Healthcare Focus

Strategic Plan

Physicians at MHA

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Connecting with the Future of Care

REPORT TO THE COMMUNITY 2010

Healthcare Mission, Vision and Principles renewed at the MHA

Our Vision

l Alliance ex Hospita The Middles st place for be e th be ll wi oviding red care; pr patient-cent quality, people, in e nc lle ce ex financial service and r patients, ce.

Safety for ouitors performan staff and vis in our Excellence ce performan r everyone Respect fo all the time that we do Value in all as our Enthusiasm way of life

S E R V E

Our Mission are the healthc To provide our expect for we would s. ilie own fam

Delivering moms and their families appreciate the special care they receive in a healthcare setting close to home, where low volumes can allow for an excellent nursing care/patient ratio. A significant percentage of delivering moms at SMGH are returning moms, which indicates a high level of patient satisfaction. Dr. Philip Vandewalle, a family physician in Strathroy who delivers babies, says, “Moms often remark on the friendly and available nursing care during and after delivery, one mom said it was the next best thing to being at home.”

Read the full story on page 6

Read the full story on page 10

What’s Inside

One South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

FCHS & SMGH Foundations “Play Together” . . . . . . . . 8

Message from the Chair of the Board . . . . . . . . . . . 3

SMGH Foundation - Together We WILL . . . . . . . . . . 9

Message from the CEO . . . . . . . . . . . . . . . . . . . . . 4

Volunteer Appreciation Evenings . . . . . . . . . . . . . . 9

Healthcare the Dutch Way . . . . . . . . . . . . . . . . . . 5

Mission, Vision and Principles renewed at MHA . . . . 10

SMGH ED Gets Lean . . . . . . . . . . . . . . . . . . . . . . . 5

Mental Health Providers Meet to Network . . . . . . . 11

Special Delivery – Obstetrics at SMGH . . . . . . . . . . . 6

Respirology Clinic . . . . . . . . . . . . . . . . . . . . . . . 11

New Surgeon at Strathroy . . . . . . . . . . . . . . . . . . . 7

Diabetes Education Centre Coordinator Awarded . . 12

New Faces at FCHS Foundation . . . . . . . . . . . . . . . 8

Strathroy Hospital at the Museum . . . . . . . . . . . . 12

Auxiliary Opens Java Hut at Strathroy Hospital . . . . . . 8

Emergency Prep . . . . . . . . . . . . . . . . . . . . . . . . 13

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One South

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HE COMPLETION OF A LONG-AWAITED NEW COMMUNICATION STATION ON ONE SOUTH PRODUCED AN EXCELLENT OUTCOME, Paul Long, CFO at MHA, says. The previous station was too small, it lacked necessary privacy and there were other issues with computerization, process flow and lighting, for instance.

The 2-phase project over three years was paid for largely by the province’s Health Infrastructure Renewal Fund (HIRF) – money that is specifically for this type of upgrade and cannot be spent on staffing or supplies. “The projects must meet certain criteria and are approved by the SW LHIN,” Long says. Additionally, a bequest of $10,000 that was ear-marked for One South

capital improvements (in a project selected

by Dr. Fournier) was also applied to this project.

The MHA has received from $125,000 to almost $200,000 each year, over the last four years for infrastructure projects. Other projects have included roof restoration, building security and brick pointing.

“The One South communication centre looks great, staff and physicians seem satisfied and we enjoyed excellent cooperation from everyone involved during construction,” Long says, “And, we have received $125,000 HIRF funding for 2009-10 for a similar project: Phase 1 of the Two South Communication Centre.”

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Message from Ralph Coe, chair of the MHA board of directors

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OUNTRY LIVING HAS MANY SPECIAL QUALITIES AND PRIVILEGES that urban dwellers just don’t enjoy. But we also know that rural healthcare is not the same. The MHA’s catchment area is largely rural and like our colleagues at small northern hospitals we experience different challenges, such as doctor recruitment, weather, distance, technology. Lynda Robinson, site director at the Four Counties Health Services, last August made a presentation to the Association of Municipalities of Ontario on rural health. She drew the group’s attention to the “inverse law:” rural communities have poorer healthcare status and greater need for primary healthcare, yet they are not as well served and have more difficulty accessing healthcare services than people in urban centres.

From her presentation, here are some of the unique characteristics of rural health:

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Fewer health-seeking behaviours Increased incidence of smoking

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Increased incidence of obesity

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Higher incidence of chronic diseases

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Higher overall mortality rates

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Less access to core & advanced healthcare services

The Ministry of Health and Long-Term Care last year established a Northern and Rural Panel to develop a province-wide policy for delivering health services in rural and remote communities. According to the Ministry, the Panel will examine the existing programs and the supports that are already in place and the services targeted to northern and rural Ontario.

The Ministry expressed a commitment to providing a framework to support northern and rural communities.

The establishment of this Panel is excellent news because rural healthcare delivery is unique, it requires a rural approach. Hospitals especially have a unique role in rural communities, providing care far beyond four walls and a bed.

Small/Rural/Northern hospitals are essential healthcare partners in our system, they are frequently the ‘hub’ for community healthcare and even an economic driver for the community – creating employment themselves and often serving as an anchor to the economic well-being of a community.

Indeed, the old measure of judging a hospital’s importance by its number of beds is an increasingly false standard. Everywhere hospital patient volumes are dropping, systems have changed and we are developing more innovative outpatient strategies.

Creating an integrated system of care in rural Ontario is important for our whole province’s economy of healthcare. If not, patients may simply be pushed along to larger urban centres, a practice that will cost the government – and all of us – more.

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A Message from Michael A. Mazza, Chief Executive Officer, MHA

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VER THE PAST SEVERAL YEARS THE MHA HAS RECOGNIZED THE IMPORTANCE – THE NECESSITY – OF BEING “CONNECTED.” The concept is in our tagline, “connecting with the future of care,” and we have invested in technology and partnered with larger regional organizations (the Thames Valley Health Partnership, TeleHealth Ontario) to ensure that we are connected to medical resources beyond our own two sites. In this way we are able to access, for example, off-site radiologists to read CT scans and off-site psychiatrists for videoconference patient consultations.

However, we also recognize the value of communicating internally. One of the most active communications links at the MHA these days is our growing Intranet. Last summer, the IT department at the MHA held a “Name our Intranet” contest. The winning name: The MHA Insider!

An Intranet is an internal website. It works as a website that is built by and for a defined group, in this instance, the staff, physicians and board members of the MHA. The MHA Insider is available to all staff when at work and can be

logged onto from outside the hospitals by board members and off-site staff, for example, working from home.

Many who work at the MHA start their day logging onto the Insider to check email, look at the cafeteria menu, check for updates on team or department “web pages” and even look to the calendar and events page for news and activities available to staff. It’s a bit like a digital bulletin board.

In the world of communication technology an Intranet is a “pull” rather than a “push.” This means people come to it for information and news rather than having it pushed to them, for example via email. Documents don’t need to be attached and emailed back and forth between departments. Instead they can be “posted” to the Insider for the appropriate department members to view or for the group to work on. In some ways, the Intranet is like an interactive, wellindexed filing cabinet.

But we haven’t ignored updates to our external MHA website. Since its redesign in 2006, we continue to expand it, recognizing its importance in helping us connect with community stakeholders.

This Community Report, for instance, is available on the MHA website – saving money and trees. And, this year we open a new “portal” on the MHA website – Health Info Online – an online library of healthcare information. Here you can view hundreds of digital entries on everything from rabies to dressing wounds and baby care, all from trusted healthcare sources.

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Healthcare Success – the Dutch Way!

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HE ANNUAL GENERAL MEETING OF THE MIDDLESEX HOSPITAL ALLIANCE (MHA) – and its foundations – was held at Trillium Village Auditorium on Tuesday June 9, 2009 and featured guest speaker Paul Thewissen, Counselor for Health, Welfare & Sports, Royal Netherlands Embassy, Washington, DC, speaking on Healthcare Success – the Dutch Way! Prior to his assignment in Washington, Mr. Thewissen worked for the Ministry of Health, Welfare and Sport on the reform of the Dutch healthcare system. “In the Netherlands, all citizens are covered regardless of socio-economic status.

Insurance companies are obliged to provide universal coverage for everyone,” Thewissen said.

Ralph Coe, a well-known community leader and member of the MHA board of directors, is now the new chair, replacing Ineke Haan. Ralph is the

General Manager/Secretary-Treasurer for the St. Clair Region Conservation Authority and the Executive Director of its foundation. He is past chair of the Strathroy Chamber of Commerce and Middlesex Community Living and is the recipient of the Governor General Canada Award, Canada 125 Medal.

MHA AGM

SMGH ED Gets Lean

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HIS SPRING, THE EMERGENCY DEPARTMENT (ED) AT STRATHROY MIDDLESEX GENERAL HOSPITAL (SMGH) IS APPLYING A STRATEGY TO IMPROVE DELIVERY OF VALUE TO PATIENTS. If the expected results are achieved it will be a key strategy for all of the MHA in the near future.

The “Lean” strategy is named so because it is designed to do more with less: less human effort, less cost, less time to achieve what the patient wants. “Although our ED wait time targets are being met, we can improve the patient experience and working environment. This will aid us in recruiting and retaining ED nurses and physicians,” Dr. Julie Copeland, head of ED Services at SMGH, says.

Lean respects the contributions of front-line staff, involving them in problem solving, improving flow and identifying waste. The strategy was derived largely from the manufacturing sector.

“The Lean strategy supports our new mission, vision and guiding principles,” Mike Mazza, CEO at the MHA, says. “Its focus is on quality of care and we expect that improvements in patient satisfaction, efficiency, waste reduction and wait times will also result from this ‘pilot’ strategy. Then, we can look at using the Lean strategy in other MHA departments.”

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Special Delivery – Obstetrics at SMGH

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BSTETRICS SERVICES WILL CONTINUE AT STRATHROY MIDDLESEX GENERAL HOSPITAL (SMGH) AND ARE BEING ENHANCED. Last April the board approved the continuation of OB as it is reconfigured in the

SMGH Transformation Plan – an initiative that last year eliminated the SMGH operating deficit.

The SMGH staff, physicians and administration worked together to deliver on this Plan – and in doing so, saved OB from closing, Mike Mazza, MHA CEO, says. “The staff were the drivers on this,” he said, “The staff said ‘We can do this’.”

Closure of the obstetrics department was proposed by an external review as a way to eliminate the final $500,000 of operating deficit. Instead, consolidating the fourth and second floors saved this same amount. “The Transformation Plan reorganizes physical space in the hospital; we save money, we increase

efficiencies and we continue to provide OB,” Mazza says.

The family-centred obstetrics program at SMGH is enhancing services with two physicians augmenting the services offered (see caption).

Additionally, personal support from staff, along with options for pain and comfort management during the progression of labour make the experience for expectant mothers, their partners and families, the best it can be. “Our qualified nursing staff is ready to provide a high standard of care and personal support,” Mary Robertson, Patient Services Project Lead at SMGH, says, “And epidural pain management is available 24 /7 as are other options.”

Low-risk expectant mothers are followed throughout their pregnancy in the Family Practice Obstetrics Clinic and Planning for Baby Clinic.

Dr. Sara Puente, Family Physician OB joins the SMGH Family Practice team monitoring prenatal patients at the Baby Clinic and in ambulatory care, and participating in OB on-call coverage for deliveries. Dr. Rob DiCecco is expanding his current consultative role to provide monthly weekend emergency C-section coverage and outpatient care, including colposcopy. In addition, he is now accepting obstetrics and gynecological surgical consults from family physicians through the SMGH Ambulatory Care Clinic.

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New Surgeon at Strathroy

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R. VAISHNAV RAJGOPAL WAS WELCOMED AS THE NEWEST ADDITION TO SUCCESSFUL HIP & KNEE JOINT REPLACEMENT PROGRAM team at the MHA, last fall. Dr. Rajgopal is an orthopaedic surgeon and graduate of the University of Western Ontario where he received his medical degree and recently completed a fellowship in adult reconstructive joint surgery.

The MHA Hip & Knee Program has received much praise from peers and patients since it started in 2006. It has been commended for excellent wait times, compared with both the provincial averages and targets, and it has been praised for patient satisfaction.

The success of the MHA Hip & Knee Program relies on a team approach including the MHA physiotherapy and nursing staff and external partners such as CCAC who assist patients preand post-operatively. Dr. Paul Ferner, chief of staff at SMGH, says, “The program continues to thrive at the MHA.” Mike Mazza, MHA CEO, says, “A community hospital such as Strathroy has the capacity to provide just this sort of program successfully and efficiently.

Patients can be referred for Total Joint Replacement surgery here – close to home – instead of having to travel to more distant hospitals.”

The successful Hip & Knee Joint Replacement Program at Strathroy hospital welcomed the newest addition to the team, Dr. Vaishnav Rajgopal, orthopaedic surgeon. If the name sounds familiar, Vai’s father, Dr. C. Rajgopal, is a well-known surgeon in London Ontario, where Vai grew up.

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New Faces at Four Counties Health Services (FCHS) Foundation

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HE FOUR COUNTIES HEALTH SERVICES (FCHS) FOUNDATION BOARD LAST YEAR INTRODUCED DEBBIE MUNN, who accepted the role of Fundraising Developer for the Foundation.

“It is very important for us to raise awareness of the growing need for ongoing support within the community,” Marigay Wilkins, FCHS Foundation board chair, says, “We are confident that Debbie can assist us in this important role.”

Born and raised in Glencoe, presently living in Rodney, Debbie was a Registered Practical Nurse at FCHS for 30 years.

Joining Debbie in the Foundation office this year as administrative assistant is Martha Wortner. Martha grew up in Bothwell and moved to Australia in 1979.

There she worked as an accountant for the same firm for 22 years and volunteered for 30 years in

Auxiliary Opens Java Hut at Strathroy Hospital

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HE GRAND OPENING OF THE JAVA HUT COFFEE KIOSK AT STRATHROY HOSPITAL LAST JULY INCLUDED FREE COFFEE SAMPLES AND FREE PARKING. The Java Hut is a project of the SMGH Auxiliary which raises money to support the hospital. Other Auxiliary projects include operating the Gift Shop, an annual Tag Day in May, bake sales and raffles.

The new Java Hut has already raised $18,500 for the hospital and is an important part of the Auxiliary’s future fundraising efforts. Last year they made a $1 million pledge to support the hospital, and raised money to purchase a blood analyzer unit for the lab that cost $70,000.

Funding to build the Java Hut was made possible through a generous donation from David and Linda Powell.

the administration of Australian Surf Life Saving, a charitable organization. She returned to the Bothwell area in 2009 where her family still resides.

Debbie Munn says, “We are very pleased that Martha is joining us at the FCHS Foundation. Her familiarity with the area, with accounting and with charitable organizations will be a great benefit.”

With Martha’s help, Debbie will be organizing many programs including annual campaigns, monthly giving and major gifts and she will also be available to speak with those wishing to provide a Legacy Gift in their wills.

You can reach Debbie or Martha at 519-693-4441 Ext 2501. Or visit the new FCHS Foundation website at www.fchsfoundation.ca

The FCHS Foundation and the SMGH Foundation join together to Play Together!

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HE SMGH AND FCHS FOUNDATIONS TOGETHER HAVE LAUNCHED AN EXCITING CONTEST that offers a chance to win $10,000 cash and other prizes – and it’s free to play!

Local businesses purchase ads on a game board that is offered free to customers. The game requires players to solve a puzzle to win prizes. Money raised through the contest will go toward the purchase of new anesthetic machines to support surgical services at SMGH (cost of $300,000) and a new colonoscope (cost $40,000).

“This is a fun way for people to get involved in local healthcare needs,” Sue McLean, CEO of the SMGH Foundation, says.

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2009 marked the 20th anniversary for the SMGH Foundation’s support of Strathroy hospital.

With gifts from donors – including many staff and physicians – SMGH Foundation has been able to transfer more than $19 million in that time, to aid the hospital in purchasing new or replacement equipment and for infrastructure expansion.

Thanks to donors, SMGH has recently purchased a new blood analyzer unit for the lab, patient care furniture, wheelchairs, and more. Last year fundraising began for new anaesthesia equipment for hospital operating rooms through the Foundation’s new ‘Together, We Will’ initiative.

Strathroy Middlesex General Hospital

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“The success of the Foundation is all due to the residents, businesses and organizations in the region and the strong support from staff at the hospital,” Susan McLean, CEO, says.

“What hasn’t changed in 20 years is the compassionate care and the generosity of this community,” McLean says. The SMGH Foundation board of directors is deeply grateful for the generous support over the past 20 years. Thank you.

395 Carrie Street, Strathroy, ON N7G 3J4 519-246-5906 info@smghfoundation.com www.smghfoundation.com

Volunteer Appreciation Evenings

The annual Volunteer Appreciation evening was held at SMGH cafeteria on April 22, 2009 with 60 volunteers and eight staff attending. Five year certificates were given to Joyce and Charlie Seed and Elaine Marshall; ten year certificates to Betty Bolton, Nan Smith, Bette Woods and Jane Visser. Special awards went to Adriana Kanters and Anne VanBavel for 30 years service; and to student volunteer Kristina Maxmute for three years (300 hours) of service.

The dietary staff prepared a delicious meal and entertainment was provided by Cathy Verkley (SMGH outpatient dietitian), her husband Tom, Bernie Gilmore and John Thuss. Tom and Cathy have sung together for 21 years and the group plays a variety of instruments including guitar, banjo, washtub drum and harmonica.

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Four Counties Health Services

The annual FCHS Volunteer Appreciation evening was held at the FCHS auditorium on Thursday evening April 23, 2009 with 42 volunteers and nine staff attending.

Following a delicious meal prepared by the dietary staff, Judy McIntyre brought greetings from the MHA board of directors and Lynda Robinson and Paul Long brought greetings from the MHA Senior Administration.

Entertainment for the evening was provided

by Carrie Howard and Darryl VanOirschot. Carrie and Darryl both grew up in Rodney and have sung together for several years. Carrie works as a Registered Nurse and Darryl recently worked with Carnival Cruise Lines.

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Mission, Vision and Principles renewed at MHA

A Strategic Plan for the Middlesex Hospital Alliance, in the works from fall, 2009 is now approved by the board of directors.

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HE PROCESS STARTED WITH KEY STAKEHOLDERS who were engaged in a process to update and combine mission and vision statements and guiding principles from FCHS and SMGH. The result for the new MHA mission statement is: To provide the healthcare that we would expect for our own families.

“The mission statement in particular captures the essence of what stakeholders and board had intended. It is short, concise and powerful,” Ineke Haan, governance committee chair with the MHA board of directors, says.

Board member Ken Williams says he shared the new MHA mission statement with some of his healthcare clients in the United States. “The reaction was very positive. They were impressed with both its strength and simplicity,” Williams says.

The mission statement, the vision statement and guiding principles all form the basis for the new Strategic Plan which covers a 2-year period starting April 1, 2010. The Strategic Plan identifies and outlines the goals, core services, centres of achievement and objectives for the MHA during that time period.

The Strategic Plan emphasizes safety, excellence, fiscal responsibility and team collaboration among the MHA’s partners – including board, volunteers, staff, physicians, nurses and senior administration.

According to the Strategic

Plan, core services for the MHA include general surgery services, diagnostic and rehab services, community-level obstetrics and two 24/7 Emergency Departments (EDs), one at SMGH and a smaller rural ED at FCHS. Additionally, the Plan identifies two “centres of achievement” – orthopaedics and Diabetes Education Centre – and two potential centres of achievement; diagnostic imaging and obstetrics.

The objectives in the Strategic Plan state that after core services, new centres of achievement will receive investment if funds are available and the investment is supported by a business plan showing community focus and fiscal sustainability. Centres of achievement may be located at only one of the two sites to ensure clinical efficiency and efficacy.

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Mental Health Providers Meet to Network

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OUR COUNTIES HEALTH SERVICES

(FCHS) WAS THE SITE FOR A FIRST EVER NETWORKING MEETING FOR LOCAL MENTAL HEALTHCARE PROVIDERS LAST APRIL, 2009.

“We are now using Telehealth technology at Four Counties and we wanted an opportunity to introduce that and talk with our peers about ways we can work together in providing mental healthcare services in this area,” Lynda Robinson, FCHS Site Director, says.

FCHS serves a catchment area comprising the counties of Elgin, Kent, Lambton and Middlesex and within each county are many healthcare providers and organizations. “Our networking meeting was an opportunity for all of us to come together and learn what services each organization provides,” Robinson says.

FCHS started providing Telemental Healthcare in November, 2008. Through using this technology,

a patient can access off-site services, including psychiatric counselling, via the two-way videoconferencing system. We now have two Telehealth consulting rooms and a second ‘I-doc’ with additional capabilities that allows not only two-way videoconferencing but also has telediagnostic instruments for monitoring blood pressure and heart rate, for instance, and which will be useful for other types of Telehealth consults,” Robinson says.

Respirology Clinic A benefit to those living with chronic lung disease

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R. GUATAM SOPARKAR WAS WELCOMED TO MHA IN 2009 WHEN HE BEGAN FCHS’S NEWEST SERVICE – A RESPIROLOGY CLINIC. Dr. Soparker is an internist and respirologist currently practicing in Sarnia. He has previously served as a program director for internal medicine residents and an examiner for the Medical Council of Canada and the Royal College of Physicians and Surgeons of Canada. He is an adjunct professor at the Schulich School of Medicine, University of Western Ontario.

The Respirology Clinic uses a shared-care model, similar to the Telepsychiatry Program at FCHS, with a Nurse Practitioner (NP) providing a pre-consultation assessment, spirometry and patient education, says Lesa Marsh, NP. “The Respiratory Clinic/ rehabilitation program can stabilize or enhance the functional status and the quality of life for patients

living with chronic lung disease,” she says.

The clinic provides comprehensive assessment, treatment, patient education and improved coping skills for people living with chronic lung disease.

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MHA Diabetes Education Centre Coordinator Receives Award

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l-r -Jammie Bowman MHA DEC administrative assistant; Melissa Ferreira MSc, Registered Dietitian, SMGH; Alison Lenny, MHA DEC coordinator; Yvonne Macrae Registered Dietitian, CDE, FCHS.

LISON LENNY, THE COORDINATOR OF THE MHA DIABETES EDUCATION CENTRE (DEC), was the recipient of the 2009 Outstanding Health Professional Award from the Canadian Diabetes Association. “I was honoured to be nominated by my team. The award recognizes our

program’s approach to improve access to diabetes education using a rural approach and targeting high risk groups such as Aboriginals. It is made possible with the expertise and commitment of our team, and support from our senior administration and our community partners,” Lenny says.

A Diabetes Awareness Brunch in November, 2009 was hosted by the FCHS Diabetes Education Centre (DEC) team in partnership with the Canadian Diabetes Association. DEC staff and volunteers served a healthy brunch to 65 local clients who also participated in a game, “Who Wants to be a Diabetes Millionaire” led by

Yvonne Macrae, RD. Generous sponsorship for the event was provided through the local Lions club, Foodland and No Frills and Chef Barbara Toomer (Strathroy Superstore) donated her time to prepare the delicious meal.

Strathroy Hospital at the Museum

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USEUM STRATHROY-CARADOC EXPLORED HEALTHCARE CLOSE TO HOME LAST SUMMER with the exhibit, A Legacy of Care: Strathroy Middlesex General Hospital. The exhibit profiled early homemade remedies, the first doctors in the area and the establishment of the Strathroy hospital.

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SMGH invited the Strathroy Volunteer Fire Department to the hospital to learn how to use the Evacu-sled Emergency Evacuation Device.

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These devices are currently found on all of Two South and some One South beds. The Evacu-sled is designed specifically for the quick and safe removal of patients over various flooring surfaces or stairs. The device is useful when patients need to be evacuated to another floor or even from the building.

Emergency Prep

Visit the MHA website, your doorway to healthcare information and services in our community. Find out about seniors’ programs, heart health classes, diabetes education and more.

Andrew King and Ryan Whitney participated in the Emergency Response Day in Strathroy on May 7, 2009 on behalf of the MHA. Approximately 2000 people went through the arena and saw the MHA display which featured the CBRN tent.

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Published by the Middlesex Hospital Alliance to provide information to the community it serves.

Contact us at:

Four Counties Health Services

Strathroy Middlesex General Hospital

1824 Concession Drive RR3, Newbury, ON N0L 1Z0

395 Carrie Street Strathroy, ON N7G 3J4

Tel: 519-693-4441

Tel: 519-245-1550