Grand River Hospital said Tuesday it is handing out notices to 45 employees as it faces an extra $7.5 million in staff and program costs.

On March 10, Cambridge Memorial Hospital issued layoff notices to 33 nursing staff — 19 nurses and 14 registered practical nurses — as it introduced a new model of care.

Grand River says it has held vacant more than 100 full-time, part-time and temporary positions.

"The hospital will issue 45 layoff notices to begin moving staff from areas where positions are reduced to areas with additional or vacant positions," Grand River said in a news release.

"The changes will result in the reduction of approximately 24 full-time equivalent positions out of a total staff of 2,564 full-time equivalents."

The layoff notices will be "divided roughly evenly between clinical and non-clinical roles," Grand River president and chief executive officer Malcolm Maxwell said in an interview on Tuesday.

People who retire will help reduce the number of people losing their jobs.

The hope is that all employees who want to keep working at Grand River will be able to do so, Maxwell said. Some people will move from one role to another.

"We've done everything we can to create opportunities internally," he said. "Our goal is to keep the good people that we have, but just ask them to look at the other roles that are available and exercise their rights under the collective agreement to move into those."

Maxwell said the collective agreement has the hospital issuing layoff notices before moving staff from one area to another.

"Unfortunately, it is a disruptive and upsetting process for people and we feel badly that we have to ask our staff to deal with this disruption," he said.

As Grand River worked on its $350-million budget, it faced an additional $7.5 million in staff and program costs, Maxwell said.

"These include costs for staffing, benefit costs and higher prices for supplies and drugs."

Grand River said it is on track for its seventh consecutive balanced budget. The hospital's fiscal year ended Tuesday.

The hospital said it reduced management positions, adjusted staffing in each department after comparisons with similar hospitals and put in place energy savings programs that have cut expenditures by $300,000 a year. It is also boosting lab productivity with a major automation project.

Maxwell said the layoffs will cut costs without affecting care.

"We have worked hard to maintain our service volumes," he said. "We are also preparing new services to better support the needs of our community, such as improved medical imaging care through our MRI for children as well as a specific unit to support care of the elderly. We will provide these services with existing funds."

Cambridge Memorial, meanwhile, said it hopes none of the 33 people getting layoff notices will leave unless they want to, meaning those positions will be eliminated through early retirement or voluntary exit packages.

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"This is a not a cost-saving initiative," said Heather Quesnelle, vice-president of clinical programs and chief nursing executive at the hospital.

Cambridge Memorial's new model of care will see it hire more personal support workers to help with everyday activities such as feeding and bathing patients to free up nurses to focus on medical care.

Grand River is not changing its model of care, Maxwell said.