Speaker Bios and Abstracts

Thursday, October 1, 2015

Professor Daniel Weinstock, IHSP Director
Welcome/Accueil

Bio

Gregory P. Marchildon, University of Toronto
Hospitals in Canada: The Great Disconnect between Policy and Reality

Bio

Abstract:
This presentation explores the policy consequences of the disjuncture between our intellectual view of the role of the hospital in Canada and the way in which we actually organize our institutions and behave as health system researchers, decision makers and senior managers. The following questions will be addressed: What changed in our intellectual understanding of the role of the hospital since the introduction of universal hospital and medical care coverage in Canada? How did the policy rationale behind regionalization not match up with the reality of its implementation in terms of the role of the hospital? Why is policy research on the hospital so limited in Canada relative to other OECD countries? What are the consequences of this disjuncture for the future?

Magda Fahrni, UQAM
Chair/ Présidence - Session I: Hospitals in History

Bio

Jim Connor, Memorial University
Listerism and the Transformation of Surgery and the General Hospital in Victorian Canada

Bio

Abstract:
This presentation describes the reception (knowledge transfer) and multiple impacts of antiseptic/aseptic surgery---Listerism--- and its impact on the general hospital in Victorian Anglo-Canada. This narrative highlights how the social, political, and intellectual connections between Canada and the United Kingdom catalysed the uptake of Listerism; this ongoing but evolving trans-Atlantic relationship between Great Britain and "greater Britain" (as William Osler famously dubbed parts of the Victorian Anglo-world) fueled further fêting of Lister (whose peak of professional fame coalesced with the period of the monarch's Diamond Jubilee celebrations in 1897, exemplified in the annual meeting of the BMA in Montreal with the now Lord Lister as guest of honour). While a uniquely Canadian story it is also one that has elements that may be readily generalizable to other Anglo-Victorian medical settings as it illustrates the transformation of operating theatres, surgical equipment, and the overall hospital physical plant and environment.

James Moran, University of Prince Edward Island
Dorchester Street Medicine: The Quebec Marine and Emigrant Hospital

Bio

Abstract:
The Quebec Marine and Emigrant Hospital (QMEH) opened its doors in 1834. By the 1850s it was treating approximately two thousand patients per year. The hospital's patients were drawn almost exclusively from injured and ill mariners, stevedores and emigrants. The QMEH's doctors and surgeons developed medical expertise in areas specific to these three patient populations. This made the QMEH a unique hospital in mid-century Quebec.

The sources offering the best accounts of the QMEH -- investigations into the hospital's mismanagement and misconduct -- have drawn most historians to assess the impact of the multiple conflicts amongst medical personnel at the hospital. This paper seeks to consider other aspects of the QMEH's significance. First it will assess how the hospital's unique role in treating emigrants and mariners shaped medical practice. Second it will consider the relationship between the QMEH and other hospitals in Quebec.

Thomas Schlich, McGill University
Chair/ Présidence - Session II: Architectures of the North American Hospital

Bio

Joy Knoblauch, University of Michigan
The Hospital, The Union, and The "Cultural Lag" at the Miner Memorial Hospitals in Appalachia

Bio

Abstract:
This presentation examines one of the first hospital 'systems' in post-WWII America. The ten hospitals, built in the Untied States between 1953 and 1956, were the result of a compromise between the United Mine Workers of America and the mine operators, aided by the not so subtle hand of the federal government of the United States. Designed by Isadore Rosenfield, Sherlock, Smith & Adams, and York & Sawyer, the buildings reflect the careful understanding of public relations in their use of concrete finishes, easily cleaned windows and the crucial element of transparency. Literally making use of extensive glass walls, providing patient manuals to explain life in the hospital, employing open entries, and clear circulation through the lobbies, these hospitals hold lessons for the history of modern architecture and hospital design.

Shay Sweeney, McMaster University
“The culmination of great dreams and hopes”: Building the Vancouver General Hospital’s Centennial Pavilion, 1948-1961

Abstract:
The culmination of great dreams and hopes: Building the Vancouver General Hospital's Centennial Pavilion, 1948-1961 This presentation examines the Vancouver General Hospital (VGH) and, in particular, the design and construction of the Centennial Pavilion in the immediate post-WWII era. The process from design to building to day-to-day operation provides a useful window into the myriad factors that influenced spatial ordering and organizational practices. These two elements formed the basis of experience within hospital space for patients and those who visited them, but also for the nurses, doctors and ancillary staff who worked there. When the building opened, unfinished, in 1959 politicians and administrators celebrated it as a moment of success and promise of a bright medical future for the community. The discrepancy between the actual state of the building and the public presentation demonstrated the important role of civic perception in defining hospitals in the 20th century.

Alain Laforest, Photographe
Architecture photography Slideshow/ Diaporama de photographies d'architecture

Bio

Jarrett Rudy, McGill University
Chair/ Présidence - Session III: L’hôpital et ses patients au Québec

Bio

François Guérard (UQAC), Martin Petitclerc (UQAM), Yvan Rousseau (UQTR):
L’hôpital et ses patients au Québec en période de transition (1881-1911): une sociographie des populations hospitalisées

Bios:
François Guérard
Martin Petitclerc
Yvan Rousseau

Résumé
Jusqu’alors fréquenté essentiellement par des patients dépourvus des ressources nécessaires pour être soignés à domicile, l’hôpital amorce vers 1880 sa transition vers un établissement de soins hébergeant des personnes de toutes conditions sociales. Cette transition repose sur de nouvelles modalités d’accès: à la charité, s’ajoutent la vente de services, puis le soutien de l’État à partir de 1921. De l’hôpital des pauvres à l’hôpital pour tous, la diversification de la population de patients empruntera ainsi trois grandes voies d’entrée. On ignore toutefois comment cette diversification se produit. Qui au juste trouve-t-on dans les établissements, de quelles origines et milieux en sont les patients, quand et de quelle façon évolue la composition des populations hospitalisées ? La réponse à ces questions, non discutées dans la documentation d’époque, doit reposer sur une reconstitution des dites populations, ce que nous proposons ici pour certains hôpitaux du Québec à l’aide des données issues des registres d’entrées et de sorties des patients de 1881 à 1911.

Denyse Baillargeon, Université de Montréal
L'Hôpital Sainte-Justine pour Enfants: l'hôpital pédiatrique canadien-français... de l'est de Montréal (1907-1957).

Bio

Résumé
Cette communication entend s’attarder au discours identitaire de l’hôpital Sainte-Justine saisi, notamment, à travers la documentation produite lors de ses campagnes de souscription annuelles organisées à partir de 1928. Elle veut montrer que cet établissement pédiatrique, fondé en 1907, se représentait et était représenté non seulement comme un lieu de soins, mais comme une véritable institution nationale, dédié à la défense et à la survie de la collectivité canadienne-française. Cette rhétorique nationaliste a séduit une part croissante de la population francophone de Montréal si on se fie au succès grandissant de ses campagnes de financement. Le sentiment de plus en plus répandu que Sainte-Justine était l’hôpital des enfants canadiens-français a cependant représenté un couteau à double tranchant quand il a annoncé son intention de déménager sur le Chemin de la Côte Sainte-Catherine vers 1950 ; frustrée de perdre « son » hôpital pédiatrique, la population francophone a alors manifesté son désaccord en boycottant la collecte de fonds organisée pour soutenir le projet de construction du nouvel immeuble qui sera néanmoins inauguré en 1957.

David Wright, McGill University
Chair/ Présidence - Session IV: Space and the Royal Victoria Hospital

Bio

David Theodore, McGill University
Planning the Hospital of the Future: Montreal’s Royal Victoria Hospital, ca. 1970

Bio

Abstract:
Around 1970 Montreal's Royal Victoria Hospital undertook planning for an extensive demolition and reconstruction of its historic buildings. The project was one of many architectural initiatives in Canada that responded to major changes in medical education and healthcare funding. Using textual and visual documents from the private collection of the late Dag Munro, this presentation will investigate the RVH project in relation to others in Canada, in particular the master plans for medical campuses in Ottawa and Newfoundland outlined by influential British hospital architect John Weeks. Overall, I will show that it was in this period that we cemented the idea of the hospital as a perfectible technology. The legacy of the this era of hospital architecture is not a particular look or form, but the idea that today every new hospital must be the hospital of the future.

Mary Hunter and Tamar Tembeck, McGill University
From Queen Victoria to Sausage Pants:Making Space for Art at the RVH and MUHC

Bios:
Mary Hunter
Tamar Tembeck

Abstract:
This presentation will examine art as a relational interface in order to critique hospital arts programming that focuses primarily on making patients, visitors, and staff “feel good.” Through a series of historical and contemporary examples related to artworks at the Royal Victoria Hospital and the Glen site, we will analyze how the functions of art in health care environments are increasingly being amalgamated into the overarching rhetoric of “patient-centered care,” and how, as a result, hospital arts commissions tend to follow a more functionalist philosophy. We will argue that purpose-driven art is not the only -- nor necessarily the most effective -- way to communicate a sense of well-being to the various populations that inhabit the hospital. By focusing on two artworks from the RVH’s collection – the monumental nineteenth-century marble sculpture of Queen Victoria and the contemporary painting Sausage Pants (a work that is not currently on display at the Glen), we will explore how art that is seemingly dysfunctional sometimes brings the best medicine.

Annmarie Adams, McGill University
Critical Care? Reusing Montreal's Royal Victoria Hospital

Bio

Abstract:
Since 1990, at least twelve Canadian cities have seen the closure of hospital facilities constructed in the twentieth century, due mostly to institutional mergers. Several significant hospitals have been demolished and many others face uncertain futures. This presentation explores the case of Montreal, where two so-called superhospitals have replaced seven historic hospitals. In particular, the presentations looks at reuse strategies pertaining to the Royal Victoria Hospital, where ten pavilions were constructed between 1893 and 1994. Research material is drawn from a co-authored heritage evaluation undertaken for the City of Montreal in 2012. Although the focus is on Montreal, the broader context of the case study points to decommissioned hospitals in other Canadian cities, and includes comparisons to at least four other peculiarly Canadian decommissioned typologies: veterans' hospitals, department stores, convents, and passenger railway stations.

Friday, October 2, 2015

Antonia Maioni, McGill University
Chair/ Présidence - Session V: Political Economy of Hospitals

Bio

Heather Whiteside, University of Waterloo
Unhealthy Policy: the political economy of Canadian public-private partnership hospitals

Bio

Abstract:
This presentation focuses on the implications of the rise in public-private partnerships (PPPs) as the means to finance, build and manage Canadian hospitals. It will explore whether the reliance on public-private partnerships (PPP) generate the promised fiscal and design benefits, and whether they allow for greater oversight or foster more opportunities for corruption. It will also explore whether there are specific ways of structuring PPPs that are particularly effective in building good hospitals, at reasonable cost, and if wider benefits are possible with a PPP, and under what conditions.

Marla Nelson, University of New Orleans
The economic potential of hospitals for the city: Strategies for promoting inclusive economic development and community revitalization

Bio

Abstract:
This presentation will focus on how hospital facilities function as economic entities in the city, with respect to land/real estate markets, employment, and business formation and trade in medically related goods and services. Particular attention is paid to the potential of hospitals to facilitate inclusive economic development and community revitalization through increased procurement with local businesses and workforce development initiatives aimed at low- and semi-skilled workers.

Stéphan Gervais, McGill University
Chair/ Présidence - Session VI : L’hôpital dans un milieu urbain et diversifié

Bio

Lara Maillet, l’École nationale d’Administration publique (ENAP) à Montréal Réforme et adaptation en santé: une question de cohérence?

Résumé:
L'objectif de cette présentation est de mieux comprendre, à travers la perspective des théories de la complexité, comment s'adaptent des organisations lorsqu'elles font face à des changements qui les dépassent? Le contexte de réforme actuel du système de santé au Québec nous servira à proposer une lecture des enjeux liés à la gouvernance multiniveaux et l'accessibilité des services de santé auprès des populations migrantes desservies. Nous mettrons ainsi en évidence (1) les différents acteurs impliqués dans ce processus d'adaptation, dont des acteurs de connectivité; (2) des leviers d'action, catégorisés comme administratif, émergent et d'habilitation; et (3) l'apparition de structures de connectivité lors de possibles imbrications de ces leviers, légitimant ainsi l'adaptation de l'organisation à l'égard des populations desservies.

Bilkis Vissandjee, Université de Montréal
La pratique infirmière en soins de premières lignes dans le contexte pluriethnique montréalais

Bio

Résumé:
L'exercice d'une profession dans le domaine de la santé et des services sociaux doit pouvoir répondre aux besoins des femmes, des hommes, des familles, des groupes et des communautés. Au cours des dernières décennies, la population à desservir est de plus en plus diversifiée sur le plan culturel, présentant des vécus migratoires complexes exigeant de mobiliser un ensemble de compétences de la part des professionnels de la santé, de prendre en compte l'intersection des déterminants sociaux de la santé affectant les trajectoires de vie et un engagement de la part des personnes aux niveaux décisionnels ainsi que des établissements. La présentation propose une analyse sur ces enjeux qui mettent au défi, sur une base quotidienne, les capacités, les comportements et les compétences des professionnels de la santé à concilier valeurs et pratiques vers des soins de qualité dans une perspective d'équité.

Sylvie Fortin, Université de Montréal
Pratiques cliniques hospitalières et diversité urbaine: quels enjeux, quels défis?

Bio

Résumé:
La mobilité internationale et la diversité des populations qui en résulte posent des défis pour la clinique au quotidien. Au-delà de la diversification des traditions thérapeutiques et savoirs sur le monde, sur le corps, sur la maladie, cette variabilité au sein de la population tient d'un éventail de facteurs tels que les rapports de genre, les statuts sociaux, l'origine ethnique ou nationale, la confession religieuse, le profil migratoire et les ressources (économiques, sociales, symboliques) dont disposent les individus. La clinique est traversée par cette diversité (clinicien/usager) et devient un espace social de négociation des savoirs, normes et valeurs (soignant/soigné/famille) polarisés par les contextes critiques d'intervention (naissance, fin de vie, passage des soins curatifs aux soins palliatifs, interruption de soins). Cette pluralité de normes et de valeurs est à son tour indissociable de l'évolution des situations cliniques liée aux progrès de la médecine, à la diversification des expertises médicales, aux modalités d'intervention et processus décisionnels.

Laurence Monnais, Université de Montréal
Chair/ Présidence - Session VII: Community Benefits of Hospital Projects

Bio

Nik Luka, McGill University
How large healthcare facilities fit into urban neighbourhoods – or not

Bio

Abstract:
The 'fit' of hospitals in urban landscapes can be highly beneficial; it can also be awkward. Their 'heavy' presence as large single-use facilities within complex urban fabrics is surprisingly under-examined in the scholarly and professional literature. They often generate significant flows of traffic, attracting particular sorts of ancillary activities while 'deadening' their immediate context by repelling the fine-grained mix of land uses that characterise lively, resilient city neighbourhoods. This presentation examines how hospital complexes get woven into urban neighbourhoods, specifically in terms of their physical, functional, and visual linkages vis-à-vis their local contexts. It highlights empirical work undertaken in graduate studios at McGill documenting good and bad examples of healthcare facilities in urban neighbourhoods in Montréal and elsewhere, highlighting analytical themes such as institutional utilitarianism, evidence-based design, therapeutic landscapes, and monumentalism. Questions for new city-building projects---such as integration, encroachment, and domination---are also explored.

Robert Mark Silverman, University of Buffalo
Securing community benefits from public projects: experiences in the United States and Canada

Bio

Abstract:
This presentation will provide an introduction to the concept of community benefits and experiences in negotiating the social, spatial and economic impacts of hospitals. It will outline experiences in securing these benefits in North America.

Lisa Bornstein, McGill University, and Maureen Kiely, McGill University Health Centre
Securing community benefits from hospitals: experiences in Montreal

Bios:
Lisa Borstein
Maureen Kiely

Abstract:
This presentation will complement Robert Mark Silverman's presentation on community benefits, and will explore the specific case of collaborations amongst community groups and health care professionals around two of Montreal's new hospital facilities, the Centre hospitalier de l'Université de Montréal (CHUM) and the McGill University Health Centre (MUHC) Glen campus. It will provide an overview of the MUHC facilities and the benefits to be expected.

Abraham Fuks, McGill University
Chair/ Présidence - Allocution de clôture / Closing Address

Bio

Damien Contandriopoulos, Université de Montréal
The future of the hospital: an environmental perspective

Bio

Abstract:
It is unlikely that the future of hospitals will be smooth sailing in the next decades. In this presentation we will tap into environmental perspectives from organizational science to discuss the pressures likely to shape the hospital future. Organizations have to deal both with internal and external dynamics. The environmental pressures -- capacity to attract resources, influence of regulation and so on -- have a tremendous impact on organization functioning, performance and survival. Predictable trends in fiscal constraints; HR availability and training; technological innovations; demography and ideology can all be used to draw a portrait of the likely future of Canadian hospitals.

MEDITHEATRE: Montreal Medicine at Expo 67

Moderator: Daniel Weinstock (McGill University)

Bio

Steven Palmer (University of Windsor)
"Expo Baby: Montreal Medicine and the 1967 World Exhibition"

Bio

Abstract

The story of the Montreal medical community's leadership role in establishing the Expo theme pavilions, especially in the area of medicine, health and the life sciences.  The talk will also reconstruct the "Man and His Health/L'homme et la santé" pavilion, and its core “Meditheatre” performance space where the film was screened.

Robert Cordier
"Miracles in Modern Medicine/Miracles de la médecine moderne"  (1967, 18 mins.)

Bio

Abstract
The Health and Medicine pavilion at Expo 67 in Montreal was built around a core exhibit, “Meditheatre”, a combined film and theatre show.  The film, shot in 1966, documents six medical interventions in Montreal hospitals (four of them at the Royal Vic), and offers an extraordinary cinematic consideration of the marriage of humans and machines at vital medicalized moments.  It was directed by Robert Cordier (Injun fender, 1974), who was then at the heart of the avant garde theatre, film and performance art scene in New York, as well as artistic director of a civil rights theatre project in the segregated South.  The cinematographer was John Palmer (Ciao! Manhattan, 1972), a gifted photographer and cinematographer in the Warhol Factory circle.  The film "Miracles in Modern Medicine", not seen for 48 years, was recently re-discovered in the film archive of Library and Archives Canada by historian of medicine, Steven Palmer. 

Robert Cordier will introduce the film and take questions following its screening.

 

 

The organizing committee would like to acknowledge the following groups for their support:
Le Comité organisateur souhaite remercier les organisations suivantes pour leur soutien: