Minutes of the Meeting of the MICs Board of Directors Wednesday, November 23 rd, 2016 1800 Hours Via videoconference @ MICs Boardrooms (LMH Lead Site) ANSON GENERAL HOSPITAL Johanne Edwards Chair Patrick Britton Vice-Chair Lee-Ann Boucher Treasurer Stéphanie Giguère Municipal Representative BINGHAM MEMORIAL HOSPITAL Bob Dennis Chair Paul Michaud Vice-Chair Irma Clarke Treasurer Doug Bender Municipal Representative LADY MINTO HOSPITAL regrets Patricia Dorff Chair Gilles Chartrand Vice-Chair Jack Solomon Treasurer Renelle Bélisle Municipal Representative MICs GROUP OF HEALTH SERVICES GUESTS Paul Chatelain MICs Chief Eecutive Officer Karen Hill MICs Chief Nursing Officer / Eecutive Leader of Clinical Services Dr. Stephen Chiang MICs Chief of Staff Dr. Joey Tremblay MICs President of Medical Staff Suzanne Gadoury MICs Eecutive Assistant (Recording Secretary) Gail Waghorn MICs Chief Financial Officer / Eecutive Leader of Corporate Services Tamara Shewciw NE LHIN Chief Information Officer and ehealth Lead Christine Leclair NE LHIN Senior Hub Officer - Cochrane 1.0 Call to Order & Chairs Remarks (P. Dorff) 1.1 P. Dorff opened the meeting with a welcome and asked Board Members for declarations of conflict. No conflicts were declared. 2.0 Consent Agenda (P. Dorff) 2.1 Approval of the Consent Agenda (items 3 to 5) Seconded by: B. Dennis THAT the Consent Agenda be approved as presented. Page 1
3.0 MICs News (P. Dorff) November 2016 MICs News was provided for information. 4.0 MICs Medical Staff (P. Dorff) 5.0 Net Meeting Dates As per agenda. 6.0 Approval of the Regular Board Meeting Agenda (P. Dorff) The agenda was reviewed. Moved by: J. Edwards Seconded by: S. Giguère THAT the MICs Board of Directors approve the board agenda for the regular board meeting as presented. 7.0 Approval of Minutes (P. Dorff) 7.1 Minutes of the MICs Board of Directors meeting held October 26 th, 2016 were provided for information. Clarification on orders for bed rails and suspected abuse AGH CAC: changes were made as recommended by L.A. Boucher Moved by: P. Britton Seconded by: I. Clarke THAT the MICs Board of Directors approve the minutes of the meeting held October 26 th, 2016 as amended. 8.0 Follow-Up Items 8.1 Review of 2016-2017 Board Work Plan The Board Work Plan was reviewed. 9.0 MICs Finance 9.1 September 2016 Financial Statements G. Waghorn Chief Financial Officer gave a detailed overview of the financial statements for the three hospitals as well as the Long-Term Care Homes BMH: submitted a surplus of $132,073; as part of the hospital accountability agreement with the LHIN, we have to submit a positive operating margin BMH s Page 2
total operating margin is 3.59%; we had budgeted for convalescent care which we did not implement resulting in a larger surplus; some of our costs are down due to low activity; operating revenue was $40,175 over budget; operating epenses were $148,325 under budget; budget ependitures were $3.7 million; salaries were $113,895 under budget at end of 2nd quarter; nursing is $36,771 under budget; physiotherapy is $42,938 under budget; overtime costs were $53,739; total sick time costs were $51,990; orientation costs were $20,629; benefit costs were at 29.5% of salaries; other supplies and epenses were breakeven; drugs under budget by $36,155 / Balance sheet: current ratio of 10.34; mainly due to the money owed by the MICs partnership; some of the assets should be invested; will wait for the RFP to go out first / Hollis Wealth Investment Statement was for information only / Capital Budget Update: bulk of capital equipment has been ordered; majority of costs were for completion of projects such as nursing desk, ventilation and carry-over from a piece of equipment; capital items need to be submitted by the end of December AGH: submitted a deficit of $124,752; going through the 2017-2018 budget; planning to bring the hospital to a breakeven position; year to date budget was breakeven; forecast is projecting a hospital operating deficit of $147,116; operating revenue was $117,987 under budget; operating epenses were breakeven; budgeted ependitures were $4.54 million; salaries were $18,924 under budget; private physician clinics were $12,857 under budget; lab was $28,418 over budget; maintenance was $22,215 over budget; total overtime costs were $98,927; total sick time costs were $34,762; benefit costs were running at 31% of salaries; other supplies and epenses were over budget by $44,183; travel of locums unbudgeted $10,467; lab supplies over budget by $21,975; radiology supplies under budget by $35,475; material management under budget by $35,000; plant maintenance over budget by $75,000 / RBC Wealth Management investment statement was provided for information only; looking at consolidating all investments into one / Balance Sheet: current ratio of 2.03; AGH has a short term portfolio; current assets are in the negative; AGH owed to the partnership but has other assets; cash flow must be monitored / Capital Budget Update: $1,627,345 was approved; majority of items were for the boiler project, flooring and SCM; there is an individual who is working on ordering all the capital items for each hospital as of September SCM: operating at a $129,994 deficit; total revenue was $2,447,562; sick costs were provided; focussing on the redevelopment LMH: operating surplus of $174,991; total margin was 2.57% of revenue; year to date budget was breakeven; yearend forecast was a surplus of $228,036; operating revenue was over budget by $145,729 which includes bases increases; operating epenses were breakeven; budgeted ependitures were $6,76 million; salaries were under budget by $32,978; overtime costs were $187,761; total sick time costs were $95,271; benefit costs were running at 31% of salaries; other supplies and epenses were globally breakeven; lab supplies are under budget by $36,804; maintenance is $42,000 over budget; drugs were under budget by $88,000; medical surgical supplies over budget by $12,000; amortization of equipment was under budget by $56,000 / Balance Sheet: strong position; in a liability position to the partnership; current ratio of 1.71% / Capital Budget Update: two big ticket items were the boiler and Villa Minto epansion VM: received additional operating funds for the epansion; in breakeven position; historically, LMH has had to subsidize Villa Minto Page 3
Seconded by: J. Solomon THAT the MICs Board of Directors approve the September 2016 financial statements for Bingham Memorial Hospital, Anson General Hospital, South Centennial Manor, Lady Minto Hospital and Villa Minto as presented. 10.0 Trustee Education/Presentations 10.1 NELHIN HIS Roadmap presentation T. Shewciw Paul introduced Tamara Shewciw and Christine Leclair Tamara gave a few eamples of patients presenting to ER and how the lack of Electronic Medical Records impacts the patients care Hospital Information System (HIS) is a computer system that can manage all the information to allow health care providers to do their jobs effectively HIS allows hospitals to manage the data related to the clinical, financial, laboratory, nursing, ER, admitting, pharmacy, radiology, pathology departments, etc. HIS allows hospitals to improve patient eperience and safety; share medical information between providers and locations to enhance clinical input to patient care; improve patient medication management and reduce errors; provide standardized and best practice approach to care Population health is about 25 hospitals on one HIS where data will be pulled to reduce epenses and better manage chronic disease, high need populations and high users The MOHLTC reviewed the different systems across the province and standardized the EMR systems into HIS NEON group is currently providing IT services to hospitals but it s time to evolve Creation of a regional NE Meditech v6.1 master site; dedicated, technology business entity focused on the delivery of HIS services with HIS being initial offering (HIS Hub); creation of a regional ehealth platform (HIS cluster) Implementation of Meditech v6.1 will be phased in based on hospital size and readiness to move forward Hospitals should not be in the IT business; the northeast hospitals will have an entity that provides IT service Once achieved, we will be perfectly aligned with the MOH HIS Hub recommendations NE LHIN is asking the board to commit to work in good faith to implement the NE LHIN Roadmap in accordance with the objectives set out The epectation is that all hospitals will work collaboratively on the implementation of the NE HIS Roadmap and not proceed unilaterally on other hospital information systems 11.0 Presentations/Reports (P. Dorff) 11.1 Chief Eecutive Officer Report: (P. Chatelain) Page 4
The report was provided for information. CEO provided the following overview: Hoping to have the RFP for South Centennial Manor done by December 2016 The roof repair is ongoing and should be completed by March 2017 Some issues with the oil tanks; might have to go with a different firm BMH parking lot repairs are complete Hospice bed project is moving forward; should be complete by February 2017 The community engagement session is scheduled for Nov. 30 th at the IFSS auditorium at 7:00 pm The board retreat is scheduled for Dec. 10 th at the Abitibi Golf Club from 9:00 am to 3:00 pm Paul attended the Northern Supply Chain media event in Sault Ste. Marie hospital on November 17 th ; he is the Vice-Chair of the committee Board members were invited to participate in the long-term service awards at all three sites; dates were provided Board Members were invited to ask questions. Discussed achieved savings with the Northern Supply Chain; should be realized within the net few months 11.2 Chief Nursing Officer Report: (K. Hill) The CNO provided a report on the following items: Virtual Critical Care: utilization for Q2 has been low Quality Based Procedures: low volumes for new quarterly wait time indicators Patient Order Sets/Nursing Order Sets: breakdown of utilization across three sites; increased uptake in this area Senior Friendly Hospital: data provided for Confusion Assessment Method (CAM) screening Medication Reconciliation on Discharge: ecellent compliance with this LTC Medical Pharmacies: compliance numbers were provided; they visit every site every quarter and provide audits; we used to do very poorly in this area previously Board Members were invited to ask questions. 11.3 Chief of Staff Report: (Dr. Chiang) The Chief of Staff provided a report on the following items: CPSO held a conference for Chiefs of Staff and Presidents of Medical Staff: Dr. Chiang attended this; he requested the presenter to present to all MICs physicians; there is a concern regarding the over prescribing of opioids; this will be dealt with Update on Medical Assistance in Dying policy: MICs physicians will work on developing a MAID policy Update on Bill 41 (formerly Bill 210): OMA is opposed to this bill; a petition to stop the bill was sent to the MPPs by a group called Concerned Ontario Doctors Update on the ongoing negotiations between the OMA and the MOHLTC: no progress Update on the Chief Coroner s request: starting mortality and morbidity rounds net week led by Dr. Tempier, psychiatrist; emergency services from NEOFACs will be discussed 11.4 OHA Health Achieve Conference Summaries P. Dorff P. Dorff and I. Clarke who both attended this year s OHA Health Achieve conference Page 5
in Toronto provided a brief summary of the sessions they attended They both agree that it was an ecellent conference There was a definite focus on mental health Patients presenting to ER should be asked how they are coping 12.0 LHIN / MOHLTC Business 13.0 MICs Quality Committee Karen provided an update on the QIP for the second quarter EA will forward to the board Total ALC patient days; monitoring zone; BMH is less than 35%, AGH has 53%, LMH has 50% - Average for MICs is 40% putting us in the red Total Margin no data available Medication Reconciliation on Discharge: in the green Hand hygiene: LMH and BMH are in the red; AGH is in the green; MICs in red LTC: no data from CIHI until December 14.0 Site Business (P. Dorff) 14.1 Anson General Hospital: 14.2 Bingham Memorial Hospital: 14.3 Lady Minto Hospital: 15.0 Partnership Business (P. Dorff) 15.1 October 2016 Board Effectiveness Survey Results 11 out of 14 surveys were submitted. If a board member is dissatisfied with the individual chairing the meeting, he/she should advise the chair on how he/she could do better Forward an email or letter through Paul in order to remain anonymous 15.2 November Board Effectiveness Survey The survey was emailed via Survey Monkey. 15.3 Resolution to Implement the NE LHIN HIS Roadmap The NE LHIN is asking our hospital board to endorse a HIS partnership with a cluster/hub model with other northeast hospitals which would ensure that every Northerner has electronic access to their health information in one patient record Board members discussed the request; as much as it s a great idea, there are concerns over the lack of information and possible costs Seconded by: I. Clarke Page 6
THAT the MICs Board of Directors hereby commits to participate in good faith in the implementation of the NE LHIN HIS Roadmap in accordance with the guiding principles as presented. Carried unanimously 15.4 Medical Assistance in Dying Policy The policy was reviewed and revised by the MICs Board Governance Committee This policy is an overarching board policy and will be followed by a medical policy to be developed by the Medical Advisory Committee The committee is recommending that the policy be approved by the Board of Directors including the request form as an attachment Moved by: L. Boucher Seconded by: J. Solomon THAT the MICs Board of Directors approve the MAID policy as amended. 15.5 Letter from the SCM Family Council The letter was provided for information only. The letter was written by the SCM Family Council thanking the staff of South Centennial Manor for the Palliative Care Room and for the special care given to the residents in palliative care. 16.0 General Information / Questions (P. Dorff) 17.0 Net Meeting Date (P. Dorff) Wednesday, January 27 th, 2017 at 6:00 p.m. (BMH Lead Site) 18.0 Generative Thinking (P. Dorff) 19.0 In Camera 19.1 Motion to go in camera Seconded by: S. Giguère 19.3 Motion to go out of in camera Moved by: J. Edwards Seconded by: J. Solomon 20.0 Approval of Physician Hospital Privileges The directors held an in camera session. Following the session, the chair advised that the MICs Board of Directors reviewed three applications for hospital privileges and UPON MOTION duly proposed, seconded and carried unanimously, it was RESOLVED that: Page 7
Dr. Raymond Tempier s hospital privileges as a consulting physician in psychiatry be approved based on the recommendation of the MICs Medical Advisory Committee. Moved by: B. Dennis Seconded by: J. Edwards Dr. Chad Workman s hospital privileges in the locum tenens category be approved based on the recommendation of the MICs Medical Advisory Committee. Moved by: L. Boucher Seconded by: I. Clarke Dr. Theodore Small s hospital privileges as an active physician for Lady Minto Hospital be approved based on the recommendation of the MICs Medical Advisory Committee. Seconded by: J. Solomon 20.0 Adjournment (P. Dorff) There being no further business, the meeting adjourned at 8:12 p.m. CHAIR, Bingham Memorial Hospital CHAIR, Anson General Hospital CHAIR, Lady Minto Hospital SECRETARY, MICs C.E.O. Page 8