Agenda item1.3.2

BoardReport

From CMH President & CEO

September2017

This report provides a brief update on some key activities within CMH as an FYI. While it is organized against our 2017-19strategic themes, it may include strategic, corporate and other projects as necessary. As always, I’m happy to answer questions and discuss issues within this report or other matters.

Goal: To safely and successfully transition from Wing B to the new Wing A and Wing C.

Wing, level, room number changes – Oct. 24

  • ProjectCo currently has October 24 tentatively booked for the Wing, Level and Room number changes. Confirmation of this changeover will happen the week of September 25.
  • These changes are necessary as we prepare to take possession of the new Wing A. To reduce confusion and to make the designations linear, the current Wings A and C will become Wings C and D respectively.
  • The levels will change from 1-5 to 0-4, which conforms to industry standards.
  • Currently, the contractor is removing old signage and preparing the current Wings A and C for the new wayfinding system and room numbers.
  • A strategy is in place to safely amend patient’s room numbers to the new system on the day of the changeover. A mock exercise was done in August to help prepare for the day. Communication will be forthcoming, once the date is confirmed.

New security system prompts revision in security badge standards

  • The new security system will require new badges for staff, physicians and volunteers. This provided us with an opportunity to review existing name badges and standardize our approach with issuing badges.
  • Regulated health care professions all have professional standards that speak to therapeutic relationships and the ability for the public to search names on the respective college’s website.
  • Moving forward to when the security system is in place, all staff, physicians and volunteers will have their full names listed on their badge in keeping with the public’s expectation of transparency. Some concerns have been raised and we continue to work through the appropriate human resources processes to address these.

Hospital-wide free Wi-Fistarted September 1

  • Thanks to our hard working IT team, our Wi-Fi systems were upgraded and made free to everyone Friday, September 1! This is a huge win for inpatients that had to pay for Internet access.
  • Visitors will also enjoy an improved experience when they come to our hospital.
  • Access to the Internet through our hotspotis separate from our internal systems, so to protect our hospital from virus threats.
  • This initiative was more than two years in the making and is the result of patient and staff feedback to get better access to the Internet in our hospital.
  • It is also part of an earlier recommendation to discontinue cable service in wait rooms throughout the hospital with the exception of waiting rooms that experience high wait times.

Current work as of September2017:

  • Exterior: Landscaping to both courtyards continues. The revolving door to the main entrance is underway. Soffit installation, sidewalk installation is ongoing.
  • Interior:Modular partitions are near completion on level 4. Coloured glass being installed on floors and in the sanctuary. Mechanical finishes, such as light fixtures and wall sockets are near completion on upper floors.
  • Planned activities over the next month:
  • Remove hoarding along Coronation Blvd once the uneven pavement and potholes are fixed. This is slated for mid to late September.
  • Continue work on lower levels, including the main entrance, birthing unit, central registration, emergency and the gift shop.

/ Improved patient & staff engagement

Hospital wide “Count Us In” working group being formed

  • On September 6, a message was sent to recruit staff for a “Count Us In” working group. To recap, we surveyed our staff and physicians this past spring to learn their level of engagement with their departments and the hospital. The departmental results have since been shared and work has started among teams to implement improvements.
  • The purpose of the working group is to bring together a cross-section of CMH staff to review the corporate “Count Us In” results and develop strategies for improving issues raised hospital-wide.It is an opportunity to get staff feedback and shape action plans to help change the culture of our hospital
  • All the hospital’s union representatives have agreed to join the group.
  • The goal is to get 15 members, who will meet four times over the next year.
  • The group’s mandate will be to focus on and set actions for corporate wide results.
  • Its first task will be to look at CMH’s lowest performing indicators – “senior managers act on staff feedback” and “I am given the opportunity to develop my career.”

/ Program growth & redesign

No report this month

/ Defining our role

Strategic Plan update

  • The Board of Directors approved the plan in June 2017.
  • The “four-pager” that highlight the major themes of CMH’s 2017-19 strategic plan is ready for distribution to staff (it appears in the Board package).
  • Included is a brief overview of the new plan, an introduction to CMH’s clinical services strategy,” and a description of our new WIGs, including Improved Patient and Staff Engagement and Program Growth and Redesign.
  • The four page summary will be distributed to staff and physicians at the end of September.

Six-month update on Acute Pain Service

  • We made an investment in the fall of 2016 to create an Acute Pain Service (APS). Its purpose was to support the Surgery Department and Women & Children’s Program, both of which are core to the Clinical Services Plan.
  • The team comprises Kathy Krupa, a Nurse Practitioner (NP) specializing in acute pain and Anesthesiologists under the leadership of Dr. Andrea Steyn.
  • Each patient followed by APS is seen by the NP twice daily and Anesthetists once daily. NP works Monday to Friday and Anesthetists round patients on the weekend.
  • Some of the quick wins include:
  • Consistent daily rounding by the NP and the ability to adjust protocols
  • Improved participation in physiotherapy after surgery
  • NP provides additional surveillance and support for post-surgical patients
  • Timely pain management support in the birthing unit for both epidurals and C-sections. NP also monitors patients for pain relief and symptom management
  • Positive feedback from patients
  • Process improvements are needed for providing APS to all surgical in-patients.
  • Looking to provide APS to patients waiting for surgery in the Emergency Department, Medicine and Oncology.
  • Looking forward, we are seeing if:
  • we can expand service to Paediatrics and the Emergency Department
  • purchase new infusion pumps to ensure technology is maintained and improved upon
  • Create education sheets on pain management for when patient is discharged home
  • Work with surgeons to review their post-operative order sets to include support by APS

/ Improving Quality

Most improved Emergency Department in 2016

  • On August 30, CMH received a letter from the Ministry acknowledging its “outstanding performance” for reducing wait times in its Emergency Department (ED).
  • Or hospital showed the greatest improvement within the “High Volume Community Hospital Group” in 2016. There are 25 hospitals classified within this group.
  • Due to the diligent work of our staff and physicians, 90% of patients seen during the year were triaged, seen, diagnosed, treated and discharged within 6 hours and 36 minutes or less. This is a half hour improvement over 2015.
  • This saved more than 2.75 years of wait time when expressed collectively amongst the 53, 798 patients we saw in our ED in 2016.
  • Reducing wait times is part of the Ministry’s “Patients First” strategy to improve the overall experience of our health care system. Supporting this strategy is the “Pay for Results” (P4R) program that rewards hospitals for improving Emergency Department wait times. In all, 73 hospitals participate in the P4R program.

Surgical wait times now posted

  • In August, Health Quality Ontario (HQO) published an on-line tool to compare surgical wait times at Ontario Hospitals.
  • The published indicators measure the “time to the patient’s first surgical appointment” and the “time from decision to having surgery.”
  • The reason for publishing surgical wait times is to promote transparency and improve our health care system.
  • According to a CBC article (Aug. 16 – found at the shortest wait times in the province are for cardiac surgery, while the longest involves knee replacements.
  • As an organization, we continually work towards improving wait times for all the services and we should pause to reflect our efforts. CMH is consistently better than most provincial wait time averages. It also beats many of the ministry’s stated benchmarks in both indicators.

It’s like, WOW!

  • Thanks to our amazing nursing staff on Medicine and Rehab, we are finishing a successful test run of the new MedWoWs (Medication Workstations on Wheels). Their feedback helped to ensure the technology worked and it solved any challenges they faced “tapping in” the new workstations with their ID badges.
  • The new MedWOWs provide a mobile work surface, the ability to transport patient records and a patient specific drawer for medicine.
  • Once delivered to units, nurses will benefit from the ability to look up information, respond to questions and document on the go by the patient’s bedside. More importantly, it will help our nursing staff meet the latest accreditation standards and promote a better patient experience.
  • Taking the MedWOW to the bedside allows nurses to review medications with patients and then administer at the bedside. Current practice is to pre-pour medications into cups, which is no longer the accepted standard.
  • Delivery to designated units has started and should be finished by the end of September.

CMH’s first ECT performed

  • In June, CMH performed its first electro-convulsive therapy (ECT) treatment on a patient.
  • ECT is a procedure that is performed when conventional treatments such as talk therapy and medicine do not work.
  • A patient is put under general anesthesia. Once asleep, a small, electric current is passed through the brain intentionally triggering a brief seizure. This causes changes to the brain’s chemistry that, in turn, can quickly reverse certain mental illness symptoms, like depression.
  • Patients undergoing ECT will normally receive 15 treatments over the course of five weeks.

/ Strength through People

Don't let the Mosquitos Win!

  • I encourage you to stop donating all of your blood to the mosquitos on your back porch! Why? Join me in giving blood to people instead.
  • Our hospital is hosting a blood donation clinic on September 15 from 1000 to 1400h.
  • Registration is easy. Call 1-888-236-6283, visit the Canadian Blood Services website at drop by their booth at CMH on September 12.

Kim Siegel, Director of Clinical Programs

  • Kim Siegel is returning to CMH on September 18 to assume the role of Director, Clinical Programs.
  • Her portfolio will include intensive care, medical units, medical day care and outpatient clinics. Our Integrated Manager of WWLHIN Home and Community Services will continue to report to this position.
  • Kim’s clinical background is in nursing, which she augmented with degrees in psychology and a Master’s in Health Studies.
  • She started her career at CMH, working in rehab, medicine/telemetry, ICU and utilization management.
  • She moved to St. Mary’s General Hospital to advance her career as their Manager Medical Program, eventually becoming Director of the Chest & Cardiac Program.
  • Kim joins us at a critical time with the opening of the new build. Her background will help us with program redesign and growth so to meet the needs of our community.
  • Rita Sharratt, who is currently in this role, will transfer to the Mental Health portfolio and retain oversight of the Emergency Department.

Barry Vermeersch, Director of Laboratory, Infection Control & Cardiodiagnostic Services

  • On September 5, Mr. Barry Vermeersch joined CMH in the role of Director, Laboratory, Infection Control & Cardiodiagnostic Services.
  • Barry brings extensive expertise in organizational leadership, health administration, laboratory operations, project management, budgeting, and data analysis.
  • He served as Director Laboratory, Imaging, Cardiac Diagnostics for Norfolk General Hospital and West Haldimand General Hospital; Quality Coordinator, Laboratory Services and Coordinator, Regional Laboratory Services for BCHC; Laboratory Supervisor for Norfolk General Hospital and St. Joseph’s Hospital (Brantford). Barry also sits on the Regional e-Health Advisory Council and the Diagnostic Imaging Leadership Steering Committee for Hamilton Niagara Haldimand Brant.
  • Barry holds a Medical Laboratory Technology diploma, Canadian Society of Laboratory Technology certification, a Clinical Laboratory Quality Manager diploma, and is a Certified Ontario Laboratory Accreditation (OLA) Assessor.

Moving towards a more inclusive environment

  • As a small, but significant step to make our hospital environment more inclusive including people from the LGBTQ+ community, single occupancy washrooms in wings A, B and C are being catalogued so that they can be allocated as genderless.
  • These washrooms will have a toilet pictogram instead of the traditional male/female stick figures. In the new patient care wing, most washrooms will be gender neutral.

/ Driving Value and Affordability

McGarry Funding Announcement

  • On July 12, Kathryn McGarry, MPP for Cambridge, was at Cambridge Memorial Hospital to announce $978,068 grants to revitalize its facilities.
  • This funding is separate from the funding that is building the new hospital and earmarked for hospitals needing to maintain and refurbish aging structures.
  • This year’s grant will go to expand our sprinkler system to the oldest part of our hospital and upgrade to our boilers, both of which are crucial to maintaining a safe and healthy environment for our patients.

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