More than "bandaids": emotional support and education during the downsizing process

This paper illustrates the importance of giving emotional support and education to patients, families, staff and managers at The Queen Elizabeth Hospital, Toronto during the Spring 1992 downsizing effort. The Queen Elizabeth Hospital is a 601-bed, two-site facility which provides complex specialized rehabilitative and supportive care, teaching and research, as well as specialty programs in rehabilitation, geriatric service, geriatric psychiatry and long-term care. Downsizing at The Queen Elizabeth Hospital meant the consolidation and closure of 82 long-term beds, on one nursing unit at each site, to offset a projected budget deficit of $5.4 million. Internal restraint over the past year and during the budget process reduced this deficit to $2.8 million, thus necessitating further downsizing consideration. Background information includes a review of the recent downsizing literature. This paper describes the informal and formalized support activities that took place during the two-month process and the educational sessions that were provided on a regular basis. It gives specific attention to methodology and rationale. The authors also make recommendations for the successful implementation of a downsizing process which can be beneficial to any health care setting involved in bed closure.