the board of governors - Trillium Health Partners

THE BOARD OF GOVERNORS
ANNUAL REPORT
2004/05
JUNE 9, 2005
BOARD OF GOVERNORS
Executive*
Norman Loberg (Chairman)
Cheryl Englander (Vice Chair)
Louis Rene Girard (Vice Chair)
Geoff Watson (Treasurer)
Wayne Fyffe (Secretary)
Colin Adamson
Catherine Clark
Dr. Barbara Clive (Chief of Medical Staff)
Dr. George Dyke (Vice President, Medical Staff Association)
John Fleming
Bill Gardiner
Cindy Heinz
Katie Mahoney (Region of Peel)
Jill McGill (President, Volunteer Partners)
Michael Murphy (Chairman, Foundation)
Dr. Can Nguyen (President, Medical Staff Association)
David O’Brien
Joanne Rogers
Wendy Roney
Nina Tangri (appointed September 30, 2004)
Bart Wassmansdorf
Randy Wright
*Due to passing of Rick Podsiadlo, Louis Rene Girard, vice chair of the 2004/05 Board of Governors
as of September 30, 2004.
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BOARD OF GOVERNORS
JUNE 2004/5
First Row (left to right): Mike Murphy; Dr. Barbara Clive, Chief of Staff; Geoff Watson,
Treasurer; Norm Loberg, chairman of the Board of Governors; Wayne Fyffe, President
and CEO; Cheryl Englander, Vice Chair
Second Row: Louis Girard; Cindy Heinz; John Fleming; Jill McGill; Dr. George Dyke;
Katie Mahoney; Dr. Can Nguyen
Third Row: Joanne Rogers; Bill Gardiner; Colin Adamson; Bart Wassmansdorf; David
O’Brien; Wendy Roney
Absent: Catherine Clarke and Rick Podsiadlo (deceased)
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REMEMBERING A FRIEND
AND FELLOW GOVERNOR
Rick Podsiadlo
The Credit Valley Hospital family wishes to acknowledge the outstanding contribution
Rick made during his five years on the Board of Governors.
Rick’s solid common sense approach combined with his genuine concern and
commitment to providing the highest quality of heath care to our patients is a legacy that
will remain with us forever.
He shared the dream of building the new Carlo Fidani Peel Regional Cancer Centre and
The Ambulatory Care Centre with all of us.
That dream will come true on June 09, 2005, thanks to Rick’s foresight, tenacity and
sound judgment.
This year’s annual report is dedicated in Rick’s memory.
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OUR VISION
The Vision of the Credit Valley Hospital is to be the finest hospital in Canada
in the hearts and minds of the people we serve.
OUR MISSION
The Credit Valley Hospital offers quality compassionate health care to the people
of the growing communities of Peel and Halton.
OUR VALUES
Excellence in Patient Care
We will provide excellence in patient care by considering the individual’s physical,
emotional and spiritual needs. We see each patient as a special individual.
Respect
We recognize and treasure the unique contribution of each member of our CVH family
(staff member, volunteer and physician) and value the rights of
our patients and their families.
Leadership
We have a culture that facilitates and promotes innovation. We foster an organizational
climate that encourages advancement of knowledge through education,
experience and leadership.
Teamwork
We have found the best outcomes are achieved when we work together.
The diverse skills and knowledge of our CVH family can be brought together
to fulfill our service objectives.
Accountability
We acknowledge our responsibility to provide the best possible quality of care by
managing our resources effectively and acknowledge our responsibility to act as
advocates for our community to secure adequate resources to meet their needs.
Partnership
We seek the opportunity to develop effective partnerships to
further improve the health of our community.
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“HEALING AND HOPE”
“Salet Et Spes”
“Salet Et Spes” : the Latin phrase beneath Credit Valley’s original hospital crest.
Twenty years later, as we mark the official opening of our expanded facility, the words
“Healing and Hope” are especially fitting.
The design of The Carlo Fidani Peel Regional Cancer Centre and The Ambulatory Care
Centre embodies architectural features to promote healing and to create a sense of
welcome and warmth. Strong wooden limbs arching to the sun, streaming through walls
of glass overhead…lush green foliage and flowers…the calming influence of water…the
warmth of wood and colours in a variety of tones and textures…all contribute to an
environment not normally associated with a hospital.
But Credit Valley has always stood apart. Technologically advanced, a leader in clinical
care, setting precedents administratively as well as creatively..why then should this
architectural tribute to healing and hope surprise any of us?
Illness impacts patients as well as their families, emotionally and physically. The power
of mind and body working together, when that energy is channeled positively, sometimes
achieves results far beyond expectations.
The unique design elements of the new facility being officially commemorated today, will
be investigated as part of precedent setting research study funded by the Ontario
Hospital Association’s Change Foundation to measure “Best Performance through
Metrics of Evidence-based design”. The project is a partnership initiative between The
Credit Valley Hospital, Cancer Care Ontario and the architectural firm, Farrow
Partnership Architects Inc. working with Workflow Integrity Networks.
Our Board of Governors is proud to officially open this beautiful new centre of healing
and hope, on the occasion of its twenty-sixth annual general meeting.
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CREDIT VALLEY AT A GLANCE
Our Staffing Complement...
Staff (1,440 permanent full time)
Physicians with Privileges (including active, associate and courtesy)
Volunteers
Total
2,539
393
799
3,731
Our Programs...
Regional Programs
Community Programs
Renal
Oncology
Maternal/Child
Genetics
Medicine
Surgery
Cardiopulmonary
Mental Health
Emergency
Rehabilitation
Activity Snapshot
Annual Budget
Admission Type
Surgery
Births
Discharges
Emergency
Outpatient Visits
Laboratory Workload
Diagnostic Imaging
$226,500,000
2002/03
13,535
4,264
21,186
66,815
297,935
10,892,060
3,341,273
2003/04*
13,082
4,699
21,901
61,520
288,672
11,349,788
3,333,235
2004/05
14,642
4,829
22,650
64,966
314,762
12,160,736
3,800,061
*Volume was restricted due to SARS precautions
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ANNUAL REPORT OF THE PRESIDENT & CHAIRMAN
“HEALING AND HOPE”
This year’s theme for our annual meeting and official opening aptly describes an
essential component of achieving our vision “To be the finest hospital in Canada in the
hearts and minds of the people we serve”.
In order to provide healing and hope, we must make decisions that support better
access to the highest possible quality of care while also being fiscally responsible to the
government of Ontario who provides most of our funds, and to the members of our
community who support us with their donations.
In this report of the activities of the fiscal year April 1, 2004 to March 31, 2005, we hope
to illustrate how we have risen to the challenge to provide healing and hope with the
support of the entire team, including our community.
Capacity
On June 9, 2005 we will officially open our Phase I project which includes the Carlo
Fidani Peel Regional Cancer Centre and integrated ambulatory care centre which will
provide 330,000 gross sq.ft. of new space to provide healing and hope to patients who
come to us on an ambulatory basis. It is particularly encouraging that our local
community will in July have access to radiation treatment for cancer. This will provide
care closer to home and shortened wait times. The design of our new building is based
on the notion of a healing environment and so we are certain that all who seek
treatment, visit or work in the new facility will experience healing and hope.
In last years report we talked about the need to focus on expanding our inpatient
capacity and our capacity for labour and delivery rooms and neonatal intensive care unit.
This is Phase II of our Comprehensive Master Plan to develop our existing site. We
were pleased with the support we received from our local MPPs and in particular, Bob
Delaney MPP for Mississauga West, who petitioned the legislature to create a priority for
this project. We regret, however, that we were unable to obtain government approval to
proceed to tender this important construction project. We are hopeful that the new
Ministry of Infrastructure Renewal will look upon our project favorably and allow us to
proceed to tender as soon as possible in the next fiscal year.
We are going to deliver 4,800 babies in a space designed for 2,700 this year, while we
eagerly await government approval for our next expansion project. In the meantime we
have voluntarily enrolled in a risk management program called MORE-ob which we hope
will help us to reduce risk factors caused by our over crowded facilities.
We also responded with enthusiasm to the government initiative to reduce wait times for
hip and knee surgery, cataract surgery, cancer surgery and MRI exams. We increased
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the volume of surgery in each case and were able to demonstrate positive impacts on
the lives of our patients.
In partnership with 3M, the hospital has undertaken a Six Sigma project to try and
improve wait times for patients in our emergency room. While the root cause of this is
lack of inpatient capacity, we are determined to do everything that we can to improve our
internal processes to reduce wait times which we know are unacceptably long.
Human Resources
There is another capacity issue facing the Canadian health care system which often
goes unrecognized – human resources. In order to maintain our reputation as an
employer of choice and therefore be able to attract the best and the brightest, we have
created an in-house educational program called “Our People Care”. This program has
been highly successful in its early stages and we look forward to the long term positive
effect on the culture of our organization as we become bigger and more complex in the
future. Similarly we have continued our negotiations with the University of Toronto and
McMaster University to seek full affiliation as a teaching hospital, again in order to
ensure that we are able to attract the best and the brightest of professionals in the
future. We were encouraged with the caliber of applicants during our search to replace
Dr. Barbara Clive who is stepping down as chief of medical staff in September after
completion of a ten year term. We expect to announce the successful candidate at our
Annual General Meeting in June and have a smooth transition over the summer months.
It was no surprise to us that Premier McGuinty visited Credit Valley last summer to
showcase our leadership in providing support to nurses. Each and every government
initiative to enhance nursing services has been responded to with enthusiasm from The
Credit Valley Hospital and as a result we rarely use contract agency nurses, our
overtime has been reduced dramatically, we use our own staff as our best recruiters,
and we have improved the quality of working life of our nurses which can only enhance
our ability to deliver healing and hope to our patients.
The Future
As we have stated on numerous occasions, we must remain focused on increasing our
capacity through the construction project known as Phase II of our Comprehensive
Master Plan. In the meantime, we are going to work with our government colleagues to
develop two smaller projects which we hope can move ahead more quickly than our
large Phase II project. The child and maternal care offsite facility has always been
planned as part of Phase II and we hope to fast track that over the next year. Also we
are proposing a new concept of an offsite surgicentre in order to decongest our
operating rooms by moving all those day surgeries that don’t have to take place in a
hospital to another site.
We expect to receive a new accountability agreement this year from the Ministry of
Health and Long-Term Care, and we look forward to working with government to ensure
that we have reasonable and clear expectations of our mutual responsibilities.
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By the end of the next fiscal year we will once again be surveyed by the Canadian
Council of Health Services Accreditation. We look forward to asking our peers who will
visit the hospital for an extensive review of our compliance with national standards, to
answer the following question “have we done everything possible to mitigate the risks
associated with an overcrowded hospital facility, while we wait for government approval
to expand?”
The best practice initiatives of the Board of Governors in the last year will lead us to a
comprehensive review of our by-laws and recommendations for major change at the
next Annual General Meeting. Finally, we look forward to working with the new entity
Local Health Integration Network just now being established by the Government of
Ontario, with a view to achieving success in fair share funding for Peel and increased
collaboration and co-operation amongst all health care providers.
Teamwork
This annual report can only provide a snap shot of the activities and initiatives in the last
year. None of these could have been accomplished in the last year without effective
working relationships with our teams and partners. The Board of Governors,
management and medical leaders meet once a year at the annual leadership summit to
ensure that we continue to have positive and productive working relationships for the
benefit of our patients. We are grateful for the continued success of our Foundation in
its capital campaign to raise $50 million, the highest goal of any similar hospital in
Canada. These funds are essential for our success in achieving capacity to match the
growing needs of our community. Hospitals are people places and the contribution of
our CVH Volunteer Partners in providing that extra care in our ever busy world cannot be
under estimated, nor can their pledge of $1 million to our capital campaign.
Accountability
Working as a team requires mutual accountability. This became a significant concern
among our Board of Governors when reviewing the initial drafts of Bill 8. We presented
our written concerns and were invited to speak to the Standing Committee on Justice
and Social Policy twice to work with them to improve the language and practicality of the
Bill. Although the new agreement is not flawless in its execution of the terms of the
agreement, we are committeed to working within the new framework. The Board of
Governors met 11 times in the last year, including two mini-retreats on the topic of best
practices in hospital governance. By the end of the year, the CVH Board had adopted
clear role statements for individual Board members and the Board as a whole, a rigorous
evaluation system for individuals and the Board as a whole, and other initiatives
reflecting best practice of modern Boards. The fact that this was undertaken voluntarily
by the Board without request from any outside body is a testament to our Board’s desire
to demonstrate best practices throughout the hospital including at the very top.
Financially, the year was difficult due to uncertainty about the amount of funding.
Despite being one of the lowest cost providers in the province, The Credit Valley
Hospital undertook a cost cutting exercise in order to achieve a balanced budget, given
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the limitations on overall government funding. The senior management team and the
Board lead the organization through a $6 million reduction in expenditures which was
implemented with the least disruption to employees and the ongoing operation of the
hospital. At year end, the hospital had a small deficit which was balanced by a previous
year’s small surplus. This was no easy task. We look forward with some trepidation
about funding levels for the next fiscal year since public services in the Region of Peel
are already under funded on a per capita basis relative to other parts of the province of
Ontario. And as the Premier has pointed out recently, the province of Ontario receives
less than its fare share from Federal transfer payments as well.
The Board’s decision to make the entire property a smoke free zone is reflective of our
responsibility and accountability to help staff, patients and visitors reduce the risk of
cancer.
Externally we try our best to ensure that our local MPPs are well informed of the
challenges that face Credit Valley Hospital and we look forward to their continued
advocacy on behalf of the patients we serve. We work closely with several teams within
the Ministry of Health and Long-Term Care as well as Cancer Care Ontario, and we look
forward to continued fruitful relationships over the next year. Finally we could not
accomplish our goals without the support of ordinary citizens within our community and
without the collaboration of all of our partners who also provide healthcare.
In Conclusion
This report is dedicated to our friend and colleague, Rick Podsiadlo who passed away
last year after a lengthy battle with cancer. As treasurer and member of the Planning
and Building Committee we know he is looking down at us and smiling – at our ability to
overcome challenges and at the wonderful new wing we will officially open on the day of
our 26th Annual General Meeting.
In September we were delighted to appointed Nina Tangri as a new member to fill the
vacancy left by Rick Podsiadlo. We thank her for her contribution along with that of
Colin Adamson and Randy Wright who were elected for three year terms at our last
AGM
Wendy Roney and David O’Brien have indicated that they wish to resign as of the AGM
for personal reasons. This will bring us to to 13 elected members plus ex-officio
members. We will miss Wendy’s long service (9 years) and wise counsel. As ex-officio
members, Jill McGill has completed a three year term on our Board representing the
Credit Valley Volunteer Partners, and Dr. Can Nguyen has completed his two year terms
representing the Medical Staff Association. We thank them for their commitment to
CVH, and look forward to working with their successors.
We will also miss the insight and counsel of our retiring Chief of Staff, Dr. Barbara Clive
who leaves our Board table and administrative offices after ten years heading our
physician leadership team. We will not fully expound her virtues in this report, favouring
a special tribute that will be held in her honour in the Fall.
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On behalf of the patients we serve and our community as a whole, we thank all our staff
and physicians for helping us to bring healing and hope to so many throughout the last
year.
Respectfully submitted,
Norman Loberg
Chairman
D. Wayne Fyffe
President and CEO
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“WORTHY OF NOTE”
2005 Initiatives and Achievements
Performance Measurement
In 2004-05 the Quality Management Department laid the groundwork for performance
measurement with a new vision and corporate direction that aligns Credit Valley’s
strategic plan with performance measurement and quality improvement activities at
Credit Valley. This has included the development of a new quality framework based on
the Hospital Report quadrants, resulting in a balanced approach to measuring
performance and setting measurable goals and objectives for improvement across the
hospital.
Service Department Keeps Customers Happy
The Credit Valley Hospital’s service department encompasses a wide variety of support
services including cleaning, patient transport, linen delivery, building systems, equipment
repairs, food services and clinical nutrition services. Each month the service department
conducts a satisfaction survey which asks our patients to rate us for 11 different
indicators. Each quarter we compare our results on 10 of these questions to five other
health care facilities encompassing 16 sites.
Credit Valley’s Service department scores consistently exceed the average for these
sites. On our March 2005 survey, Credit Valley scored higher than the average for all
questions, scored the highest on five out of 11 questions (related to cleaning, customer
service and food temperatures) and tied for highest on two out of 11 questions (related
to equipment repair and cleaning). Other scores were within 1-4 points of the highest.
Operation 555 Butt Out
On May 5, 2005 (05-05-05) Credit Valley and the property bounded by Erin Mills
Parkway, Eglinton Avenue West and Credit Valley Road became “smoke-free”. This
initiative, the first of its kind in Ontario at a hospital the size and scope of Credit Valley
was the result of nine months preparatory work and a commitment by our Board of
Governors to promote health and wellbeing. The significance of 05-05-05 was to
commence this initiative on the “unofficial” opening date of the new regional cancer
centre, sending a clear message to all that wellness is about prevention as much as
treating illness.
Human Resources
The Human Resources Advisory Committee applied and successfully achieved “short listing”
on Maclean’s magazine Employer of Choice for 2004.
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Obstetrics/Gynecology Program
Babies have been big business at Credit Valley this year with 4,863 deliveries. All
inpatient and outpatient maternal and newborn services are stretched to capacity with
increasing demand, including significant growth in the high risk pregnancy clinic under
the direction of perinatologist Dr. John Smith.
An exciting professional development initiative, the MOREob program was recently
launched for our labour and delivery staff and physicians. This unique three year
program sets the foundation for advancing a culture for delivering consistently high
quality care by all members of the healthcare team with a focus on increasing safety for
the patient.
Expansion of maternal child facilities is an urgent priority with plans ready to move
forward for Phase 2 of the hospital comprehensive master plan which will include 15
labour and delivery rooms and new facilities with 37 bassinets for the special care
nursery.
Perinatal on-line documentation (POD) is a technological initiative underway in the
perinatal units to create an electronic health record for the patients.
Plans have also been completed for a Women’s and Children’s Centre to be located in
an off-site facility to provide coordinated, comprehensive services for women and
children including obstetrics and gynecology outpatient clinics, women’s health clinics,
physicians offices and associated diagnostic services.
A regional gynecologic oncology program was launched July 2004 as a collaborative
with Credit Valley gynecologists and the Credit Valley oncology program in partnership
with Princess Margaret Hospital and the University Health Network department of
gynecologic oncology. The program has been very successful in providing specialized
services as close to home as possible and coordinating services for patients with
gynecologic malignancies who reside in the communities of Halton and Peel.
Paediatrics Program
The Credit Valley Hospital is designated as a Regional Children’s Health Centre (RCHC)
with responsibilities to provide more complex care for newborns and children. With
shrinking hospital resources and delays in approval for capital expansion, we have been
challenged over the past year to enhance and expand our programs and services to
meet the growing need for more specialized services closer to home.
Several initiatives have been implemented over the past year to improve the care for
children and families including the following highlights:
•
Paediatric pain management initiatives to improve pain management and
decrease anxiety in the area of procedure preparation and post-procedure care
for children throughout the hospital.
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•
Palliative care education and program development to address palliative and
end-of-life care for patients and families.
•
Paediatric code blue developed as a new emergency measures code to facilitate
appropriate emergency response to situations where resuscitative measures are
needed for paediatric patients anywhere in the hospital.
•
Clinical practice case review team initiated to identify opportunities for
improvements in clinical practice.
•
Regional retinopathy or prematurity (ROP) screening clinic implemented April
2004 to facilitate follow-up screening by paediatric ophthalmologist Dr. Andrew
Budning for premature newborns in Peel and Halton.
•
Satellite paediatric oncology program growth with a 17 percent increase visits to
the clinic this past year.
•
Paediatric diabetes education program growth continues with approximately 25
new children diagnosed with diabetes each year. With a grant from the Toronto
Automobile Dealers Association, Credit Valley staff go to the schools of newly
diagnosed children and deliver education to both the class and their teachers. A
transition program has been established to assist teens with diabetes as they
move from the adolescence and transition to the adult system for diabetes
management.
•
Continued success through the paediatric asthma education program in reducing
hospitalizations and emergency department visits for children with asthma by
improving management of asthma through education regarding medications,
triggers and self-management.
Emergency Program
Emergency department (ED) visits returned to projected volumes following the impact of
SARS in 2003/04 with 64,953 visits this past year.
There is a continuing trend to higher acuity with 77 percent of the patients presenting as
triage category 2 and 3 (emergent and urgent).
With the trend to higher acuity and no increase in the hospital-wide bed capacity for
admitted patients, the emergency department is frequently backlogged with admitted
patients which results in excessive delays in throughput of ED patients.
The emergency department management system (EDMS) was implemented during this
past year to improve workflow by providing a system for tracking patients throughout
their stay in the ED and facilitating quick access to the patient’s clinical information
including diagnostic test results.
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Electronic (on-line) triage documentation has also improved communication and access
to patient information among care providers in the ED. Transition to electronic format
was very successful despite a substantial change in practice for triage nurses.
CVH continues to be above the benchmark for clinical indicators for management of
patients presenting with acute myocardial infarction (heart attacks).
Clinical guidelines, medical directives and pathways, have also improved management
of patients and reduced requirements for admission.
A trauma care process improvement initiative has resulted in a reduction of 30 minutes
from the time of presentation to transfer and revision to the trauma flow sheet to facilitate
more complete documentation.
The crisis intervention team and quick response program staff are integral members of
the team and assist in management of patients and families presenting to the ED.
Laboratory
The department of laboratory medicine, through tremendous enthusiasm and teamwork of all
staff, has achieved:
•
Accreditation by the College of American Pathologists
•
Accreditation by the American Association of Blood Bank
•
Implementation of an electronic document management system and
•
Launch of a laboratory home page via the CVH intranet
These are integral components in the laboratory's implementation of a quality system.
Rehabilitation Services
Physiotherapy
Acute care physiotherapy has added two very effective “best practice” treatment
techniques to their protocol for treating patients with respiratory conditions:
breathstacking and the use of an acapella device; both of which support improved
bronchial hygiene. The outpatient physiotherapy department has implemented a postoperative knee class, improving the timeliness and efficiency of intervention and
education for patients who have had knee surgery.
Speech Language Pathology
Speech pathologists co-led an oral hygiene pilot project in ICU/CCU. Across the
hospital, speech pathology staff is providing supported conversation training (a
communication technique used with patients who have impaired communication
following a stroke) to other members of the multidisciplinary teams. Department-specific
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data bases have been created to support and streamline documentation regarding
assessment and intervention with communication and swallowing-disordered patients.
Audiology
The audiology department has changed its processes and scheduling practices to
increase the number of patient visits in a week, improving wait time and increasing
revenue.
Rehabilitation Day Hospital
The seniors and rehabilitation day hospital has implemented a fall prevention program,
providing assessment, exercise and education to patients who are at risk of falling, in
order to minimize the incidence of fall-related injuries and related hospital admissions.
Social Work
The social work department has worked closely with CCAC to shift elements of the
process supporting the transition of discharged patients into nursing homes. With CCAC
assuming greater responsibility for the placement process, it has freed up time for the
social work staff to provide counseling and care to inpatients.
Quick Response Program
The QRP staff has supported the hospital-wide delirium project by adding to their
assessment two screening tools for elderly patients in the emergency department; both
tools help to identify patients presenting with delirium and allow for early intervention and
management.
Diagnostic Imaging
CT/MRI PROGRAM
With the support of a private donor, a second CT scanner was purchased to help reduce
the waiting times for CT examinations. The Philips Brilliance Scanner was installed in
December 2003 and operational in January 2004. With the addition of this scanner, we
were able to reduce our CT waiting list from 7 months to 2 weeks.
The CT program has expanded to include cardiac imaging and CT colonography.
cardiac CT examinations are performed and reported in a joint venture between the
radiologists and cardiologists.
Wait Time Strategy
MRI hours increased as a result of participation in the provincial government’s wait time
initiative which resulted in the addition of 144 hours of MRI service from January to
March 2005. As a result of meeting this objective, we have been given additional
funding to continue the initiative this year.
Our present waiting times for various exams show pressure in a few specific areas. MRI
has the longest wait time, at 8 months for a routine indication. It is hoped the additional
funding for MRI will not only be continued, but augmented. Construction for our second
MRI will commence this June, with anticipated clinical start date in October.
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Ultrasound
The IPS (integrated prenatal screening program) ultrasound appointments were
increased by 60% to meet increasing demands.
High risk clinic obstetrical ultrasounds performed in the main department were increased
by 50% in keeping with our role as a regional centre for child and maternal care.
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ANNUAL REPORT OF THE CHIEF OF MEDICAL STAFF
The motto of The Credit Valley Hospital and the theme of this year’s annual report is
Healing and Hope.
To allow people to heal, we must provide hope. At The Credit Valley Hospital, we
provide this in two ways: through our beautiful new physical facility that has been built to
meet the growing healthcare needs of our community and also through the work of our
staff.
Our staff provides healing through their knowledge of science and medicine. How do we
provide hope? It has been said that “hope is not pretending that troubles don’t exist, it is
the trust that they will not last forever, that hurts will be healed and difficulties overcome.
It is the faith that a source of strength and renewal lies within, to lead us through the
dark, to the sunshine”.
The caring and kindness shown by our staff plays a significant role in enabling our
patients to draw upon their inner strength. Working together with our professionals,
patients and their families learn to guide their own path to health and healing or perhaps
even a comfortable death.
This type of compassionate care can only be accomplished through good leadership.
In April 2004, we were pleased to welcome Dr. Paul Philbrook as the new chief of family
medicine. Dr. Philbrook has been a family physician at Streetsville Medical since 1983.
Under his leadership, we have maintained a strong role for family medicine within the
hospital which unfortunately, has not been the case in many hospitals across the
province and country.
Dr. Don Jones was welcomed as the new medical director of surgical oncology in the
summer of 2004. Don is respected not just for his vision of regional surgery services for
our cancer centre but also as an outstanding thoracic surgeon.
Dr. Michael Barsky was reappointed for a second five year term as the chief of
diagnostic imaging in recognition of his excellent leadership of the imaging department
over the previous five years.
Dr. Margaret Grant was appointed the physician director for rehabilitation and continuing
care. Dr. Grant will build on the strong foundation built under the leadership of
Dr. Vesna Page.
This year, the medical advisory committee welcomed Anne Marie Lang-Berkowitz as the
new chair of the professional practice advisory committee, formerly chaired by Karyn
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Lumsden. Their participation demonstrates the importance of all of the members of the
healthcare team in the provision of patient care.
I must thank Dr. Mathias Gysler for his continued leadership as the acting chief of
anaesthesia and David Rowe, senior vice president, for providing their ongoing support
and guidance to this essential department within our hospital.
In November 2004, we responded to the wait list strategies presented to us by the
Ministry of Health and Long-Term Care. With additional financial resources to extend
operating room time, our surgical program was able to increase the number of
procedures to better meet the needs of our community.
In September 2005, I will be stepping down as the chief of medical staff. Over the past
ten years I have grown in this role with the guidance of the Board of Governors and staff
of The Credit Valley Hospital. I am honoured to have been given this opportunity of a
lifetime.
Helen Keller said “I long to accomplish a great and noble task, but it is my chief duty to
accomplish many small tasks as if they were great and noble”. I had a similar vision
when I took on my role as chief of medical staff, and looking back, I do believe I have
accomplished many small yet noble tasks. I believe I have contributed to a more open
culture of respect amongst the many disciplines that provide healthcare to our patients. I
have increased teamwork and greater recognition of the contribution of all providers to
the healing of our patients.
Positioning Credit Valley as a teaching facility was another of my priorities. I believe this
is the correct path to purse in light of the increased competition for healthcare providers.
Also, our role as a teaching facility will serve to invigorate our staff and encourage us to
take that quantum leap to a teaching facility specializing in the provision of quality,
compassionate patient care. We are currently working on four different teaching
initiatives, participating in the development of a Medical School Academy of the
University of Toronto at the UTM Campus, development of a Family Medicine Teaching
Unit with the University of Toronto at The Credit Valley Hospital, exploring a full affiliation
with the University of Toronto and exploring clinical teaching agreements with McMaster
University.
In my role as chief of staff, I have also strongly supported the growth of research at our
community hospital. I believe this is essential in attracting health care providers in the
forefront of medicine and providing our patients with the best possible care available.
The senior management team and I have worked diligently over the years to try and
move our Comprehensive Master Plan forward to ensure that there is a physical facility
that will meet the needs of our community. The completion of this first phase of
construction – The Carlo Fidani Peel Regional Cancer Centre and The Ambulatory Care
Centre – demonstrates our initial success.
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I know that the next chief of staff will build on my accomplishments and focus on new
areas of interest and growth to make The Credit Valley Hospital truly the finest hospital
in Canada in the hearts and minds of people we serve.
Respectfully submitted,
Barbara Clive MD, FRCP(C)
Chief of Medical Staff
20
ANNUAL REPORT OF THE CHAIRMAN OF
THE CREDIT VALLEY HOSPITAL FOUNDATION
The Credit Valley Hospital Foundation reached an exciting milestone this year.
2003-2004 marked another successful year in all areas of endeavour thanks to the
extraordinary support of our donors, volunteers, staff and the entire hospital family.
I am proud to report that we have reached $41 million toward our goal of
$50 million in support of the hospital’s $300 million expansion project. Within weeks, the
long-awaited Carlo Fidani Peel Regional Cancer Centre and the new Ambulatory Care
Centre opening will provide world class care to our patients.
This past year we received three $1 million gifts, bringing our total to twelve campaign
gifts over $1 million. We welcomed 22,000 donations, acquired 306 new monthly donors
bringing our total to 595, increased membership in our Roots of the Community Program
to 52 members and received our first ever pledge from the union community. We
expanded our communications initiatives - direct mail, billboard and media advertising into the regional communities we serve. This wider distribution of our campaign
message resulted in increased giving from these communities.
We met the Kresge Challenge together! Throughout the year we appealed to the entire
community to help us raise a portion of the campaign total. The community responded.
We successfully raised $4 million required to receive the $1 million grant from the
Kresge Foundation, a distinction we are privileged to hold.
Members of our world class hospital family rose to the challenge too. Our hospital and
foundation board volunteers, past and present, have donated more than $684,000 to the
campaign. Our appeal to the staff and physicians to date has raised more than
$768,000 demonstrating intense commitment to expanded services from those mostly
closely involved with patient care.
I wish to express my heartfelt gratitude to all donors who responded to our appeals.
Your gift is highly valued and your support makes a great difference to our patients.
We look forward to the coming year with enthusiasm as we enter the final phase of the
campaign. We have $9 million to raise. We hope you will continue to share your
enthusiasm for Credit Valley with other donors-to-be.
Thank you for your continued role in helping to realize our vision of expanded world
class health care right here in our community.
Michael Murphy
Chairman , The Credit Valley Hospital Foundation
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REPORT OF THE PRESIDENT
OF THE CREDIT VALLEY VOLUNTEER PARTNERS
Credit Valley Volunteers have once again provided outstanding results and performance
in their efforts to provide the Health & wellness of the hospital, its patients, staff and
volunteers.
The 799 volunteers have contributed 82,288 hours in sterling service in as many as 65
areas of the hospital where quality compassionate health care was the required
objective. Presently involved in intense efforts to recruit and train some 200 additional
volunteers for service in the expanded hospital, we welcome the support and
collaboration we will be receiving from the Canadian Cancer Society to help us in this
initiative.
The tremendous support provided by our youth volunteers has once again positively
verified the quality of our present youth who seem to be a bottomless reservoir of able
willing helpers. We owe a great deal to these young people who are guided and coordinated by our youth co-ordinator and the internally elected youth council.
Once again our fundraising efforts have successfully met the promises made to the
capital campaign. Our contribution of $200,000.00 to the Foundation has brought our
total to $815,000.00 of the $ 1 million total pledge with one year of the five left to go. The
main contributor was the Gift and Flower Shop (including the work done by our silk
flower, knitters and craft groups) which has shown improved sales and profit over last
year. The annual Christmas Craft Sale, Geranium Sale, HELPP Lottery, 50/50, Grocery
tapes, The Traveling Suitcase, Bookcart and Cartridge return programs have also
provided significant support.
Finally, to every one of our volunteers, who week after week in fair or foul weather make
their way to all those hospital departments and unselfishly give their time, friendship,
care and support to the thousands of patients who daily look to the hospital for help,
health and wellness, THANK YOU.
Respectfully submitted,
Jill McGill
President, Volunteer Partners Board
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2004/05 OPERATING SUMMARY
AUDITORS’ REPORT
The Credit Valley Hospital
CONDENSED BALANCE SHEET
As at March 31
2005
$
2004
$
[000’s]
ASSETS
Current assets
Long-term receivable
Investments
Capital assets, net
LIABILITIES AND NET ASSETS
Current liabilities
Long-term debt
Other long-term liabilities
Accrued post-retirement benefits
Deferred capital contributions
Net assets
28,719
9,685
194,511
232,915
24,080
2,633
31,536
150,127
208,376
40,892
4,824
1,616
4,523
153,030
28,030
232,915
33,367
5,017
4,163
134,547
31,282
208,376
CONDENSED STATEMENT OF OPERATIONS
Year ended March 31
REVENUE
Ontario Ministry of Health and Long-Term Care grants 182,943
Other revenue sources
43,522
226,465
EXPENSES
Salaries, wages and employee benefits
Supplies and other
Drugs, medical and surgical supplies
Depreciation
163,538
29,266
26,814
10,099
229,717
Excess (deficiency) of revenue over expenses for the year (3,252)
172,602
39,738
212,340
147,968
27,022
25,031
10,426
210,447
1,893
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AUDITORS’ REPORT
The accompanying condensed balance sheet and statement of operations are derived
from the complete financial statements of The Credit Valley Hospital as at March 31,
2005 and for the year then ended on which we expressed an opinion without reservation
in our report dated May 3, 2005. The fair summarization of the complete financial
statements is the responsibility of management. Our responsibility, in accordance with
the applicable Assurance Guideline of The Canadian Institute of Chartered Accountants,
is to report on the condensed financial statements.
In our opinion, the condensed financial statements fairly summarize, in all material
respects, the related complete financial statements in accordance with the criteria
described in the Guideline referred to above.
These condensed financial statements do not contain all the disclosures required by
Canadian generally accepted accounting principles. Readers are cautioned that this
condensed balance sheet and condensed statement of operations may not be
appropriate for their purposes. For more information on the Hospital’s financial position,
results of operations and cash flows, reference should be made to the related complete
financial statements.
Toronto, Canada,
May 3, 2005.
Chartered Accountants
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CREDIT VALLEY PERFORMANCE REVIEW
The Credit Valley Hospital is a high performing hospital.
Despite increasing patient volumes and per capita spending far below the provincial and
national averages, Credit Valley continues to be a high performing hospital. The
following graphs illustrate the funding gaps between major cities in the province and
across the country. The final slide shows that Credit Valley is 7.7% below the expected
cost per weighted case.
2002-2003 Community Hospital Funding
$ Per Capita
$1,200
$900
$600
Sau lt
St e.
Marie
Pet e
rbo ro
u gh
Sud b
ury
Ki tch
e ner
North
Bay
Thun
der B
ay
Bel le
v il le
O nta
rio
O we
n So
un d
Bran
tfo rd
Wi nd
s or
G uelp
h
St. C
a tha
rines
Barr ie
$0
Pee l
Dur h
am
G TA
/905
Hal to
n
York
$300
Per Capita Public Spending on Hospitals
Ontario to Canada
Per Capita Public
Expenditure
1,500
1,196 1,199 1,207 1,214 1,218
1,250
994
1,030 1,042
1,074
1,121
1,300 1,323
1,166
1,000
750
500
SASK
BC
ONT
YT
Can
Non- MAN
Ont
PEI
QUE ALTA
NS
NB
NL
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CREDIT VALLEY PERFORMANCE REVIEW
Actual Versus Expected
Cost Per Weighted Case 2002/03
Ministry of Health and Long-Term Care statistical analysis of inpatient costs on an
“apples to apples” basis of comparison. Credit Valley is the most cost efficient hospital of
its type in the Province of Ontario, spending 7.7% less than expected, to do similar work.
10.0%
5.0%
0.0%
-5.0%
-10.0%
Act vs Exp Cost
CVH
Trillium
Halton
Osler
-7.7%
-7.0%
-0.6%
6.4%
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2005 CAL GUTKIN AWARD NOMINEES
The Dr. Calvin Gutkin Award was established in 1995 to recognize outstanding
achievement by a team/ individual who has made a significant quality improvement. The
Team Award was open to all members of the hospital and medical staff.
The following teams have been nominated for the award this year: The award will be
presented at the June’s President’s Forum for staff.
Code White Team
Safety measures put in place to support staff dealing with violent patient or visitor
behaviour.
Downtime Reduction for Phones - Telecom Project Team
The core infrastructure for the telephone system had a number of failures during 2002
and 2003. The old companion mobile telephone system was at capacity - no new
mobile telephone sets could be added. Voicemail system was antiquated and not
supported anymore. Telecommunications had no way to track call volumes and times for
any area. Improvements were required!
Home Death Program – Palliative Care & Oncology Programs
For terminally ill patients at Credit Valley, an expected death at home had not been a
well-supported option from a medical and community resource perspective. With strict
criteria in place, a collaborative approach from the CVH palliative care and oncology
programs, CCAC of Peel and the Mississauga funeral homes and in conjunction with the
Coroner’s office, we are now able to allow these patients the option to die at home with
appropriate support from Credit Valley and community resources to facilitate a smooth
transition from home to funeral home. This initiative exemplifies an appropriate
allocation of physician, hospital and community resources which in turn allows for more
appropriate utilization of acute care beds.
Narcotic/Controlled Drug Discrepancy Avoidance & Resolution
– Denise Nonomura, Cheryl Dakin and Cindy Van Horn
The project involved training nursing staff in narcotic/controlled drug discrepancy
avoidance and resolution on the omnicell cabinets. This involved reinforcing the legal
importance of this function as well as teaching the skills necessary to carry out the
procedures accurately and use the cabinet correctly.
Oncology Outpatient Self Check In - Oncology Outpatient Program & Information
Systems
The oncology outpatient program and information systems have taken a proactive
approach to improving the quality of patient care and efficiency of human resources as it
pertains to the patient registration process. Patients are able to empower themselves by
checking themselves in for their scheduled appointments and alleviate long waits at the
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registration desk. The process ensures that Ontario Health cards are valid and that
current patient information is maintained.
Outpatient Fall Prevention Program - Outpatient Fall Prevention Program Task
Force and Implementation Team
The outpatient fall prevention program is a multidisciplinary service for patients 65 years
and older who have experienced a fall or are at risk of falling. The clinic provides a
comprehensive geriatric assessment of the patients’ risk for falls, a series of group
exercise sessions, education sessions and the opportunity for one-on-one consultation
with professionals as needed. Each patient attends the program twice weekly for six
weeks and the team facilitates enrollment in community exercise activities at the end of
the program.
POGO (Paediatric Oncology Group of Ontario) Satellite Program - POGO Satellite
Paediatric Oncology Program Team
Satellite program to provide some components of a child’s cancer care closer to home in
partnership with the HSC and POGO.
- Minimizes travel for the patient and family
- Supports delivery of equitable care across the tertiary and satellite hospitals by
facilitating communication and education
- Facilitates data capture to improve care
Restraints Minimization Committee
The project involved the complete re-development of the policy / procedure, practice and
education around restraint use for those patients who do not fall under the mental health
act. A multi-disciplinary approach to minimize restraint use through a least restraint
philosophy is the goal.
Sustaining the Gains: Newborn Transition – Perinatal Multidisciplinary Team
As part of the West Cluster of the CHN, admission rate data indicated that an abnormal
number of newborns were being separated from their families for care in the special care
nursery. A detailed analysis of the standard of care at the time was compared to the
evidence and recommendations were made to the hospitals via the development of a
practice guideline by a regional multidisciplinary team. This initiative led to education
followed by practice changes by the clinical team which resulted in a decrease to the
admission rate to the special care nursery by 40%.
Trauma Committee – Emergency Department Trauma Committee
The emergency department trauma committee was established to facilitate improved
outcomes for patients with multiple traumatic injuries. This was accomplished by
retrospective trauma case study analysis to identify barriers to rapid assessment,
interventions and transfer to tertiary trauma care as well as through emergency staff
education. The trauma committee partnered with ancillary support systems at Credit
Valley Hospital as well as tertiary care trauma centers to accomplish these goals.
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