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Strategic Plan

2008 - 2011

Developed with assistance from KPMG LLP


Sherbourne Health Centre serves the diverse communities of downtown Toronto, providing innovative family health care, counselling, and health education in collaboration with others. Sherbourne also offers two specialized programs for people who are homeless: the Rotary Club of Toronto Health Buses, and an InďŹ rmary for acute convalescent care. Special programs for the lesbian, gay, bisexual, and trans (LGBT) communities, include: Supporting Our Youth, the LGBTQ Parenting Network and a province-wide program, Rainbow Health Ontario. As a learning organization, Sherbourne hosts placements for student doctors, nurses, social workers, chiropractors, naturopaths, chiropodists and others in the health sector.


Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Sherbourne’s Operating Environment . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Our Beliefs and Guiding Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Strategic Direction: Expand Our Impact in the Community . . . . . . . . . 8 Strategic Direction: Improve Quality and Safety . . . . . . . . . . . . . . . . . 11 Strategic Direction: Organizational Health . . . . . . . . . . . . . . . . . . . . . 12 Strategic Direction: Enhance System Integration. . . . . . . . . . . . . . . . . 14 Measuring Success. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Strategy Snapshot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Appendix A - The Strategic Planning Process . . . . . . . . . . . . . . . . 17 Appendix B - Summary of Needs Assessment . . . . . . . . . . . . . . . . 18 Appendix C- York University’s Social Determinants of Health . . 20 Appendix D – Sherbourne Anti-Oppression Framework. . . . . . . . 21 Appendix E – Quality Framework. . . . . . . . . . . . . . . . . . . . . . . . . 22 Appendix F – Resource Documents . . . . . . . . . . . . . . . . . . . . . . . 23

Sherbourne Health Centre - Strategic Plan 2008-2011

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Expand Our Impact on the Community

Improve Quality and Safety

Improve Organizational Health

Enhance System Integration

Introduction Sherbourne Health Centre (Sherbourne) continues to balance the need for effective service delivery with ongoing initiatives to address the social determinants of health that are the root causes of many of the health problems in our communities. The past several years have been successful at Sherbourne. The redevelopment and occupancy of the 333 Sherbourne Street building has enabled the collocation of staff teams and greatly increased our capacity and the quality of our space. Services have been expanded and new programs have been added. Two health buses have replaced the original bus and an Infirmary for people who are homeless has been opened. The award of a Family Health Team has enabled the expansion and integration of our primary/family health care services. A provincial program, Rainbow Health Ontario, has been added to our Lesbian Gay Bisexual Trans (LBGT) services. Building on these and many other successes, Sherbourne is now looking forward, and has developed a Strategic Plan (the Plan) to guide future development. The Plan, developed through an inclusive strategic planning process (Appendix A) highlights our operating environment and describes who we serve within our environment The Plan then outlines Sherbourne’s beliefs and guiding principles and identifies key strategic directions for the next five years. Key objectives are presented for each strategic direction. Performance measures for these strategies and objectives will be developed and documented through our annual operating planning processes. The Plan concludes with a summary titled “Sherbourne’s Strategy Snapshot.” Appendices to the Plan detail our strategic planning process and list the resource documents that informed the plan.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Expand Our Impact on the Community

Improve Organizational Health

Improve Quality and Safety

Enhance System Integration

Sherbourne’s Operating Environment To build an effective strategic plan, it was first necessary to understand the current and future needs of the communities we serve. Our approach included a comprehensive needs assessment that reviewed population trends, the current mix of services available from service providers in our catchment area, demand for services and provincial priorities. Our needs assessment engaged our many stakeholders in interviews, surveys, focus groups and workshops. Our stakeholders included clients, community members, service providers, researchers, funders and our staff. Staff and Board workshops were held to validate the findings of the needs assessment, and to generate future strategies. The Needs Assessment confirmed that the communities we serve are constantly changing. It also reaffirmed the need to build and strengthen the services we currently provide. As well, it identified needs within the community that are currently not being addressed (Appendix B). Changes in Sherbourne’s operating environment will continually affect our organization. Important shifts are occurring at the neighbourhood level and within public policy, particularly policy related to the social determinants of health and health service delivery. Provincial health system priorities now acknowledge the importance of community driven approaches that focus not only on helping the individual, but also on strengthening the communities in which they live. These trends will be monitored to ensure that Sherbourne’s services and initiatives continue to meet the needs of our communities.

Neighbourhood Level Impacts The major groups of clients we serve are: • Newcomers/immigrants; • Homeless and under-housed people; and, • People who identify as lesbian, gay, bisexual, or trans. It is important to look at changes these groups experience at the neighbourhood level because primary/family health services should be located close to peoples’ place of residence. That is, services should be located for easy and timely access thus promoting health, preventing disease and providing lower cost alternatives to care.

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Since its inception, Sherbourne’s catchment area has been defined as the Southeast Toronto neighbourhoods located east of Yonge, south of Bloor, west of the Don River and North of Eastern Avenue. The majority of clients who access our services live within these neighbourhoods. Notable exceptions are clients accessing our specialized LGBT services who come from many areas of the GTA.

Map of Sherbourne’s Catchment Area

The neighbourhoods within Sherbourne’s catchment area are generally described as high density and ethno-racially and socio-economically diverse. However, the physical, social and demographic composition of these neighbourhoods is changing. While these changes are less dramatic than those within other neighbourhoods in the Greater Toronto Area, they are worth noting. The most noteworthy change is the fact that the proportion of low and middle income residents in many of the neighbourhoods is declining, whereas the proportion of very high income residents is rising. The recent intensification of housing, particularly market-driven housing within many of the neighbourhoods is contributing to this change and may continue to do so. Also noteworthy is a recent trend for newcomers and immigrants to Toronto to locate outside of the southeast downtown and to locate within the “inner suburbs” or areas ringing the downtown. These changes will be important to monitor as Sherbourne implements this Plan and prepares future plans. Income disparities within neighbourhoods have been found to have negative impacts on the health status of their residents and these changes may negatively impact our clients. Over time, these changes may also influence where we locate our services. However in the next five years the needs assessment indicates that there will be a strong demand, within our catchment area, for Sherbourne’s services for the LGBT, newcomer/immigrant and homeless communities (Appendix B).

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Sherbourne Health Centre - Strategic Plan 2008-2011


Expand Our Impact on the Community

Improve Organizational Health

Improve Quality and Safety

Enhance System Integration

Our Beliefs and Guiding Principles The diverse clients and communities we serve inform our beliefs and the guiding principles for our actions. This strategic planning process has reaffirmed Sherbourne’s core values. We believe in the value of diversity and respect for the individual. We believe in equity and an anti-oppression philosophy that underlies everything we do. We act with integrity in every choice and decision we make. We consider the whole person and believe that we cannot act alone; we must collaborate with our clients and partners to build the health of our clients and community. These beliefs and principles are summarized as follows.

Social determinants of health We believe that the social and economic context of peoples’ lives has a big impact on their health. We support the concept of the social determinants of health as developed by the York University Conference (See Appendix C)1. We consider the social determinants of health when we plan and offer services, engage in advocacy activities and develop community and health system partnerships. We strive to understand and influence policies that will strengthen the communities we serve.

Anti-oppression framework We believe in an anti-oppression approach to our work. This is “a person centred philosophy; and egalitarian value system concerned with reducing the deleterious effects of structural inequalities upon people’s lives.”2 Our anti-oppression approach grounds our actions at the individual level, the organizational level and in pursuing positive social changes that will promote health (Appendix D).

Raphael, Dennis. (2004). Social Determinants of Health. Chapter 1.Toronto: Canadian Scholars’ Press Inc. 2 Adams, R., Dominelli, L. and Payne, M. (2002) Anti-Oppressive Practice, Chapter 14. Basingstoke: Palgrave MacMillan Ltd 1

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Multiple accountabilities We believe that we must balance our accountability to clients, communities of service, funding agencies, stakeholders and staff. We understand that to serve our communities we need to be prudent stewards of our resources and strive to ensure the future sustainability of our services.

Commitment to quality and safety We define quality primary health care as working with our clients to deliver the best care and services to achieve the best possible outcomes. We are committed to providing services in a safe manner and to working with our clients to provide health services that do no harm. We are also committed to ongoing continuous improvement of quality and safety (Appendix E).

Responsibility for ecological stewardship We believe that we are responsible for promoting policies and practices that reflect corporate responsibility and stewardship for the environment. We will make thoughtful choices to minimize Sherbourne’s ecological footprint while optimizing positive impacts on environmental health. We are committed to minimizing harm while contributing to a healthy planet. These beliefs have influenced the strategic directions that will shape the organization over the next several years.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Expand Our Impact in the Community

Improve Quality and Safety

Improve Organizational Health

Enhance System Integration

Vision We have identified a Vision for the Sherbourne Health Centre that builds on our current strengths and reflects our understanding of the communities we serve. We strive to build health and wellness through excellent primary health programs, services and initiatives that are committed to: • Strengthening diverse communities; • Creating an inclusive, accessible health service environment; • High quality and client satisfaction; and, • Collaboration within an integrated health system.

Strategic Directions Our Vision will be our inspiration to challenge ourselves to achieve excellence and succeed through serving our communities. We have set four core strategic directions to guide us: • Expand our Impact in the Community: a focus on improving access to primary family health services, and influencing public policy and health system decision making; • Improve Quality and Safety: a focus on delivering high-quality services through continual improvement and a culture of safety; • Improve Organizational Health: a focus on creating a healthy, sustainable workplace that supports our beliefs of an inclusive, accessible and non-judgmental atmosphere; and, • Enhance System Integration: a focus on creating an integrated health system that responds to the unique needs of our clients. These four strategic directions will establish a foundation for an integrated health system, connecting clients to the services they need. These strategic directions will enable Sherbourne Health Centre to continue to build on its strengths and expand its scope of services in response to the needs of the community, with a focus on continuous quality improvement and safety. In the following section each of these Strategic Directions is more fully described, along with a set of key objectives.

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Strategic Direction: Expand Our Impact in the Community

Expand Our Impact in the Community To increase our impact in the community and to further the successes of the past, Sherbourne will continue to build its core strengths and expand into new services. The organization will continue building primary/family healthcare services through the Family Health Team, LGBT programs and services, Mental Health services and Homeless and Under-housed Programs. Sherbourne will also develop newcomer programming, a satellite clinic in St. James Town and enhance primary care capacity in chronic disease prevention and management (concentrating on Diabetes, Hepatitis C and HIV/AIDS). Our impact in the community will also include an expanded commitment to building our capacity to influence public policy, especially policy related to the social determinants of health. Sherbourne works with marginalized populations and we believe change in public policy is required to assist these populations to achieve and maintain optimal health. The key objectives for this strategic direction are highlighted below:

Family Health Team • Increase access to care for all communities of focus, in particular by expanding the Family Health Team with a satellite clinic in St. James Town; • Improve access to care through advanced access scheduling, unscheduled care, and after-hours and weekend clinics and continue to explore innovative models of access; and, • Develop chronic disease prevention and management programs based on Ontario‘s Chronic Disease Prevention and Management Framework with a focus on: • Design systems to enhance the capacity of proactive practice teams to provide health care to informed and activated clients; • Continue development of innovative models of collaborative care using inter-professional teams of healthcare providers focusing on the needs of clients and community; and, • Increase care coordination through partnerships and linkages with other providers and agencies in the community.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Mental Health • Enhance mental health services by increasing counseling capacity for all communities of focus, and by building capacity in the areas of crisis counseling, addictions and concurrent disorders;

LGBT Programs and Services • Increase capacity within Supporting Our Youth to address the needs of youth, particularly newcomer youth; • Develop peer and professional counseling programs for Trans Youth transitioning into adulthood; and, • Develop the Rainbow Health Ontario (RHO) in partnership with other community organizations.

Homeless and Under-housed Programs and Services • Increase capacity in the Infirmary and Health Buses; and, • Continue to build partnerships both internally and externally to promote seamless and coordinated care across the continuum of homeless service providers.

Newcomer Programs and Services • Expand newcomer services, building capacity and competence that respond to the needs of diverse communities; and, • Utilize the Family Health Team satellite clinic as a focus for the development of innovative and comprehensive services for newcomers.

Dental Health Services • Increase access to dental health services for low income, newcomers and homeless/under-housed communities by building dental services with partners in the community, locating the service either on-site at 333 Sherbourne Street, or elsewhere.

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Advance Public Policy • Consult with client groups and community partners to identify initiatives where cooperation between governments and social profit organizations would improve the health of urban communities; • Work in partnership with centres of higher learning to conduct and evaluate research designed to identify and evaluate solutions to urban health challenges; • Create opportunities for dialogue with the leadership of all political parties and movements, to share the results of consultations and research; • Be prepared to serve as an advisor to governmental funding bodies as they develop and evaluate new initiatives; and, • Commit resources to research and learning in community health, centered on improving service delivery and accessibility to Sherbourne’s populations of focus.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Strategic Direction: Improve Quality and Safety

Improve Quality and Safety Sherbourne has a history of providing innovative, high-quality services. We will increase our focus on responding to the specific needs of our clients within our Quality Framework (Appendix E). To achieve this, Sherbourne will pursue the following quality and safety key objectives:

Performance Measurement • Expand our focus on quality with the use of benchmarking; • Expand our measurement of performance by adopting the use of quality dashboards in all programs and areas; • Support staff to engage in a process of performance measurement that includes both personal and organizational performance; and, • Develop measures to monitor progress in achieving the Strategic Directions.

Quality and Safety • Promote a culture of learning and collaboration; • Promote a culture of high quality and safety; • Implement quality and safety processes to meet the expectations of Accreditation Canada; • Ensure the organizational infrastructure is in place to promote client safety; • Develop a Quality/Risk Management Plan that will include goals, indicators, outcomes and reporting for all programs; • Expand training to ensure a safe environment for clients, staff and volunteers.

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Strategic Direction: Improve Organizational Health

Improve Organizational Health An organization that is healthy and sustainable provides the foundation for excellent, high-quality services and fulfilled staff. Sherbourne values the dedication and compassion of all staff and believes that supporting their health will positively impact the health of the clients and communities we serve. We will strive to make Sherbourne a great place to work and create an inclusive, accessible and non-judgmental atmosphere for all clients, staff and volunteers using an anti-oppression framework, as exemplified in Appendix D. Sherbourne will create a safe, healthy, ecologically sustainable workplace that embodies respect, learning and work life balance for all staff. The following key objectives will enable Sherbourne to achieve these directions:

Staff Focused Programs • Delineate clearly the roles and responsibilities of all staff; • Measure staff satisfaction and identify strategies to improve the workplace experience; and, • Use an anti-oppression framework to support the values of respect, learning and equity.

Ecological Footprint • Establish policies and procedures to minimize Sherbourne’s ecological footprint and maximize our positive environmental impact

Financial Sustainability • Continue developing sound fiscal practices; • Continue to seek ongoing funding for existing and new programs

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Sherbourne Health Centre - Strategic Plan 2008-2011


Strategic Direction: Enhance System Integration

Enhance System Integration We seek to enhance our clients’ health and well being through strong collaboration with community partners. The service environment in which Sherbourne operates is increasingly aware of the benefits of integrated service delivery models in serving the needs of clients. This model is further becoming the focus of Sherbourne’s primary funder, the Toronto Central Local Health Integration Network (TCLHIN). Sherbourne will work with its partner organizations in downtown southeast Toronto to explore a full range of integration opportunities that will enable us to better serve common communities of interest. Within its changing environment Sherbourne is building a collaborative model of care that follows the client along a continuum of services. Sherbourne will explore and develop joint programs and services with partner organizations to develop a coordinated network of service providers. Our first priority will be programs serving people who are homeless or under-housed. We will also build on our leadership in electronic health records by exploring the development of a community support services, shared service hub. To achieve this, Sherbourne will pursue the following key objectives:

Joint Programs and Services • Develop joint programs and services in partnership with community organizations to respond to the needs of our clients in the following areas: • Services for Homeless and Under-housed • St. James Town Satellite Clinic; • Dental Services; and, • Other programs where synergies can be created to meet client needs; • Maintain and enhance relationships with partner organizations; and, • Develop the tools (e.g. Memorandums of Understanding) that will enable effective partnerships.

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Electronic Health Records • Continue our leadership in Electronic Health Records; • Provide support to partners to develop integrated client records that enable a common view of clients; and, • Leverage the electronic information to support, the planning, delivery and funding of integrated community programs.

Community Services Hub • Develop a community support services hub to gain economies of scale in critical support functions: • Human Resources; • Finance; • Information Technology; and, • Purchasing.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Expand Our Impact in the Community

Improve Quality and Safety

Improve Organizational Health

Enhance System Integration

Measuring Success Sherbourne Health Centre is committed to monitoring its progress in achieving this new Strategic Plan. We will adopt the use of quality dashboards to track, measure and report performance across all programs and areas. The four Strategic Directions will be imbedded in the dashboard. Specific indicators will be developed that are aligned with each strategic direction. Staff will be engaged throughout this process to ensure their involvement in all aspects of measuring the Centre’s performance. The Board will review an annual report on the status of the Strategic Plan and refine the Plan as necessary to align it with any new developments. Some potential outcomes that may be measured are presented in the following exhibit:

Expand Our Impact in the Community

Improved Access to Service

Improve Quality and Safety

Improved Quality of Service

Improved Coordination of Care

Improve Organizational Health

Improved System DecisionMaking

Improved Working Environment

Enhance System Integration

Increased Skill Level of Board and Staff

These outcomes will be further refined into sets of measurable indicators as the Strategic Plan is implemented.

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Strategy Snapshot Who We Serve

The Sherbourne neighbourhood with a focus on people who are: • Newcomers / Immigrants • Homeless and Under-housed • Lesbian, Gay, Bisexual, Trans

Influences

Our Beliefs Expand Our Impact on the Community Family Health Team Mental Health LGBT Programs & Services Homeless and Under-housed / Newcomers Programs & Services Dental Health Services Community Building Advance Public Policy

• Social Determinates of Health • Anti-Oppression framework • Mulitple Accountabilities • Commitment to Quality and Safety • Responsibility for Ecological Stewardship

Informs Domains / Strategic Directions, Goals & Objectives

Expand Our Impact in the Community

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Improve Quality and Safety

Family Health Team Mental Health LGBT Programs & Services Homeless and Under-housed / Newcomers Programs & Services Dental Health Services Community Building Advance Public Policy

Performance Measurement Quality and Safety

Improved Organizational Health

Enhance System Integration

Ecological Footprint Staff Focused Programs Management

Joint Programs Electronic Health Records Community Services Hub

Sherbourne Health Centre - Strategic Plan 2008-2011


Appendix A - The Strategic Planning Process Sherbourne Health Centre has just completed the end of a three-year planning cycle. To keep the organization moving in a desired direction, the Board initiated a strategic planning process to examine past successes and determine the appropriate strategy for moving forward. The strategic planning process was completed by accomplishing the following steps: • Completion of a Community Needs Assessment that examined the needs of Sherbourne’s communities of focus (see Appendix B). • Following completion of the Community Needs Assessment, Sherbourne conducted a full-day planning retreat for all staff and board members to discuss the impact the needs assessment might have on Sherbourne. • The Board of Directors built on the results of the full-day planning retreat with staff and conducted two separate planning sessions. One of the sessions included a day-long planning retreat where they discussed many issues related to the organization’s past and future including the following: • Discussion on past strategies at Sherbourne with specific focus on those areas and initiatives that led to success for Sherbourne. • Examination of a Situation Analysis that described the issues in the environment that will impact the organization and influence its strategy in the future. • Discussion on the organization’s Vision and Mission. • Discussion on core strategic directions for the organization that will define the strategy over the next 3-5 years. • Discussion on high-level goals and objectives for each of the strategic directions that provide more detailed descriptions of what direction the organization will take in the future. • Review of the Strategic Plan and Consultation with key partners. • Implementation planning involving directors and their staff to guide them in executing the strategy. A complete document list is enclosed in Appendix F that references the documents used to build this plan.

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Appendix B - Summary of The Community Needs Assessment The Community Needs Assessment was an exercise to reach out to our communities of interest to assess their needs and to determine whether changes are required to address these needs. The assessment employed the following methods, to capture information from a wide variety of stakeholders. • Internal Data Analysis: Data from Sherbourne internal client information system and data from client registration survey reports was collected and analysed to determine the characteristics of clients coming to Sherbourne over the past several years. • Community Catchment Data Analysis: Existing catchment area data, reports and analysis were collected and analysed to develop a picture of the neighborhoods surrounding Sherbourne. Examples of reports collected and analysed include City of Toronto Neighborhood analyses, 2001 Census data as reported by Toronto Health Profiles, Reports on Poverty by United Way and a Catchment area analysis conducted for Sherbourne in 2004. • Community Partner Survey: Selected community partners were asked to respond to a short survey that described their perceptions of the needs of the community, how these needs could be addressed, and their perceptions of the role Sherbourne should play in addressing those needs. • Interviews with Community Thought Leaders: Interviews with selected community thought leaders were conducted to capture their perceptions of the needs within the community and their perception of how Sherbourne could work to address those needs. • Management and Board Workshops: Workshops were conducted with Sherbourne Management and Board members to discuss their perceptions of the surrounding community and the needs within the community. • Staff Focus Groups and Retreat: Several focus groups were conducted with Sherbourne staff as well as a full-day retreat with staff and Board members to discuss their perceptions of the needs of the clients they work with everyday. Discussions also took place on prioritizing these needs and determining the role Sherbourne should play in addressing these needs. • Client Interviews: Interviews were conducted with Sherbourne’s clients who responded to an open invitation.

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Sherbourne Health Centre - Strategic Plan 2008-2011


Through these methods, community needs were identiďŹ ed. Further analysis of the data revealed several core priority needs: access to dental services; increased primary care capacity that address the needs of the homeless and under-housed; unscheduled care and services for the uninsured; increased mental health and addictions programming across all communities of focus and, the development of more fulsome programming for newcomers. The top ten needs identiďŹ ed through the Needs Assessment are shown below:

Mental Health & Addictions Increased Primary Care Capacity Dental Services Culturally sensitive care / Multilingual services Holistic Trans Health Services for the Uninsured Services & Outreach for New Corners More Non-traditional Health Services Chronic Disease Management / HIV / AIDS Care Drug Coverage

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Appendix C York University’s Social Determinants of Health The 11 social determinants of health identified by the organizers of the 2002 York University conference, “Social determinants of health across the life span” • Aboriginal status • Early life • Education • Employment and working conditions • Food security • Health care services • Housing • Income and its distribution • Social safety net • Social exclusion • Unemployment and employment security

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Sherbourne Health Centre - Strategic Plan 2008-2011


Appendix D – Examples of Anti-Oppression Strategies

Programs and Services:

Governance

Human Resources

• Are planned with and for the intended communities • Incorporate an analysis of oppression and its effects into assessment and treatment • Support communities to build capacity, combat social exclusion

• Board members are knowledgeable and reflective of our communities • Strategic plans are responsive to the needs, strengths and priorities of clients/ communities

• Includes robust anti-discrimination and anti-harassment policies • Creates hiring policies to welcome and promote people from diverse and traditionally marginalized groups

Communications • Written materials are designed to speak to all user groups, e.g. appropriate language and literacy level, translation, cultural sensitivity • There are clear ways for clients and others to communicate with the organization, to make suggestions or complaints

Community Relations • Outreach activities ensure that socially isolated groups gain access to services • Partnerships and community development activities assist marginalized groups to organize and make change

Sherbourne Health Centre - Strategic Plan 2008-2011

Physical Facility and Environmental • Buildings are designed to facilitate physical access • Furniture, pictures, and public spaces create a welcoming environment. • Meeting rooms are shared with partners and community to the extent possible

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Appendix E – Quality Framework Quality Statement We believe that everything we do should be guided by our values – the fundamental beliefs and principles that are the essence of the Sherbourne Health Centre. One of our values is quality and to promote this value, our Quality Statement outlines our definition of quality and the key principles that we believe support our approach to quality.

Definition of Quality We believe that quality primary health care is defined as working with our clients to deliver the best care and services and to achieve the best possible outcomes. We also recognize the need to identify and respond to client and community health needs within the broader determinants of health.

Key Principles Sherbourne Health Centre believes in using quality improvement processes within a learning environment and supports the following key principles: • Leadership’s commitment to quality improvement is demonstrated through active involvement and by example; • Collaboration and teamwork are required throughout the quality improvement process; • The contribution of every individual in a quality improvement process is valued; • It is important to use internal as well as external measures of quality; and, • We recognize and support our accountability to multiple stakeholders for the quality of our care and services. Adopted at the June 5, 2006 meeting of the Board of Directors

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Sherbourne Health Centre - Strategic Plan 2008-2011


Appendix F – Resource Documents The following source documents were instrumental in defining the beliefs, strategic directions and goals and objectives contained in this report, as well as any documents referenced throughout the planning process. 1) Access Alliance Multicultural Community Health Centre (2006). Immigrant and Refugee Engagement Summary, Toronto Central LHIN. July 2006. 2) Centre for Addiction and Mental Health (December 2006). Diversity Action Plan 2006-2009 3) City of Toronto. Neighborhood Profiles: www.toronto.ca/ demographics/neighbourhood_profiles.htm 4) Dobilas, G., Battye, F. (2005). Measuring Neighbourhood Vitality, January 2005. 5) Hwang, S., Bugeja, A (2000). Barriers to Appropriate Diabetes Management among Homeless People in Toronto. CMAJ, July 25; 163 (2). 6) Hwang, S. (2001). Homelessness and Health. CMAJ, Jan 23; 164 (2). 7) McKeown, David. (2005). Public Health in Toronto, 2004: Public Profiles and Indicators. Toronto Public Health, February 2005. 8) Ministry of Health and Long-Term Care (2007). Preventing and Managing Chronic Disease: Ontario’s Framework. 9) O’Connell, J. (2004). Dying in the Shadows: The Challenge of Providing Health Care for Homeless People. CMAJ Apr 13, 204; 170(8). 10) Oldfield, M., Hart, D. (2004). East Downtown Toronto: Sherbourne Health Centre Catchment Area Profile 2. 11) Ontario Prevention Clearinghouse, Ontario Women’s Health Network, Toronto Christian Resource Centre, Toronto Public Health. (2006). Count Us In! Inclusion and Homeless Women in Downtown East Toronto, June 2006. 12) Planned Parenthood of Toronto (2005). Improving Access for Newcomer Youth to Sexual Health Resources and Services. December 2005. 13) Plumb, J. (2000). Homelessness: Reducing Health Disparities. CMAJ, July 25; 163 (2). 14) Rainbow Health Network (2006). What Are Social Determinants of Health for LGBTTIQ People? May 3, 2006.

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15) Raphael, D (2004). Social Determinants of Health. Toronto Canadian Perspectives. Canadian Scholars’ Press Inc. 16) Sherbourne Health Centre (2008). Anti-oppression Framework. 17) Sherourne Health Centre (2007). Community Needs Assessment. 18) Sherbourne Health Centre (2006) Family Health Team Business Plan. November 2006. 19) Sherbourne Health Centre (2008). Green Team Discussion with Management Committee. 20) Sherbourne Health Centre (2006). Newcomer / Immigrant Needs Assessment. 21) Sherbourne Health Centre (2006). Quality Statement. 22) Sherbourne Health Centre (2004) Strategic Plan 2004-2007: Health Without Barriers. September 2004. 23) The Centre for Innovation in Primary Care (2001). More than One Way to Skin a Cat: Building Capacity in Primary Care to Reduce Pressure on Hospitals. Sheffield, UK. 24) The Conference Board of Canada (2008). Briefing, Horizon Scanning. 25) The Health of Urban USA (2007). Big Cities Health Inventory. 26) Toffler Associates (2007). Hospital of the Future. 27) Toronto Central Local Health Integration Network (2006). Diversity Report. 28) Toronto Central Local Health Integration Network (2006). 2007 – 2010 Integrated Health Service Plan. November 2006. 29) Toronto Health Profiles: http://www.torontohealthprofiles.ca/ . 30) United Way of Greater Toronto and the City of Toronto (2005). Strong Neighborhoods, A Call to Action. 31) United Way of Greater Toronto and The Canadian Council on Social Development (2004). Poverty by Postal Code, The Geography of Neighborhood Poverty, City of Toronto, 1981 – 2001.

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Sherbourne Health Centre - Strategic Plan 2008-2011


333 Sherbourne St. Toronto, ON M5A 2S5 416.324.4180 Services: Administration: 416.324.5062 Email: info@sherbourne.on.ca

www.sherbourne.on.ca Charitable Business # 86577 6827 RR0001


SHC - Strategic Plan - 2008 to 2011