5.8
                    North of Hwy 402                         5.4
                    South of Hwy 402                         6.1




                                                                                                14
  Change in Overall Quality of Care


   The majority (61%) of residents think that the quality of health care in their community
    has worsened over the past few years, with one-in-four (26%) reporting the quality of
    care has worsened “a great deal.”
            80%

                                                                           Total Worsened=61%

            60%



            40%                                                               35%
                                                           25%                                  26%
                    Total Improved=11%
            20%
                                          9%
                        2%                                                                                     4%
             0%
                    Improved A         Improved        Stayed About        Worsened          Worsened A     Don’t Know
                    Great Deal         Somewhat         The Same           Somewhat          Great Deal



Q3: Over the past few years, would you say the overall quality of health care available in your community                15
    has...? (READ LIST)
Change in Overall Quality of Care, by Genderation


   Young residents (between 18 and 34 years of age) are most likely to think the overall
    quality of care in their community has improved over the past few years (32% among men
    and 27% among women in this age group).
   In contrast, residents between 35 and 54 years are most likely to believe the quality of
    care has worsened (66% among men and 69% among women in this age group).

                                           Total Improved           Total Worsened
                                                  %                        %
       Total                                     11                        60
       Male                                      12                        57
       Male 18-34                                32                        23
       Male 35-54                                10                        66
       Male 55+                                  9                         58
       Female                                    10                        64
       Female 18-34                              27                        27
       Female 35-54                              9                         69
       Female 55+                                9                         66


                                                                                               16
Change in Overall Quality of Care, by Region


   Residents living south of Highway 402 are significantly more likely than their northern
    counterparts to believe that the quality of care in their community has improved (14% vs.
    8%, respectively), although the majority of the population in both regions report the quality
    of care has worsened.


                                           Total Improved            Total Worsened
                                                  %                         %
       Total                                     11                         60
       North of Hwy 402                           8                         67
       South of Hwy 402                          14                         54




                                                                                                17
Change in Overall Quality of Care, by Opinion Leaders


   Opinion leaders* are significantly more likely than other residents to believe that the
    quality of care has worsened in their community over the past few years.


                                                                Total Improved                          Total Worsened
                                                                       %                                       %
        Total                                                            11                                       60
        Opinion Leader*                                                  11                                       68
        Not An Opinion Leader                                            11                                       54
     * NOTE: Opinion leaders are defined as those members of the community who are actively involved in the social and political life
             of their communities. These citizens have done at least one of the following activities in the past year: made a public
             speech, written a published article, written a letter to the editor of a newspaper or magazine, served as an officer for a
             club or organization, called a radio or TV talk show, or volunteered for a political party or candidate.




                                                                                                                                          18
Change in Overall Quality of Care, by Household Income


   As household income increases, so too does the likelihood of residents reporting that the
    quality of care in their community has worsened over the past few years (from 46%
    among those living in households earning less than $25,000 to 74% of those living in
    households earning $100,000 or more).


                                          Total Improved           Total Worsened
                                                 %                        %
       Total                                    11                       60
       Less than $25,000                        15                       46
       $25,000 to less than $50,000             12                       55
       $50,000 to less than $75,000             5                        64
       $75,000 to less than $100,000            9                        67
       $100,000 or more                         8                        74




                                                                                                19
  Change in Overall Quality of Care – Reasons for More
  Positive Opinion

     One-third (31%) of residents who think that the quality of health care services in their
      community has improved over the past few years point to more doctors as the main
      reason for this improvement. One-fifth (20%) also believe it is now easier to get the
      service and that the health care community is doing its best.
                                              More Doctors                    31%
                  Easier To Get Service/Doing Their Best              20%
      Poor Quality Care/Wait Times/Could Not Get Help               11%
                      Building New Hospital/Renovations             9%
                        More Services/More Accessibility            9%
                                      Personal Experience           7%
                              Improved On Waiting Times             7%
                Better/More/New Technology/Equipment               7%
                                                  Research        4%
     Doing Best They Can With Lack Of Doctors/Nurses              2%
                                                       Other       7%
                                      Don’t Know/Refused           6%
                                                             0%      20%      40%         60%   80%   100%

Q4: (IF IMPROVED AT Q3) Why do you say that? (OPEN-END; ACCEPT UP TO 3 MENTIONS; PROBE:                      20
    Any other reasons?) (n=55)
 Change in Overall Quality of Care – Reasons for More
 Negative Opinion


            Lack Of Doctors/Nurses/Staff                    38%
                              Wait Times             25%
                     Poor Quality Of Care          19%
              Cutbacks/Lack Of Services          15%
                        Poor Management         12%                Two-fifths (38%) of residents who
     Lack Of Accessibility/Beds/Hospitals      11%                  think that the quality of health care
         Poor Condition Of Hospital/Dirty     7%                    services in their community has
               Conflict/Bad Relationships     7%                    worsened over the past few years cite
    Poor Working Conditions/Low Morale        4%                    a lack of doctors and nurses as the
              Word Of Mouth/What I Read       3%                    main reason for the decline in the
               Financial Mismanagement       3%                     quality of care. One-in-four (25%) also
           Through Personal Experience       3%                     point to wait times.
           Decline In Health Care System     3%
           User Fees/Cost Of Health Care     2%                    One-fifth (22%) of these residents
             Doctors Resigned Privileges     2%                     also point to management issues as a
                 Lack Of Communication       2%                     reason for their opinion.
                         Lack Of Funding     2%
                                    Other         10%
                     Don’t Know/Refused      2%
                                        0%         20%     40%    60%      80%     100%




Q5: (IF WORSENED AT Q3) Why do you say that? (OPEN-END; ACCEPT UP TO 3 MENTIONS;                         21
    PROBE: Any other reasons?) (n=304)
  First Choice Hospital


   Almost one-half (46%) of residents point to Bluewater Health as their preferred hospital if
    they or a family member were to require the services of a general hospital.


                                                Bluewater Health                                    46%
                                       Sarnia General Hospital                   12%
                          London Hospital (NONSPECIFIC)                        10%
    London Health Science Centre/University/Victoria                          8%
                                          St. Joseph’s Hospital               7%
                          General Hospital (NONSPECIFIC)                    3%
                            Sarnia Hospital (NONSPECIFIC)                  2%
                                                               Other        6%
                                           Don’t Know/Refused                6%
                                                                      0%         20%        40%        60%   80%   100%


Q6: If you or a family member were to require the services of a general hospital, which hospital would be                 22
    your first choice? (DO NOT READ LIST; ACCEPT ONE RESPONSE ONLY)
  Reason for Preference for First Choice Hospital,
  by Hospital of Choice

      Two-thirds (68%) of residents who prefer Bluewater Health express this preference
       primarily because of the location of the hospital and not because of the high quality of
       care received there: 35% say it‟s the only hospital available and 33% say it‟s the closest
       hospital.
      In contrast, more than two-fifths (41%) of residents who prefer a hospital other than
       Bluewater Health do so because of the perceived better quality of care and service
       received at this hospital.

                                               Total            Bluewater Health    Other Hospital
                                                %                     %                   %
      Better quality of care/service             30                     17               41
      Only hospital available                    24                     35               13
      Closest                                    23                     33               13
      Familiar/Previous experience               16                     14               17
      Where I live/Local/My hospital             9                      13                6




Note: Table has been reversed to include top mentions of why specific hospital is                    23
preferred. Mentions of 5% or less are not shown.
General Impressions of Bluewater Health




                                          24
  Quality of Health Care at Bluewater Health


   Residents are more likely to think the quality of health care at Bluewater Health is worse
    than average (35%), as opposed to average (29%) or better than average (5%).


                                                    Better Than
                                                     Average
                                                        5%
                             Don’t Know/                                                      Average
                              Refused                                                           29%
                                31%




                                                                        Worse Than
                                                                         Average
                                                                           35%

Q8: In your opinion, how does the quality of health care at Bluewater Health compare to other hospitals in   25
    southwestern Ontario? Is it...? (READ LIST)
Quality of Health Care at Bluewater Health,
by Hospital of Choice

     Only one-in-twenty (6%) residents who mention Bluewater Health as their preferred
      general hospital think the quality of health care available there is “better than average”. In
      fact, one-in-four (25%) residents who choose Bluewater Health as their hospital of choice
      think the quality of care is “worse than average”.



                                Better than                         Worse than       Don’t Know/
                                 Average           Average           Average          Refused
                                    %                 %                 %                 %
    Total                            5                29                35                31
    Bluewater Health                 6                36                25                32
    Other hospital                   4                25                42                29




                                                                                                   26
Quality of Health Care at Bluewater Health,
by Usage of Hospital

      Residents who have visited Bluewater Health in the past year, either for themselves or for
       a loved one, are significantly more likely than those who have not visited to think the
       quality of care received at Bluewater Health is “worse than average” (39% vs. 23%,
       respectively).



                                 Better than                      Worse than      Don’t Know/
                                  Average         Average          Average         Refused
                                     %               %                %                %
    Total                            5               29               35               31
    Yes – Visited for Self           4               27               38               30
    Yes – Visited for Family
                                     3               30               42               25
    Member
    Yes – Visited for Both           8               27               36               30
    Yes – Have Visited B.H. In
                                     5               28               39               28
    Past Year
    No – Have Not Visited
                                     4               33               23               40
    B.H. In Past Year


                                                                                                27
Quality of Health Care at Bluewater Health,
by Region

     More than two-fifths (42%) of residents living north of Highway 402 think the quality of
      health care available at Bluewater Health is “worse than average” (compared to 27% of
      residents living south of Highway 402).




                               Better than                       Worse than       Don’t Know/
                                Average          Average          Average          Refused
                                   %                %                %                 %
    Total                          5                29               35                31
    North of Hwy 402               3                26               42                29
    South of Hwy 402               6                33               27                34




                                                                                                 28
Quality of Health Care at Bluewater Health,
by Opinion Leaders

     Opinion leaders are significantly more likely than other residents to think that the quality of
      health care at Bluewater Health is “worse than average” (39% vs. 30%, respectively).




                                Better than                         Worse than       Don’t Know/
                                 Average           Average           Average          Refused
                                    %                 %                 %                 %
    Total                            5                29                35                31
    Opinion Leader                   5                27                39                29
    Not An Opinion Leader            5                32                30                33




                                                                                                    29
  Biggest Challenge Facing Bluewater Health



         Poor Administration/Management                             27%
            Shortage of Medical Personnel                    15%          One-in-four (27%) residents point to
                  Getting New Hospital Built                12%            poor management and
                                                                           administration as the biggest
                  Budget/Finances/Funding                  11%             challenge facing Bluewater Health.
                                                                           In addition, 9% mention the
           Resolving Conflicts/Differences                 9%              resolution of conflicts, while 4% think
                                                                           Bluewater Health should focus on
                     Services/Quality of Care           4%                 restoring the trust and confidence of
                                                                           the community.
Gaining Trust/Confidence of Community                   4%
                                                                          One-in-seven cite a shortage of
                                   Waiting Time        2%                  medical staff (15%) or the
                                                                           construction of the new hospital
                                            Other      3%                  (12%) as the biggest challenge.
                         Don’t Know/Refused                  12%
                                                  0%         20%       40%       60%        80%     100%


Q9: In your opinion, what is the biggest challenge facing Bluewater Health? (OPEN-END; ACCEPT ONE                30
    MENTION ONLY)
  Biggest Challenge Facing Bluewater Health,
  by Recall of Having Heard/Read Something About
  Bluewater Health
     Residents who remember hearing or reading about Bluewater Health recently are more
      likely than those who have not to believe poor administration and management (30% vs.
      20%, respectively) and getting the new hospital built (15% vs. 5%) are the biggest
      challenges facing the Hospital.

                                                                                     No – Have Not
                                                   Yes – Have Heard/Read          Heard/Read Anything
                                      Total        Something About B.H.               About B.H.
                                       %                     %                             %
      Poor Administration/
                                       27                     30                          20
      Management
      Shortage of Medical
                                       15                     13                          20
      Personnel
      Getting New Hospital
                                       12                     15                          5
      Built
      Budget/Finances/Funding          11                     11                          12
      Resolving Conflicts/
                                        9                     10                          8
      Differences



Note: Table has been reversed to include top mentions of the biggest challenges                         31
facing Bluewater Health. Mentions of 5% or less are not shown.
   Impressions of Specific Aspects of Bluewater Health

    On average, the Hospital‟s volunteers receive the highest impression rating (8.2) while
     the Board of Directors receive the lowest impression rating (2.9).
                                                                                                                               Mean:
                                       he hospital’s nursing staff       20%                 57%                13% 3% 6% 7.8
                                                                                                                      1%
                                        The hospital’s volunteers        20%                49%              7% 1%1% 22% 8.2
                           The hospital’s physicians and doctors        14%               49%                20% 4% 3% 9%          7.2
                      The quality of care provided at the hospital      10%          44%                   29%      6% 3% 8% 6.7
                The level of communication between health care
                        providers and patients and their families       8%          39%                29%         8% 5% 11% 6.3
                                         The hospital facility itself   5%    27%               36%          14% 10% 9%            5.3
                                     The speed of access to care        4%    26%               37%           17% 8% 8%            5.2
                                      The hospital’s management         2% 9% 20%         20%              30%         20%         3.2
                       The level of communication between the                                                                      3.4
              hospital’s management and the local community             2% 8% 28%               23%          27%        12%
    The ability of the hospital’s doctors, Board of Directors, &        1% 23%
                                                                          7%                                                       3.1
mngmnt to work together to solve problems facing the hospital                              25%               32%        12%
                              The hospital’s Board of Directors         1% 5%18% 21%                  32%             23%          2.9
                                                                    0%         20%        40%         60%        80%        100%
                  10 Very         7-9 Somewhat         4-6 Neither Impressed         2-3 Not Very     1 Not At         Don’t Know/
                  Impressed       Impressed            Nor Unimpressed               Impressed        All Impressed    Refused


Q10-20: On a scale from 1 to 10, where 1 is “not at all impressed” and 10 is “very impressed”, how would                             32
        you rate the following aspects of Bluewater Health? (READ AND ROTATE)
Perceptions of Management Issues


     Residents who have heard or read anything about the issues facing Bluewater Health rate
      their impression of the various management issues lower, on average, than those who
      have not read or heard anything about Bluewater Health recently.
     Similarly, opinion leaders are more likely to be critical of the Hospital‟s management
      issues than other residents.

                                                                               The Ability of the
                                                          Communication       Hospital’s Doctors,
                                                         Between Hospital’s   Board of Directors,
                                     The Hospitals’      Management & the     and Management to
                                    Board of Directors      Community           Work Together
                                            #                    #                     #
    Total                                  2.9                   3.4                  3.1
    Yes – Have Heard/Read
                                           2.6                   3.1                  2.7
    Something About B.H.
    No – Have Not Heard/Read
                                           3.6                   4.4                  4.3
    Anything About B.H.
    Opinion Leader                         2.7                   3.1                  2.8
    Not An Opinion Leader                  3.0                   3.7                  3.3



                                                                                                33
Awareness of Issues Regarding Bluewater Health




                                                 34
  Whether Read or Heard Anything About Bluewater
  Health Recently

   The vast majority (71%) of residents have read or heard something recently about
    Bluewater Health.
   Among these residents, the main source of that information was through a community
    newspaper (85%).
                               Community Newspaper                                                  85%
                                      Through Radio            29%
                                     Television News       15%
                                    Family Or Friend       14%
                                     Doctor Or Nurse    6%
                                 National Newspaper     5%
                                            The Rally  4%
                Information Provided By The Hospital 3%
                                              Internet 3%
                      Word Of Mouth (NONSPECIFIC)      3%
                                Personal Experience 2%
                         Community/Public Meetings 2%
                                  Hospital Newsletter 2%
                                                Other    9%
                                Don’t Know/Refused 1%
                                                      0%       20%      40%       60%         80%    100%


Q21: Have you heard or read anything recently about Bluewater Health?                                       35
Q22: (IF YES AT Q21) What was the source? (DO NOT READ LIST; SELECT ALL THAT APPLY) (n=358)
Whether Read or Heard Anything About Bluewater
Health Recently – Opinion Leaders

   Opinion leaders are significantly more likely than other residents to have read or heard
    anything about Bluewater Health recently (80% vs. 63%, respectively). The most common
    source of this information was through a community newspaper (85%).
   Opinion leaders are more likely than other residents to read:
      – The Sarnia Observer (86% vs. 76%, respectively)
      – The London Free Press (34% vs. 23%)
      – Sarnia This Week (12% vs. 5%)
      – Toronto Star (9% vs. 4%)
      – Globe and Mail (9% vs. 5%)




                                                                                           36
Whether Read or Heard Anything About Bluewater
Health Recently, by Genderation

   The likelihood of having read or heard anything about Bluewater Health increases with
    age among both men and women.


                                     Yes – Have Read/Heard        No – Have Not
                                           Something           Read/Heard Anything
                                               %                        %
       Total                                   71                       29
       Male                                    69                       31
       Male 18-34                              41                       59
       Male 35-54                              68                       32
       Male 55+                                74                       26
       Female                                  74                       26
       Female 18-34                            50                       50
       Female 35-54                            70                       30
       Female 55+                              79                       21




                                                                                            37
  Whether Read or Heard Anything About Bluewater
  Health Recently, by Community Newspaper Read
  Regularly
     Residents who regularly read the Sarnia Observer (78%), Sarnia This Week (93%), the
      Globe & Mail (88%), or the London Free Press (81%) are significantly more likely than the
      population in general to have read or heard anything about Bluewater Health recently.

                                            Yes – Have Read/Heard           No – Have Not
                                                  Something              Read/Heard Anything
                                                      %                           %
          Total                                        71                        29
          Sarnia This Week (n=42)*                     93                        7
          Globe and Mail (n=33)*                       88                        12
          Toronto Star (n=33)*                         82                        18
          London Free Press (n=140)                    81                        19
          Sarnia Observer (n=406)                      78                        22
          Lambton County Smart
                                                       75                        25
          Shopper (n=12)*
          Petrolia Topic (n=47)*                       59                        41




* Note: Results for readers of community newspapers marked with an asterisk                    38
        should be interpreted with caution due to small base sizes.
  Bluewater Health Issues Read or Heard About

   Among residents who have read or heard anything about Bluewater Health recently, the
    vast majority of mentions (85%) about what was read or heard pertain to management
    and communication issues.

 Problems With Doctors And Management/Doctors Resign                            40%
                Poor Management/CEO/Board of Directors                    28%
                  Problems With New Hospital/Expansion              13%
                              Mismanagement Of Funds               11%                          85% - total
                                  Report/Dr. Kevin Smith          8%                           management/
                                    Poor Quality Of Care          8%                          communication
                 Complaints/Conflicts/Poor Relationships         5%                               issues
                                    Poor Communication          4%
                      Negative Comments (NONSPECIFIC)           4%
                                 Community Involvement          3%
                                   Staff Cuts/Shortage Of      3%
                     Cleanliness Of Building/Condition Of      2%
                     Poor Working Conditions (GENERAL)         2%
                                                    Other       5%
                                     Don’t Know/Refused           7%
                                                          0%       20%       40%      60%      80%    100%


Q23: (IF YES AT Q21) What did you read or hear? (DO NOT READ LIST; ACCEPT UP TO 3 MENTIONS;                   39
     PROBE: Anything else?)
  Direction of Bluewater Health


   The majority of residents (51%) feel that Bluewater Health is moving in the wrong direction.



                                                                                         Right
                                   Don’t Know/                                         Direction
                                    Refused                                               28%
                                      21%




                                                                       Wrong
                                                                      Direction
                                                                         51%

Q24: In general, do you believe that Bluewater Health is heading in the (ROTATE: right direction or the   40
     wrong direction)?
Direction of Bluewater Health, by Recall of Having
Heard/Read Something About Bluewater Health

   Residents who have read or heard anything about Bluewater Health are almost twice as
    likely as those who have not to say the Hospital is heading in the “wrong” direction (59%
    vs. 32%, respectively).



                                          Right Direction          Wrong Direction
                                                %                        %
       Total                                    28                        51
       Yes – Have Read/Heard
                                                22                        59
       Something About B.H.
       No – Have Not Read/Heard
                                                41                        32
       Anything About B.H.




                                                                                                41
Direction of Bluewater Health, by Genderation


   The likelihood of believing that Bluewater Health is heading in the “wrong” direction
    increases with age among both men and women.


                                      Right Direction          Wrong Direction
                                            %                        %
              Total                         28                        51
              Male                          26                        50
              Male 18-34                    55                        31
              Male 35-54                    27                        49
              Male 55+                      22                        53
              Female                        29                        53
              Female 18-34                  68                        27
              Female 35-54                  31                        50
              Female 55+                    22                        58




                                                                                            42
  Reasons for Saying Bluewater Health is Headed in
  “Right” Direction

  Among those who think that Bluewater Health is headed in the right direction, almost three-
   in-ten (28%) point to the construction of the new hospital as a reason for their optimism,
   while one-in-four (24%) say the hospital is doing its best and getting things done.

                             Building A New Hospital                28%
             Doing Their Best/Getting Things Done                  24%
                      Good Quality Care/Good Staff              13%
      They Are Working Together/Communicating                  9%
                                    Get More Doctors           5%
        Can’t Get Worse/Didn’t Hear Anything Bad               5%
                          Amalgamation/Downsizing             4%
                                            Expansion         4%
                                 Personal Experience          3%
                                               Funding       2%
                   Improving Condition Of Hospital           1%
                                                  Other         9%
                                 Don’t Know/Refused               14%
                                                        0%       20%      40%      60%      80%   100%

Q25: (IF RIGHT DIRECTION AT Q24) Why do you say that? (OPEN-END; ACCEPT UP TO 3 MENTIONS;                43
     PROBE: Any other reasons?) (n=139)
  Reasons for Saying Bluewater Health is Headed in
  “Wrong” Direction

     Two-fifths (40%) of residents who think Bluewater Health is headed in the “wrong”
      direction point to poor administration and management, while one-in-four (24%) say
      management and hospital staff are not resolving their differences and conflicts.

                 Poor Administration/Management                            40%
               Not Resolving Conflicts/Differences                   24%
                          Timeline For New Hospital                20%
               No Trust/Confidence of Community               11%
                                      Quality Of Care         10%
                                          Low Morale          9%
                                            Cutbacks         6%
                                     Lack of Funding        5%
                                    Shortage Of Staff       5%
                        From My Own Observations            4%
                                     Wrong Location         4%
                                                 Other       9%
                                                       0%      20%       40%      60%   80%   100%


Q26: (IF WRONG DIRECTION AT Q24) Why do you say that? (OPEN-END; ACCEPT UP TO 3                      44
     MENTIONS; PROBE: Any other reasons?) (n=258)
   Level of Trust in Hospital Administrators

    Two-fifths (43%) of residents report that they distrust Bluewater Health‟s administrators,
     with one-in-four (25%) saying they “completely distrust” the administration to properly
     manage the health system resources for Sarnia and the surrounding area (i.e., give a
     rating of 1 on a 10-point scale where 1 means “completely distrust” and 10 means
     “completely trust”).
                   80%
                                                                                                                            Mean: 4.0

                   60%
                                                                                                43% Distrust

                   40%               17% Trust                          36%
                                                                                                                 26%
                   20%                                                                       18%
                                                    14%
                                 3%                                                                                              5%
                     0%
                          10 Completely 7-9 Somewhat                 4-6 Neither       2-3 Somewhat 1 Completely Don’t Know/
                              Trust        Trust                      Trust Nor           Distrust     Distrust   Refused
                                                                       Distrust
Q27: Hospitals work to provide a wide variety of health service needs to the community. To what extent do you trust Bluewater
     Health’s hospital administrators to properly manage the health system resources for Sarnia and surrounding communities?            45
     Please use a scale from 1 to 10 where 1 means you “completely distrust” them and 10 means you “completely trust” them.
Level of Trust in Hospital Administrators,
by Genderation

   The level of trust that the public places in Bluewater Health‟s hospital administrators
    decreases with age among both men and women.


                                                        Mean Trust Score
                                                               #
                     Total                                     4.0
                     Male                                      4.1
                     Male 18-34                                6.3
                     Male 35-54                                4.5
                     Male 55+                                  3.6
                     Female                                    3.8
                     Female 18-34                              5.6
                     Female 35-54                              4.2
                     Female 55+                                3.3




                                                                                              46
Level of Trust in Hospital Administrators,
by Recall of Having Heard/Read Something About
Bluewater Health
   Residents who have read or heard something about Bluewater Health recently rate their
    level of trust in the Hospital‟s administrators significantly lower than those who have not
    heard anything about the Hospital recently (3.6 vs. 5.1, respectively).


                                                       Mean Trust Score
                                                              #
                     Total                                    4.0
                     Yes – Have Read/Heard
                                                              3.6
                     Something About B.H.
                     No – Have Not Read/Heard
                                                              5.1
                     Anything About B.H.




                                                                                                  47
   Who Should Be Most Responsible for Managing Health
   Resources

    The majority (54%) of residents feel that hospitals in the community should be most
     responsible for managing Sarnia‟s health resources.


                      The Hospitals In Your Community                                               54%

                                  The Ontario Government                        18%

                                                             Both       1%

                                     Community/People/Me                3%

                 Someone Knowledgeable/Competent                        2%

                                              Doctors/Nurses            2%

                                                            Other        8%
                                       Don’t Know/Refused                    12%
                                                                   0%        20%        40%         60%   80%   100%


Q28: Who do you think should be most responsible for managing the effective use of limited health                      48
     resources in Sarnia? Should it be...? (READ AND ROTATE)
Usage of Bluewater Health




                            49
  Accessed Bluewater Health in Past Year


   Almost three-quarters (72%) of residents have had direct contact with Bluewater Health
    in the past year.



                                                      Yes - Self
              No                                        32%
             27%



                                                                               72% Total Yes




             Yes - both
                                                       Yes - Other
               15%
                                                         Family
                                                        Member
                                                          25%

Q29: Have you, or any member of your family, accessed Bluewater Health in the past year?       50
Accessed Bluewater Health in Past Year,
by Household Composition

     Residents living in households with children are significantly more likely than those with no
      children to have visited Bluewater Health in the past year (85% vs. 72%, respectively).



                                            Yes – for       Yes –                     Total – No
                              Yes – for   Other Family    Visited for    Total -      Have Not
                                Self        Member           Both        Visited       Visited
                                 %             %               %           %              %
    Total                        32            25             15           72            27
    Children Under 10 Years      24            41             19           84            16
    Children 10-17 Years         22            33             29           85            15
    Any Children                 25            35             25           85            15
    No Children                  32            24             15           72            28




                                                                                                   51
  Services Used at Bluewater Health

   Among those who have used services at Bluewater Health in the past year, more than
    one-half (53%) have gone to the Hospital for emergency services.
   Just under one-fifth of these residents went to Bluewater Health for day surgery (17%)
    or outpatient services (15%).
                                 Emergency Services                                  53%
                                Day Surgery Program               17%
                                  Outpatient Services            15%
                            Inpatient Medical Services          12%
                                   Diagnostic Imaging           12%
                      X-Ray/Cat Scan/MRI/Ultrasound             11%
                                         Chronic Care         7%
                                 Blood Test/Lab Work           6%
                        Rehabilitation/ Physiotherapy        5%
                                         Cardiac Care       3%
                         Tests/Treatments (GENERAL)        2%
                                  Doctor Appointment       2%
                                                 Other         11%
                                 Don’t Know/Refused        2%
                                                      0%       20%       40%         60%   80%   100%


Q30: (IF YES AT Q29) What services were used? (OPEN-END; DO NOT READ LIST) (n=363)                      52
  Whether Services at Bluewater Health Met Expectations

   For three-fifths (60%) of residents who have used the Hospital‟s services this past year,
    their expectations were met.
   Almost three-in-ten (28%) report that their experience fell short of their expectations.

                                                                       Exceeded
                                                 Don’t Know/             Your
                                                  Refused             Expectations
                                                     1%                  10%
                            Fell Short Of
                                Your
                            Expectations
                                 28%




                                                                                                            Met Your
                                                                                                          Expectations
                                                                                                             60%




Q31: I’d like you to think about your expectations of the hospital service that you or your loved one used.              53
     Did the service...? (READ AND ROTATE LIST)(n=363)
Whether Services at Bluewater Health Met Expectations
by Service Used

     Residents who used Bluewater Health‟s day surgery program (33%) or inpatient medical
      services (33%) are most likely to say their care fell short of expectations.


                                     Exceeded                               Fell Short of
                                    Expectations      Met Expectations      Expectations
                                         %                   %                    %
    Total                                10                  60                  28
    Emergency Services                   11                  61                  26
    Day Surgery Program                  9                   57                  33
    Outpatient Services                  7                   66                  27
    Inpatient Medical Services           9                   55                  33
    Diagnostic Imaging                   9                   62                  27
    X-Ray/Cat-Scan/Ultrasound            7                   71                  22




                                                                                             54
  Whether Affected by Changes at Bluewater Health


   Three-in-ten (30%) residents report that they have been personally affected by the changes
    that Bluewater Health has made to its services and programs in the past few years.


                                          Don’t Know/
                                           Refused                                 Yes
                                              3%                                   30%




                                                      No
                                                     68%


Q32: Hospitals in Ontario, including Bluewater Health, have faced budget challenges in the past few years
     and have been involved in restructuring services and programs. Have you personally been affected       55
     by any changes that Bluewater Health has made to its services or programs?
Whether Affected by Changes at Bluewater Health,
by Perceptions of Change in Community Health Care

   Residents who think the quality of care in their community has worsened over the past few
    years are significantly more likely than those who think care has improved to say they
    have been affected by the changes made at Bluewater Health (39% vs. 13%,
    respectively).


                                        Yes – Have Been         No – Have Not Been
                                            Affected                 Affected
                                               %                        %
       Total                                   30                       68
       Quality of Care Has Improved
                                               13                       85
       Over Past Few Years
       Quality of Care Has Worsened
                                               39                       60
       Over Past Few Years




                                                                                           56
Whether Affected by Changes at Bluewater Health,
by Recall of Having Heard/Read Something About
Bluewater Health
   One-third (34%) of residents who have read or heard anything about Bluewater Health
    recently report that they have personally been affected by the changes at the Hospital
    (compared to only 19% of those who have not heard anything about Bluewater Health
    recently).


                                         Yes – Have Been         No – Have Not Been
                                             Affected                 Affected
                                                %                        %
       Total                                   30                        68
       Yes – Have Read/Heard
                                               34                        63
       Something About B.H.
       No – Have Not Read/Heard
                                               19                        79
       Anything About B.H.




                                                                                             57
Whether Affected by Changes at Bluewater Health,
by Opinion Leaders

   Opinion leaders are almost twice as likely as other residents to report that they have been
    personally affected by the changes made at Bluewater Health (39% vs. 21%,
    respectively).



                                         Yes – Have Been          No – Have Not Been
                                             Affected                  Affected
                                                %                         %
       Total                                    30                        68
       Opinion Leaders                          39                        59
       Not An Opinion Leader                    21                        75




                                                                                              58
  How Patients Have Been Personally Affected by
  Changes at Bluewater Health

   Among residents who say they have been affected by changes at Bluewater Health, just
    over one-in-four (26%) say they have not received proper care or service.
   Other ways in which patients have been affected include longer wait times (18%) and
    experiencing the effects of cutbacks on services (16%).
                          Lack Of Proper Care/Service              26%
                                     Long Wait Times            18%
                                Cut Backs (GENERAL)           16%
                                     Shortage Of Staff        13%
                                 Lack Of Accessibility       11%
         Procedures/Appointments Delayed/Cancelled           9%
             Having To Go Out Of Town For Treatment         7%
                                  Now Must Pay Fees         4%
                                  The Food Is Terrible     3%
                     Sending Patients Home Too Soon        3%
                                      Hospital Is Dirty    2%
                                                Other        9%
                                 Don’t Know/Refused         7%
                                                      0%      20%       40%      60%   80%   100%

Q33: (IF YES AT Q32) How have you been affected? (OPEN-END; ACCEPT UP TO 3 MENTIONS;                59
     PROBE: Anything else?) (n=149)
Media Usage & Preferences




                            60
  Usage of Bluewater Health Website


   Only one-in-ten (10%) residents have visited the Bluewater Health website.



                                                           Yes
                                                           10%




                                                             No
                                                            89%



Q35: Have you ever visited the Bluewater Health website?                         61
  Satisfaction with Website


   Among respondents who have visited the Bluewater Health website, the majority (57%)
    are satisfied with the information on the site.

            80%
                        Total Satisfied=57%

            60%

                                               47%
            40%                                                   Total Dissatisfied=26%


            20%                                                                          16%             18%
                         10%                                       10%

             0%
                    Very Satisfied          Somewhat             Somewhat          Very Dissatisfied   Don’t Know
                                            Satisfied           Dissatisfied                            /Refused



Q36: (IF YES AT Q35) Are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very                     62
     dissatisfied with the information available to you on the website? (n=51)
  Preferred Medium Through Which to Receive
  Information About Bluewater Health

   Almost one-half (47%) of residents prefer to receive information about Bluewater Health
    through articles in a community newspaper, followed by direct mail from the hospital
    (17%).


                Articles In Community Newspaper                                           47%
                      Direct Mail From The Hospital                      17%
                    Word Of Mouth (NONSPECIFIC)                   5%
                                       Hospital Website            5%

                                                     Radio         4%

                                Media (NONSPECIFIC)                4%
       Printed Material Picked Up From Hospital                   3%
                                                      Other         6%
                                  Don’t Know/Refused                 10%
                                                             0%        20%        40%       60%         80%   100%

Q37: What do you think is the best way for you to receive information about Bluewater Health? (ACCEPT                63
     ONE MENTION ONLY; DO NOT READ LIST)
Suggestions for Improvement




                              64
   Suggestions on How to Improve Hospital’s Image

    Three-in-ten (30%) residents recommend improved communication and a more open
     approach as a way to improve Bluewater Health‟s image in the community.
    One-in-four (23%) suggest replacing the Hospital‟s management would be the best way
     to improve the Hospital‟s image.
                               Better Communication & More
                          Honest/Open/Accountable Approach                             30%
                         Replace Management/Administration                           23%
                                   Better Relationship Between
                                    Administration/Staff/Public              10%
          Better Care/Service & Competent/Courteous Staff                    9%
                                              Build New Hospital           6%
                                                         More Staff      5%
                                           Manage Money Better           3%
                        Board Of Directors Should Be Elected             3%
                                              Better Accessibility       2%
                                                              Other           11%
                                            Don’t Know/Refused                       20%
                                                                    0%         20%        40%        60%     80%   100%

Q38: Hospitals are always looking for ways to improve their relationship with the community. In your view,
     how could Bluewater Health’s image in the community be improved? (ACCEPT UP TO 3                                     65
     MENTIONS; PROBE: Anything else?)
Suggestions on How to Improve Hospital’s Image:
Verbatim Comments

 The following are some verbatim comments from respondents on their
  recommendations for improving Bluewater Health‟s image in the community:
     “Be far more open with the public. They have closed door meetings and they
      should be open to the public.”
     “Board needs to do a better job communicating with the community and doctors.”
     “Give a little more information on what they’re doing in the newspapers.”
     “Have more public meetings.”
     “Change the administration and board of directors.”
     “Put patient care first.”
     “Show visible signs of improvement.”
     “Settle the dispute with the doctors.”
     “Get on with building the new hospital.”
     “Attract a large number of good doctors.”




                                                                                       66
       Roland Merbis
Vice President, Public Affairs

    101 Yorkville Avenue, Suite 301
      Toronto, Canada M5R 1C1
Tel: 416.921.0090 / Fax: 416.921.3903
           www.pollara.com

				
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