This is the Future of Health Care December 2019
Combining AI, Machine Learning and Professional Expertise to Help Deliver Better, Faster and Safer Patient Care
Humber River Hospital Revolutionizes Patient Care in World First Humber River Hospital (HRH) is using technology to bring a new standard of patient-centred quality health care to Ontario, in a world first. In September, the hospital launched four new clinical analytic applications or ‘tiles’ inside its hospital command centre that will revolutionize patient care. At Humber River Hospital, patient safety and high reliability health care are key priorities. These new clinical applications or analytic tiles are displayed on large-screen monitors in the Hospital’s NASA-style Command Centre, with key items alerted immediately to the staff or physician’s dashboard. The tiles integrate standardized early warning systems, predictive analytics, realtime information from multiple digital systems, and professional expertise to provide an added layer of protection for patients with conditions that make them more vulnerable to risks of adverse events, or adverse outcomes. Through this process, clinical staff can be alerted
to a changing patient’s condition even sooner, so that they can intervene to keep that patient’s care on track. It is a known concern that patients who visit hospitals can be at risk of adverse events. According to data from the Canadian Patient Safety Institute and Canadian Institute for Health Information, 1 in 18 hospital stays in Canada involved at least one harmful event.1 According to research in CMAJ (Canadian Medical Association Journal), the costs of experiencing hospital harm amounted to more than $1 billion in Ontario in fiscal year 2015-16.2 Humber River Hospital’s vision for high reliability health care is clearly manifested in our clinical analytic tiles. For instance, the Mother and Baby tile alerts our front-line staff and physicians in the Obstetrical Unit and the Clinical Expediter in the Command Centre when an expectant mother or newborn is at elevated obstetrical risk.
Humber River Hospital nurses entering information into a vital signs monitor.
Similarly, the new Risk of Harm tile is designed to help reduce the likelihood of adverse events for patients who are at an elevated risk of harm, such as sepsis. The Delays in Care tile includes a number of items based on the Registered Nurses’ Association of Ontario (RNAO) best practice guidelines related to falls risk intervention, wound and skin management, pain management and delirium. A Seniors Care tile focused on mobility, dietary intake, early ambulation and medications causing risk with particular focus on preventing deterioration that often accompanies hospitalization for this vulnerable population. Continued on back page.
1 Statistic is based on the year 2014-15. Canadian Institute for Health Information, Canadian Patient Safety Institute. Measuring Patient Harm in Canadian Hospitals. What can be done to improve patient safety? authored by Chan B, Cochrane D. Ottawa, ON: CIHI; 2016. 2 Lauren Tessier, Sara J.T. Guilcher, Yu Qing Bai, Ryan Ng and Walter P. Wodchis. CMAJ August 12, 2019 191 (32) E879-E885; DOI: https://doi.org/10.1503/cmaj.181621
THIS IS THE FUTURE OF HEALTH CARE
INSIDE THIS REPORT Report from the Humber River Hospital Board Chair ..................... 2 Enhanced Care for Women & Babies ............. 2 North Western Toronto Ontario Health Team Moves Forward ............... 3 The Heart of Seniors Care .................... 3 HRH Hosts Community Open House ... ................. 4
Humber River Hospital
MESSAGE TO THE COMMUNITY from Terry Leon, Humber River Hospital Board Chair HRH Board Chair Terry Leon (left) with Barbara Collins, HRH President and CEO
On behalf of the Humber River Hospital Board, I am pleased to present our 2019 Community Report, and to share a few of the activities of the Board of Directors over the past year.
we were pleased to be joined by the Hon. Christine Elliott, Deputy Premier of Ontario and Ontario Minister of Health, as we showcased our Church site, which is already undergoing a 39-bed expansion.
At Humber River Hospital (HRH), patients and families are at the heart of everything we do. From the Boardroom to the front lines, Humber River Hospital has been committed to finding new ways to use technology, research, innovation and professional expertise to improve the patient experience.
In keeping with our vision to deliver innovative and efficient models of care, as identified in our Strategic Plan, the Board has forged ahead in support of the enhanced features to the Hospital’s Command Centre. Launched in 2017, Phase One of the Command Centre has improved patient flow and put an end to hallway health care at HRH. Phase Two focuses on delivering even safer care and will be completed by January 2020.
The Humber River Hospital Board approved the development of the Reactivation Care Centres at both our Church and Finch sites, which together with our 8 GTA partner hospitals, provide a place of therapy and activation for our patients who need longer to recover. Last December,
Through our technology-rich Command Centre, we have been able to increase capacity to an equivalent of 35 beds and saved $11 million in operating costs. The Hospital has used that money to provide even more care to our community—by funding an additional 750 total joint surgeries, purchasing
Enhanced Care for Women and Babies Ensuring that women have access to compassionate and patient-centred health care is essential. That’s why Humber River Hospital has partnered with community organizations to offer expanded services for women and babies. Steris RealView in Labour and Delivery Unit With STERIS RealView, loved ones eagerly awaiting baby news in Humber’s Labour & Delivery Family Lounge now receive rolling updates on the television screen. Patient names have been swapped out for unique IDs, and updates are immediate so visitors are always informed. Intrauterine Device (IUD) Clinic This new clinic streamlines IUD insertion so that counseling and insertion can be provided quickly and efficiently in one visit, rather than several. Rexall Pharmacy at Humber River Hospital maintains all common IUDs in stock so that insertion is not delayed if a patient doesn’t come with their device in hand. The clinic is held weekly and physicians aim to see patients within one month of referral to ensure contraceptive needs are met quickly.
Postpartum Wellness Clinic In partnership with Toronto Public Health, Humber River Hospital’s Postpartum Wellness Program is designed to uniquely meet the needs of the community we serve, by supporting the wellness of the young families living within it. Through this program, we are able to better identify those patients at risk of developing postpartum depression and provide the extended support and resources that will enable improved outcomes for them and for their children. Milk Bank Partnership Recently, Humber River has become a member hospital of the Rogers Hixon Ontario Human Milk Bank run by Mount Sinai Hospital. Safe, pasteurized milk (donated by moms) is now distributed by prescription to our fragile pre-term babies.
THIS IS THE FUTURE OF HEALTH CARE
a new MRI machine and staffing it 16 hours per day, expanding services for better care to our community like our Totally Kids Clinic, Humber’s Elderly Assess and Restore Team (HEART) to help seniors, and partnering with the Hospital for Sick Children to bring pediatric general surgery by their general surgeons to our community. The Board has updated our policies and by-laws in response to the changing health care landscape to ensure operations continue to run smoothly. As your hospital continues to grow in activity and services, it has been our pleasure to approve privileges for 89 new physicians, among the various specialties of oncology, urology, neurology, to name a few. As you may know, the Ontario government has a vision to build a connected, sustainable health care system through the creation of Ontario Health Teams (OHT). The Board has endorsed the Hospital’s participation
in the development of an OHT for north and west Toronto called the Northwestern Toronto OHT. We are delighted with the government’s decision to select this team to move forward to a full application and we await their response. The Board also approved the Hospital’s partnership with Runnymede Healthcare Centre to create centres of excellence in aging. The Board extends a warm thank you to our physicians, nurses, staff and volunteers, who work so hard to bring high reliability health care to our patients and the community we serve. As you read this report, I invite you to take a closer look at how Humber River Hospital is using digital innovation to improve your health care and the care of our community.
Humber River Hospital Orthopaedics offers shortest wait times in Ontario
North Western Toronto Ontario Health Team moves forward to full application The Government of Ontario has a vision to build a connected, sustainable health care system centred on the needs of patients. Key to realizing this vision is the creation of Ontario Health Teams (OHTs).
Current members of the team include:
• Addiction Services for York Region
Primary Care • Humber River Family Health Team • Black Creek Community Health Centre • Unison Health and Community Services
Residential Long Term Care and Community Services • Villa Colombo Toronto
Within this new model, health care providers will work as one coordinated team to make it easier for patients and our community to navigate the system and transition between providers.
Rehabilitation and Complex Care • Runnymede Healthcare Centre • West Park Healthcare Centre
Humber River Hospital, along with 12 partner organizations covering a broad scope of services, have partnered to form the North Western Toronto (NWT) Ontario Health Team (OHT).
Secondary Care/Emergency/ Lab & Diagnostics/Midwifery • Humber River Hospital
Home and Community Support Services • SE Health • Lumacare Mental Health and Addictions • LOFT Community Services • Canadian Mental Health Association (CMHA) Toronto Branch • COTA
The Ministry of Health received more than 150 applications from interested teams across Ontario. Of those, the NWT OHT was 1 of 31 teams invited to submit a full application as a next step to becoming an Ontario Health Team. The government’s plan is to form 30-50 OHTs across the province over time, selected through a self-assessment submission. The NWT OHT is committed to expanding our mandate and membership to include other interested organizations. The official announcement of teams by the Ministry of Health will take place in the Fall of 2019. For more information, follow @NWTorontoOHT on Twitter.
With seniors making up 73% of Humber River Hospital’s patient population, Humber River Hospital is taking action to ensure that our patient population has the best resources to keep them on track in their patient care and to smooth the transitions from hospital to community or home living.
HEART is comprised of a physiotherapist, an occupational therapist, two rehabilitation assistants and a registered practical nurse. Together, these professionals work to minimize functional decline so that upon discharge, seniors are able to complete the vital daily tasks—like showering
Currently, Humber River Hospital Orthopaedics is one of the hospitals offering the shortest wait times in Ontario to see an Orthopaedics specialist, despite the Orthopaedics Team completing 1500 joint surgeries per year. Humber River Hospital Orthopaedics is leading the way in surgical innovation. For instance, the GTA’s first anterior hip replacement surgery using the Hana Table was performed at Humber River Hospital. This specialized piece of equipment enables the Anterior Approach for surgery, which typically leads to less pain and results in faster recovery.
The HEART of Seniors Care
Last September, the Hospital launched Humber’s Elderly Assess and Restore Team (HEART) to help frail, at risk seniors transition successfully from hospital care back to their daily lives. Our goal is to help ensure that these seniors leave Humber River Hospital with the same— or improved—functional skills.
The Humber River Hospital Orthopaedics Team is a Centre of Excellence for Orthopaedic surgery—advancing surgical boundaries with state-of-the-art technology and innovative techniques, an exceptional physician complement and a commitment to quality patient care.
Humber River Hospital specializes in using the Same Day Anterior Hip Arthroplasty Program, COIN program for Total Shoulder procedures and Total Ankle Arthroplasty. Prioritized patient access to fracture clinics is available 6 days per week, and patients have access to recovery care resources including cryotherapy, physiotherapy and rehabilitative services. and preparing meals— that they were able to manage at the time they were admitted to hospital. Through HEART, all patients over the age of 65 are screened within 24 hours of admission through a series of questions about what their lifestyle was like before they came to the hospital. Those at-risk patients who are identified as candidates receive ongoing
reassessments and therapies over the course of a seven-day continuum. The results of this program have been phenomenal. Currently, 100% of HEART patients are able to go back to their daily living activities with at least the same level of function as they had when they were admitted. In fact, 34% of these patients went home with even better functional skills!
The Humber River Hospital Orthopaedics Team offers expert care without patients ever having to leave their community, unless they live outside the GTA. There is nothing more rewarding than seeing our patients return to playing their favourite sport, or taking a walk in the neighbourhood, or engaging in daily living activities free of chronic joint pain. At Humber River Hospital, our commitment is provide exceptional care to help improve the lives of patients.
Humber River Hospital
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HRH’s digital transformation began in 2005 with the planning of the hospital’s new location, which opened in October 2015 making HRH North America’s first fully digital hospital. HRH launched the first generation of its Command Centre two years later, providing real-time insight on patient flow using capacity, demand and other operational data. Since the launch of its Command Centre, HRH has unlocked inpatient capacity equivalent to 35 additional beds, eliminated hallway medicine and reduced Emergency Department wait times, despite experiencing 8% growth in ED volume during this same period. The launch of these four new analytic tiles in the HRH Command Centre marks a major milestone in the hospital’s multi-generational roll-out. The next phase will introduce additional Command Centre functionality, with analytics designed to further integrate the hospital with the community it serves so that more patients can receive care at home.
Humber River Hospital hosts 2nd Annual Community Open House Friendly staff, cutting-edge technology, and quality care. These were the buzzwords that visitors used to describe what they saw at Humber River Hospital, during its 2nd Annual Community Open House, held in September.
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the operating rooms, the MRI, laboratory, and experienced many of the new digital technologies Humber River Hospital uses to deliver patient-centred care. “We were delighted to welcome visitors to the Open House to gain a better understanding of Humber River Hospital, to see what goes on behind the scenes —and to get to know us better—the physicians, staff, and volunteers who provide trusted care to our community,” said Barbara Collins, President & CEO.
with Barbara Collins, President and CEO of Humber River Hospital Tuesday, January 21st at 7 pm Participate in the live telephone conversation or join our webinar. Learn about new initiatives, programs and services at the Hospital, and share your feedback on the patient experience. Stay tuned to hrh.ca for more information.
Humber River Hospital opened its doors to welcome more than 850 patients, families and visitors who had an opportunity to tour the hospital and learn more about its programs and services. Open House visitors were able to see first-hand Canada’s only technologyrich NASA style Hospital Command Centre. The Command Centre features powerful analytical and predictive tools combined with professional expertise to
help improve patient care, flow, safety and quality throughout the hospital. Visitors also interacted with the robots that deliver supplies throughout the building and met Pepper the social robot who greets patients and helps alleviate anxiety for children who are receiving medical services and having surgery. At the Open House, guests also learned about health care professions, toured
The North Western Toronto Ontario Health Team partners also hosted a booth at the Open House to seek feedback from members of the community about the future of health care. A student band from Michael Power/St. Joseph High School played tunes, while visitors explored the hospital. As always, kids enjoyed caring for their stuffed teddy bear at the Teddy Bear Clinic and then took their free teddy bear home. Humber River Hospital will be hosting its 3rd Annual Community Open House in the Fall 2020.
DONATE NOW We’re enhancing patient outcomes and reinventing patient care. Your Humber River Hospital Foundation needs you to support our growing community. Connect with us Visit us at hrh.ca
THIS IS THE FUTURE OF HEALTH CARE
Humber River Hospital
Humber River Hospital December 2019 Community Report