Annual Report for the year ending March 31, 2006

Ministry of Health Annual Report for the year ending March 31, 2006 For more information on this report, contact: PO Box 2000, Charlottetown, PE, Canada, C1A 7N8 Tel: 902 368 5272 Fax: 902 368 4969 or visit our Web site at www.gov.pe.ca/health

Message from the Minister To the Honourable Barbara A. Hagerman Lieutenant Governor of Prince Edward Island May It Please Your Honour: It is my privilege to present the Annual Report of the Ministry of Health for the fiscal year ended March 31, 2006. Respectfully submitted, J. Chester Gillan Minister of Health

Table of Contents Deputy Minister s Overview... 1 Overview of New Department of Health... 3 Organizational Structure... 4 Roles of Divisions... 5 Community Hospital Authorities... 7 Community Hospital Authority Interim Board Members... 8 Year in Review... 9 Highlights of the Year... 11 Wellness... 11 Healthy Child Development... 15 Access to Services... 19 Human Resources... 23 Health Information Technology... 27 Partnerships to Address the Determinants of Health... 29 Results Achieved... 31 Goal 1: Improve the health status of Islanders... 31 Goal 2: Increase our acceptance of responsibility for our own health... 39 Goal 3: Improve the sustainability of the system... 45 Goal 4: Increase public confidence in the system... 49 Goal 5: Improve workplace wellness and staff morale... 51 Legislative Responsibilities... 55 Legislative Changes... 57 Appendices... 63 Appendix A - Summary of Expenditures... 63 Appendix B - Budget Estimate... 65

Deputy Minister s Overview The Honourable Chester Gillan Minister of Health Province of Prince Edward Island Honourable Minister: It is my pleasure to submit the 2005-2006 Annual Report for the health system. This past year the health and social services system restructuring process was completed resulting in the new Department of Health. The 2005-2006 Annual Report for the Department of Health reflects the progress we have made toward the goals outlined in the 2001-2005 strategic plan for the health and social services system. An extensive strategic planning and consultative process has started that will establish the health system priorities for the coming years and we look forward to unveiling that in 2007. I am proud of our many accomplishments in 2005-2006 and would like to highlight some major achievements: The QEH Redevelopment Project began with the completion of the Master Program/Master Plan. This project will ensure that health care services at the QEH will continue to be efficiently and effectively delivered well into the future. Island EMS was chosen to provide an enhanced, province-wide ambulance system to the citizens of PEI. The (interoperable) Electronic Health Record / Clinical Information System Project led by Cerner Canada was initiated in January 2006 and will involve the development and implementation of a clinical information system within the seven acute care hospitals and four health centres. Page 1

The addition of the pneumococcal conjugate vaccine to the routine schedule for children brought the PEI schedule up to the full recommendation of the National Advisory Committee on Immunization. The number of physicians practicing on PEI was at an all time high. As well, nurse practitioners were introduced to PEI and regulations on their role were developed. Nutrition policies were implemented for elementary and consolidated schools in both the Eastern School District and the Western School Board in partnership with the PEI Healthy Eating Alliance, School Districts, PEI Home & School Federation, Department of Education and UPEI. I am pleased with the progress we have made in the last year and I look forward to meeting future challenges as we work together towards improving the health status of all citizens on PEI. Respectfully submitted, David B. Riley Deputy Minister Page 2

Overview of New Department of Health In April 2005, the Government of PEI restructured the provincial health and social services delivery system. Prior to 2005, health and social services on Prince Edward Island were administered and delivered by four regional health authorities and the Provincial Health Services Authority (PHSA), each with their own budget and administrative structure. The Department of Health and Social Services provided the regional health authorities with advice and assistance on matters of policy and strategic direction, and provided regulatory and public health services directly to the public. As a result of the restructuring process, the pre-existing Department of Health and Social Services was replaced by two new departments, the Department of Health and the Department of Social Services and Seniors. In addition to the creation of two new departments, the restructuring also resulted in a number of administrative changes. Some of the most significant include: The role of the Department of Health changed from responsibility for providing advice and assistance on policy and strategic direction to responsibility for overseeing direct service delivery; Administration and support for line services moved from a regional to a departmental model; Under the previous organizational structure, each of the four regional health authorities had governing boards (PHSA had an Advisory Council). Under the new organizational model, each of the five community hospitals has a governing board. The Queen Elizabeth Hospital, Prince County Hospital and Hillsborough Hospital are administered through the Department of Health and do not have a board due to the provincial nature of their role. The role of the new Department of Health is to: Provide leadership in maintaining and improving the health and well-being of citizens; Provide leadership in innovation and continuous improvement and to provide specific high quality administration and regulatory services to the health system and Islanders; Provide high quality, client-centered health services consistent with community needs. The Department of Health fulfills this role by providing public health services, primary care, acute care, community hospital and continuing care services to Islanders to help ensure their optimal health. Page 3

Organizational Structure The Prince Edward Island Health System is comprised of the Department of Health and five Community Hospital Authorities: Souris, Montague, Tyne Valley, O Leary and Alberton. As a department of government, the Department of Health is overseen by a Minister of the Crown, who is ultimately accountable for departmental performance and results to the rest of government and the citizens of the Province. The Department of Health is managed by a departmental management committee comprised of the Deputy Minister and eight senior directors. This group is responsible for providing overall management direction to the department and for overseeing long term strategic planning. Community Hospital Authority Boards Minister Hon Chester Gillan Deputy Minister Dave Riley Support Services Director Corporate Services Pam Trainor Director Finance Terry Keefe Director Medical Services Dr. Richard Wedge Line Services Director Community Hospitals and Continuing Care Cecil Villard Executive Director QEH/HH Rob Philpott Director Population Heath Teresa Hennebery Director Primary Care Leanne Sayle Executive Director PCH Arlene Gallant-Bernard Page 4

Roles of Divisions Direct Service Delivery (Line) Divisions Queen Elizabeth Hospital and Hillsborough Hospital This Division is responsible for the delivery of medical, nursing, hospital and support services at the Queen Elizabeth Hospital (QEH) and Hillsborough Hospital. Administratively, the Executive Director of QEH/Hillsborough Hospital is responsible for this division and is a member of the Departmental Senior Management Team. Prince County Hospital This Division is responsible for the delivery of medical, nursing, hospital and support services at the Prince County Hospital. Administratively, the Executive Director of Prince County Hospital is responsible for this division and is a member of the Departmental Senior Management Team. Community Hospitals and Continuing Care This Division provides acute care services to rural communities and supportive services to adults and seniors in need of continuing care. Programs and facilities include five community hospitals, long term care, home care, palliative care, the Provincial Geriatrician Program, the PEI Dialysis Program, convalescent care, and under 60 population care. Administratively, the Director of Community Hospitals and Continuing Care is responsible for this division and is a member of the Departmental Senior Management Team. Primary Care This Division provides primary health care services. Programs and facilities include Community Mental Health and Addictions (including the Provincial Addictions Treatment Facility), seven health centres, Public Health (including Public Health Nursing, Speech Language / Audiology, and Community Nutrition), Diabetes Education, and Healthy Living. Administratively, the Director of Primary Care is responsible for this division and is a member of the Departmental Senior Management Team. Population Health This Division provides public health, health protection and regulatory services throughout the province. Programs and services include Environmental Health, Vital Statistics, Private Nursing Home / Community Care Inspection (including dietetic inspection), Adult Protection, Public Guardian, Communicable Disease Control and Immunization, and Health Emergency Preparedness. In addition, the Division contains the Office of the Chief Health Officer and the Epidemiology Unit. The Divisional Director is also the Director of Emergency Health Services pursuant to the Emergency Measures Act. Administratively, the Director of Population Health is responsible for this division and is a member of the Departmental Senior Management Team. Page 5

Corporate Support Services Finance This Division is responsible for the financial planning, financial accounting and reporting, and materials management for the Department of Health. The financial planning section is responsible for the preparation and coordination of the Department of Health s budget ensuring the public funds are properly budgeted and monitored. This section provides support and advice in matters relating to financial management. The financial accounting and reporting section is responsible for the timely and accurate processing, administration, and reporting of accounts payable, account receivable, and payroll transactions. The material management section is responsible for the economical procurement of goods and services as well as inventory management. Administratively, the Director of Finance is responsible for this division and is a member of the Departmental Senior Management Team. Medical Programs This Division is responsible for the delivery of medical programs and services which include the Provincial Medicare Program, physician services, physician referrals, physician recruitment and medical education, physician billing assessment and payment, Out-of-Province Liaison Program, air and ground ambulance, in-province and out-of-province medicare claims, medical technology assessment, Interprovincial Blood Services, and organ and tissue donation. Administratively, the Director of Medical Programs is responsible for this division and is a member of the Departmental Senior Management Team. Corporate Services This Division provides leadership and support to the Department of Health in the areas of human resources / labour relations, communications, policy and evaluation, results measurement, utilization of health services, quality and risk management, Freedom of Information and Protection of Privacy (FOIPP), records information management, legislation / processes, French language services, federal-provincial relations, accreditation, and occupational health and safety. Administratively, the Director of Corporate Services is responsible for this division and is a member of the Departmental Senior Management Team. Page 6

Community Hospital Authorities Together with the Department, the health system includes five community hospital authorities which were created through the Community Hospitals Authorities Act, effective January 1, 2006. The five community hospital authorities are each governed by a Community Hospital Authority Board. The community hospital authorities are as follows: the Souris Community Hospital Authority has responsibility for Souris Hospital; the Montague Community Hospital Authority has responsibility for Kings County Memorial Hospital; the Tyne Valley Community Hospital Authority has responsibility for Stewart Memorial Hospital; the O Leary Community Hospital Authority has responsibility for Community Hospital; and the Alberton Community Hospital Authority has responsibility for Western Hospital. Community Hospital Authority Board s Responsibilities Each Community Hospital Authority Board is accountable to the Minister and has a mandate to deliver the programs and services offered through the community hospitals. Boards will be composed of elected members, with the exception of the current interim board members who were appointed by the Minister. The Community Hospital Authority Board is responsible for: The operation and management of the community hospital; Meeting the regulations of the Community Hospital Authorities Act and Hospital Act; Identifying and prioritizing the health services needs of the community; Preparing an annual business plan; Holding a public meeting; Reporting on the facilities performance and results to the Minister and local communities. Minister s Responsibilities The Minister is ultimately responsible for the administration of the Community Hospital Authorities Act. As such, the Minister has the authority to establish parameters and give directions to a community hospital authority in relation to planning, organization, management and delivery of health care services by the community hospital authority. The Minister may: Establish annual performance targets with respect to: 2 Its development as an organization; 2 Its financial management; 2 Ensuring access to approved health services provided by the community hospital authority; 2 Achieving satisfactory patient outcomes; 2 The level of patient satisfaction with the approved health services; and 2 Any other matters prescribed by the regulations. Approve by-laws or policies of the community hospital authority. Appoint the Administrator after consultation with the Community Hospital Authority Board. Page 7

Community Hospital Authority Interim Board Members Souris Community Hospital Authority David MacAulay, Chair Thelma MacDonald Denis Thibodeau Walter Townshend Bill Rooney Montague Community Hospital Authority Michael Gallant, Chair Sherry Kacsmarik Marion Trowbridge Niall MacKay Hugh Robbins Tyne Valley Community Hospital Authority Lorraine Robinson, Chair Susan Williams Denis Marantz Chief Darlene Bernard Allan Lewis O Leary Community Hospital Authority Allison Ellis, Chair Thelma Sweet, Vice Chair Eileen McCarthy Justin Rogers Ellen Larter Alberton Community Hospital Authority Colleen Handrahan, Chair Phyllis Porter Claude Dorgan Donna Crocker David Cahill Page 8

Year in Review Departmental Planning The new Department of Health is currently undergoing a departmental planning process to develop its priorities for the coming years so that the evolving health needs of Islanders are effectively met now and into the future, and challenges and opportunities facing the system are effectively addressed. This new plan does not fall within the time line for this annual report; therefore, this report will be based on the former strategic plan of the health and social services system (2001-2005). The five-year strategic plan for the health and social services system on Prince Edward Island was established to provide a framework to improve the health of Islanders and the performance of the system over the five-year period from 2001 to 2005. Based on consultation with service providers and the public, the 2001-05 strategic plan identified six critical issues that face the system: public expectations and demand, recruitment and retention of health professionals, appropriate access to primary health care, personal health practices, the aging population and disease prevention. In the 2001-05 strategic plan, six strategies outlined the direction the system was taking to improve its desired results. These strategies included Wellness, Healthy Child Development, Access to Services, Human Resources, Health Information Technology and Partnerships to Address the Determinants of Health. The following section highlights the progress achieved by the system in 2005-2006, in relation to each strategy and the aforementioned critical issues. Page 9

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Highlights of the Year Wellness Wellness initiatives, which encourage people to reach and maintain their full health potential, have been implemented to focus on disease prevention and improve the health status of Islanders. Strategy for Healthy Living The Prince Edward Island Strategy for Healthy Living was launched in June 2003. The strategy continues to enable government, community alliances and non-government organizations (NGOs) to work together to encourage Islanders to address the three common risk factors for chronic disease: healthy eating, active living, and reduction of tobacco use. The development, implementation and evaluation of the strategy is coordinated through a steering committee comprised of provincial government departments of Health, Social Services and Seniors, Education, Community and Cultural Affairs, and Attorney General, federal and municipal governments, non-government organizations and the PEI Healthy Eating Alliance, the PEI Active Living and the PEI Tobacco Reduction Alliance. Over this past year, several initiatives that contributed to the overall strategy were undertaken: Healthy Living Coordinators Regional Healthy Living Coordinators connected and worked with various partner organizations and members of the community to enhance existing programs, create new initiatives and develop supportive environments for healthy living. Healthy Eating The Department of Health continued to be actively involved in the implementation of the Healthy Eating Strategy which was developed and released by the PEI Healthy Eating Alliance in 2002 to improve current eating behaviours of Island children and youth through nutrition education, promotion and by creating supportive environments. Several initiatives were undertaken this past year to increase awareness and knowledge of good nutrition among parents and children: September 2005 marked the implementation of nutrition policies for elementary and consolidated schools in both the Eastern School District (ESD) and the Western School Board (WSB). Work on the promotion of healthier school nutrition environments in intermediate schools has continued. Page 11

Monthly healthy eating tips were developed and distributed to elementary and consolidated schools. The tips consist of practical information to assist parents and children in making healthy life choices. The Nutrition Education and Promotion (NEP) working group organized a new initiative in 2005 - the School Terry Fox Run Contest. The NEP group partnered with the Active Living Alliance in securing funding from the Partnerships for Children Fund to produce Eat Right! Stay Fit! A Healthy Living Song and accompanying DVD. The Access to Safe and Healthy Food Working Group continues to administer the Breakfast and Snack Programs in Island Schools. In 2005, there were 43 such programs in operation, up from 18 in 2003. Tobacco Reduction The Department of Health continued to be an active member in the PEI Tobacco Reduction Alliance (PETRA). The Department of Health worked collaboratively with others to help nonsmokers stay smoke-free, to encourage and help smokers to stop using tobacco, and to promote healthy environments by eliminating exposure to second-hand smoke. The Students Working In Tobacco Can Help (SWITCH) tobacco prevention clubs in Island high schools organized numerous awareness raising activities in their schools and communities. PEI continues to be a leader in providing comprehensive, bilingual support for quitting smoking through the toll free PEI Quitline (1-888-818-6300) and the Quit Care Program at Addiction Services across the province. Stepping Out Program The PEI Stepping Out program is a pedometer-based program designed to increase the physical activity levels of Islanders. Since 2002, the Department of Health provided funding to the PEI Active Living Alliance to offer the Stepping Out program to communities and workplaces across the Island. During 2005-06, there were 12 community based programs with 475 participants. The Stepping Out Schools had 9 schools participating with a total of 12 programs for a total of 763 participating students. The Stepping Out to the Olympics challenge was an exciting and friendly competition that was offered to workplaces across the Island. Workplace programs totalled 11, with 312 participants. The partnership with Provincial Libraries continues to be beneficial for many Islanders. The number of pedometers borrowed from Provincial Libraries totalled 564. Active Healthy School Communities Initiative The education sector contributed to the Strategy for Healthy Living through the Active Healthy School Communities Initiative. This initiative is intended to build active healthy school communities where students, teachers, parents and communities work together to encourage youth to adopt healthy lifestyles that last a lifetime. Page 12

Pap Screening Program The PEI Pap Screening program was established in January 2001 to reduce the incidence and mortality from cervical cancer through regular Pap screening. Cervical cancer is largely preventable. About half of the women who develop cancer of the cervix have never had a Pap smear or have not had regular Pap smears. PEI s overall two-year screening rate for women aged 20 to 69 remains at 58 per cent. Highlights of the PEI Pap Screening program s fifth year include the following: Public Education and Awareness The program held its 6 th Pap Awareness Campaign, Take Action - Regular Pap Tests Prevent Cervical Cancer, in October 2005. This year was the second year that a television commercial produced in collaboration with Nova Scotia and Newfoundland was used and it aired in January 2006. Pap Screening Clinic and Out-reach Pap Clinics In response to an increasing demand for Pap clinic services, the PEI Pap Clinic continued to hold out-reach Pap clinics across the Island. These clinics have been successful at providing alternative access to under-screened women - 65% of women attending had not had a Pap test within the previous two years. Pap Screening Guidelines Draft provincial Pap screening guidelines have been developed and are currently under review. In 2006, the Pap Screening Program Advisory Committee and Mammography Steering Committee were dissolved and replaced with a Cancer Screening Committee. Cancer Control Strategy In October 2004, Partners Taking Action: A Cancer Control Strategy for Prince Edward Island 2004-2015, was released. The strategy has three main goals: to reduce cancer incidence, mortality and morbidity in P.E.I.; to enhance the quality of life of cancer patients and families; and to improve the sustainability of the healthcare system. The Strategy includes recommendations regarding cancer prevention, screening and diagnosis, treatment and supportive care, palliative and end-of-life care, and survivorship. The report was developed by an advisory committee comprised of representatives of the Canadian Cancer Society, the Department of Health and Social Services, the Hospice Palliative Care Association, the Cancer Registry, the Cancer Treatment Centre, the Health Research Institute, the Medical Society of P.E.I., the Provincial Health Services Authority and cancer survivors. In 2005/06, the Department of Health has continued to work with its partners to address cancer care in PEI. Page 13

Over the last year, the province has undertaken several initiatives to improve support given to cancer patients and their families in PEI through enhancing the Cancer Treatment Centre, including new staff positions and the addition of cancer drugs to the formulary. West Nile Virus Strategy and Mosquito Surveillance Program A dead bird surveillance was again conducted during 2005. Birds of concern included crows, ravens and blue jays. All calls received by the Department of Health regarding dead birds of these species were acted on by staff members from the Department of Environment, Energy and Forestry. All recovered birds were submitted to the Atlantic Veterinary College and tested for West Nile Virus. None from PEI were found positive in 2005. A mosquito technician was again hired by the Department of Health in 2005 and mosquito traps were set up in West Prince, the Charlottetown area and the north shore of Queens County. Low counts prevailed throughout 2005 with Culex species found mainly in West Prince, with lower numbers in the Charlottetown area. No control measures for mosquitoes, such as spraying, were necessary in 2005. Environmental Health Officers Prince Edward Island Environmental Health Officers inspect restaurants, child care facilities, nursing homes, community care facilities, schools, swimming pools, slaughterhouses and tattoo parlours. Environmental Health staff are responsible to enforce the Tobacco Sales and Access Act and Smoke-free Places Act. Additionally, boil water advisories are issued when a private water supply serving a public or semi-public building experiences water quality problems. Page 14

Healthy Child Development Positive experiences in early childhood have a lasting impact on education and the ability to form relationships and participate in community life. During the restructuring process in 2005/06, the components of the Healthy Child Development Strategy were realigned between the newly formed Department of Health and the Department of Social Services and Seniors. Immunization Program In June 2005, the addition of the pneumococcal conjugate vaccine occurred to the routine schedule for children. This vaccine protects against infections caused by a bacteria called Streptococcus pneumoniae including meningitis, pneumonia, blood infection and ear infections. The vaccine is administered at ages 2, 4, 6 and 18 months during immunization clinics conducted by Public Health Nursing. The addition of this vaccine to the routine schedule for children brought the PEI schedule up to the full recommendation of the National Advisory Committee on Immunization. The rate of immunization coverage for this vaccine of children on PEI exceeds 90%. Pertussis Vaccine Pertussis (Whooping Cough) cases during childhood were dramatically reduced as a result of the universal infant and childhood immunization programs. However, the increasing incidence of pertussis in adolescents and adults has likely been caused by the decreasing immunity to the pertussis vaccine received in childhood. Until recently, the recommended time period to wait before administering a booster dose for continued protection against pertussis was 10 years after the initial vaccine, which is normally given at 4 years of age. A recent study of children and adolescents attending PEI schools was carried out to obtain clear results for a recommendation to reduce the time period for administering the pertussis vaccine booster dose to less than 5 years. This study was led by Dr. Scott Halperin (Clinical Trials Research Centre, Dalhousie University) and Dr. Lamont Sweet (Chief Health Officer, PEI Department of Health) and was completed in October 2005. This study demonstrated that a time period of less than 10 years, after the initial 4 year old injection, was in fact possible without concern for a significant increase in adverse reactions. The results of this study were presented in the Final Adacel (Tetanus - Diphtheria - Acellular Pertussis) Vaccine Report (Pediatric Infectious Disease Journal, 25(3): 195-200, March 2006). The pertussis vaccine is now given, as part of the Adacel Vaccine, to adolescents on PEI. Adults and very young infants (who have not completed their initial series yet) have a greater chance of protection against Whooping Cough as a result of this program. Page 15

Nutrition Policies The PEI Health Research Fund contributed finances to support research to improve understanding of the enabling factors/barriers to implementing nutrition policies in schools on PEI. The Department of Health worked closely with the PEI Healthy Eating Alliance, School Districts, PEI Home & School Federation, Department of Education and UPEI, to develop and implement nutrition policies for elementary and consolidated schools in both the Eastern School District (ESD) and the Western School Board (WSB). These polices were implemented in September 2005. Work continued on the promotion of healthier school nutrition environments in intermediate schools throughout 2005/06. Stepping Out Program The Department of Health provides funding to the PEI Activity Living Alliance to offer the Stepping Out Program to junior and senior high schools and communities across PEI. This program is pedometer-based and is designed to increase the physical activity levels of children and youth. During 2005/06, 763 students participated in a total of 12 programs at 9 schools. The Stepping Out Program was piloted in targeted elementary schools across the Island in 2005/06. The program was adapted to be age appropriate for younger children. Awareness of Exposure to Tobacco Smoke Ongoing efforts to increase awareness on the dangers of children and youth being exposed to second hand smoke occurred in partnership with the PEI Tobacco Reduction Alliance throughout 2005/06. The Department of Health continued to distribute smoke-free decals, to be placed on vehicles and homes, to promote awareness of the need to protect children from exposure to tobacco smoke in homes and the community. In addition, the Students Working In Tobacco Can Help (SWITCH) tobacco prevention clubs in Island high schools organized numerous awareness raising activities in their schools and communities. Breastfeeding The PEI Breastfeeding Coalition presented Beyond the Basics: Breastfeeding Conference in September 2005 with guest speaker Barbara Wilson-Clay, a prominent clinician/researcher from Austin, Texas. The conference was held in partnership with the PEI Reproductive Care Program, Atlantic Lactation Consultants Association and Association Women s Health Obstetric and Neonatal Nurses (AWHONN) Canada. Page 16

Additionally, a pre-conference presentation Everything You ve Always Wanted to Know about Breastfeeding (But Were Afraid to Ask) provided little known facts about breastfeeding and was following by a question and answer period. This presentation was held especially for mothers and families, as well as the general public. PEI Reproductive Care Program The aim of the PEI Reproductive Care Program (RCP) is to optimize fetal, maternal, newborn, and family health during the prenatal through postnatal periods. A number of practice guidelines were reviewed and updated to reflect current best practice information in 2005/06. In March 2006, the RCP, in partnership with the Aboriginal Women s Association of PEI, coordinated a two day workshop Raising Awareness about Alcohol Use in Pregnancy and Supporting Change. The goals of the workshop were to increase awareness of the impact of personal beliefs on our work, to increase awareness of the role of alcohol in our society, to increase skills in screening for alcohol use in pregnancy, and to look at effective strategies to assist pregnant women in addressing alcohol use. In addition, the RCP developed an information resource entitled Be Safe: Have an alcohol-free pregnancy. Joint Consortium for School Health In 2005, the PEI Departments of Health and Education became part of the Joint Consortium for School Health. The Consortium was established by provincial and territorial ministries and federal departments to strengthen the capacities of health, education, and other systems or agencies in school health promotion. Provincial Diabetes Program The Provincial Diabetes Program continued to develop its pediatric program to better meet the needs of Island children and youth with diabetes in 2005/06. Regular pediatric diabetes clinics are held in Summerside and Charlottetown. These clinics are delivered by a multi-disciplinary team, and at a minimum, include a pediatrician, nurse and dietitian. Public Health Public Health Nursing Public Health Nursing provides a standard immunization schedule to protect against serious and life- threatening childhood illnesses at 2, 4, 6, 12, 15, 18 months and 4 years of age. The proportion of PEI children 2 years of age and under (Born from April 1, 2004 to March 31, 2006) who were fully immunized for childhood diseases rose from 92% in 2004/05 to 94% in 2005/06. This rate is one of the highest in Canada. Page 17

Public Health Nursing conducts a Best Start Program, which is an intensive screening, assessment and in-home visiting program that targets children at risk and their parents in preventing child abuse and neglect. In addition, Public Health Nursing performs thorough nursing assessments of normal growth and development enabling early problems in children to be found and referred on to other specialists or family doctors. Information on parenting and children s health issues (nutrition, preventing poisonings and accidents, toilet training, etc.) is also provided to families. Speech Language Pathology Speech Language Pathology provides assessment, diagnosis and intervention for individuals with communication difficulties. Research supports the efficiency of early intervention for speech language difficulties; therefore, priority has been placed on younger children, with pre-schoolers receiving focused therapy, and grades 1-3 receiving consultative services. Audiology The Audiology Program provides services to children and youth who are deaf or hard of hearing, and who are at risk of hearing loss due to noise exposure, genetic causes, and exposure to certain drugs or middle ear infections. Community Nutrition The Community Nutrition Team provides nutrition assessment, counseling, education, advocacy and consultations to high risk, pregnant women, infants, children, and low income families so they can achieve optimal nutrition to improve their health and reduce their risk of chronic disease. The Community Nutrition Program also provides free milk tickets and prenatal vitamin/mineral supplements to pregnant women receiving nutrition counseling and considered to be in financial need. Page 18

Access to Services The success of improving access to services relies on our ability as a health system to embrace innovation in service delivery to benefit the health and well being of citizens and to improve the quality of those services. Queen Elizabeth Hospital Redevelopment The Queen Elizabeth Hospital (QEH) is 24 years old. There have been many changes in programs, services, and standards over these years. The QEH Redevelopment process aims to ensure that health care services can continue to be efficiently and effectively delivered well into the future. The Master Program/Master Plan for the QEH Redevelopment project has been completed. This phase provided a high level description which outlined where expansion is needed, which departments logistically need to be located adjacent to one another and a high level projection of the cost of the redevelopment project. Functional Programming for this project will be conducted during the fall and winter of 2006/2007. The QEH Redevelopment project will be implemented in two phases. Phase 1 of the project includes the initial architectural design and construction of a new Emergency Department and Ambulatory Care Centre and improvements to Day Surgery and associated services. (Phase 1 will be designed and developed over the next several years.) Government has allocated a budget of $47 million toward this first phase. Hearing Access Program Patients with hearing loss and /or deafness have barriers in accessing services. A Hearing Access Program was developed at the Queen Elizabeth Hospital to educate, identify and provide appropriate equipment and signage to ensure these patients receive a safe and quality service. This program was implemented after completing staff education through the use of classroom sessions and written materials. This information has also been incorporated into the staff orientation sessions. The Hearing Access Program is currently being evaluated. Prince County Hospital Upon opening in 2004, the new Prince County Hospital had 14 In-patient Mental Health (Psychiatry) beds. Of these, two were designated as observational beds. These two beds are now being used as In-patient Mental Health beds, thereby increasing access for Mental Health patients. Page 19

Island EMS (Emergency Medical Services) In November 2005, the Department of Health issued a Request for Proposals for the delivery of an enhanced, province-wide ambulance system to commence operations on April 1, 2006. The enhancements sought by the Department included: a seamless ambulance service where existing operator geographic boundaries are removed; a centralized dispatch service; standardized vehicles and equipment; and enhanced life-saving skills training. In late January 2006, Island EMS, a subsidiary of Medavie Blue Cross, was selected as the Bidder of Choice by Government. In February, Government entered into a Memorandum of Understanding for the operation of the province-wide ambulance system commencing on April 1, 2006. Family Health Centres (FHCs) FHCs are community-based and bring together physicians, registered nurses and other health providers working collaboratively with shared responsibility for patient and client outcomes based on assessed health care needs. These centres provide a defined set of services with emphasis placed on diagnosis and treatment, health promotion, illness prevention, and chronic disease management. Family health centres are based on the interdisciplinary collaborative practice model and continue to be an integral part of primary health care. Collaborative practice family health centres on the Island include: Eastern Kings (Souris); Four Neighbourhoods (Charlottetown); Central Queens (Hunter River) and Gulf Shore (satellite site in Rustico); Harbourside (Summerside); and Beechwood (O Leary). Other family practice models include: Southern Kings (Montague)and Evangeline (Wellington). Central Line Dialysis Pilot Project Many diseases contribute to kidney failure, but the most common causes are diabetes and high blood pressure. Dialysis is required when kidneys become permanently impaired and can no longer function normally to maintain life. Dialysis cleans the blood of wastes and removes excess fluid. There are two ways to deliver hemodialysis - peripheral vascular access and tunneled catheter access. Peripheral vascular access is the preferred method, and approximately 50% of hemodialysis patients on PEI undergo this type of treatment. For some people, though, this method is not a viable option, and tunneled catheter dialysis is required. For this reason, this service is valuable to those Islanders. Prince Edward Island participated in a pilot project to offer tunneled catheter (central line) hemodialysis. The treatment was initially made available from the existing satellite dialysis clinic, located in East Prince. On the basis of positive results in the pilot, the service was extended to Queen s Dialysis Unit in Charlottetown. Page 20

French Language Services Opportunities to obtain health services in French have been identified as a high priority by the Acadian and Francophone community. Accordingly, the Department of Health, in collaboration with the P.E.I. French Language Health Services Network, has worked towards the implementation of the French Language Services Act. A French Language Services Analyst position is shared between the Department of Health and the Department of Social Services and Seniors. This position is responsible for monitoring compliance with the French Language Services Act and for providing advice and assistance to the Department of Health and the Department of Social Services and Seniors to improve the delivery of French language services. In order to increase access to French language services, the Department of Health obtained project funding from Société Santé en français. Three projects were started during the year in different areas of Prince Edward Island: The Primary Care Division implemented a project entitled Healthy Choices, Healthy Communities. This project included the development of French educational workshops and French health promotion materials on the topics of tobacco reduction, healthy eating, and physical activity. The project s main objectives were to increase awareness among the Acadian and Francophone population of the risk factors leading to chronic illness, and to increase collaboration on health promotion between the Acadian and Francophone community and the health system. The Prince County Hospital began work on a project to improve the Health Resource Centre. This initiative was focused on: ensuring the addition of French language health resources to the existing Health Resource Centre to assist the Acadian and Francophone population in better managing its own health; improving linkages between and among facilities, health care providers and specialists, the Department of Health and PEI s Acadian and Francophone community; and improving the capacity of the organization to respond to demands for delivery of health services in French in a manner that is compliant with the French Language Services Act. The Eastern Kings Acadian and Francophone residents benefited from an initiative that offered French health and educational services through videoconferencing technology. Videoconferencing increases access to French language services in a manner that is compliant with the French Language Services Act. It also provides employees with some educational opportunities in French. French Language Health Services Network The PEI French Language Health Services Network (FLHSN) was established in November 2002 by the Minister responsible for Acadian and Francophone Affairs and the Minister of Health and Social Services, who agreed that the most appropriate means for the health system to prepare for the full proclamation of the French Language Services Act was to create a joint government-community network. The purpose of the FLHSN is to propose practical solutions for the delivery of French-language health and social services in PEI and share information between the health system and the Acadian and Francophone community. Page 21

The FLHSN has 17 members and includes representatives from health, social services, and the Acadian and Francophone community. The network reorganized its structure during the past year, to be in line with the new government structure. The updated membership includes representatives from the public, the Société Saint-Thomas-d Aquin, the Société éducative, the Acadian Communities Advisory Committee, a number of Divisions within the Department of Health, the Department of Social Services and Seniors, and a representative from the Acadian and Francophone Affairs Division. Setting the Stage Project A significant achievement during the year was the completion of the Setting the Stage project. Setting the Stage was coordinated by the FLHSN and fully funded by Société Santé en français. Through this project, a set of recommendations and an accompanying Action Plan for the Delivery of Primary Health Care Services in French were developed and submitted to the Department of Health. Wait Times Strategy In the 2004 Ten-Year Plan, First Ministers agreed to collect and provide meaningful information to Canadians on the progress made in reducing wait times. PEI has participated in all national discussions regarding wait times. To date, the Provinces and Territories have approved comparable indicators for each of the five priority areas (including cancer, heart, diagnostic imaging, joint replacements, and sight restoration)and have agreed to benchmarks where sufficient evidence is available. PEI, in consultation with its physicians, surgeons and other health providers, has started the work required to develop a strategy to improve access to services in priority areas. Sub-groups have been established in four areas: joint replacement, site restoration, radiation oncology and diagnostic imaging (cardiac surgeries are not included as they are performed out-of-province). These sub-groups will identify multi-year strategies and targets to decrease wait times in line with national benchmarks. Page 22

Human Resources A number of human resource planning initiatives have been undertaken to ensure an adequate supply and the correct mix of professionals to meet the health needs of Islanders. Recruitment and Retention Government is committed to maintaining an adequate supply of health professionals in Prince Edward Island. A number of initiatives have been implemented to meet this challenge. Active recruitment was carried out throughout the year for a variety of health professionals and additional initiatives were implemented to deal with some of the more difficult to fill positions. Physician Recruitment Strategy In February 2000, government implemented the four-year, $4.2 million dollar Physician Recruitment Strategy to address serious challenges in physician resources. The strategy included funding for family practice and specialist training, new medical school seats, medical trainee sponsorships, student loan assistance, location grants, relocation cost assistance, locum support, continuing medical education, hiring a recruitment officer, enhancing recruitment resources and incentives to attract international medical graduates. The physician complement and number of physicians practicing on PEI was at an all time high in 2005/06. In March 2006, the physician complement (total number of allowable positions for physicians)on PEI was 203.1, up from 195.1 in March 2005. Physician s Master Agreement The enhancement of physician services continues to be a priority of government. The Master Agreement, effective April 1, 2004 until March 31, 2007, ensures PEI remains competitive with other jurisdictions so that Islanders can continue to access a quality health care system. Government and the physician community collaborated significantly to bring this process to a satisfactory conclusion. The issue of recruitment and retention remains an important focus for the government. Many advancements have been made and this agreement will continue to support government s priority in this area. The current Master Agreement provided for economic increases of 2 per cent in the first year, 2.5 per cent in the second year, and 3 per cent in the final year. Also, government will invest an additional $2.1 million, to be implemented over three years, to address areas which will make the health system more competitive so that it can maintain services and increase the success of recruitment and retention efforts for physicians. Negotiations will commence in the fall of 2006 with representatives from government and the Medical Society of PEI to contract a new Master Agreement effective April 1, 2007. Page 23

Medical Education Program The Medical Education Program continued to provide training opportunities in 2005/06. The program is administered under the Department of Health which works closely with Dalhousie Medical School in Halifax. Residents in medical schools across Canada are also welcomed by available teaching physicians. Residents are doctors enrolled in postgraduate training after receiving their medical degrees. A residency is otherwise known as an apprenticeship. This is a time during which doctors take their theoretical skills and apply them, practicing their clinical skills. Family practice residents apprentice for two years while residents in other specialities spend from four to seven years acquiring their expertise. Medical residents spend time with preceptors - qualified doctors who mentor them. When Island physicians work with medical residents it is beneficial for both since such teaching opportunities are one of the most rewarding aspects of medical practice. Teaching helps demonstrate pride in one s craft, helps sustain the discipline as a whole, and aids in recruitment efforts. Medical residencies are also opportunities to show what the Island has to offer. Encouraging residents to complete clinical rotations on Prince Edward Island provides the Island with an opportunity to have an influence on the resident s choice of where they would like to practice medicine. Atlantic Health Human Resources Planning Study The Atlantic Health Human Resources Planning Study was initiated in February 2002 to integrate information on regional demand for the health disciplines and health education training programs to allow for informed health education planning and decision-making in Atlantic Canada. In September 2005, Deputy Ministers agreed to accept the final report on the Atlantic Health Human Resources Planning Study and all task deliverables. Six reports were delivered and accepted, meeting the requirements as specified in the agreement with the contractor, including: (1) Executive Summary; (2) Final Report; (3) Comparative analysis of previous provincial studies; (4) Roll-up of data contained in the provincial studies; (5) Inventory of health education/training programs database user manual; and (6) Environmental scan of health education/training issues. Bachelor of Nursing Sponsorship Program Registered nurses comprise the largest group of health care providers on PEI. The Bachelor of Nursing Sponsorship Program enhances recruitment and retention by providing financial assistance to third and fourth year nursing students who agree to work in the province upon graduation. Page 24