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m o u n t s i n a i h o s p i ta l St r at e g i c e d u c at i o n p l a n

Education for All that Enables Putting Patients First 2012 to 2017


Contents Executive Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Introduction: Education is a Fundamental Part of Who We Are . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Making Education a Priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Learning at Mount Sinai: Our Learners, Learning Activities and Resources to Support Learning . . . . . . . . . . . . . . 2

Mount Sinai Community of Learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Our Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Education and Continuing Education for Medical and Hospital Staff and Volunteers . . . . . . . . . . . . . . . . . . . . . . 5

Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Health-care Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Professional Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Organizational Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Clinical Placements (Classic Learners) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Education for External Audiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Simulation as an Education Modality for Many Types of Learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Our Strategy for the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Vision, Mission and Guiding Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Strategic Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1.  We will Foster a Culture Where Everyone is a Learner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

2.  We will Significantly Expand Team-based Interdisciplinary Learning that is Focused   on Improving Patient Outcomes and Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

3.  Each Centre of Excellence will Tangibly Demonstrate the Use of Education   and Knowledge Exchange to Improve Patient Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4.  The Development, Use and Evaluation of Innovative Education Approaches will Increase Significantly . . . . 8

5.  We will Ensure that Our Local, National and International Education Efforts   are High Quality and have Significant Impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

6.  Education Research Activities will be Fostered and Enabled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10


Executive Message

Joseph Mapa President and CEO

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As one of Canada’s pre-eminent academic health science centres, Mount Sinai Hospital is committed to delivering The Best Medicine. Central to that mandate is our continued effort to integrate education, patient care and research and educating the next generation of health-care providers. Simply put, our vision for education is to provide leading innovative education that enables putting patients first.

05945_D_20120912_0026.NEF Our Education Strategy will help us achieve this vision. This is an exciting time to be re-defining education in health care. The new generation of health-care learners come in with the desire to work collaboratively, are eager to develop new models of working together and are comfortable with online education. Our Education Strategy takes all these factors into consideration. Based on valuable input from all departments and health disciplines at Mount Sinai, our strategy explores our strengths and impressive education accomplishments to date, acknowledges our challenges, and focuses our future educational efforts and growth on furthering our priority of putting patients first. The plan also builds on and strengthens the Hospital’s unique contribution to education and to the larger Toronto Academic Health Science Network, regional and global health. Jacqueline James Vice-President Education

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Our Education Strategy “Education for All that Enables Putting Patients First” will guide our efforts to support learning for all.

05945_D_20120912_0028.NEF Joseph Mapa President and CEO

Jacqueline James MD MEd Vice-President Education

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Background INTRODUCTION: Education is a Fundamental Part of Who We Are The core business of every hospital is to care for people. Leading hospitals diagnose and treat illnesses, prevent disease, ensure provision of services in a patient-centred, safe and timely way, and enable the discovery of new and better ways to care for patients. As an academic health science centre, Mount Sinai Hospital makes an additional pledge to be a great teaching and learning hospital, one which delivers on the integration of education and research and with patient care — our triple promise. Education not only supports the training of the next generation of health-care providers and clinician researchers, but is fundamental to who we. Mount Sinai attracts clinicians and staff who want to teach and learn because of our commitment to education. We believe that everyone associated with our Hospital is a learner and that everyone benefits from education. This includes patients and their families, medical and health-care providers, the next generation of care providers, support staff, executive leaders, management, students, volunteers and visitors. Ultimately, the focus of all our education activities is to benefit the care of our current and future patients.

Making Education a Priority Mount Sinai considers education a priority and works to provide significant resources to support education programs. Our commitment is evidenced in the establishment of the Vice-President of Education portfolio and the Interprofessional Education Advisory Council, both vital avenues to strengthening our education strategy and delivery. We are dedicated to the continuous evolution of our education initiatives and to identifying the necessary resources and requirements to deliver on our education goals. We recognize the critical need for staff to be kept up-to-date on scientific advances and improvements in patient care. We also feel a deep obligation to take our learnings beyond our walls.

LEARNING AT MOUNT SINAI: OUR LEARNERS, LEARNING ACTIVITIES AND RESOURCES TO SUPPORT LEARNING We believe that everyone associated with Mount Sinai is a learner and that everyone benefits from education. Providing exemplary and outstanding medical, nursing and allied health professional education is at the core of our commitment to strategy. Mount Sinai is proud of its academic affiliation with the University of Toronto and numerous other universities and colleges for which we provide clinical training. Our education efforts will continue to use best practices and innovative approaches for the benefit of our patients. Sharing the knowledge and expertise gained from developing and researching educational innovations will empower us to shape and influence health education practices locally, nationally and internationally. To that end, our expertise in simulation will continue to grow and we will expand team-based learning aimed at improving patient outcomes. We believe the best way to learn how to care for patients is in interprofessional teams rather than in professional silos.

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Mount Sinai Community of Learners

Figure 1 Medical and Hospital Staff and Volunteers Lunenfeld Staff: 705

Volunteers: 1,172

Part-time Staff: 1,103

Auxiliary: 1,052 MDs – Active: 263

Full-time Staff: 2,392

MDs – Associate: 372 Midwives: 4

Learners in Clinical Placements at Mount Sinai, 2010 (Total = 2,260) Nursing: 400 Dental: 86

Medical: 1,580

Allied Health: 154 Lab and Diagnostic Imaging Technologists: 20 Pharmacy: 20

Figure 3 Patient Encounters, Year Ending March 31, 2011 800,000 700,000

688,000

600,000 Numbers

Over 2,250 learners had clinical placements at Mount Sinai in 2010 (Figure 2). Known as “classic learners”, these individuals come to the Hospital to meet the clinical placement requirements of their education programs. Proportion of clinical placements: • medical 70 per cent • nursing 18 per cent • allied health 9 per cent

Figure 2

400,000 300,000

187,733

200,000 26,595

48,709

Admissions

ER Visits

Imaging Procedures Activity

The length of time of a clinical placement depends on the professional program ranging from a few days to months. Mount Sinai Hospital patients are potential learners as their encounters with health-care providers can be important teaching moments (Figure 3). Over 26,000 patient admissions to the Hospital and over 700,000 ambulatory and ED visits provide opportunities for patients to be educated on prevention, how best to manage their conditions, and/or prevent reoccurrence. The education of patients extends to their families ranging from parents of infants being cared for in the Women’s and Infants’ Health Centre all the way to family members of older patients being cared for in the Acute Care of the Elderly Unit. Mount Sinai also attracts external individuals who come for specific education opportunities offered by the Hospital (e.g., continuing education, Fellowships, visiting professorships, faculty development, etc.).

500,000

100,000 0

Over 7,000 medical and hospital staff and volunteers are employed, have privileges or volunteer their time at the Hospital (Figure 1). These individuals may receive initial training to do their work and ongoing education support during their time at Mount Sinai.

Ambulatory Visits

Our Learning Activities Education and Continuing Education for Medical and Hospital Staff and Volunteers In specific areas Mount Sinai provides initial training necessary for staff and volunteers to do their work. For example, Volunteer and Interpreter Services provides formal volunteer orientation sessions to new volunteers who also receive additional training when they begin their volunteer assignment. Diversity and Health Equity provides formal orientation training to all new staff as well as ongoing continuing education sessions to keep staff up-to-date and help address diversity and health equity-related issues in their work environment. Medical, clinical and many other hospital staff receive continuing education which can include clinical skills training, leadership development, and organizational development such as team building and communication skills. The duration of continuing education programs ranges from short online or classroom sessions or workshops to more extensive courses of study. Medicine In 2011, Mount Sinai either provided or had a strong presence in over 40 continuing medical education courses that were attended by more than 8,400 individuals locally, nationally and internationally. These education events included simulation classes, workshops, education days, preceptorships, review days, symposia, conferences, lectures and annual meetings. Nursing The Department of Nursing supports lifelong professional learning, role development and career advancement. The Department offers courses in classrooms and online. For example, the eLearning Centre is a web-based, learn-on-demand system that gives nurses the flexibility to complete required courses and seminars to suit their individual schedules. In 2010/11, the Department offered: • 57 online courses (compared to 44 in the previous year). A total of 17,909 nursing staff took these courses reflecting over 7,808 online education hours. • 24 instructor-led classroom courses and 93 face-face session. A total of 1,554 staff attended these classes and accounted for 4,479 hours. Health-Care Professionals Capitalizing on the expertise of Mount Sinai’s all RN staff, Sinai C.A.R.E. develops and presents quality courses in Clinical Practice, Professional Development, Human Resource Development and Resource Utilization and Management. Sinai C.A.R.E. is owned and operated by Mount Sinai’s Department of Nursing. In 2010/11 nine courses were offered (21 sessions) which were attended by 288 staff and accounted for 2,326 education hours. Professional Development Mount Sinai offers a wide-range of professional development courses and seminars provided by various clinical departments.

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Organizational Development Mount Sinai provides a wide range of organizational development workshops for staff. In fiscal year 2010/11, 67 workshops were attended by over 1,030 staff (compared to the previous year where 52 workshops were attended by 609 staff).

Our Strategy for the Future

Clinical Placements (Classic Learners) Classic learners come to Mount Sinai to meet the clinical placement requirements of their education programs. Placement requirements are clearly stipulated in agreements between the Hospital and the university or college. The length of time of a clinical placement varies widely depending on the professional program and can range from a few days to months. Medical and other clinical staff at Mount Sinai take on the role of educators as part of their commitment to work in an academic health science centre. Education for External Audiences External individuals may come to Mount Sinai for specific education opportunities. As well, medical and hospital staff educate others outside of the Hospital. An example of this two-way education flow is the Peter A. Silverman Centre for International Health at Mount Sinai. The Centre has innovative partnerships with over 50 international health-care and educational institutions in more than 25 countries. In addition to building sustainable partnerships, the Centre focuses on building patient care capacity through continuing education and professional development in partnering countries. Education opportunities include but are not limited to needs assessments, curriculum planning and development, evaluating education, executive leadership, exchange programs, postgraduate fellowships, international electives, custom courses, clinical research training, visiting professorships and faculty development.

Mount Sinai’s Education Strategy embraces a comprehensive hospital-wide perspective, supports learning by all, and positions the Hospital to lead in innovative education that enables putting patients first. The strategy reflects the input of a wide range of individuals — including education leaders — working throughout the Hospital. The strategy identifies a mission, guiding principles, six strategic goals and priorities to be delivered over the next five years. Building on Mount Sinai’s commitment to accountability for results, the Education Strategy includes performance measures. A key component of the plan will be to track and measure our performance over the next five years and target efforts where additional improvements are needed.

VISION, MISSION AND GUIDING PRINCIPLES

Mount Sinai Hospital’s Education Vision

To lead in innovative education that enables putting patients first.

Simulation as an Education Modality for Many Types of Learners Mount Sinai is well known for its use of simulation to educate many types of learners including medical and hospital staff, classic learners, patients and their families, and external individuals (Table 1). • The University of Toronto Surgical Skills Centre at Mount Sinai offers university-wide core and continuing education programs focused on basic and complex surgical procedures. Surgical residents and medical undergraduates receive hands-on training to develop their surgical skills. The Centre also provides highly regarded co-operative work placements for high school and university students. • The Program for Resuscitation Education and Patient Safety (PREPS) uses simulation to train groups on how to work effectively and safely in teams. Examples of simulation courses include advanced cardiac life support certification, ICU resident sessions, obstetrical medicine emergency simulation, mock code blues, and neonatal resuscitation. • The Hospital regularly offers CPR courses for parents of patients and the general public.

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Table 1 University of Toronto Surgical Skills Centre at Mount Sinai

8,400 per year (700 per month)

Program for Resuscitation Education and Patient Safety (PREPS)

960 per year (80 per month)

Public/Patient Education Respiratory Therapy CPR for Parents

400 per year

The Hospital’s Education Mission We develop and deliver education across the continuum of learners based on our clinical strengths, collaboration, best practices and novel educational approaches. (The continuum of learners includes Hospital and medical staff, students, volunteers and patients.)

The following principles guide the strategic education plan: Everyone in the organization is a learner.

We support access to education that enables all learners to develop and achieve their potential.

We acknowledge and respect the diversity of learners and learning needs.

We continuously strive to improve our performance.

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STRATEGIC GOALS

We will Foster a Culture Where Everyone is a Learner

Education Research Activities will be Fostered and Enabled

VISION To Lead in Innovative Education that Enables Putting Patients First

We will Significantly Expand Team-based Interdisciplinary/ Interprofessional Learning that is Focused on Improving Patient Outcomes and Experience

Each Centre of Excellence will Tangibly Demonstrate the Use of Education and Knowledge Exchange to Improve Patient Outcomes

We will Ensure that Our Local, National and International Education Efforts are High Quality and have Significant Impact The Development, Use and Evaluation of Innocative Education Approaches will Increase Significantly

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Strategic Goal #1: We will Foster a Culture Where Everyone is a Learner Priorities

1. Identify and collect education indicators to measure, monitor and improve our education performance and, thereby, support efforts to foster a culture where everyone is a learner. 2. Develop meaningful and relevant learning plans for all medical and hospital staff that align learning outcomes with the patient experience and putting the patient first. 3. Improve communications that promote and support learning. 4. Expand formal mentorship and coaching programs. 5. Recognise the achievements of learners.

Strategic Goal #4: The Development, Use and Evaluation of Innovative Education Approaches will Increase Significantly Priorities

1. Expand the use of simulation to support and enable the acquisition of clinical skills and team-based learning. 2. Expand the use of e-learning. 3. Expand the use of other innovative education approaches.

Performance Indicators:

• Staff and students trained in simulation centres; • Novel programs offered; and • Medical and hospital staff taking e-learning courses.

Performance Indicators: • • • •

Employees with a documented learning plan; Staff using the Learning Management System to enrol and participate in education activities; Staff participating in workshops and programs; and Percentage of our budget spent on staff education.

Strategic Goal #2: We will Significantly Expand Team-based Interdisciplinary/Interprofessional Learning that is Focused on Improving Patient Outcomes and Experience Priorities

1. Promote team-based, interdisciplinary/interprofessional learning that is focused on improving patient outcomes and the patient experience. 2. Target area-specific team-based, interdisciplinary/interprofessional learning that is focused on improving patient outcomes and the patient experience.

Performance Indicators:

• Number of team-based programs offered; and • Number of interdisciplinary/interprofessional programs for learners.

Strategic Goal #3: Each Centre of Excellence will Tangibly Demonstrate the Use of Education and Knowledge Exchange to Improve Patient Outcomes The Mount Sinai’s Centres of Excellence include: • Frances Bloomberg Centre for Women’s and Infants’ Health • Christopher Sharp Centre for Surgical Oncology • Daryl A. Katz Centre for Urgent and Critical Care • Centre for Inflammatory Bowel Disease • Centre for Musculoskeletal Disease • Samuel Lunenfeld Research Institute

Strategic Goal #5: We will Ensure that Our Local, National and International Education Efforts are High Quality and have Significant Impact Priorities

1. Improve the quality of the core education programs provided to learners who have clinical placements at Mount Sinai. 2. Improve the quality of the education programs provided to medical and hospital staff at Mount Sinai. 3. Expand Mount Sinai’s education efforts nationally and internationally. 4. Brand Mount Sinai’s external education efforts.

Performance Indicators: • • • • • • • • • •

Student placements by academic institution; Student placements by program level; Residents who choose Sinai as their first choice for placement; Learner satisfaction and engagement scores; Patient satisfaction with care delivered by trainees; Continuing education programs offered; Different professions or departments involved in teaching and education; Different academic institutions and partnerships; International trainees/visitors hosted by a department; and Different countries that visitors come from to be at Mount Sinai.

Strategic Goal #6: Education Research Activities will be Fostered and Enabled Priorities

1. Maintain an ongoing inventory of Mount Sinai’s education research. 2. Strengthen education research at Mount Sinai.

Priorities

3. Support education research with infrastructure support and fundraising.

1. Each Centre of Excellence will identify its education strengths and opportunities to improve patient outcomes through education.

Performance Indicators:

2. Each Centre of Excellence will implement an education initiative that advances patient quality, safety and best practices.

Performance Indicator:

• Number of education programs sponsored by each CoE targeted at improving patient outcomes.

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• • • • •

Internal and external funding grants for research in education; Publications, posters and presentations on research in education that are produced and delivered; Clinicians actively engaged in education research; Percentage of eligible clinicians who hold an academic appointment; and; Percentage of clinicians actively engaged in education research.

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600 University Avenue Toronto, Ontario, Canada M5G 1X5 t 416-586-4800 www.mountsinai.ca


Mount Sinai Hospital Strategic Education Plan