Monday, March 8, 2010

Going beyond Peer Review Report recommendations

Chair’s Blog: Janet Ecker

To: The Rouge Valley team: all staff, physicians and volunteers

We did it.

Rouge Valley Health System has successfully implemented its Peer Review Report recommendations, as confirmed in a recent letter from the Central East Local Health Network (CE LHIN).

In his letter to me, CE LHIN Board of Directors Chair Foster Loucks states that Rouge Valley has met the requirements of the report, which were grouped in these categories: leadership; culture; strategy, financial; and governance. He adds, “Thank you for all of your hard work and dedication. The Rouge Valley Health System (RVHS) is to be commended for its many accomplishments.”

As chair of the RVHS Board of Directors, I wish to publicly thank and congratulate the entire Rouge Valley team – all staff, physicians, volunteers, my fellow members of the Board of Directors, the senior management team and medical leaders – on this considerable achievement.

Planning and action

Your focused planning and action in the categories identified in the Peer Review Report have put the hospital on the right track for our patients, communities and for our team. More than this, your collective focus has moved us well beyond implementation of the report.

This focus began with the Strategic Plan On-A-Page in 2007-08, which led to plans and actions on financial accountability and transforming work processes with a patients-first approach.

We are all now engaged in transforming Rouge Valley on a variety of key measures for our patients: quality care; wait times; effective use of our limited resources; and reinvestment in our facilities.

To best address the challenging recommendations of the report and engrain a culture of constant improvement, our senior management team has worked with our RVHS Board of Directors, our medical leaders, physicians, management staff and front-line staff. All of these groups have received extensive training and/or coaching in Lean management, a philosophy and method of constant improvement.

We are already recognized as leaders in the CE LHIN and beyond for our ongoing application of Lean, because of our tangible results already, including:
• Patients going home sooner thanks to improved patient flow and discharge planning at both hospital campuses;
• Patients and doctors getting lab test results faster at both hospital campuses;
• Patients spending less time waiting for care in our emergency departments, where almost 90 per cent of ambulatory patients are discharged in less than four hours;
• RVC ambulance offload times continuing to be among the lowest in Toronto. This initiative will be implemented at RVAP, now that our new emergency department is open.

I’m also proud to say that you have met and exceeded our commitment to maintain annual service volumes (at 2006-07 levels), while reducing costs to stay within budget as per the best peer hospitals in Ontario. For the fiscal year ending March 31, 2010, we will have:
• Cared for 8,500 more emergency room patients than in 2006-07;
• Delivered 400 more babies;
• Carried out 600 more surgical procedures;
• Treated 900 more weighted cases; and
• Increased mental health services in outpatient capacity and in providing more crisis services.

Among other key Lean-related improvements, as documented from March 31, 2007 to September 30, 2009, we have reduced the amount of time patients wait for:
• Cancer surgery, from 82 days to 54 days;
• Hip replacement, from 300 days to 204 days;
• Cataracts, from 339 days to 167 days; and
• Magnetic Resonance Imaging (MRI), from 128 days to 122.

Our publicly-reported quality indicators on hospital-acquired infections, Safer Healthcare Now Interventions, hand hygiene and Hospital Standardized Mortality Ratio, have all shown marked improvements during the similar period. In fact, our hospital mortality rate is the lowest in the Central East LHIN.


The Peer Review Report also recommended that RVHS defer its capital development and installation of a Magnetic Resonance Imaging scanner at Rouge Valley Ajax and Pickering hospital campus. This was the sole recommendation that we disagreed with, as we believe MRI is an essential modern diagnostic tool needed by our west Durham community. The Central East LHIN has been supportive of RVHS on this point. We will continue to work on getting an MRI at our west Durham hospital campus.

Summation: Quality and effectiveness

In short, we are all doing the best for our patients within our allocated resources – and so much better than we did before.

We all know we have more to do and are constantly challenging ourselves to innovate, eliminate waste and improve quality. Again, it’s my pleasure to congratulate our entire team on this accomplishment and encourage you all to remain focused on improving patient care. Thank you.

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