Special Feature on the JGH
Special Feature on the JGH

Introduction
Since 1934, the Jewish General Hospital (JGH) has been providing cutting‑edge treatment and compassionate care to patients from diverse religious and cultural backgrounds in Montreal, throughout Quebec and beyond. As one of the province’s largest and busiest acute-care hospitals, this 637‑bed McGill University teaching hospital admits more than 23,000 patients a year, while handling at least 300,000 outpatient visits, 67,000 emergency visits and more than 4,000 births on an annual basis.

Mission
  • To provide patient care of the highest quality in a humane and caring manner, with an emphasis on specialized and ultra-specialized care
  • To develop and promote an environment for leadership and excellence in health sciences education
  • To encourage and support research in order to advance the knowledge of the prevention, cause and treatment of illness and the promotion of health
  • To actively participate in and lead the development and evaluation of new technologies in order to enhance patient care
History
From the 1880s to the 1920s, millions of Jews from Eastern Europe and Russia flocked to North America to seek refuge from religious persecution. Many of them settled in Montreal and substantially increased the size of the Jewish community that had existed in the city since the 18th century.

Upon their arrival in Montreal, Jewish immigrants encountered a far more tolerant society than the ones they had escaped. Nevertheless, religious prejudice was not uncommon in Montreal (or in other parts of North America) in the early 20th century. As a result, Jews sometimes encountered great difficulty in obtaining proper health care and in finding employment in Montreal’s leading hospitals. This prompted medical and civic leaders in the Jewish community to establish several small clinics during the 1910s. However, as new waves of immigrants poured into the city, it became apparent by the mid‑1920s that a larger and more comprehensive solution was required.

After a series of meetings in the late 1920s, Jewish leaders and philanthropists reached the consensus that a hospital ought to be built in order to meet the growing needs of Jewish community. However, there was also unanimous agreement that the new hospital, though geared to Montreal’s Jews, would welcome patients and staff from all religious, ethnic, cultural and linguistic backgrounds.

On Sept. 22, 1929, a mass meeting of more than 3,000 people was held at the Mount Royal Hotel to officially launch a fund‑raising campaign to build the hospital. Ironically, only a month later, the stock market in New York crashed, and this triggered the Great Depression, a calamity that threatened the ambitious plans of the hospital’s founders. Suddenly, many of Montreal’s Jewish families, left with only a fraction of their savings, were struggling to survive and were unable to promptly honour their financial pledges of support. Nevertheless, the desire for a Jewish hospital was so strong that almost every pledge was eventually honoured, even though some cash‑strapped donors took until the 1940s to fulfill their commitments.

Ground was broken by Canada’s Governor General, Lord Bessborough, on Aug. 3, 1931, and in 1933 the facility at the corner of Côte‑Sainte‑Catherine Rd. and Côte-des-Neiges was officially named the Jewish General Hospital. It was also in 1933 that philanthropist Allan Bronfman, who had been instrumental in the hospital’s creation, was named President and began a term that lasted until 1955. In that same year, Samuel S. Cohen arrived from New York to become the first Executive Director, a position he held until 1968. On Oct. 8, 1934, Lord Bessborough placed the final stone on the main building, and a week later, the first patient was admitted.

The hospital’s initial decade was a difficult one, as the new institution coped first with the Depression and then with the need to support Canadian and Jewish efforts during World War II. However, starting in 1936, major assistance was provided by the volunteers of the Women’s Auxiliary (now known as the JGH Auxiliary), who launched a wide array of committees and initiatives to provide much-needed hospital equipment and services.

The end of the war saw the beginning of an era of dramatic growth and heightened medical sophistication and innovation. From 1951 to 1972, the hospital housed its own School of Nursing, and during the ’50s and ’60s, new wings were built to accommodate the growing number of specialized departments, divisions and programs. Three major milestones were reached in 1969 with the opening of the Lady Davis Institute for Medical Research (LDI), the establishment of the JGH Foundation, and the granting of McGill University affiliation to most of the hospital’s departments.

As the pace of growth intensified in the 1970s and thereafter, the Jewish General Hospital made an ongoing effort to ensure that patients’ rights and needs were properly addressed. For instance, in 1973, the JGH became the first Canadian hospital to create the ombudsman-like position of Patient Representative. And in 1981, the Auxiliary launched Hope & Cope, a visionary and pace-setting support program for cancer patients and their families, which is now internationally recognized for its excellence. Also noteworthy in 1978 was the official change of the hospital’s name to the Sir Mortimer B. Davis - Jewish General Hospital in recognition of a bequest from the distinguished philanthropist and businessman.

By the end of the 20th century, the JGH had achieved remarkable progress. Five Centres of Excellence were designated in oncology, cardiology, emergency medicine, family medicine and obstetrics-gynecology. These designations indicate that while the hospital strives to offer first-rate treatment and care in all medical fields, it has distinguished itself in those five particular specialties.

The Modern Era
At the dawn of the 21st century, the Jewish General Hospital finds itself coping once again with the rapidly burgeoning needs of new waves of immigrants—arriving this time from around the world. The Côte‑des‑Neiges neighbourhood, where the JGH is located, has become the destination for many of Montreal’s new arrivals and it has been transformed into one of Canada’s most ethnically and culturally diverse urban areas.

This has prompted the JGH to expand, upgrade and broaden its range of medical services. In 2005, in order to provide much‑needed space for growth, the hospital purchased six acres of adjoining land and buildings from Les Soeurs de Sainte-Croix, an order of nuns. This property is now in use, with the opening of a hemodialysis unit in 2005 and the Cardiovascular Prevention Centre in 2006. In coming years, it will serve as the site for various patient services, including larger and improved premises for the Emergency Department, the Intensive Care Unit and the Herzl Family Practice Centre.

Also noteworthy was the launch in 2006 of the Segal Cancer Centre, housed in four of the eight new floors that were built atop an existing pavilion in the western portion of the hospital. The Segal Cancer Centre brings together almost all of the JGH’s cancer‑related services and programs under one roof, including diagnosis, treatment, research, prevention and psychosocial support. In this way, the efficiency and effectiveness of treatment is improved, since healthcare professionals from a wide variety of fields are centrally located and can act quickly to provide optimum care.

This multi‑disciplinary approach, especially evident at the Segal Cancer Centre, has become standard practice throughout the Jewish General Hospital, as teams of diverse healthcare professionals collaborate closely and regularly in the best interests of the patients.

Patient Population
Although the Jewish General Hospital continues its tradition of serving Montreal’s Jewish community, it provides treatment and care to a broad cross‑section of individuals of all backgrounds. These patients generally come from the hospital’s immediate neighbourhood and other parts of Montreal. However, in light of the JGH’s status as a referral centre in such fields as cancer and neonatology, large numbers of patients are also referred from across Quebec and other Canadian provinces. Approximately half of the hospitalized patients come from the region around the hospital, 30 per cent from elsewhere in Montreal, and 20 per cent from outside Montreal.

The hospital is located in one of Canada’s most culturally and ethnically diverse neighbourhoods. In fact, of all the immigrants who arrive each year in Montreal, nearly half settle in the immediate vicinity of the Jewish General Hospital. Although firm statistics have not been compiled, it is estimated that about two dozen languages can be heard in the hospital on a regular basis, in addition to English and French.

The pressures that the JGH faces are a result of the hospital’s relatively high proportion of elderly patients, plus the fact that its patient population is growing faster than the overall population of Montreal. In fact, the JGH handles almost twice as many elderly patients (over the age of 75) as any of Montreal’s other teaching hospitals. These patients are often seriously ill, requiring a higher level of care, often by a combination of specialists and healthcare professionals. In addition, the Emergency Department is one of Montreal’s busiest, with 67,000 patients in 2006 (up 30 per cent since 2001) and 12,000 ambulance arrivals in 2006 (up 32 per cent since 2001).

To handle this load, the Jewish General Hospital has been transforming its patient services by treating more patients on an ambulatory basis, rather than admitting them to the hospital. The hospital has also shifted as many activities as possible from in‑patient to out‑patient, thereby treating the lighter cases on an ambulatory basis, while concentrating a greater effort on sicker patients.

Research and Teaching
Since its inception in 1969, the JGH’s Lady Davis Institute for Medical Research has been an integral part of the hospital, and has helped to strengthen the JGH’s academic links and status vis-à-vis McGill University. Extensive clinical investigation and laboratory research are essential, since these activities leads to improved diagnoses, earlier detection of disease and more effective forms of treatment.

The JGH carries out approximately 22 per cent of the training for McGill’s Faculty of Medicine, while the Lady Davis Institute consistently receives one of the highest rankings from the Fonds de la recherche en santé du Québec. Researchers at the LDI are awarded approximately $40 million in research grants from external sources each year. This places the LDI at or near the top of the list in funding per researcher in Quebec’s hospital‑affiliated research institutions.

The LDI is considered one of Canada’s major biomedical research institutions and has earned international recognition in fields such as AIDS, aging, cancer and genetics. It also serves as the home to various McGill programs, including:
  • the McGill AIDS Centre, headed by Dr. Mark Wainberg, Past President of the International AIDS Society
  • the Bloomfield Centre for Research in Aging, where clinician-scientists have made major discoveries in understanding age-related diseases such as Alzheimer’s and Parkinson’s
  • the McGill Centre for Translational Research in Cancer, designed to speed up the time it takes for discoveries in the lab to be brought to patients at the bedside
  • the McGill Head and Neck Surgery and Oncology Program
  • the McGill Menopause Clinic
  • the Terry Fox Molecular Oncology Group
  • the Centre for Nursing Research
Philanthropy and Volunteers
Community involvement has been an intrinsic aspect of the JGH’s activities since the day the hospital opened. Donors and benefactors at all income levels, from all walks of life and from a multitude of ethnic and religious backgrounds have been instrumental in enabling the Jewish General Hospital to upgrade its services to patients on an ongoing basis. Outreach to benefactors and the administration of donations are co‑ordinated by the JGH Foundation.

Financial support is also provided by the JGH Auxiliary, whose continuing programs and special events generate funds that allow equipment to be purchased for a variety of hospital departments. At the same time, the Auxiliary’s volunteers give generously of their time in Humanization of Care programs that boost the morale of patients and provide emotional support during a difficult time in their lives.

The efforts of most of the hospital’s volunteers are co‑ordinated by the Department of Volunteer Services, which was created in 1955. These individuals range from high school students in their teens to retirees in their 80s. Some simply enjoy taking an active role in a major medical institution, while others are looking for a way to thank the JGH for the exceptional medical care they received. It is not uncommon for volunteers to spend a quarter‑century serving the hospital, while a select few have done so for more than 40 years. Altogether, the JGH’s 875 volunteers provide the hospital with a total of approximately 90,000 hours of service per year.

The Future
As the Jewish General Hospital progresses into the 21st century, its primary objective is to find innovative, efficient and cost‑effective ways of responding to the changing demographics and medical needs of its patients.

One important means of doing so is through the physical expansion of existing premises (for instance, constructing a new Radiation Oncology facility below ground level, near the main entrance) and the extensive development of the neighbouring property acquired from Les Soeurs de Sainte‑Croix. All facilities, whether old or new, will also continue to benefit from major upgrades in digital and wireless technology. In this way, the JGH expects to cut waiting times while modernizing its patient services.

These changes will be complemented by an ever‑increasing emphasis on teamwork and collaboration among those who provide treatment and care to patients. Instead of being “passed” from one healthcare professional to the next, the patient is treated by a co‑ordinated that includes doctors and nurses, as well as affiliated professionals such as pharmacists, physiotherapists, nutritionists and social workers.

As the number of seniors increases with the aging of the baby-boom generation, the Jewish General Hospital is also placing significant emphasis on the prevention of illness. Currently, this is particularly apparent in the activities of the Segal Cancer Centre and the Cardiovascular Prevention Centre, where patients are regularly advised on strategies for maintaining good health. While the hospital’s goal is to provide the best possible treatment where necessary, it also strives to help patients avoid the necessity of treatment in the first place. Similarly, the JGH’s long‑term objective is not just to extend life expectancy, but to help individuals achieve a healthy and self‑sufficient lifestyle for as long as possible.

Statistics
Beds: 637
Medical and surgical specialties: More than 40
Doctors: 645 attending doctors, most of whom hold teaching appointments with McGill
Medical residents: 188 medical residents based at the JGH, plus 636 medical residents rotating through the JGH
Nurses: 1,441
Total staff: 4,869
Nurses trained per year: 650
Patient admissions: Approximately 24,800 (1 every 21 minutes)
Outpatient visits: Approximately 572,000 (1 every 8 minutes)
Emergency Department visits: Approximately 67,000 (1 every 8 minutes)
Babies delivered: Approximately 4,540 (1 every 2 hours)
Surgery patients: Approximately 14,300 (39 per day)
Radiology exams: Approximately 186,000 (510 per day)
Echocardiograms (ultrasound): Approximately 7,500
Physiotherapy: Approximately 46,000 treatment days per year
Volunteers: More than 1,000