Division of Respirology

Clinical Program

Clinical services are provided across the city at the four sites: St. Joseph’s Hospital, McMaster University Medical Centre, Hamilton General Hospital and Hendersen General Hospital. All four sites provide in-patient respirology consultation, out-patient services, bronchoscopy and intensive respiratory care. In addition, McMaster Medical Centre offers advanced Cardio-Pulmonary Exercise testing and a Cystic Fibrosis Clinic, Hamilton General Hospital offers an Adult Pulmonary Hypertension Clinic, and the Hendersen Hospital offers Lung Cancer Clinic and Interventional Bronchoscopy services.

Firestone Institute for Respiratory Health

The Firestone Institute for Respiratory Health (FIRH) t St. Joseph’s Hospital is the designated regional respiratory centre providing service for the City of Hamilton and the Hamilton Niagara Haldimand Brant Local Health Integrated Network. FIRH has a unique Chest Programme that comprises respiratory medicine, head-and-neck/ENT surgery services and thoracic surgery services; all are located on one site. The Institute is supported by state-of-the-art pulmonary function and sleep laboratories, an airway inflammometry laboratory, an aerosol laboratory, a gastrointestinal motility laboratory, the departments of diagnostic imaging, critical care and endoscopy, and a regional laboratory-medicine programme. In addition to a number of specialty services, the Firestone Clinic also offers consultation to patients with, chronic suppurative lung diseases, pleural diseases and those who require long-term home ventilation. The clinic also houses a treatment facility, minor surgical and phlebotomy rooms and an audiovisual patient-education suite.

Inpatient Respiratory Care Unit

Respiratory inpatient care has recently been reintegrated to the medicine inpatient programme. Four acute beds are dedicated to the treatment of patients with complex respiratory diseases, usually those who have not responded to treatment in the outpatient programme for chronic respiratory problems. These beds are closely aligned with the six pulmonary rehabilitation beds housed within the rehab programme. There are 14 beds for Thoracic Surgery.

Within the inpatient programme, three of the six surgical step-down beds that are allocated to the acute thoracic surgical population. The programme also benefits from an inpatient room constructed solely for the delivery of radiation therapy for the treatment of thyroid disorders.

The programme committee structure supports a close co-operation between physicians, surgeons and the members of the multidisciplinary care team in what are usually complex clinical problems.

Outpatient Clinics

The clinics accommodate more than 32, 000 patient-visits yearly. In addition to clinics for general respiratory diseases, specialty clinics for severe asthma, allergic disorders and adverse reactions, interstitial lung diseases, sleep disorders, tuberculosis and thoracic surgery are held in the Firestone Institute. The organization of the clinics ensures the complete investigation of patients in a timely fashion. The clinic has recently developed a dedicated Diagnosis Assessment Programme for patients with suspected lung cancer.

Collaborative Chronic Respiratory Care Programme

This interdisciplinary programme for patients with Chronic Obstructive Pulmonary Disease includes inpatient and day hospital respiratory rehabilitation and the Breathworks exercise programme at St Peters Hospital in Hamilton.

Laboratory Services

Initial physiological studies included spirometry, lung volumes, arterial blood gases, single-breath CO transfer capacity, and cardiopulmonary exercise testing. Later, methacholine airway responsiveness, lung mechanics, and control of breathing were added, bringing the lung function laboratory up to the highest international standards. In addition, the laboratory now offers sputum induction and cell counting, bronchial and skin allergen challenge, and sleep studies. More than 20 000 procedures are carried out annually.