Clear Direction - IWK Health Centre

2009/10 REPORT TO THE COMMUNITY
Clear Direction
PRIMARY HEALTH
Burcu Kaptan, Human
Resources Consultant at the
IWK, and Diversity & Inclusion
(D&I) Committee member
Heather McDonald, Registered
Nurse (RN), IWK’s Women’s
and Newborn Health program,
and D&I Committee member
Creating a welcoming
& inclusive environment
Diversity refers to the ways we
are different from one another
(some examples are race, age,
gender, sexual orientation,
socio-economic status, religion
or illness), and inclusion
encourages us to embrace and
support these differences. At
the IWK, we’ve created a phrase
that reflects our commitment to
evolve as an organization that is
welcoming and inclusive for all:
Every one, Everyone.
The IWK is working to ensure that the
complex needs, experiences and traditions
of the diverse communities we serve are
recognized and supported.
One of the many diversity and inclusion
initiatives recently implemented at the IWK
is our Lens Tool, which is a set of questions
to help our staff, physicians and volunteers
consider the concepts of diversity and
inclusion in the development and/or revision
of programs, policies and practices. The Lens
Tool represents the importance of including
diversity and inclusion principles throughout all
our programs, and in everything we do.
Diversity and inclusion work is not new to the
Health Centre – over the years there have
been many seen and unseen leaders within
the IWK community, passionately committed
to supporting diversity and inclusion.
In 2009, a Diversity & Inclusion Strategy for the
Health Centre was developed and launched.
Since then (and even before that as well),
the IWK’s Diversity & Inclusion Committee
has focused its work on educating staff and
physicians about the principles of diversity
and inclusion, building relationships with our
diverse communities, translating patient and
family information materials and integrating
diversity into the IWK’s artwork and signage,
to name a few.
Wenche Gausdal, Immigrant Health
Coordinator and Settlement Worker,
Immigrant Settlement and Integration
Services (ISIS)
“At ISIS, I support newly arrived refugees
with complex health needs to access
services at the IWK Health Centre. On many
occasions I have worked with staff from
departments such as the Perinatal Unit,
Bilingual Services, Dentistry, Social Work,
Hematology/Oncology and the Emergency
Department who have gone beyond their
regular duties to meet the unique needs of
their patients. They have been very open to
look at ways to make their programs and
services more accessible to our diverse
population, and have strived to provide
culturally sensitive and patient-centred care.
The IWK Health Centre, in collaboration
with ISIS, has also supported internationally
trained health professionals through
employment and volunteer opportunities,
work placements, medical observerships
and in accessing the IWK’s resource library.
These examples of the Health Centre’s
commitment to diversity and inclusion are
important to our community, to its employees
and to the people who use its services.”
The IWK’s diversity and inclusion initiatives
are led by our Primary Health program with
support from individuals and teams from all
areas of the Health Centre. These initiatives
are supported by funding from the Nova
Scotia Department of Health.
To learn more, visit clearlyiwk.ca
3
Women’s and Newborn HEALTH
Designated a strategic priority at the IWK,
Models of Care is both a provincial project
and an IWK effort to implement a new
“Collaborative Care Model” in patient care
areas. The model is designed to help ensure
that the right people, processes, technology
and information systems are in place to
support the safest and best possible care,
while being cost effective.
At the IWK, Models of Care implementation
began on our Family Newborn Adult Surgery
Unit (FNASU) – the unit that cares for new
moms, babies and women’s surgery patients.
That was 2008. Since then, we’ve made many
improvements on FNASU, including:
• the amalgamation of two separate units
into one Family Newborn Adult Surgery Unit
(including breast health patients);
• the addition of new roles to the care
team (Licensed Practical Nurses and
Care Team Assistants);
Finding new ways
to care
From patient needs to technology, things change rapidly in health
care. That’s why the IWK is committed to changing how we provide
care. And that’s where the Models of Care initiative comes in.
Charlotte Guyomard, Registered Nurse,
IWK Family Newborn Adult Surgery Unit
“I have to say I was nervous when I first heard
about Models of Care on the Family Newborn
Adult Surgery Unit. I didn’t know where it
would take the Registered Nurse in the future.
I quickly learned that it would mean more
of a leadership role and I really liked that. I
personally feel that I had a say in the process
and that has led to greater satisfaction with
the transition.
To me, Models of Care at the IWK means the
right person doing the right job. I feel more
able to work within my scope of practice – my
time is better spent focusing on more complex
care issues. Now my patients get more of me.
I really think we have done a great job of making
our unit run like a team. It’s about our whole
team working together so our families flourish.”
• the implementation of new processes
and tweaking of some existing ones (for
example, processes for sharing patient
reports at staff shift changes);
• and the introduction of new technologies
(for example, equipment for post-partum
patients with special needs).
Our evaluation so far indicates that we are
headed in the right direction. We have seen
significant improvements in staff satisfaction
on FNASU, as well as improved patient and
family satisfaction. We have also recorded
decreases in overtime, sick time and
absenteeism, as well as decreased infant
readmission rates.
As we roll-out Models of Care efforts across
patient care areas in all of our programs
(Women’s & Newborn Health, Children’s Health
and Mental Health & Addictions), we look
forward to building on these successes for the
benefit of all IWK patients, families and staff.
To learn more, visit clearlyiwk.ca
5
CHILDREN’S AND YOUTH HEALTH
Bridging the gap
The health care needs of youth are
unique and often not adequately
addressed by either child or
adult services. That’s why the
IWK is developing a strategy to
help better define and direct the
enhancement of youth-centred
health care services.
As part of the IWK’s strategic plan, the
development of a youth health strategy will
help us meet the care needs of Maritime youth
in a way that works for them. The objectives
of the strategy are:
• to identify gaps in providing health care to
youth at the IWK;
• to identify best practices for providing youthcentred health care;
• to identify partnerships within the IWK, Capital
District Health Authority (CDHA) and community
to meet the health care needs of youth;
• and to work together with teams across the
Health Centre to develop a model that will
reflect expanded youth health services.
By working towards these objectives, our
intent is to build a framework of services that
meets the unique needs of our youth.
Of course, consultations with youth themselves
have been an important part of this strategy
development. The IWK Youth Advisory Council
(YAC), a group of youth ages 14-19 working to
create a supportive environment for youth at
the IWK, has been an important contributor to
this process. Our YAC has done excellent work
to advance the needs of youth in the health
care setting, including a recent initiative to
create a movie (supported by the IWK Auxiliary)
and handbook for health care professionals
about how best to care for youth.
Laura Flick, IWK Youth Advisory
Council member
Caleb Adams, IWK Youth Advisory
Council member
“Adults being treated at the IWK can talk to
the adult care providers about what they want,
and the children don’t really care as long as it
doesn’t hurt. Youth are a different story; health
care professionals either treat us as adults, and
use huge words we don’t understand, or they
treat us as children, with baby nicknames such
as ‘peanut.’ Care providers are sometimes
scared of how to interact with youth; they
don’t know how to talk to them. Therefore,
a huge gap between the care providers and
the youth being treated is created, making the
youth feel unwelcome and the care providers
uncomfortable. The Youth Advisory Council is
here to bridge that gap.”
“I find that the transition from child to adult is a
hard one and is longer than many people think.
We are the sum of our experiences so some
people could reach the young adult stage very
early, while others take time. I don’t think a lot of
people realize this and that’s why I enjoy helping
get the voices of all the youth in and around the
IWK heard.”
We hope to begin rolling out the IWK’s youth
health strategy soon.
To learn more, visit clearlyiwk.ca
7
MENTAL HEALTH AND ADDICTIONS
Leading the way home
In 2010, the IWK Mental Health and Addictions service, previously
known as the Children’s Response Program (or CRP), announced
its name change to COMPASS – Centre for Collaborative Child and
Family Treatment. This change was about more than just re-naming –
it was intended to reflect an important new direction for the program
as it works to guide patients and families on their journey to wellness
from a mental health perspective.
COMPASS provides evidence-based
treatment for severe behavioural disorders
(for example, Oppositional Defiant Disorder
and Attention Deficit Hyperactivity Disorder)
for children up to 13 years of age. Treatment
is provided in a residential setting with an
average length of stay of six months.
Zach Griffin, COMPASS patient, 13 years old
Families play an active and pivotal role in
each child’s treatment. Following a twoweek “settling in” period, patients spend
their weekends at home. Weekends provide
both the child and parent/guardian(s) an
opportunity to apply what they learn from the
program as they go. Another important piece
of the service is our transition team, who
provide support to families during weekends
and as patients transition back to their home
communities at the end of treatment.
I went through a stage, which I think every
kid is going to go through, which was feeling
miserable about having to start the program.
I’m sure it was just as hard for my parents, but
in the end, it was worth it.
COMPASS’ multidisciplinary team includes
occupational therapists, recreational
therapists, social workers, child and youth
support workers, special education teachers,
registered nurses, physiologists and
physicians. Together, they work to provide
patients with the best evidence-informed
behavioural treatment available.
“When I first started the COMPASS program,
I was a different kid than I am today. I was
depressed, anxious and just really didn’t want
to continue my life. I had given up all hope, but
then my parents told me there was help.
When I started COMPASS, I’m not going to
lie, I hated it there. It was a long, painful six
months, but around the fifth month, I started
to realize that this program was helping me.
From day one, my parents said that it was
helping me, but I honestly don’t think it was
that apparent so early on.
But, eventually, once the time spent at COMPASS
got shorter, I got to be home, at my regular
school and with my friends longer, everything was
getting better. Me and my family are all as happy
as anyone can be, unless they have a bunch of
video games (just kidding). My friends all asked
where I was during the school year, and I happily
told them all, “I was sick. But I’m all better now!”
If anyone from COMPASS ever reads this: Thank
you for everything.”
To learn more, visit clearlyiwk.ca
9
RESEARCH
Touching lives
around the world
IWK researchers are world-renowned for their discoveries on various
conditions, disease prevention and new therapies. With over 40 research
studies currently underway at the Health Centre, IWK researchers play a
key role in helping achieve our vision of “Healthy families. The best care.”
Researchers at the Canadian Center for
Vaccinology (CCfV), located at the IWK, have
undertaken a series of studies – the first
series of its kind in the world – to test whether
vaccinating a pregnant woman against
pertussis or “whooping cough” provides
protection to her unborn baby.
Whooping cough can cause severe illness
lasting several weeks, and is responsible
for between one and three infant and child
deaths in Canada, and 300,000 such deaths
worldwide, each year. While vaccination
provides protection against the disease, many
babies contract whooping cough before they
can receive their first vaccination at two months.
It is the goal of our researchers to establish
maternal vaccination as an alternative
approach to protecting mothers and babies
from whooping cough infection.
The CCfV is a partnership between the IWK,
Dalhousie University and Capital District
Health Authority. The CCfV was established
to develop, implement and evaluate vaccines
for infectious diseases that have a significant
impact on Canadian and global health.
Beth Halperin, RN, MN, Principle Investigator
“Our burning question as researchers is how
to protect these babies from pertussis [or
whooping cough] earlier than two months
of age. We know from our research that
antibodies pass through the mother’s
placenta to the fetus before birth. What if we
immunized mom against whooping cough
during pregnancy? Would this provide baby
with the protection they need very early in life?
It is a very exciting and important project,
and it is our hope that through this research,
we will be able to find another way to protect
young infants, so that no more babies have to
die from this disease.”
Angela Currie, study participant
“Prior to taking part in this study, my husband
and I did quite a bit of research and reading
on whooping cough. After checking with
our family doctor, we enrolled in this study
immediately as we were expecting our son
in late August 2009. Ensuring the health and
well-being of Liam was our main concern.
Throughout the process of the study and the
interactions we have had with the research
staff, we discovered that Liam was not only
being well-cared for, but he is receiving the
best possible individual attention.
The fact that we are participating in a study
that could help infants, like Liam, only makes
our decision that much more rewarding.”
To learn more, visit clearlyiwk.ca
11
Operations and Support Services
Building better care
To align the physical structure of our Children’s Site with the IWK’s
commitment to excellence in family-centred care, we embarked on a
five-year (2005-2010) renovation and expansion project to build better
care for our patients and families.
The IWK Children’s Site Redevelopment
Project involved the renovation and retrofitting
of 144,000 square feet of space, including
the construction of 48,000 square feet of new
space. Spaces renovated included inpatient,
perioperative and clinic space. The Children’s
Building at the IWK was built in the late
1960s when health care practices were quite
different than they are today. While care had
changed, the physical environment at the IWK
had not kept pace.
Our new Ron Joyce Operating Suite is one
example of how our redevelopment enabled
the dramatic improvement of some existing
space. This area now consists of seven new
operating rooms with updated technology and
equipment. In addition, the new Day Surgery
and Recovery space includes 16 private areas
for patients and families to prepare for day
surgery and get ready to go home afterward.
All of this complex work took place in a
functioning hospital, which resulted sometimes
in inconvenience and disruption for our patients,
families, staff, physicians and volunteers. We
sincerely appreciate the cooperation from
everyone as well as the generous support of
our government partners and donors. Thanks
to all involved, we now have state-of-the-art
pediatric space that focuses on patient safety
and family-centred care.
Dr. Joe Hyndman, Chief of Orthopaedics,
IWK Health Centre, and Professor of
Surgery, Dalhousie University
“The new OR and perioperative space
represents the end of a long, collaborative
process to build better care at the IWK. The
whole concept was designed as a familycentred area and it’s working very well.
We have a single entry point where patients
are welcomed and administrative work is
completed. It allows for improved flow and
enhanced privacy for patients and families,
and the best possible working space for
health care professionals.
It’s a different time now – we’re living in a
digital world. I’m at the end of my career and
one of my greatest satisfactions is seeing
this project completed. It allows us more
opportunities for teaching and recruitment.
Now, my younger colleagues can take full
advantage of the technology in a setting that
is equal to or better than anywhere else in the
world. And I’m delighted that my colleagues
will have a much better unit, it is really about
the patients and delivering the best care.”
Kiannah Hubley, patient, 8 years old
“In the spring of 2010, I had to spend some
time at the IWK. I had a chance to see the
new day surgery area. The new rooms were
very big and bright. I hope other kids enjoy
their stay.”
To learn more, visit clearlyiwk.ca
13
IWK Foundation
Yi and Anita Lee and family, donors
Robbie Shaw, President & CEO, IWK Foundation
Thanks to our
generous donors,
anything is possible
The IWK Foundation inspires
and celebrates giving to support
excellence in specialized care for
Maritime families.
Thanks to the generosity of donors from
across the Maritimes in 2009/10, the IWK
Foundation was able to provide almost $10
million to support areas of critical need in the
Children’s Health, Women’s Health, Mental
Health and Addictions, and Primary Health
programs at the IWK Health Centre. Donations
help purchase essential medical equipment,
fund life-changing and world-leading research,
and support special programs that bring extra
comfort to patients and families during difficult
times. With your support, the IWK Health
Centre is a very special place.
Dr. Alex Gillis, Former Chief of Surgery and
former CEO, IWK Health Centre
“Amazing advances in health care continue
to enhance our lives. These advances are
an inspiration to the IWK as we strive to
be a world-wide leader in the pursuit of
new knowledge, and in the provision of
modernized and excellent care for our patients
and their families. In support of these goals
the generosity of our donors is of critical
importance. That’s why the partnership
between the IWK Health Centre and the IWK
Foundation is vitally important. For more than
40 years, I have seen the difference donors
make to help the IWK be exceptional.
The IWK was built on a strong foundation
of philanthropy and Maritime generosity.
Several decades ago, Mrs. Dorothy
Killam donated $8 million to help build
a new institution, which was named the
Izaak Walton Killam Hospital for Children
in honour of her late husband. Over the
years, thousands of donors have given
generously to enhance care and research,
and to support a greatly enlarged facility that
includes the former Grace Maternity Hospital.
To supplement support from governments,
donor gifts have contributed enormously
to new space and equipment, expanded
programs, world-class research and a level
of care that is unsurpassed.
I know that our evolution as a health facility
will always require the generosity of donors to
help us remain a special place in the lives of
Maritime children, women, youth and families.
On behalf of former and current colleagues,
and in particular, on behalf of patients and
families, thank you for your extraordinary
support. You have truly made a difference.”
To learn more, visit clearlyiwk.ca
15
FINANCIALS
Using our
resources wisely
Operations and Support Services
The IWK’s ‘Dial for Dining’ inpatient room service program was
awarded the prestigious 3M Quality Award for ‘Programs and
Process in an Acute Hospital Setting.’ Dial for Dining has decreased
our food wastage to under four per cent and enhanced revenues,
saving the Health Centre hundreds of thousands of dollars.
Using our taxpayer and donor funding wisely, and being accountable is
fundamental to everything that we do. The IWK is committed to living within
our means by ensuring that we are able to provide the world-class care
we are known for while still balancing our budget. We are always exploring
new and creative ways to improve program delivery, and reduce costs while
continuing to provide the best care for our patients and families.
Assets
2010
Cash and cash equivalents
$18,088,000
Receivables and prepaids
$47,670,000
Inventories
$2,179,000
Property and equipment
$173,437,000
2009
Susan Mercer, Senior Director,
Mental Health and Addictions
$29,433,000
$38,073,000
$1,346,000
$164,905,000
$241,374,000
$233,757,000
“The IWK’s Mental Health and Addictions Program works in close
collaboration with a number of care providers in the community for
early identification and assessment. This ‘shared care’ model can
provide better access to care for young people – and save the health
system time and money.”
Liabilities
Payables and accruals
Retirement Allowances and Benefits
Facilities Loan Payable
Appropriations and reserves
2010
2009
$32,454,000
$23,699,000
$12,786,000
$11,802,000
$29,089,000
$20,909,000
$13,381,000
$19,067,000
Expenses
$80,741,000
$82,446,000
Administration
Operations & Support Services (IT, Maintenance, Housekeeping, etc.)
Medical Services
Women’s & Newborn Health (NICU, Birth Unit, ORs Breast Health, etc.)
Mental Health & Addictions
Children’s Health (PICU, ORs, Inpatient Units, etc.)
$3,894,646
$55,440,018
$24,332,575
$46,484,835
$26,462,998
$57,177,214
Total Expenses
$213,792,286
Equity
$160,633,000
$151,311,000
$241,374,000
$233,757,000
To learn more, visit clearlyiwk.ca
17
IWK Health Centre Board of Directors
Brian Fisher, Audiovisual
Technician, IWK Health
Sciences Library
Message to the Community
Kim Miller, General Worker,
IWK Food Services
Look what we’ve done
In 2009/10, our community-based board of 14 volunteers from throughout
the Maritimes – and four representatives from the IWK Health Centre –
focused on strategic direction, action and accountability.
The IWK Board of Directors:
• Advanced the mission, vision, values and
strategic direction of the IWK Health Centre
by ensuring focus on key priorities, and
developing adaptability for the complex and
changing healthcare environment.
• Advanced specific advocacy initiatives,
including the challenge of obesity.
• Continued collaboration with New Brunswick
and PEI to best meet the tertiary care needs
of Maritime women, children and families.
• Ensured there was an effective IWK Health
Centre Ethics Strategy and Framework.
• Completed an overhaul of the medical
credentialing process through the Privileges
Review Committee.
•P
rovided leadership during the H1N1
pandemic crisis, and committed to future
pandemic planning and support.
•C
ontinued informed governance through
KPIs (Key Performance Indicators) and
Progress Reports.
•P
artnered with Capital Health and the
Population Health Committee, and
contributed by having a Board member
active on this committee.
•A
cted as trusted advisors to Government.
•S
upported the IWK Health Centre’s strategic
planning priorities for 2010/11.
Look where we’re going
Thank you for taking the time to learn
more about the ongoing work happening
at the IWK Health Centre. We hope that
you enjoyed the first hand stories shared
by members of our community: staff,
physicians, volunteers, patients, community
partners, researchers, study participants and
supporters of the IWK Foundation. This is
the story of the IWK in their words.
We are a Health Centre in motion. An
organization that is complex and ever
changing, with many competing priorities.
We are focused on high performance, using
our resources wisely, keeping patients safe,
and being the best teachers and researchers
we can be. Ultimately, we want to help
families be healthy and get the best care.
We have never been in a more complex health
care environment, where the stakes are high
and the expectations for strategic planning,
action and accountability are even higher.
We have to be on the forefront of change, and
willing to lead change at the IWK and in the
health care system – while always remembering
that patient care is our number one priority.
To date, we have looked to our Core Values,
Vision, Mission and Key Directions as our
guide in providing the best care to our
patients and families. They define – not just
in one year, but long term – what it means
to be the IWK. We have a lot to measure
up to, and we are consistently tracking our
process against key performance measures,
rationales and targets.
We are moving forward with a clear direction for
the future… Healthy families. The best care.
Anne McGuire
President & CEO
IWK Health Centre
John Rogers
Chair, Board of Directors
IWK Health Centre
To learn more, visit clearlyiwk.ca
19
IWK Health Centre
5850/5980 University Avenue
P.O. Box 9700
Halifax, Nova Scotia
B3K 6R8
clearlyiwk.ca