ANNUAL REPORT 2010-2011
Creating a healthier world
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VISION, MISSION AND VALUE S
OUR VALUE S Our Values represent the philosophy and beliefs of our organization, guiding all of our decisions and actions.
Human Dignity We value each person as a unique individual with a right to be respected and accepted.
Excellence We value quality in care, work life, education and research.
Compassion
Creating a healthier world, through our culture of caring and discovery
We value a quality of presence and caring that accepts people as they are and fosters healing and wholeness.
FROM OUR MISSION STATEMENT
Social Responsibility
OUR VISION
At St. Michael’s we recognize the value of every person and are guided by our commitment to excellence and leadership. • We provide exemplary physical, emotional and spiritual care for each of our patients and their families • We balance the continued commitment to the care of the poor and those most in need with the provision of highly specialized services to a broader community • We build a work environment where each person is valued, respected and has an opportunity for personal and professional growth • We advance excellence in health services education • We foster a culture of discovery in all of our activities and support exemplary health sciences research • We strengthen our relationships with universities, colleges, other hospitals, agencies and our community • We demonstrate social responsibility through the just use of our resources The commitment to this mission from our staff, physicians, volunteers, students, community partners and friends inspires us to maintain a quality of presence and tradition of caring, the hallmarks of St. Michael’s.
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We value integrity and the promotion of the just use of resources entrusted to us for the enhancement of human life.
Community of Service We value a work climate of mutual trust and harmony to enable healing, collaboration and the fulfillment of human potential.
Pride of Achievement We value our colleagues, our work and our accomplishments and take pride in bringing our rich tradition of hope and healing to every person in our care
ME SSAGE FROM THE CHAIR, BOARD OF DIREC TORS AND THE PRE SIDENT AND CEO
A message to our partners and community This year will be long remembered as the year when the Li Ka Shing Knowledge Institute opened. Within the spectacular walls of this brand new building, the Keenan Research Centre houses our research infrastructure and wet labs for those engaged in basic science and the Li Ka Shing International Healthcare Education Centre provides space for students, a refreshed health sciences library and staff and physician learning and teaching. Our vision for the Li Ka Shing Knowledge Institute is “To be a world leader in the ethical generation and use of knowledge, to benefit the patients and surrounding community of St. Michael’s and people throughout the world.” Of great symbolic importance, given that vision, a bridge now joins the Li Ka Shing Knowledge Institute to the hospital visually linking research and education to patient care. As with all major projects, the iconic building would not have been possible without partnerships – with different levels of government, the University of Toronto and other academic and research organizations, our community partners, and our Foundation, and through it, the many donors who have supported our vision. We would like to thank everyone for the dedication shown. We also refreshed our strategic plan, having completed the previous plan’s key objectives a year early. The new plan elevates quality to a corporate principle to ensure we build quality improvement into everything we do. We are very impressed by the palpable energy shown by staff and physicians as they constantly work to enhance patient care. In today’s health care world, partnerships are becoming even more integral to success. At St. Michael’s, we
continue to work closely with a number of organizations, particularly Bridgepoint Health, Providence Healthcare, Casey House, Toronto Central Community Care Access Centre (CCAC) and the community organizations that serve patients and families before they arrive at St. Michael’s and after they leave. We are also a member of the Catholic Health Corporation of Ontario. With government, we hosted the Honourable Dalton McGuinty, Premier of Ontario, at the opening of our fifth Family Health Team clinic at 80 Bond Street. We also saw the enactment of several new pieces of legislation – notably, the Excellent Care for All Act and the Broader Public Sector Accountability Act – that guide our operations, particularly concerning the quality of patient care and the transparency of financial processes. In closing, we would like to thank the many volunteers, staff and physicians who make St. Michael’s a wonderful place. We would like to acknowledge the dedication and hard work of the Board members of both the hospital and the Foundation. We expect the next few years to be challenging as the province struggles with the ongoing fiscal impact of economic turmoil. However, we are proud that St. Michael’s is well-positioned to meet these challenges and continue to pursue its vision.
Robert Howard, MD President & CEO, St. Michael’s Hospital
Bill Morneau Chair, Board of Directors, St. Michael’s Hospital ANNUAL REPORT 2010-2011 | 3
PATIENT C ARE
Providing high quality care to the disadvantaged, critically ill and those with complex diseases Since its founding in 1892, St. Michael’s mission has always been to provide the best possible care to the inner city community that surrounds the hospital. Today the hospital’s catchment area includes some of the wealthiest people in the city and young urban professionals moving into condominium projects, but it continues to serve the disadvantaged – people with severe and persistent mental illnesses, the elderly, women and children at risk, and the homeless. St.Michael’s is the downtown Toronto trauma centre. This means the most severely injured patients arrive at any time and are treated by a team of highly-specialized health professionals with immediate access to dedicated trauma intensive care beds. In addition, St. Michael’s has developed special expertise in the treatment of several complex diseases including multiple sclerosis, cystic fibrosis, diabetes, hemophilia and obesity, and is a provincial resource providing cardiac, vascular and neurosurgery services. The hospital does not stop its interaction with patients when they leave the building. Rather, it undertakes community outreach to prevent hospital stays and
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provide follow-up after discharge. St. Michael’s operates Family Health Team clinics with five practice sites so that residents in the community have better access to primary care. The organization provides health services in local shelters for the homeless, children’s health outreach in Regent Park, a mobile crisis centre for the mentally ill partnering with the police and many other programs. St. Michael’s continues its commitment to improve the quality of its patient care. The hospital embarked on projects to improve both the flow of patients in and out of the hospital to reduce wait times as well as to enhance the quality of care during hospital stays. Nursing staff are in the midst of a three-year process to become a Best Practice Spotlight Organization with the Registered Nurses’ Association of Ontario. The process includes demonstrating the use of 17 best practice guidelines to continuously enhance and sustain excellence in nursing practice, education and research.
HOSPITAL FACTS • Total revenues for 2010-11: $611.558 million • 460 acute adult inpatient beds • 64,263 emergency visits annually
Thanks to the efforts of the Foundation, $6.3 million was raised to renovate the Women’s Health Centre and the lobby at 61 Queen Street East.
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RE SEARCH AND INNOVATION
Discovery that impacts on patient care As part of the Keenan Research Centre in the Li Ka Shing Knowledge Institute, close to 200 researchers work in sophisticated laboratories settings to explore both the basic dynamics of disease and the best ways to improve patient outcomes.
Priority areas include: Exploring the fundamental mechanisms of organ dysfunction, the determinants and consequences of diseases and evaluate the benefits and harms of various interventions.
The Centre for Research on Inner City Health, which conducts research to better understand the linkages between poor health and poverty, homelessness and social exclusion.
The Centre for Global Health Research, which focuses on the epidemiology and prevention of premature death in developing countries, specifically as a result of HIV/AIDS, tuberculosis and chronic diseases.
The Applied Health Research Centre, which advances patient care through clinical research involving human subjects.
And the Joint Program in Knowledge Translation, which develops tools to increase the likelihood that medical breakthroughs are quickly transformed into bedside treatments.
The discovery work at the Keenan Research Centre narrows the gap between insight and impact. In 2010-11, a number of research studies brought to life the goal of “bench to bedside to community”: the impact of folic acid supplements on breast cancer rates in animal studies, the alarming death rates from tuberculosis in homeless populations, the benefits of screening tools for physical, emotional and sexual abuse, population studies of the survival rates for cardiac arrest in various settings and many, many others. As much as a new building focuses the research activities, it is the people who work in the building who make the difference. Several of our scientists received major recognition. These include: three from St. Michael’s who were appointed Chairs at the School of Public Health, University of Toronto: Adalsteinn (Steini) Brown as the first Chair in Public Health Policy, Prabhat Jha as inaugural Chair in Disease Control and James Orbinski as the inaugural Chair in Global Health; Drs. Jha and Orbinski were on The Globe and Mail’s first list of 25 Transformational Canadians; and Dr. Howard Leong-Poi (Cardiac Imaging and Hemodynamic Core Facility for Translational Research) and Dr. Xiao-Yan Wen (Zebrafish Centre for Advanced Drug Discovery) received Leaders Opportunity Fund grants of $1.2 million from the Canada Foundation for Innovation.
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> VIDEOS
HOSPITAL FACTS • Approximately $55M in total research funding in 2010-2011 • 180 Investigators (scientists and associate scientists)
Donors funded research chairs in Women’s Health, Multiple Sclerosis and Gastroenterology to keep top scientists at St. Michael’s and to finance their projects.
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EDUC ATION
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Supporting the learner and the teacher Education has also moved into its new home in the Li Ka Shing International Healthcare Education Centre. Education at St. Michael’s is anchored in the concept that everyone is both a student and a teacher. Annually, St. Michael’s is home to over 3,000 students from 26 health disciplines. Our major partner is the University of Toronto, but St. Michael’s also works closely with Ryerson University, George Brown College and the Michener Institute among others, including institutions from China and Saudi Arabia.
Education activities are divided into four key areas: One-stop service for students that helps them navigate St. Michael’s and also ensures their ideas are heard and used.
Continuing education and professional development provides world class educational opportunities to physicians and staff so that they, in turn, can improve patient care and outcomes. The Centre for Faculty Development, a partnership between St. Michael’s and the University of Toronto, offers programs to health professional educators.
Technology is a key enabler of education. The new Allan Waters Family Simulation Centre provides students with the opportunity to “rehearse” for real life dramas in hospitals. For example, the Basic Life Support program helps staff meet training needs and comply with Code Blue policy.
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Patient and family education provides access to evidence-based patient and family education tools and resources, helps clinicians improve their patient and family teaching skills and develops appropriate ways to measure the impact of patient education.
HOSPITAL FACTS • Approximately 3,147 students trained in 2010-11 • 5,021: Number of staff and physicians who used the Learning Management System to enroll and participate in educational activities
Through generous donations, the St. Michael’s Allan Waters Family Simulation Centre offers the opportunity to practise health procedures on life-like mannequins.
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PEOPLE , TOOLS, SPACE
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Investing in people, infrastructure and equipment In order to provide the best patient care, research and education, St. Michael’s must attract and retain the best people and provide them with the best tools and space. St. Michael’s received national recognition for its efforts to integrate internationally trained professionals into its workforce. The Toronto Star Award for Excellence in Workplace Integration, and Canada’s Top 100 Employers for New Canadians Award praised St. Michael’s efforts to assist employees who are recent immigrants. At St. Michael’s values are more than just a plaque on the wall – they are key drivers of a long-standing culture. Each year, individual staff members and teams receive Values in Action awards that demonstrate how the values are embodied in their day to day work. We take our responsibility to the community seriously. Efforts to minimize impact on the environment received recognition with the Recycling Council of Ontario Gold Award and the Green Health Care Award for Waste Management from the Ontario Hospital Association and the Canadian Coalition for Green Health Care.
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St. Michael’s has invested in effective information technology to provide an electronic patient record that is available to health care professionals throughout the Canadian health care sector. Having the right equipment is an integral part of providing excellent patient care. For example, a 3D minimally-invasive navigational system ensures that spinal procedures such as placing screws for spinal fusion occurs with complete accuracy without having to expose the spine. An endo-bronchial ultrasound provides earlier, safer and less invasive diagnosis of respiratory problems. Even as the organization celebrated the opening of the Li Ka Shing Knowledge Institute, a project team was hard at work on a proposal for a new patient care tower at the northeast corner of Victoria and Queen Streets that will allow the transformation of many patient care areas at St. Michael’s including the Emergency department.
HOSPITAL FACTS • Almost 2 million square feet of property • 436,998 ambulatory visits annually
Donors, through the St. Michael’s Foundation, provided $5 million for a surgical robot that is used for prostate and gynecology surgery. Donors also funded a new 3D minimally invasive navigational system for spinal procedures, and an endo-bronchial ultrasound that provides safer and less invasive diagnosis of respiratory problems. ANNUAL REPORT 2010-2011 | 11
FINANCIAL AND HOSPITAL STAT S
Revenues $611.558 million Ministry of Health and Long-term Care/ Toronto Central LHIN 72.88% Sales and other revenues 7.89% Amortization 11.02% Patient revenues 4.69% Other 3.52%
MORE HOSPITAL FACTS • 5,345 staff • 682 physicians
Expenses $601.651 million Salaries and benefits 63.30% Medical/surgical supplies 8.36% Drugs 5.94% Other supplies 13.96% Amortization 4.22% Other 4.22%
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• 628 volunteers • 15,226 surgical cases • 271,941 diagnostic, therapeutic and other visits • 26,076 inpatient separations (Average Length of Stay: 6.1 days) • Supported by 250 volunteers, the St. Michael’s Hospital Foundation provided over $72 million to the Hospital, from fiscal 2009 to 2011, to fund urgent priorities in patient care, education and research.
FOUNDATION AND VOLUNTEERS
Celebrating the spirit of giving The gift of time
The gift of funds
The culture of St. Michael’s is enhanced by the generosity of our community. There are hundreds of people who contribute their time to enhance the patient experience here.
In 2010/11, more than 25,000 donors made gifts to the St. Michael’s Foundation. Those gifts allow St. Michael’s to achieve a level of excellence that would not be possible otherwise.
Hospital volunteers provide meaningful and compassionate service throughout St. Michael’s. Inpatient care units, clinics, waiting rooms and many specialty areas all benefit from the gift of volunteer time. Volunteers improve the patient experience by fostering an environment of healing and hope for our patients and visitors. Volunteers also support the Foundation for fundraising and special events, assist our research scientists with their studies and bring the community’s views to St. Michael’ s as members of our community advisory panels. Many staff and physicians at St. Michael’s also volunteer their time around the world to share their health care skills with those in developing countries. One of these, the annual mission to the Philippines, received the June Callwood Outstanding Achievement Award in Volunteerism from the Ministry of Citizenship and Immigration. Each year, the team assesses close to 9,000 patients and performs over 100 surgeries.
Government covers the operating costs of running a complex organization like St. Michael’s; however, such necessities as equipment, information technology, renovations, research and education activities are not funded. Thanks to the $25 million the Foundation provided this past year, St. Michael’s was able to sustain itself as a health care leader. Building, renovations & equipment
$13.2 million
Education & patient care programs
$2.7 million
Research
$9.1 million Total of $25 million
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OUR COMMITMENT TO QUALIT Y
We continue to champion quality across all activities St. Michael’s has adopted quality improvement as a cornerstone of activity using the six dimensions of quality as defined by the Institute of Medicine: Safety, Outcomes, Access, Patient experience, Equity and Efficiency (SOAPEE). This priority has also been aligned with the expectations of government, as articulated in the Excellent Care for All Act. St. Michael’s will continue to champion quality across all activities, and ensure that the quality improvement requirements of the government are integrated into our operations.
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Given our expertise in knowledge translation and the advancements on our quality improvement journey, St. Michael’s is well positioned to lead as an academic health sciences centre focused on improving patient care quality. Highlights of the past year include the development of our Quality Improvement plan, and the development of our Patient Declaration, in accordance with the Excellent Care for All Act (Bill 46), through a robust process of broad engagement with stakeholders.
Board of Directors 2011
Executive Steering Group
Dr. Richard Alway Mr. Tony Arrell Dr. Alan R. Berger Mr. Ian L.T. Clarke Ms. Ruth daCosta Ms. Julie C. Di Lorenzo Mr. Bill Etherington Ms. Ella Ferris Mr. Tony Gagliano Mr. Anthony R. Graham Dr. Robert Howard Mr. Claude Lamoureux Dr. Guylaine Lefebvre Ms. Mary A. McConville Mr. Don McDermott
Robert Howard, President and Chief Executive Officer (Chair)
Ms. Heather McGregor Ms. Noella M. Milne Dr. Cheryl Misak Mr. Bill Morneau (Chair) Mr. Tom O’Neill (Vice Chair) Hon. David R. Peterson Ms. Dale R. Ponder Dr. Ori D. Rotstein Dr. Rajiv R. Shah Mr. Harcharan (Harry) Singh Mr. Frank J. Techar Ms. Kristine Thompson Mr. Rick Waugh Dr. Cathy Whiteside
Ella Ferris, Executive Vice President, Programs and Chief Nursing Executive Patricia Houston, Vice President, Education John King, Executive Vice President and Chief Administrative Officer
Alayne Metrick, President, St. Michael’s Foundation Guylaine Lefebvre, Chair, Medical Advisory Committee Douglas Sinclair, Executive Vice President, Programs and Chief Medical Officer Arthur Slutsky, Vice President, Research
Medical Advisory Committee Voting Members Chair Guylaine Lefebvre Vice-Chair Andrew Baker President, MSA Rajiv Shah Vice-President, MSA Kenneth Pace Department Chiefs: Anaesthesia Patricia Houston Critical Care Andrew Baker Emergency Medicine Glen Bandiera Family and Community Medicine Philip Berger Laboratory Medicine Serge Jothy Medical Imaging Tim Dowdell Medicine Thomas Parker Obstetrics and Gynaecology Guylaine Lefebvre Occupational Health Linn Holness Ophthalmology Alan Berger Otolaryngology Jennifer Anderson Paediatrics Tony Barozzino Psychiatry Vicky Stergiopoulos Surgery Ori Rotstein Other Appointments: EVP & Chief Medical Officer
Program Medical Directors: Diabetes Comprehensive Care Program Heart and Vascular Program Inner City Health, Core Services Specialized Complex Care Program Mobility Program Trauma and Neurosurgery Program Perioperative Services
Jeff Zaltzman Michael Freeman Philip Berger Jerry Teitel Earl Bogoch Andrew Baker (interim) James Mahoney
Non-Voting Members Other Appointments: President and CEO EVP & Chief Nursing Executive EVP & CAO Vice President, Research Vice President, Education General Counsel Administrative Support
Robert Howard Ella Ferris John King Arthur Slutsky Patricia Houston Alan Belaiche Narisha Jiwa
Medical Directors: Quality and Patient Safety Clinical Informatics Patient Access and Flow
Chris Hayes Michael Freeman Richard Bowry
Doug Sinclair
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Support St.Michael’s through our Foundation. Call 416. 846.5000 or visit stmichaelsfoundation.com
30 Bond Street, Toronto, ON M5B 1W8 Canada Telephone: 416.864.6060 stmichaelshospital.com Fully affiliated with the University of Toronto 16 | ANNUAL REPORT 2010-2011