Wednesday, February 25, 2009

President’s Blog - Clinical Services Plan (CSP)

By Rik Ganderton - President and CEO, RVHS

Tuesday, the Board of Directors of Rouge Valley Health System received information on the Hospital Clinical Services Plan. The information was presented by Central East Local Health Integration Network (CE LHIN) Board Chair Foster Loucks and CSP Project Manager Susan Plewes.

The full plan was released on February 17th when it was presented to the CE LHIN Board of Directors.

The plan represents the first phase and the initial steps towards "One Acute Care Network" which is defined as;

Improved and equitable patient access to an integrated hospital system that provides the highest quality of care across the Central East LHIN.

The plan covers five program areas (Cardiac, Mental Health, Maternal Child Youth, Thoracic Surgery and Vascular Surgery) as well as recommendations relating to Physician credentialing, Regional On Call coverage and central scheduling for operating rooms.

Our board fully supports the vision of "One acute Care Network" and sees the value in the direction of the recommendations contained in the CSP. We look forward to working in partnership with the LHIN and other health care providers throughout the central east area as the CSP is communicated, by the LHIN, to its partners during the next several weeks.

The Clinical Services Plan includes (amongst other things) a recommendation to make Rouge Valley the regional centre for cardiac care in Scarborough and Durham, which is both an affirmation of our existing role and confirmation of one of the hospital's strategic directions set more than 18 months ago.

The Central East LHIN presentation to our hospital board was the first of several presentations to health care providers in the Central East area, stretching from Haliburton to Peterborough, through Durham and into Scarborough.

We are examining the plan in greater detail and we are now going to consult with our internal stakeholders to understand their perspectives as part of the CE LHIN's requested feedback process.

Further details on the plan have been presented at recent Town Halls, joint Board, MAC and Management meetings and will be shared with the Leadership Forum and the Medical Staff Society during the next few weeks. Summary detail is available on the RVHS Intranet and the full report is available on the LHIN website.

Tuesday, February 24, 2009

Get moving for better health

Heart Month a great time to get up, and get moving

By Dr. Amir Janmohamed / Rouge Valley Cardiologist

February is Heart Month. And as we use this month to focus on the importance of heart health, if you’re not already incorporating ways to keep your heart healthy, there’s no better time than now to start.

Regardless of age, it’s never too late to add physical activity to your life. And making it a regular part of your life can turn out to be a lifesaver. Just 30 to 60 minutes of exercise a day can help you to dramatically lower your risk of heart disease and stroke. It can also help to control or even prevent risk factors such as high blood pressure, high cholesterol and obesity. As well, it improves your sense of well being and quality of life.

Light activities such as walking, gardening or yoga are great ways to get started. If you’re ready for more moderate activities, try brisk walking, swimming, cycling or dancing.

While physical activity can help prevent heart disease, stroke and many other conditions, remember that vigorous physical activity can be strenuous in extreme weather conditions, such as frigid cold temperatures, smog, and intense summer heat. The Heart and Stroke Foundation of Ontario recommends approaching activities such as shoveling snow in cold weather, with caution, especially if you have been diagnosed with heart disease, high blood pressure, or lead an inactive lifestyle.

Here are some tips to remember when exercising in extreme weather conditions:
• Prepare for the activity by doing a few minutes of a warm-up activity like walking, to slowly increase your heart rate;
• Take frequent breaks to prevent your body from becoming strained;
• If you need to complete an urgent task, such as clearing snow, ask family or friends for help;
• When shoveling snow, stop if you feel tired;
• Wear weather-appropriate clothing, and keep water close by to stay hydrated.

Almost anyone can benefit from a more active lifestyle. And if you have other health issues such as arthritis or osteoporosis, it can help to keep you mobile. If you have already had a heart attack, physical activity can help to prevent another one.

Of course, always consult your physician or healthcare provider before beginning any physical activity regimen.

Dr. Amir Janmohamed is a cardiologist at Rouge Valley Health System.

Tuesday, February 3, 2009

Real progress, but must stay the course

By Rik Ganderton
President & CEO, RVHS

We are making real progress in improving Rouge Valley Health System (RVHS) for our patients and all staff. I say that with caution, because RVHS is still early in our transformation journey.
Now, here comes the “but” of this message.
But, we need to ensure that our mutual focus on transformation, and the Deficit Elimination Plan, does not waiver or slip. The transformation of our culture into a hospital that is delivering top-quartile health care, safe, connected to its communities, accountable, transparent and united has only begun.
For getting our positive improvements underway, I thank all staff, physicians and volunteers for their growing engagement.

My perception is that there are “sighs of relief” starting to echo around some tables. We need to be cautious as we have not yet won the first battle and are nowhere near declaring victory in the war!
We have made positive strides as we deploy Lean methodology, but our culture has not yet changed. At best, we can say we have woken ourselves up to see what is possible and also that there is a vast amount of hard work that has to be done to deploy and sustain change for many years to come.
Use of Lean methodology is moving us toward engraining a systematic, continuous improvement approach; we are focusing our many and broad activities on reducing waste, improving care and our workplace while aligning all of our efforts to become the best at what we do for our patients.

Four Transformation Themes
We must continue to focus our efforts on our four transformation themes:
1. Patients first — providing the best patient/family experience
2. Earn our reputation as the best everyday
3. No waste
4. We are one team, inspired and involved

Deficit Elimination Plan
On the financial front, we have achieved some early successes. We had a balanced run rate (spending within our funding) in November and December. At the end of December we have a small surplus on a year to date basis.
But again, I say that with caution. We have our busiest months ahead of us. Assuming we achieve out targets (and I believe we will), we must remember that success this year is just a one-year event. It does not address the magnitude of what we have to fix and improve. As a reminder:
* We need to generate significant surpluses to -
- Maintain required infrastructure. Thanks to many years of capital starvation, our buildings, our infrastructure and our capital equipment are woefully inadequate. We have already agreed to add $3.5 million to our long-term-debt to deal with potentially catastrophic failures of boilers and roofs. These are the tip of the iceberg.
Rebuild our working capital and fund our capital needs. Our working capital deficit is $39.5 million.
- Find two to three per cent compounded efficiency every year based on shortfalls of funding increases provided by government each year. This means $5 million to $7.5 million in efficiency every year.
* In late February the Board will be presented with our 09/10 operating plan and multi-year capital plan. Operationally we have had to squeeze very hard to achieve our Hospital Service Accountability Agreement (H-SAA) committed targets to the government. Our capital needs are huge and many are vital to the safe and efficient functioning of our workplaces and the safety and standards of care for our patients.

Patient volumes
Essentially we continue to be on target in all areas for meeting our H-SAA commitments within the performance corridors, meaning we are treating the same number of patients this year as we did last. Maintaining patient volumes and improving quality of care are among the key commitments we made in our Deficit Elimination Plan, back in March of 2008.

Community Outreach

We continue to meet with our communities, through the many health care and community organizations in west Durham and east Toronto. Our running list of presentations is available at
Keep up your commitment and enthusiasm for positive improvement at Rouge. We will succeed as a team. Thank you all.