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markham stouffville hospital 2017/2018 YEAR IN REVIEW

2017-2018


no longer require the acute care of a hospital but still require care while they wait for their next placement or they get strong enough to return home. The teams also furthered the work on developing our Alongside Midwifery Unit. This unit is the first of its kind in Canada and allows women to have their birth supported by a midwife just steps from all the supports available in our Childbirth Unit. This is a great step forward in serving the needs of our community and positioning MSH as an innovator and a leader. In Uxbridge, we expanded a number of clinics and moved forward on our redevelopment journey. We are excited about evolving our programs and services to meet the needs of our communities.

Message from the President & CEO Sometimes the best way to look ahead is to look to the past. In looking at our recent successes and accomplishments, we can be re-energized and excited about the future and the great potential that lies ahead. 2017/2018 was a great year for MSH and there were many wonderful accomplishments and achievements. The team did extensive engagement and we developed values for the organization that supported our code of behaviour. This foundational work is a great anchor for all our future work. We continued to put our patients at the centre of everything we do. Our Care Transitions program launched with a focus on making meaningful connections and keeping individuals healthy and safe in their homes longer. We also planned for our move to the Reactivation Care Centre in Toronto. A move of this magnitude takes considerable time and effort to coordinate. This highly specialized unit will allow us to care for patients who

We also looked for ways to enhance the patient experience and launched 24 / 7 visiting to allow families to spend more time with their loved ones and launched a new website – www.msh.on.ca that provides greater information to patients and can be translated into over 120 languages. All of these examples show that we focus on our patients and develop programs and services to meet their unique needs. As we look to our future, we are working on our new strategic plan that will position the organization for growth and success. We have had broad engagement from all of our stakeholders and have heard what is important to them and where they would like to see the hospital in the future. We look forward to launching our new plan in the Fall of 2018. All of this great work is possible because of our committed team. Every person – whether a staff member, a physician, a midwife or a volunteer – is a caregiver and comes to MSH to provide exceptional care to our patients. It’s because of this, that the future is so bright for our hospital and we continue to accomplish great things together.

Jo-anne Marr President & CEO


developing a new code of behaviour A new code of behaviour was developed in 2017/2018 which includes five core values respect, trust, commitment, compassion and courage. The code of behaviour was developed with careful engagement of internal and external stakeholders from the MSH community, keeping in mind the culture we want to foster for the future and our strategic direction. This new code of behaviour will set the foundation that feeds into our current work on the hospital’s new strategic plan, which includes the review and

preparing to shine The first initiative of the SHINE (Shared Health Information Network Exchange) partnership is the implementation of MEDITECH 6.16 hospital information system (HIS). In the last year all three hospitals (Markham Stouffville Hospital, Southlake Regional Health Centre (Southlake) and Stevenson Memorial Hospital (Stevenson)) reached major milestones toward the launch of the new HIS. At MSH, the new HIS, MEDITECH 6.16 is almost completely built, 96 New MEDITECH servers moved to our modern SHINE data centre and testing has begun. Staff will be trained on the new system just in time for launch on September 1, 2018 at MSH and December 1, 2018 at Southlake and Stevenson.

revision of our vision and mission, this upcoming year. Our goal is for each person who steps through the hospital doors, whether they are a patient, a staff member, physician, midwife, visitor or volunteer – anyone, to live and breathe these values, through our everyday interactions and work.


Making great strides to transform MSH We are embedding a culture of innovation at MSH that combines the art of caring with the science of best practice. This year, we received four grants worth over $1.7 million which has enabled us to develop 12 projects across the hospital including: • CloudDX, a project that helps chronic obstructive pulmonary disease patients live independently and self-manage their illness from home. This is helping us support more patients and reduce their need to be re-admitted to the hospital. • ShiftLink, an automated process for filling vacant staff shifts. Supervisors use the mobile and desktop application to notify all qualified and available staff of a shift opportunity to which staff can quickly and easily respond.

We also hosted a number of events including the HELIX Summer Institute - a special innovation ‘design jam’ to help improve the lives and cognitive skills of patients in our Transitional Care Unit, three Innovation Cafés for staff and a market engagement session for our GetConnected digital hospital codesign project.


Award winning greening initiatives As part of the hospital’s commitment to being a good corporate citizen and providing a clean, safe and healthy environment for our patients, staff, physicians, midwives and volunteers, the Corporate Services department continued to work to reduce energy and utility consumption throughout the year. Their efforts resulted in the hospital being the recipient of the 2018 Energy and Environmental Stewardship Award from the Canadian College of Health Leaders. There were a number of initiatives which led to this award: • LED lights were installed in hallways and corridors as part of an LED retrofitting program resulting in the equivalent of 236 cars being removed from the road or a reduction 2.4 million lbs of CO2. The plan is to expand the retrofitting program throughout the hospital.

• Air handling units in the hospital were rescheduled to meet occupancy needs. This resulted in the equivalent of 152 cars being removed from the road or a reduction of 1.5 million lbs of CO2 . • A steam trap audit revealed over 30 defective traps which were replaced. This resulted in a savings of 94,146 cubic meters of gas. This award reflects the importance of greening initiatives in the hospital as every dollar saved on energy and utilities can be directly reinvested into patient care.


transitioning patients back into the community Supporting patients safely transitioning out of the hospital back into the community in a seamless coordinated manner is an organizational priority. The Rehabilitation, Complex Continuing Care, Alternate Level of Care, Palliative Care and Hospital to Home teams share a common purpose of supporting patients and their families through transitional periods. This year, these teams were brought together under the umbrella of the Care Transitions department. To further achieve our goals, a new clinic opened called the Community Medicine Clinic (CMC). An integral component of the Hospital to Home program, the CMC provides patients and their families care services with urgent medical consultation for complex needs, helping to prevent visits to the Emergency Department and

re-admissions to the hospital. The CMC works in partnership with community physicians, York Region Paramedics Services, and Home and Community Services. All programs in the Care Transitions department strive to provide extraordinary care to our diverse patients and their families both while they are at MSH and when they transition back into the community.


“I became a PEP because I really wanted to have a voice in the future of patient care.”

partnering with patients Partnering with patients, their families and their caregivers is essential to the way MSH delivers high quality and safe care to all of our patients. As such, patient experience continues to be at the forefront at the hospital. In November of this year, MSH launched the PEP (Patient Experience Participants) program. PEP volunteers work with hospital staff and physicians, sharing their ideas, perspectives and experiences to inform decisions that directly impact care delivery, services and the patient experience.

Cynthia Ross-Hiatt is one of 15 PEPs in the program that have already logged over 60 hours of service as a group. As a former paramedic, she understands the complexities of the healthcare system. As a family member of patients at MSH, she recognizes her role in shaping and improving care at the hospital. As a PEP, she has worked with the oncology department providing input on the unit, conducting staff interviews and participating in safety walks all with the goal of “helping staff at the hospital understand and see things that they may not be seeing as part of their everyday work.”


When you open up and become vulnerable and ask for help, you’re going to get it.

Shining a spotlight on bipolar disorder Esther Herbert doesn’t remember pretending to be her boss - sitting at her desk and answering her phone. But she remembers being handcuffed and escorted by police to an ambulance and taken to MSH.

After finding the right medication, her life completely changed “Now that I’m diagnosed and committed to the program, I want to tell people you can live with and manage this. You can be productive.”

It was then that she was diagnosed with bipolar disorder. For many years, she was misdiagnosed with depression and given medication that exacerbated her bipolar disorder. “I’ve had this illness since I was about 15 or 16 years old, but it was not diagnosed until 2000,” says Esther, who is now 54 years old.

MSH is a leading mental health treatment centre specializing in patient-centred community integrated mental health which supports a holistic approach to care. This includes an outpatient mental health care team with group programs to serve more patients and help prevent relapses and recurrences.


bringing more expertise and resources to our community

MSH became the first community hospital to join Kids Health Alliance (KHA), which was founded in June 2017 by The Hospital for Sick Children, Holland Bloorview Kids Rehabilitation Hospital and the Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre. This partnership provides an opportunity for MSH to benefit from the expertise of these renowned paediatric centres and give children the care they need in their community.

How does our community benefit from KHA? • Makes transitions easier when patients are transferred from one healthcare provider to another including improved access to health records through shared technology platforms. • Improves the short- and long-term health of children and youth by embedding best clinical practices and principles. • Creates consistent approaches to connecting along the continuum of care. • Drives innovation through collaborative research and education.


10,000

access to information requests

120,000 people registered at central registration

msh at a glance 6.5

31,000

days average length of stay (medicine units)

visitors to our fracture & plastics clinics

427

new staff that joined MSH

3,414 babies born

3,651 training hours devoted to staff development

4,899

visitors to our breast feeding clinic

1.3 million tests performed by laboratory


30,000 Mental Health Department visits

103,823

101

Emergency Department visits

home visits by clinicians to patients

amount of grants for innovation

diagnostic tests completed

overall hand hygiene compliance across the hospital

chemotherapy clinic visits

$1.7 million

232,228

94%

14,934

3,757

children who received service from the York Region Preschool Speech and Language Program

600,000+ medicine orders

25,159

YouTube videos views

2,410 follow-up calls to patients 72 hours after leaving the hospital

20,145

surgeries performed


UXBridge The Uxbridge site saw a significant increase in volumes (between 15-20 per cent) in areas such as the Emergency Department and diagnostic imaging after opening its doors to Port Perry residents when their hospital was damaged by a fire. The Uxbridge team handled the additional volumes well, bringing in extra staff when necessary. Focusing on the future of healthcare services in Uxbridge, the hospital created a special committee of the Board of Directors to oversee the Uxbridge site and any future redevelopment plans. A pre-capital submission for the redevelopment of the Uxbridge site was also made to the Ministry of Health and Long-Term Care.

UXBridge cottage hospital foundation (UCHF) The UCHF celebrated another successful year with contributions from the community. This demonstrates the community’s appreciation of having a hospital with emergency services in Uxbridge. We had a unique opportunity to partner with Precious Minds to host a Perfect Pairings event in November that benefitted both worthy charities. Along with our annual golf tournament, several third party fundraisers, the amazing support of the Cottage Hospital Auxiliary and individual contributions, the UCHF was able to fund several pieces of essential equipment, support renovations and other special projects for the Uxbridge site.


$162,000 Cancer care including

$477,000 including

General equipment

$48,000

$44,000

$1.3 Million

14 art of care oncology chairs

$69,000

IT upgrades & enhancements

Pain & Symptom Management Clinic

wheelchairs

$504,000

Childbirth & Children’s Services & Mental Health including

$156,000

transport isolette

$97,000

Alongside Midwifery Unit (AMU) furniture & equipment

$7.4M RAISED

$48,000

Education

includes adult patient simulator mannequin

IN 2017/2018 *As of March 31, 2018 over $4M given to MSH. Please visit mshf.on.ca to see our full audited financial statements.

$65,000 Palliative & Critical Care Includes quiet room revonation & rapid infuser

$166,000 AMBULANCE

$154,000 Emergency services & Diagnostic Imaging

The Power of Giving to MSH: Extraordinary care close to home

Surgical care including

$55,000

Orthopaedic Joint Assessment Clinic

$52,000

Anaesthesia pumps

$1 Million Infrastructure enhancements

Generous community support makes a real impact on the lives of the thousands of patients and families who rely on MSH each and every day. From essential, life-saving equipment to inspiring stories of recovery and hope – the power of generosity is everywhere. Generosity inspires everything at MSH.


Volunteers Volunteers are vital to the success of the hospital. An integral part of the health team, they can be found in both clinical and non-clinical service areas throughout the hospital. From wayfinding to assisting patients coming in for a procedure, these committed individuals contribute their time and talent to supplement the extraordinary care delivered at the hospital. This year, over 50 departments and clinics benefitted from volunteers. Each volunteer brings a wealth of skill and experience to their role, helping enhance the overall patient experience.

teaching the next generation MSH has a new adult patient simulator mannequin, which supports interprofessional practice team members during new-hire orientation and staff skills refresher days. The mannequin, an untethered and wireless medium-fidelity simulator, enables staff to run simulated-patient scenarios in the simulation lab or on units. We also teach future healthcare providers in all disciplines across all departments. Last year we had 556 nursing students, 95 medical students, 64 residents and fellows, 10 midwife trainees, and 52 allied health students at MSH. Having trainees as part of our patient care teams helps raise the standard of care and brings unique perspectives to our community, making a lasting impact on patient’s lives.


financials Hospital operations year ended March 31, 2018 Revenue $253,694,630 Expense $248,482,361 Excess of revenue over expenses for the year $5,212,269

2017/18 Revenues

$253,694,630

Ministry of Health Funding ..................................................... Patient Services ........................................................................... Amortization of Deferred Capital Contributions........... Parking and Ancillary ................................................................. Other Revenues ........................................................................... Special Programs .........................................................................

$184,417,959 $26,387,891 $15,755,164 $9,715,884 $9,167,399 $8,250,333

2017/18 Expenses

$248,482,361

Salaries and Employee Benefits............................................. Other Supplies & Expenses ..................................................... Amortization of Capital Assets .............................................. Medical Staff Remuneration ................................................... Drugs, Medical and Surgical Supplies.................................. Special Programs .........................................................................

$138,630,600 $44,283,847 $18,788,961 $18,738,710 $19,810,227 $8,230,016

2017/18 Expenses by program

$248,482,361

Medical Imaging & Lab Services ............................................ Surgical Services .......................................................................... Medical Services .......................................................................... Childbirth & Childrens’ Services ........................................... Emergency Services ................................................................... Pharmacy and Oncology........................................................... Mental Health Services ............................................................. Child Development Programs ................................................ Care Transitions ........................................................................... Uxbridge Clinical .........................................................................

$36,236,312 $28,866,865 $27,702,625 $13,310,952 $11,523,409 $11,115,776 $7,826,488 $6,902,009 $6,868,888 $5,475,389

15% 12% 11% 5% 5% 4% 3% 3% 3% 2%

Facility and Support Services ................................................. Information Technology ........................................................... Plant and Biomed ....................................................................... Professional Practice ................................................................. Other Services ..............................................................................

$11,537,691 $11,204,844 $10,272,373 $8,680,787 $50,957,953

5% 5% 4% 3% 21%

73% 10% 6% 4% 4% 3%

56% 18% 8% 8% 8% 3%

Expenses by program


Board Report It has been an exciting year for Markham Stouffville Hospital as we embarked on a new strategic planning process that will focus our efforts on serving our diverse community and ensuring we are the hospital of choice for patients and their families. This renewed hospital focus and planning process was made possible by the strong oversight and direction of the Board and valued input and engagement from our staff and physicians who are committed to transforming the patient and family experience. We are proud of the accomplishments we have achieved in both governance and leadership. A tremendous amount of work has been undertaken by our Board to ensure we are meeting best practices in governance. This includes reviewing and amending governance policies and by-laws based on current legislation recognizing they will guide us in assessing and planning better care and services for our patients as well as driving our new strategic directions.

Message from the chair

Tom Barlow Board Chair

On behalf of the Board, I would like to thank President and CEO, Jo-anne Marr, and her senior colleagues for their commitment to patient care and leadership, as well as each of our 2,300 staff, 500 physicians and 1,300 volunteers for their dedication to providing high quality care and an extraordinary experience for our patients.


Finance and Audit committee The Finance and Audit Committee focused its efforts on the future financial health and sustainability of the organization. Fiscal 2018/19 will be the last year that the hospital will receive post construction operating funding from the Ministry of Health and LongTerm Care (MOHLTC) for the Markham site redevelopment. This funding has been critical to help support the growth pressures that the hospital has experienced over the past $ five fiscal years. A three-year financial plan was developed which highlighted upcoming financial pressures. A priority was to reduce the cost per weighted case which is a key input in the provincial funding formula. Cost savings were realized through the implementation of financial health strategies. The organization ended the fiscal 2017/18 in a strong financial position, reporting a $5.2M bottom line surplus, a strong cash flow position with an ending current ratio at March 31 of 1.39 and a $92 reduction in cost per weighted case to $5,365 per case for the acute inpatient and day surgery module. The Committee had primary oversight over technology infrastructure investments needed to allow the organization to realize its vision to become a digital hospital. The Shared Health Information Network Exchange (SHINE) partnership agreement with Southlake Regional Health Centre and Stevenson Memorial Hospital was signed, with the first major deliverable being the implementation of the latest version of MEDITECH called Expanse. The committee also monitored the progress being made on the implementation of recommendations identified in a third party IT security review. Significant progress was made mitigating risks identified in the review.

Governance Committee Governance renewal was a key priority for the Governance Committee in fiscal 2017/18. Maureen Quigley and Associates was contracted to support a revision of current governance practices. Her recommendations have been incorporated into Board and Board Committee meeting practices, ensuring MSH is using leading practices in advance of the September 2018 Accreditation Canada survey. Corporate by-laws and policies were updated. Significant effort was made ensuring Board policies are in alignment with the revised bylaws. This work will continue in the 2018/19 Board cycle. The Governance Committee facilitated the Board nominating and selection process. Three new members were added to the Board at the June annual general meeting.


Dr. Garg

Dr. Monavvari

Dr. Geenen

Medical Advisory Committee The activities during the regular monthly meetings of the Medical Advisory Committee included receiving reports from all subcommittees, including the credentialing of new physicians and the yearly recredentialing process, approval of new policies and medical directives, discussion of critical incidents and quality of care issues. Highlights of the committee work included: • Appointment of interim physician lead, Informatics Partnership, Dr. Abhinav Garg for MEDITECH and SHINE partnership • Supported the appointment of a new Vice President, Medical Operations, Dr. Alan Monavvari • Recruitment and appointment of the new Chief of Staff, Dr. Caroline Geenen in March 2018, as the term of Dr. David Austin was completed • Revisions and additions of professional staff categories in the professional staff by-laws • Improvements to the transcription process • Progress on the use of hospital only email for physicians • Preparation for accreditation • Implementation of a new process for peer departmental reviews • Proactive physician human resources planning


Human Resources committee The committee monitored performance, compensation and succession plans for the President and Chief Executive Officer (CEO) and Chief of Staff (COS) based on agreed upon objectives identified in their accountability agreements. At the end of the fiscal year, the committee reviewed and approved performance results and compensation as well as approving the CEO/COS 2018/19 accountability agreements. The committee provided oversight on the development of the executive compensation framework for the executive team that was originally submitted to the MOHLTC for approval in August 2017. The committee identified priority areas of focus for the refreshed people strategy to be developed in fiscal 2018/19 including succession planning, employee engagement, and employee wellness and recognition programs.

Quality Committee The Quality Committee published a 2017/18 annual report of the Quality Committee highlighting the committee’s achievements. The committee developed the quality improvement plan (QIP), which included a robust and structured process which was regularly reviewed by the committee including a draft and final QIP for approval by the board. Patient stories were shared which promoted better understanding of patients and families’ experiences. “Go and see” was implemented, where the committee members visited various departments to better understand the processes and issues encountered. Monthly summaries were prepared for the Board on key activities including patient engagement, patient ombudsman, QIP and leading practices. A detailed summary of the committee’s achievements are included in the committee’s annual report.

Special Committee The Special Committee was established in February 2018 to focus on the redevelopment of the Uxbridge site by providing Board oversight and guidance for the project. To date, the committee’s accomplishments include a review and completion of MSH’s pre-capital submission to the MOHLTC, approval to commence master planning for the Uxbridge and Markham sites and preliminary planning for road assumptions by the city of Markham from the 2014 redevelopment project.


381 Church Street PO Box 1800 Markham, ON L3P 7P3

www.msh.on.ca

/MarkhamStouffvilleHospital

@MSHospital

@MSHospital

Profile for Markham Stouffville Hospital

MSH Year in Review - 2017-2018  

A look back at the last fiscal year at Markham Stouffville Hospital.

MSH Year in Review - 2017-2018  

A look back at the last fiscal year at Markham Stouffville Hospital.

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