August 2011 A Vision for the Future Corporate Renewal of St. Joseph s Health System From the Desk of the President and CEO The last few months were of great significance in the life of our organizations. Our April Leadership Convention has kicked off tremendous momentum with the launch of our renewed Mission/Vision/ Values and Strategic Plan, and engaged our leaders in common objectives. The convention also helped to deepen our understanding of what we exist for and what we hope to achieve. Moving forward, we are now better positioned than ever before to deliver on our ambitious goal of providing a true continuum of care which enhances the experiences of all those we serve and the work life of those who make up St. Joseph s Health System (SJHS). As we rapidly approach an October election in the Province of Ontario, we continue our work with our government to determine how St. Joseph s Health System might demonstrate the true potential in our model of integrated care. Government decisions to pursue a bundled care model dovetails perfectly with our willed future. Our leadership teams have much to do to further our integration and fulfill the promise of our ambitious Strategic Plan. I am extremely confident, however, that our vision will be achieved in harnessing the remarkable collective energy at all our member sites. Sincerely, Dr. Kevin Smith President and CEO Overview In April 2009, SJHS announced its plans to move forward with the implementation of an ambitious and visionary renewal process that will ensure the continued realization of the System s Mission, Vision and Values both in Ontario and in developing countries. During the following months, a number of task groups were formed by the Board. These task groups reported and made recommendations at the SJHS Annual Meeting in June 2010. This exciting and innovative renewal process continues through the implementation phase of the project at both the governance and management levels. Our success to date would not have been possible without the full and ongoing support of the local Boards in Guelph, Kitchener, Brantford and Hamilton at both the System and Foundation levels. St. Joseph s Health System Member Organizations: St. Joseph s Healthcare Hamilton St. Joseph s Home Care (Hamilton) St. Joseph s Health Centre (Guelph) St. Joseph s Lifecare Centre (Brantford) St. Joseph s Villa (Dundas) St. Mary s General Hospital (Kitchener) International Outreach Program (Haiti, Uganda)
A Vision for the Future Page 2 Strategic Plan & Leadership Convention On April 11th, St. Joseph s Health System held the first Leadership Convention in the organization s history, and launched a renewed Mission/Vision/Values and Strategic Plan which had been approved by the organization s Executive and Board. The following are the new statements: Mission: Living the Legacy Compassionate Care. Faith. Discovery. Vision: On behalf of those we are privileged to serve, we will: deliver an integrated high quality care experience, pursue and share knowledge, respect our rich diversity, always remaining faithful to our Roman C values and traditions. Values: We commit ourselves to demonstrate in all that we undertake, the vision and values that inspired our Founders, the Sisters of St. Joseph. These are: Dignity, Respect, Service, Justice, Responsibility and Enquiry. Strategies: Continuum of Care: We will break down barriers between stages of care to provide an optimal, seamless patient experience - in particular for at risk populations including the chronically ill and frail elderly. Safety & Quality: We will make quality and safety a central part of our culture, achieving world-class performance on markers of quality. Professional Development: We will inspire our staff by articulating and reinforcing the legacy of the Sisters in our culture and developing our teams through support, empowerment, and accountability. Culture of Philanthropy: We will encourage a culture of philanthropy throughout our organization which is required to support our vision, and the communities we serve. Poor and Marginalized: We will give special attention to the poor and marginalized in the delivery of our services across the continuum and with our international partners. Innovation and Research: We will develop cutting-edge, cost-effective innovations and adopt them into practice by embracing a culture of inquiry and evidence-based decision-making. Accountability: We will be committed to effective and efficient stewardship of all our resources and will embrace a culture of transparency. Partnerships: We will seek and cultivate partnerships to support our mission.
A Vision for the Future St. Joseph s Health System Leadership Convention At the Leadership Convention, all of the 250 leaders in attendance participated in planning groups to address each of the eight strategies of the Strategic Plan. Each group was tasked with determining what can be done to enhance each area of focus across all the partner organizations, and to determine enablers and barriers to success in the area in question. A report based on the convention workgroups is being prepared and will be presented to the Executive Team and Board in the Fall. Page 3
A Vision for the Future Page 4 International Outreach Program A key milestone in the long term sustainability of the International Outreach Program was reached earlier this spring when it received official charitable status. The IOP can now solicit funds and provide charitable tax receipts to donors for its overseas work, providing the foundation necessary to build long term relationships with funders. Having charitable status is tremendously important, said Peter Sweeney, president of the IOP. It means we can now build our own network of supporters and ambassadors to further our important work. We can issue charitable receipts, apply for grants on our own, and build a database of loyal followers. In other developments, our work in Haiti continues to transform the Hospital of Peace into a symbol of progress in what remains a fragile state. In March, the Canadian Ambassador helped us inaugurate a number of initiatives and remarked that our work is a template for effective global partnerships between Haitian citizens and international donors. In July, a small team from Hamilton and Brantford traveled to Uganda for clinical training focused on reducing maternal mortality at the Mbarara Regional Hospital. And finally, the IOP assisted a team of Libyan-born physicians working at St. Mary s Hospital in their efforts to supply a medical relief mission to a refugee camp in Tunisia where thousands of Libyans have fled the fighting in their homeland.
A Vision for the Future Page 5 Research Research is an important cornerstone of the SJHS Strategic Plan and a critical enabler for the future of our organization. Major discussion has occurred at the SJHS Board and at the Executive Team concerning how to ensure the sustainability of the research enterprise at SJHS, and how to best prepare to make SJHS a research leader in Canada in the future. A taskforce of leadership has been struck to determine a sustainable funding model, a strategic plan for research, and metrics of research performance. The committee will also determine new leadership for research at SJHS and will launch an external review of the research enterprise, focused on what are the appropriate goals and areas of focus for the future. The taskforce is also concerned with improving communications coming out of research, both in partner organizations and to the public. Poor & Marginalized Since the Poor and Marginalized Report of 2009, work has been ongoing at partner organizations to reinforce our commitment to those in need. Recent efforts at St. Joseph s Home Care demonstrate this commitment. Serving the poor and marginalized is entrenched in the organization s strategic plan and is a strategic goal. St. Joseph s Home Care invests 5% of net assets per annum to providing seniors who are poor and marginalized with access to a range of services to enable them to remain living at home safely and independently while preserving the individuals dignity. Because health is so closely linked with nutrition, one of the areas of focus is food security for seniors. Food insecurity is driven by poverty and for many seniors, fresh fruit and vegetables are just too expensive. The HNHB LHIN identified that in a recent study of community-living seniors with functional limitations, 68.7% of the sample were at risk of poor nutrition because of low fruit and vegetable intake. In an attempt to assist in some small way, St. Joseph s Home Care is partnering with Environment Hamilton to provide subsidized Good Food boxes to seniors identified as being at risk of poor nutrition. Another important focus area is foot care and once again this year, St. Joseph s Home Care s foot care nurse will be providing free foot care to individuals who are in need at the Hamilton Out of the Cold program. Announcement Following discussions between Kevin Smith and Sue Matthews, the President and CEO of the Niagara Health System (NHS), Brady Wood, Director of Strategy and Public Relations, SJHS has been seconded to NHS effective July 11th, 2011. It is anticipated that the period of this appointment will be several months and subject to review by both parties on an ongoing basis. Appointed interim Chief Communications Officer at NHS, Brady will report directly to the President and CEO and be a full member of the NHS Executive Team. We offer best wishes and ongoing support to Brady and our colleagues and partners at NHS during this secondment.
A Vision for the Future Page 6 Collaboration Improving Care for Older Adults to Return Home. St. Joseph s Healthcare Hamilton and St. Joseph s Villa continue to partner on the Assess and Restore Program. This program offers timely transition to a rehabilitation focus for patients from all Hamilton acute care facilities. The program has been very successful clinically with 331 patients admitted in 2010/11. The program is very efficient with almost 100% occupancy and importantly, 74% of the patients are successful in returning home. Chronic Disease Management Learning from the success at St. Mary s in consistently achieving low readmission rates for patients with congestive heart failure, St. Joseph s Healthcare Hamilton is working to implement similar approaches with the care of a Nurse Practitioner to provide timely follow-up to prevent readmission Improving Safety for Patients in Endoscopy and Minor Procedures Both St. Mary s and St. Joseph s Healthcare Hamilton recognized the need to expand the consistent use of a safety checklist in procedural areas beyond the operating rooms where safety checklist have already become a part of everyday practice. St. Mary s had completed this initiative and have shared their approach with SJHH where plans are now underway to implement these checklists. Mission Integration The Corporate Mission Integration Committee has been meeting for several months, with a goal of integrating our mission into the day-to-day operations of the partner organizations and reinforcing our values and the legacy of our founders. This group will also be looking at standards of behavior. The group is composed of multi-organization leaders including Donna Johnson, Emile Penner-Cloutier, Giles Scofield, Jennifer O Brien, LeeAnne Kidd, Mary DuQuesney, Brian Guest and Brady Wood. The Corporate Mission Integration Committee also thanks Maureen Tettman for her many contributions. Maureen is retiring this year from St. Joseph s Villa after a remarkable career coloured by commitment to the mission. Beverly Greenwood will be replacing Maureen on the Committee. The group s first task has been to examine the initiatives currently underway at all System partners, and has also reviewed the programs at other institutions (St. Joseph s London), including those in the private sector (Porter Airlines, Sheraton Hotels). A preliminary draft report will be prepared over the Summer months for presentation to the SJHS Executive in the Fall.
Page 5 A Vision for the Future Page 7 Quality & Safety Quality and Safety are critical elements of our strategic plan and essential to fulfilling our service promise to those we care for. The Quality focus has been of major focus at both the System Board and the Boards of member organizations to the degree that it has been entrenched as part of regular practice and through he examination of quarterly metrics. The Quality focus has also extended to the dayto-day operations of member organizations. To date, a common Never Events approach and reporting structure has been launched for three of our sectors (long -term care, acute care, and home care) and is now in place for five of our sites. As part of this initiative, the patient/resident/consumer voice has been elevated by reviewing a patient story at Quality meetings, and through the implementation of family, resident and patient councils. Balanced scorecards are being developed locally, systemic and by sector (e.g. elder care). Elder Care Lead Positions within LTC and Home Care This month, the Presidents of Long Term Care (LTC) and Home Care have been interviewing internal participants for the following Lead positions: Financial, Human Resources, Clinical and Dietary. The goal of the Lead positions is to standardize our care and processes within the three LTC homes and within Home Care as appropriate. For example, instead of each organization developing their own standards of practice for required clinical practices such as wound care, one approach would be taken, utilizing the latest evidence. We expect to announce the successful candidates soon after the publication of this newsletter. Dementia Care and High Risk Behaviours Approximately 500,000 or 1.5% of the Canadian population have some form of dementia. It is one of the most significant causes of disability among Canadians over the age of 65 and is expected to increase two-fold within 20 years. Approximately 90% of people living with dementia will experience at least one behavioural or psychological symptom such as screaming, wandering, agitation, aggression, depression and psychosis as the disease progresses. These symptoms often lead to LTC home placement. St. Joseph s Health System s LTC homes are seeing an increase in the number of residents who are experiencing responsive behaviours including aggression. As part of a Canadian Institute of Cont d on Next Page
A Vision for the Future Page 6 Page 8 Patient Safety research grant, all three homes are using the High Risk Assessment protocol prior to admission of residents. Our data collection should be completed in the Fall which will assist us and others to determine the effectiveness of our protocol in managing high risk behaviours. Resident Satisfaction Surveys This Summer, we will be surveying our residents and families within our three LTC homes using a standardized reliable tool to determine what we are doing well and where we can improve. With the help of the SJHS Research Network, the information will be collated and we will be able to compare our organizations to identify collectively an area of focus improvement. Hospital Senior Friendly Care Initiative In response to the Toronto Central LHIN s claim that the Senior Friendly Care program results in positive outcomes, all LHIN hospitals have completed the Hospital Senior Friendly Assessment. The objectives of the program are to reduce the risk of functional decline and risk for elderly people when they are admitted to hospital. The goal is to provide information in how to modify the care model that will improve elderly person s outcomes. As part of the Senior Friendly Care initiative there are five domains: Organizational Support Processes of Care Emotional and Behavioural Environment Ethics in Clinical Care and Research Physical Environment Each of our hospitals has completed the Senior Friendly Care Assessment and our Regional Geriatric Program has collated and reviewed the results. Each LHIN has taken a different approach towards the next steps. The Waterloo Wellington Local Health Integration Network formed a Steering Committee of experts in Elder Care across the care continuum to review the results and develop recommendations. The HNHB LHIN utilized the HNHB/Geriatric Access and Integration Network Senior Friendly Hospital Task Force Working Group to review all of the assessments. Letters have been sent to all hospitals within both LHINs that identify strengths and areas for improvement. The next step is for hospitals to develop improvement plans within their existing budgets. As a System we will be sharing our results and determining what we can learn from each other. SAGE Awards St. Joseph s Health System was this year s sponsor for the Annual Service Awards for Geriatric Excellence (SAGE). These awards are organized by the Regional Geriatric Program and attract nominations from across the region. This year, SJHH contacted the organizers to volunteer to sponsor the event. We quickly recognized that this was an opportunity for our System to sponsor the event particularly with our strategy to improve elder care. A number of leaders in geriatric care were instrumental in organizing this year s event. Dr. Michelle Gangon, SJHH leader in Geriatric Medicine, received the award for outstanding achievement in Executive/Senior Leadership Category. One of her nominators wrote an outstanding clinician and educator and we thank her for bringing research to us in a way we can all understand and put into practice. Feedback? Questions? Please contact: Brady Wood, Director - Strategy & Public Relations, St. Joseph's Health System Email: bwood@stjoes.ca Telephone: 905.522.1155 ext. 35878 All feedback is kept in the strictest of confidence and no individual or group will be identified.