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Mount Sinai Hospital Strategic Plan 2010-2013


Mount Sinai Hospital Strategic Plan The Mount Sinai Hospital Strategic Plan, 2010-2013, reaffirms the Hospital’s long-standing commitment to excellence in patient care, teaching and research. Since our modest beginnings Mount Sinai Hospital has developed a strong culture of excellence and caring and has established several leading, national and international programs. Our strategic plan sets the direction that Mount Sinai will take over the coming years to maintain and enhance its leadership position in these areas. In addition, we believe by focusing on the patient experience we will emerge a stronger organization, better positioned and prepared to deal with the challenges of our health-care system. We are on the cusp of a new era in health care, termed personalized medicine, which will profoundly change patient care — delivering the most effective and timely intervention to each individual patient. This is possible because of the advances in gene-based research and information technology.

Our strategy is to advance a patient-oriented approach in our Centres of Excellence which enables us to take a leadership position and to most effectively serve our stakeholders: For Patients and Families: a Hospital committed to serving patients’ needs, in our key areas of focus, from wellness and disease prevention to treatment and follow-up. For Staff: a healthy, supportive, interdisciplinary work environment in which each member of the Mount Sinai Hospital team continues to feel connected with our patient-centred approach and the importance of his/her role in its successful implementation. For Government and the Local Health Integration Network (LHIN): a hospital delivering on its promise and vital role within the health-care system.

We have therefore incorporated a strategy focused on personalized medicine. The Samuel Lunenfeld Research Institute has been a key attractor of clinical/research talent, which not only enables us to provide “The Best Medicine” but is also setting the foundation for translating the most recent advances in research into personalized medicine.

For our Partners, including Hospitals, Educational Institutions and Community Agencies: a committed partner working together for effective co-ordinated and integrated services.

In today’s world, resilient organizations distinguish themselves by continuous evaluation and an unrelenting drive towards improvement. There are a number of ways we intend to do this through this strategic planning exercise:

For our Board: a Hospital where the status quo is not an option. If we are standing still, we are regressing.

For our Financial Partners and Donors: a fiduciary commitment to financial responsibility, risk management and innovation.

• Renewed focus on the experience of our patients and employees. • Increased performance measurement and management and promoting transparency with the public. • Heightened focus on clinical and research integration to improve clinical practice and deliver “personalized medicine”. • Targeted partnerships with other organizations to co-ordinate patient care in order to promote co-ordinated care for our clients both when they are in and out of our institution. • Vigilant attention to the financial health and viability of our key programs. 1920s: Ladies of the Auxiliary (Ezras Noshem Society) of Mount Sinai Hospital.

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Our History Mount Sinai Hospital was established in 1923 as a 33-bed maternity and convalescent hospital on Yorkville Avenue by a group of dedicated Jewish women volunteers. In 1953, the Hospital relocated to University Avenue and formed an affiliation with the University of Toronto. Since that time the Hospital has continued to grow, serving Toronto and Ontario as a world-class centre for patient care, teaching and research with leading clinical specialty areas and an internationally renowned research institute. Our ability to create a culture of excellence and care has made Mount Sinai an institution where patients want to come for care — and staff and trainees want to work. We remain inspired by the dedication of our founders and we are committed to their vision of providing excellent care, now and in the future.

Our Mission, Vision and Values Mission Discover and deliver the best patient care, research and education with the heart and values true to our heritage.

Vision Provide and be recognized for The Best Medicine.

Values Excellence and Innovation in Clinical Care, Teaching and Research Pursue excellence in everything we do with continuous improvements in quality, service and cost-effectiveness. Patient-Centred Care Prioritize safety, quality and the patient experience in everything we do. Teamwork Embrace a collaborative and interdisciplinary approach to clinical care, teaching and research. Collaboration Establish internal and external partnerships to integrate and coordinate patient services effectively. Respect and Diversity Value and respect the differences of the patients and families who seek our care as well as those who provide that care. Leadership Promote the development and growth of leaders throughout the organization and continue to allow our leading programs to export our knowledge nationally and internationally.

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Core Business Strategies Business Strategy 1 Focus our Centres of Excellence (CoE) on Improving Integrated Team Care and Clinical Outcomes The Hospital will distinguish itself in five clinical Centres of Excellence and the Samuel Lunenfeld Research Institute, as described below and depicted in Figure 1.

Dr. Shoo Lee

Paediatrician-in-Chief

To facilitate the CoEs mandate and focus on improving integrated team care and clinical outcomes, the responsibilities of the CoEs have been revised, the composition has been refocused and new accountabilities defined. A balanced scorecard will be created for all CoEs focused on quality and safety, access and wait times and the patient experience. Key Operational Initiatives • Realigning and re-organizing the Centres of Excellence model • Developing integrated care models for specific medical conditions for both inpatients and ambulatory services • Improving “best practices” in the patient experience by addressing needs, access and equity for diverse populations • Adopting Magnet* hospital standards • Launching an integrated hospital-wide geriatric care program • Implementing a Health Equity Plan • Aligning program budgets to emphasize focus on CoEs * Magnet status is an award given by the American Nurses’ Credentialing Centre (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing.

Dr. Lee Adamson Senior Investigator

Julie Rozmanc 3

Registered Nurse Peri-operative Services


A description of each clinical Centre of Excellence, including its core and complementary service lines and the Samuel Lunenfeld Research Institute follows.

The Best Medicine

Figure 1

Improved Patient Experience

Frances Bloomberg Centre for Women’s and Infants’ Health

Christopher Sharp Centre for Surgical Oncology

(Interprofessional Teams)

(Interprofessional Teams)

Translational Research

Daryl A. Katz Centre for Urgent and Critical Care

(Interprofessional Teams)

Samuel Lunenfeld Research Institute Centre for Inflammatory Bowel Disease (IBD)

Centre for Musculoskeletal Disease (Research Laboratories) (Interprofessional Teams)

(Interprofessional Teams)

diagnostic centres

Medical Imaging, Pathology & Laboratory Medicine and Microbiology & Infection Control

clinical departments

Anesthesiology, Dentistry, Family Medicine, Medicine, Obstetrics and Gynaecology, Ophthalmology, Otolaryngology, Paediatrics, Psychiatry, Surgery

nursing & allied health

Nursing, Clinical Nutrition, Occupational Therapy, Pharmacy, Physiotherapy, Respiratory Therapy, Social Work, Speech Language Pathology

corporate

Corporate and Support Services

community

Community Networks and Partnerships

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Business Strategy 1 Continued Frances Bloomberg Centre for Women’s and Infants’ Health This is the Hospital’s largest program with an average 6,500 deliveries annually. It features a Level III perinatal centre with fetal therapy and translational research programs. The Centre will further develop its highly regarded high-risk obstetrics program and continue to serve as a hub for obstetrics, gynaecology and neonatal care. The program is aligned with the provincial government’s priority of improving maternal/child health. Core Service Lines

Complementary Service Lines

High-Risk Pregnancy, Fetal Health and Neonatal Intensive Care, In vitro fertilization and Urogynaecology

Low-Risk Obstetrics and Gynaecology

Daryl A. Katz Centre for Urgent and Critical Care This Centre includes the Hospital’s core inpatient and ambulatory care programs, including Diabetes, General Internal Medicine, Critical Care/Respiratory Failure and Cardiology. A major thrust of this Centre will be to provide innovative and comprehensive care to manage the increasingly complex and chronic needs of elderly patients. This program, with its highly regarded teachers and clinician-scientists, will continue to carry out a significant proportion of the Hospital’s undergraduate training. Its focus will encompass the full cycle of care by employing the skills and resources of its ambulatory and primary care programs including the Schwartz/Reisman Emergency Centre as well as those of its partners.

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Core Service Lines

Complementary Service Lines

Critical Care/Respiratory Failure, General Internal Medicine, Diabetes, Cardiology, Emergency Care, and Geriatrics

Mental Health/Psychiatry, Family Medicine, Palliative Care, Endocrinology and Pain Management

Christopher Sharp Centre for Surgical Oncology The core elements of our Surgical Oncology Centre of Excellence are: Sarcoma, Head and Neck, Breast, Urological and Oculoplastics. Mount Sinai Hospital is a designated provincial treatment centre for sarcoma, drawing approximately 85 per cent of its patients from outside the Toronto Central LHIN. We have gained an international reputation in the area of head and neck oncology, which is one of the main foci of the Joseph and Mildred Sonshine Family Centre for Head and Neck Diseases. Through the Marvelle Koffler Breast Centre, a premier facility specializing in breast health and disease, more than 33,000 women annually receive multidisciplinary care. The focus of this Centre of Excellence aligns with the increasing incidence of cancer and responds to Cancer Care Ontario’s strategy of expanding cancer service capacity in the Greater Toronto Area. Core Service Lines

Complementary Service Lines

Sarcoma, Head and Neck, Breast, Urological, Oculoplastics

Oral and Maxillofacial, Medical Oncology, Cancer Prevention and Screening

Centre for Inflammatory Bowel Disease The Centre, with its evidence-based care and leading edge research, is unique in the corrective procedures it provides. It serves a significant portion of the market, with over 60 per cent of its referrals coming from outside the Toronto Central LHIN. The Centre has a leadership position in the Familial Gastrointestinal Cancer registry and the Ontario Registry for Studies of Familial Colorectal Cancer and is recognized internationally for its Colorectal Fellowship Program. Our focus in this area is consistent with our clinical strengths and supports the government’s colorectal cancer prevention strategy. Core Service Lines

Complementary Service Lines

Cancer, Inflammatory Bowel Disease, Crohn’s and Colitis

Gastroenterology and Colorectal Surgery


Centre for Musculoskeletal Disease Similar to Inflammatory Bowel Disease, the musculoskeletal program is unique in the corrective procedures it provides. To serve its patients better, Mount Sinai will expand its focus on bone and musculoskeletal research, chronic diseases (e.g., arthritis, rheumatology) and health and wellness programs. Further growth is expected in this program, particularly in the area of primary and revision hip and knee replacement due to the growing needs of the aging demographic. Core Service Lines

Complementary Service Lines

Orthopaedics, Hip and Knee Replacements/Revisions, Cartilage Transplantation, Arthritis/Rheumatology, Regenerative Medicine and Imaging

Rehabilitation and Wellbeing, Sports Medicine

Nana Asomaning

Nurse, Emergency Department

Samuel Lunenfeld Research Institute The Samuel Lunenfeld Research Institute (Lunenfeld) of Mount Sinai Hospital is one of the world’s leading centres in biomedical research and is committed to excellence in discovery, translation and application of health research. The Lunenfeld has a strong portfolio of leading edge scientific programs that include systems biology, women’s and infants’ health, cancer biology, neurobiology, diabetes, arthritis and genetic disorders. Its researchers work collaboratively with physicians and clinicians to foster the cross-pollination of ideas and concepts that are key factors to bringing research discoveries to the patient’s bedside.

Tiomi Gao

Registered Therapist

Brendan D’Souza Registered Therapist

Dr. Jay Wunder Surgeon-in-Chief

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Business Strategy 2 

Business Strategy 3 

Advance Translational Research for Personalized Health care

Expand Partnerships for Co-ordinated Care

Mount Sinai Hospital, a world-renowned centre of clinical and research excellence, will bring the promise of personalized medicine to our patients. An early adopter of this new health-care paradigm, we will begin by seeding personalized medicine in two key areas where Mount Sinai has world-renown clinical and research strength: 1. Maternal and Infant Health/Neonatology, where a personalized approach can help to prevent and better treat pregnancy complications such as high blood pressure and gestational diabetes, and help ensure that timely interventions are in place to promote healthy deliveries and healthy starts for infants and neonates; 2. Rheumatoid Arthritis (RA), a chronic disease where greater understanding of the causes of a patient’s disease, and which medications they are likely to respond to, can help alleviate and even reverse the severity of the disease. Mount Sinai is embarking on a seven year pilot project, in which patients in these areas will receive more extensive diagnostic testing to help clinicians better assess their health in order to tailor their care. We have already made encouraging strides in these areas. Our plan is now to implement and closely study the impact of personalized medicine in these pilot areas, perfect the model, and then expand it across the Hospital’s clinical areas, and ultimately across the province and beyond. To do this, we will partner with key provincial agencies, including the Ontario Ministry of Health and Long-Term Care and other key stakeholders. An external blue ribbon panel from leading centres in the United States has indicated that the Hospital, with its clinical Centres of Excellence and Samuel Lunenfeld Research Institute, is well positioned to successfully execute a personalized medicine strategy. Key Operational Initiatives • Securing strategic partners to leverage funding and resources for our two pilot projects • Establishing a Council on Bridging Clinical Care and Research with a focus on translational research/ personalized medicine • Developing a comprehensive informatics infrastructure to transform and synthesize clinical and research data into new patient interventions

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Partnerships and collaborations are an important component in the delivery of clinical services at Mount Sinai. Mount Sinai is committed to ensure better co-ordination of patient care before, during, and after a patient visits the Hospital in its efforts to enhance the patient experience. Mount Sinai is also committed to facilitating, to the best it can, areas of service that we do not currently provide. To accomplish these goals we will not only review our existing partnerships but also identify and pursue other opportunities. For example, we will explore preferred provider relationships and/or other forms of partnership with rehabilitation and complex continuing care facilities. We may also wish to increase our offerings in neurosciences, for example, by developing stronger partnerships with organizations that provide such services (i.e., Baycrest). Key Operational Initiatives • Re-focusing current partnerships for improved service co-ordination along the continuum of care, health equity, access to care and economies of scale • Forming new relationships with health-care providers in York region to serve a growing population. Our proposed Mount Sinai Wellness Centre on the Joseph and Wolf Lebovic Jewish Community Campus will be a focal point for these activities • Forge partnership arrangements and preferred provider relationships with specific organizations in areas that enhance our array of services


Business Strategy 4 Improved Cost Performance Patient value includes the concept of superior cost performance as compared to peer organizations. The need for rigorous expense management is consistent with government funding requirements and the Hospital’s long-term strategy to generate operating surpluses to reinvest in technology, equipment and infrastructure. Key Operational Initiatives • Continued implementation and tracking of Key Performance Indicators (KPI’s) • Reviewing major programs to identify opportunities for cost control and performance improvement

Linnette Livingston Clinical Housekeeper

• Productivity improvements and financial accountability at all levels • Development of an Effective and Efficient Utilization Committee that integrates best/evidence-based care into the process • Seeking cost savings through outsourcing/collaborative/ shared services initiatives

Sabrina Mastronardi

Infection Control Practioner

Tory Perkin

Registered Nurse

Dr. Samir K. Sinha Director of Geriatrics

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Corporate-wide Operating Strategies in Support of Our Business Strategies The four business strategies will be supported by the following five operating strategies: 1. A re-designed organizational structure to support our Centres of Excellence and the patient experience 2. A talent management strategy focused on leadership and interdisciplinary team development 3. Development of a fully integrated electronic patient record 4. Renewed facilities and equipment 5. Financial health

Operating Strategy 1  A re-designed organizational structure to support our Centres of Excellences and the patient experience A key enabler of our strategy is a new organizational structure that integrates clinical activities of our Centres of Excellence under a single leader. The objective of the new organizational structure is to create effective linkages and develop better communication within and among our Centres of Excellence which will lead to better co-ordination of patient care. In parallel, the Operations Portfolio will come under a single leader as will our Organizational Development and Performance portfolio, both of which aim to support our Centres of Excellence. A new Office of Performance Optimization, staffed with planners, data support specialists and process review experts, will serve as an essential resource to our Centres of Excellence, departments and corporate functions. The focus of this new office will be on costing, measurement, reporting, monitoring, process improvements, co-ordination and productivity improvements.

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Operating Strategy 2 

Operating Strategy 4 

A talent management strategy focused on leadership and interdisciplinary team development

Renewed Facilities and Equipment

Our talent management strategy will have a strong focus on interdisciplinary team development as well as training in process improvement methodologies. These additional skills are key to orientating staff to a culture of patient value, productivity and continuous improvement. As a top employer and to meet the needs of our diverse communities, we will also continue our focus on leadership development, wellness, diversity and equity and work life balance.

Operating Strategy 3  Development of a fully integrated electronic patient record Our Hospital, like the rest of the health-care sector, is lagging behind in effective IT systems and a comprehensive electronic health record. We are therefore aggressively re-aligning our IT strategy to better support our corporate strategy, including translational research. The objective is to ensure a strong operational base and prioritize the resources and key investments that will enable our corporate strategy. Key to this initiative is the development of an integrated health record, which is essential to improving patient safety, co-ordination of care among professionals, patient information, and productivity and quality improvements.

Modernization of our facilities, equipment and technology will continue to be a major initiative in improving the delivery of care and the overall patient experience. The Hospital is in the midst of a major capital redevelopment with investments in building, equipment and technology.

Operating Strategy 5 Financial Health In addition to securing appropriate levels of government funding and taking advantage of opportunities under new funding programs, initiatives will be undertaken in three key areas — business development, research commercialization and philanthropy. Each of these areas will be reviewed and restructured as required to maximize revenues and impact. The financial health of the organization will continue to be measured through comprehensive performance measures that critically assess our progress in this area.

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600 University Avenue Toronto, Ontario, Canada M5G 1X5 t 416-596-4200 www.mountsinai.ca

200902546


Mount Sinai Hospital Strategic Plan 2010 - 2013