Update: Birthing Centre / Town Halls / Mental Health / Socials

By Rik Ganderton President and CEO

I have a few pieces of news to update you on today.

* Town Halls
First, sorry it's been so long since we've had a Town Hall. Scheduling of various meetings has got in the way. We will resume our regular monthly staff-physician-volunteer Town Halls on Thursday, Dec. 18 at each hospital campus:
- 9:30 a.m. at RVC's Dr. Bruce Johnston Conference Room; and
- 2 p.m. at RVAP's Conference Rooms B and C.

* Birthing and Newborn Centre at RVC
My congratulations to our RVHS Foundation team for their successful events on November 20 when volunteers were thanked for their tremendous $1 million support for the new centre and an evening event at which key donors and supporters were recognized. I would also like to acknowledge the work of the whole Women's and Children's Program team for all their efforts in making the new Birthing Centre a reality. While all have worked tirelessly I would especially like to thank
· Julie Goldstein, Program Director (now with the TMO)
· Sue Fyfe, Program Director
· Penny Katz, Manager, Perinatal
· Sheri Ferkl, Manager, Paediatrics
· Rose Owen, Clinical Practice Leader
· Debbie MacInnes, Clinical Practice Leader
· Debbie Lopresti, Resource Nurse, Perinatal
· Kim Eeuwes, Resource Nurse, NICU
· Amer Syed, Manager, Respiratory Therapy
· Dan Flood, Purchasing
· Nicki Modeste, Purchasing
· Rick Gowrie, Senior Director
· Ed Carroll, Manager - Plant Admin, Projects
· Martin Green, Manager, Security
· Siamak Sadr, Director
· Teresa Alzner, Resource Nurse, Paediatrics
· Kim Kaizer, Clinical Practice Leader, RVAP
· Mary Ellen Stevenson, Manager, RVAP

We look forward to having the official grand opening of the centre early in the 2009 and subject to the availability of government leaders. We'll announce the date as soon as possible.
It is indeed a beautiful facility which we can be proud of.

* Mental Health improvements
Our implementation of the plan announced in March continues to move forward.
Rouge Valley also continues to look for opportunities presented by the improved mental health service model.
We have asked the Central East LHIN (in June 2008) to fund the hospital for 29 additional acute care medical beds to go into the space being vacated as part of our improved model of care. It is our intention to house 22 of these beds on RVAP's 3 West, if they are funded.
We desperately need this medical bed capacity to improve the flow of patients through our emergency department. Durham region has some of the lowest rates of admission to inpatient medical beds in the province. When compared to other centres it appears we are substantially under resourced in terms of inpatient acute medicine bed capacity.
We'll let you know when we have an answer from the Central East LHIN on our request.

* Rouge Holiday Socials
I hope to see you at our annual Rouge Holiday Socials for all staff, physicians, board members, and volunteers.
The socials are:
- Dec. 15, 2-4 p.m. at RVAP’s Conference Rooms B and C. Plus we'll have a traveling minstrel and holiday food going floor to floor from 7:30 p.m. to 9:30 p.m.
- Dec. 16, 2-4 p.m.. at RVC's Dr. Bruce Johnston Room. Plus we'll have a traveling minstrel and holiday food going floor to floor from 7:30 p.m. to 9:30 p.m.
This is purely an end of the year social event. I'll put way my projector and PowerPoint. Please come and enjoy some good food, good music and equally good conversation!

Prevent the flu in you and in patients! / New Echo

By Rik Ganderton - President & CEO
I'm pleased once again to get my flu shot and encourage us all to do so.
To get his year's campaign going, you'll see that many managers and Board members have already rolled up their sleeves to encourage everyone at Rouge to get their shot. This is the best way to prevent us from getting sick with the flu and to prevent spreading it to our patients.
Thank you all for rolling up your sleeves starting next week at flu shot clinics for staff, physicians and volunteers at Rouge Valley. It's your personal decision, but please do consider getting it for your health and for that of our patients.
And my thanks to RN Amanda Fyfe for making it so painless!
...

President's Blog
By Rik Ganderton - President and CEO
Oct. 31, 2008

Even the Echo is transforming ...

Welcome to our new echo.

More than simply a smartly re-designed magazine, echo is now serving a wider audience — reverberating and spreading the good word about the new Rouge, which all of you are so busy transforming.
echo will continue to be a newsletter for staff-physicians-volunteers. But now it will also serve as a community magazine, mailed six times a year (electronically and by post) to health care partners, political leaders and more than 350 community organizations in east Toronto and west Durham.

Please have a good read through this issue and send any comments to Public Affairs and Community Relations Director David Brazeau at dbrazeau@rougevalley.ca. As with everything we do at Rouge, we want it to be the best – reflecting your tremendous ongoing work to constantly improve patient care!

In this issue, we continue to focus on the transformation that is well underway at both Rouge Valley hospital campuses. At our Oct. 1 Transformation Celebration Town Hall, we showcased the successes of our first four kaizen event teams. This was an opportunity for team leaders to showcase the positive changes their teams achieved for patients and for each other. We take an inside look at these kaizen events in our cover story, but I would like to highlight some of the biggest achievements here and offer my own “thank you” to all of our kaizen team members.

RVAP Emergency Department 5S
Clinical Practice Leader Tina Shoemaker showed us how the Rouge Valley Ajax and Pickering emergency department organized itself more efficiently for patient care, by making these key changes:
Cleaned and organized the working environment;
Conducted daily 5S audits (sort, set in order, scrub/shine, standardize and sustain); and
Ongoing monitoring of sustainability.
I want to underline this: sustainability is the key to all kaizen event successes! We must be vigilant in maintaining the truly terrific changes you have made.

RVAP Emergency Department Lab TAT
Senior Technologist Renee Liscio demonstrated how this team improved turn-around time (TAT) for blood and urine specimens. The key changes achieved for our patients were:
Visual management system for specimen pick up was established;
A back-up system was set up to inform our patient services reps that pickup was required; and
Standard work was established for all staff involved.

RVC Medicine Discharge Room TAT
Physiotherapist Louie Lu shared these key turn-around time changes achieved by his kaizen team:
Discharge TAT visual management board established;
Standard work created for staff members to improve patient flow; and
Linen carts have been reorganized using the 5S principles.

RVC Medicine Discharge Process
Outpatient and Corporate Rehab Manager Karl Wong showed us how his team improved flow, coordination of discharge process on the RVC Medicine 9W unit, through these key changes:
Discharge planning visual management board was put in place;
Physician communication tool was created for patient charts; and
Signs were made to educate patients and families about discharge days and times.

Thank you to all team members and to our kaizen process owners: Program Director of Mental Health and Emergency Cheryl Williams; and Program Director of Medicine and Critical Care Margot DaCosta. I would also like to thank all staff, physicians and volunteers for working as a team, at every level of Rouge Valley, to provide the best health care experience for our patients and their families.

And to all our other readers, I hope you enjoy this first issue of the new echo and will continue to come back to these pages to learn more about how Rouge Valley is working to be the best at what we do.

Please feel free to email any questions or comments you have for me to rganderton@rougevalley.ca.

For more from the president:
internal—check out the President’s Page on the RVHS intranet site
external—visit the RVHS Blog at rvhs.blogspot.com

Rouge continues to move forward: wins second court challenge

By Rik Ganderton - President and CEO

Rouge Valley has won its second legal challenge to its Deficit Elimination Plan (DEP).

The Divisional Court has recently ruled in favour of the hospital in a challenge brought forward by the provincial head office of the Ontario Nurses Association. The court ruled that the decision to approve the DEP by the Rouge Valley Board of Directors was an “internal” and "reasonable” decision.

The court accepted the hospital’s arguments that it had consulted about its plan to reduce the deficit. This summer the court also ruled in favour of the Central East LHIN and Rouge Valley in a similar challenge brought forward by OPSEU - Read our August 2008 news release.

This means we can continue to move forward in our well-publicized plan, of March 25, 2008, to fix Rouge Valley's historic financial challenges.

As we've said at leadership forums with managers and Town Halls with all staff, it is thanks to the engagement and participation of staff and physicians that Rouge Valley is now heading in a positive direction on finances and, most importantly, in transforming itself into being the best at what we do for patients.

The complete ruling is available here.

President’s Blog: My Personal Business Commitments

By Rik Ganderton - President & CEO

My Personal Business Commitments (PBCs) are available here.

I am sharing my PBCs as part of my accountability to the organization. These are the major things that we as an organization have set for ourselves to do this year. They have been developed directly from the Strategic Plan on-a-Page, which set our strategic direction and is posted on our public website and internal Intranet.


As a reminder, you'll recall we've said we intend "to be the best at what we do" and that:
- We will work as a team;
- Live our values every day;
- Relentlessly focus on quality in a health workplace;
- Maintain and strengthen core services and enhance centres of excellence;
- Deliver services within the context of the Central East Local Health Integration Network, Integrated Health Service Plan and Clinical Services Plan; and
- Live within our resources.

My Personal Business Commitments have been approved by our Board of Directors. By sharing these PBCs, we at Rouge Valley are cutting a new path that you are all a big part of.

Open communications has been a key of that path since I had the pleasure of joining the Rouge team in 2007.

I’m publishing my PBCs to help provide greater clarity for us all and to help each of us understand how our varied roles contribute to achieving our strategy at Rouge Valley. By focusing on achievement of these goals we will ensure that the day to day "noise," that we all face, will not distract us from our major objectives.

I want our vice-presidents, chiefs and all physicians, directors, managers and all staff and volunteers to see the very tangible targets the Board and I have set for me and for Rouge Valley itself.

PBCs have also been set by our senior team and are being cascaded throughout the leadership organization so that we are all aligned on our goals. The management team will be sharing their PBCs with their teams. The senior team has shared their individual goals with each other so that there is clarity and understanding between us.

By publishing my PBCs, and later those of our entire management team, all staff and physicians with be better able to work toward our common vision to be the best acute care community hospital.

We will continue to work as a team, at every level of Rouge Valley, to provide the best health care experience for our patients and their families.

PBCs are the tool we will use to provide clarity to the direction we have set our selves and how we will achieve and measure our success on that journey. They also make the links across management and staff, physicians, departments, campuses and disciplines.

The development of PBC's will become and annual exercise for the whole management team so that we have clear alignment of our actions to achieve our strategic intent of being "the best at what we do."

Please feel free to email me (rganderton@rougevalley.ca) any questions or thoughts you have about my PBCs.

Implementing our plan

By Rik Ganderton
President & CEO

As many of you will now be aware, OPSEU has decided to withdraw its motion for an injunction that was to be heard in Court on Friday May 16th. An application for judicial review of the process used by the CELHIN will now be heard by the Court on July 11th.

RVHS is now in a position to start implementing the Deficit Elimination Plan that was approved by our Board on March 25th. The plan is the foundation for the Hospital Services Accountability Agreement (H-SAA) that we signed with the Central East LHIN in early April.

This afternoon we provided formal notification to our various Unions regarding the restructuring. This will mean the provisions of the various collective agreements will kick in and we will start to deal with Early Retirement and Voluntary Exit Packages and subsequent (and hopefully minimal) individual notices of layoffs.

This has been a very difficult time for all our staff. We all know that we had to take these difficult but important actions. We have all been frustrated by the implementation delays forced on us over the last six weeks or so. However, we will now start implementation and the transformation of RVHS into a higher performing hospital; a hospital that we can be proud to work for, that provides the core services our communities need in a caring and efficient way and relentlessly focuses on delivering the highest quality of care.

Thank you all for your patience during this very difficult period. We have lots of work to do as we continue to develop detailed implementation plans and make the needed changes. I look forward to working with you all as we transform RVHS to be the best at what we do.

Injunction

By Rik Ganderton
President and CEO

OPSEU has brought a court application seeking a Judicial Review of the Central East LHIN's process in approving the RVHS Deficit Elimination Plan, which includes the consolidation of mental health beds at Centenary. OPSEU has also served RVHS with a Notice of Motion seeking an injunction restraining it from implementing the mental health bed consolidation until the application is determined by the Court. In these circumstances, our legal counsel has advised that:

1. We should not discuss this matter publicly, while it is before the courts; and

2. We should not commence implementation until the legal matter is resolved.

We will keep you posted as to updates on this matter.

The facts on our improved Mental Health model

By Rik Ganderton
President and CEO

Our improved model for mental health care at Rouge Valley Health System has received much media coverage.
But lost or buried is the fact that the new model will improve mental health care by –
• Increasing expert mental health crisis intervention services from 12 hours (8 on weekends) to 16 hours a day, seven days a week at the Ajax and Pickering Campus.
• Maintaining our outpatient services at Ajax and Pickering Campus. Outpatient Mental Health Care serves the vast majority of mental health patients
• Continuing access to all mental health services, including emergencies, through our Ajax and Pickering Campus
• Consolidating specialized Mental Health Nursing expertise for inpatient care so that more hours of nursing care will be provided to those patients who require treatment on an in-patient basis.
• Adding a further eight beds to General Medicine at the Ajax and Pickering Campus to improve patient flow and reduce wait times in our Emergency Department.
We are also exploring alternate patient care uses for the space that will be vacated in the Ajax and Pickering Campus. Among the alternate uses is the possible addition of more medical beds at our Ajax and Pickering Campus to further reduce Emergency Department Wait Times. These would require additional funding which we are discussing with the LHIN.

THE NEXT THREE YEARS
Furthermore, there has also been a considerable amount of misrepresentation by some parties as to the number and nature of jobs we must eliminate over the next three years. The facts are –
• 220 positions will go over three years: 60 at the Ajax and Pickering Campus; and 160 at the Centenary Campus.
• Of the 60 jobs at Ajax and Pickering Campus, 36 are Mental Health staff who will be re-employed at Centenary Campus; in other words they are not losing their jobs.
• Of the total positions being eliminated over the next 3 years, 72 are nursing. However, the nurses currently filling those positions will have the opportunity to move into newly funded positions such as those required for the expansion of the specialized Neonatal Intensive Care Unit (14) and the Ajax and Pickering Campus (60) as well as the other options described below.
It is our strongly held belief that almost no person will have to leave RVHS involuntarily. Our normal staff turnover rate is about five per cent a year, which represents 150 positions a year. In addition we will –
• Fill vacancies in areas not being restructured.
• Provide early retirement and voluntary exit packages in accordance with our collective agreements, which cover more than 90% of our staff.
• Provide retraining to support redeployment.
• Fill new positions created by our expansion projects.
Our three-year plan represents changes for the better. Rouge Valley will be a top performer in the healthcare system. We will deploy staff at similar levels to our best performing peers. We will improve the quality of care we deliver and reduce wait times in our Emergency Departments. We will live within the money provided to us.
We know we can do this because we have compared ourselves against other Ontario hospitals. We have seen how they treat patients more quickly, with better service quality and lower resource use than Rouge Valley. As we do this we will continue to grow our services in conjunction with the directions of the Central East Local Health Integration Network.

By Rik Ganderton
President and CEO

So much to say. Firstly, my thanks and thanks from our executive team and the Board of Directors to our nurses, security, physicians and all staff involved in handling a significant incident in our Emergency Department at the Centenary campus on April 16.

We placed the Centenary Emergency Department on redirect status following the incident in which a patient seriously injured himself late that morning. Staff and physicians responded immediately to the situation and in handling the redirection of ambulances and emergency patients like the professionals they are.

OUR RECOVERY CONTINUES
We have been busy in healthcare partner and public consultations concerning our improved new model of mental health care delivery.

Much has been reported in the media. For clarity, please reference the information posted on our web site since March 25.
From the consultations, we have been able to better define issues, such as transportation of patients and families, which we will address during the next five months before our improved model of mental health care is put into place.

It’s important that our patients, families and communities—in addition to all of you—know that this model represents better access to our services by:

• Increasing crisis services from 12 to 16 hours a day, seven days a week at both campuses;
• Maintaining our outpatient services, which serves the majority of mental health patients at both campuses;
• Ensuring access to all mental health services, including emergencies, continues at each campus;
• Pooling expertise for inpatient care.
Our Rouge Valley Ajax and Pickering mental health information page has much more detail on this.

More information is available online at www.rougevalley.ca and at www.centraleastlhin.on.ca.

FUNDING
We have received funding from the provincial government as announced on April 13. That funding is not new and will not change our need to become more effective as we move up to the standards of the best community hospitals in Ontario.
We also remain focused on implementing our Deficit Elimination Plan so that we can effectively reduce our $78 million long-term debt and working capital deficit.

You’ve heard me say it many times in our Town Halls, but it’s worth repeating: we know we can perform with the best hospitals in Ontario—a top quartile performer rather than average, or worse. Rouge Valley is striving to be among the best of Ontario community acute care hospitals in both quality and effectiveness.

Having met many of you during the last year, I know we have the dedicated, high quality staff, physicians and volunteers to achieve this.”

Ministry Funding

By Rik Ganderton
President and CEO
Rouge Valley Health System

On Sunday, the Ministry of Health and Long-Term Care announced a $667 million funding boost for Ontario hospitals to address new beds, more surgeries and shorter wait times.

While the actual amount for Rouge Valley Health System is still be to announced by the Central East Local Health Integration Network, we are pleased to receive any additional funding and thank the Ministry.

It is important to note that this additional funding does not change our financial challenge. We remain focused on implementing our Deficit Elimination Plan so that we can effectively reduce our $78 million long-term debt and working capital deficit. These additional funds will be a positive first step in getting our financial house in order so that we can better focus on the future healthcare needs of our communities in west Durham and east Toronto.

Our plan is about more than simply reducing our debts and deficit. Rouge Valley is now focusing on performing at higher standards of effectiveness, as other hospitals do. You’ve heard me say it many times in our Town Halls, but it’s worth repeating: we know we can bring ourselves to the benchmarks of the best hospitals in Ontario—a top quartile performer rather than average, or worse. Rather than aiming for the median, or average, Rouge Valley is now striving for top-quartile performance in quality and effectiveness.

Having met many of you during the last year, I know we have the dedicated, high quality staff, physicians and volunteers to achieve this.

Details of our Deficit Elimination Plan are available on the Intranet.

CE LHIN Board motion adds 30-day consultation period

By Rik Ganderton
President and CEO
Rouge Valley Health System

New information has just become available from the Central East LHIN's Board meeting today, March 28.

The LHIN Board members have passed a supplementary motion, which is relevant to our Deficit Elimination Plan. Here is the wording of the Central East LHIN Board motion: "Be it resolved that the (CE LHIN) Board requires RVHS to work with the LHIN prior to the implementation of the planned consolidation of MHA (Mental Health and Addictions) services in conducting a 30 day consultation period with community stakeholders, and the general public.”

As a consequence of this, we will receive clarification from the LHIN during the next week. We will share that clarification with all of you – staff, physicians and volunteers – as soon as possible. I’m sorry we don’t have any greater detail on this yet. But I wanted to share this information with you now. We will continue to keep you informed in a timely fashion.

Our recovery continues

By Rik Ganderton
President and CEO
Rouge Valley Health System

Rouge Valley’s recovery process continues to be developed. As discussed at our Town Hall meetings with you in January, our senior administration has been analyzing and developing a recovery implementation plan.

This is all part of the Peer Review process initiated by the Central East Local Health Integration Network (CE LHIN) with Rouge Valley’s full support.

Here’s an outline of how that process will work.
• Currently senior administration is developing the plan. Phase One of this plan will be to live within our means and balance our budget. We have massive debt to deal with, as I said in our Town Halls.
• Our implementation plan will be reviewed by the RVHS Board of Directors.
• The Board will then forward the approved implementation plan to the CE LHIN Board before the end of March for its approval.

During 2008 our recovery plan will go into place, providing a platform for the hospital to establish itself as the best at what we do – providing excellent, quality-focused community hospital care.

Please know that RVHS will be maintaining its 24/7/365 Emergency Departments and access to core services at both of its hospital campuses, as part of its community hospital identity.

The significant redevelopment of RVAP continues as planned. As you know, we are adding 140,000 square feet of new and renovated space to greatly enhance our emergency and related services, including cardiac diagnostics, diagnostic imaging and lab services—to name a few. Our two smaller, but important projects, at RVC also continue: the Birthing and Newborn Centre; and Mental Health Supportive Housing.

We will continue to communicate regularly. I welcome your comments and questions.

As always, thank you for your continued commitment to Rouge Valley and our patients.

Town Hall Q&A

By Rik Ganderton

President and CEO

Rouge Valley Health System

Good day to you all.

It was my pleasure to present the latest information on the Peer Review Process and the RVHS approach to it in Town Halls this week.

That presentation is available here for your reference.

Thank you for your many insightful questions. I think, this month, I will share your questions from each of our Town Halls at RVAP and RVC on Jan. 23 and 24, along with the answers that we gave.

Here’s a sample of questions asked and answered:

Q1 - Is the Birthing Centre going ahead?
Yes, the Birthing and Newborn Centre is going ahead, as are our other two major capital projects--the redevelopment of RVAP and the Mental Health Supportive Housing Project.

Q2 - How about having a lottery to raise funds, like at Princess Margaret Hospital?
(Reply from Chad Hanna, RVHS Foundation President and CEO) The Foundation was involved in a car lottery that was not raising enough money to continue. The Board is always reviewing opportunities to raise funds, including our recently launched Cash Cow staff lottery.

Q3 - What will happen with our regional paediatric program?
Our regional paediatric program is unfortunately not funded as a regional program. Our pacemaker program and cardiac rehabilitation programs, among others, are also not fully funded. We have not determined any specific plan for these or other programs at this time. We are working with the Central East LHIN to determine how best to deliver these services within the region.

Q4 - How does our financial status compare with that of other hospitals?
Our working capital deficit is the worst in the province, I'm sorry to say. Years of overspending have put us here and now we must balance our budget and live within our means. Part of the issue is that we have, over the last several years, taken on programs that we are not funded for, and part of it is that we have not operated as efficiently as we could have and need to.

Q5 - The CE LHIN commented in the newspaper (The Scarborough Mirror) recently that staffing levels might be affected as part of implementing the Peer Review. When are you going to start implementing that?
We don't have that plan developed yet. We have already done the analysis on this. Now we are working (as a senior executive, medical leadership and Board team) to determine how we implement the changes we need. Staffing levels are going to be affected since 80% of our expenses are related to staffing. In order to scale our spending back to live within our means, we will have to look for staffing reductions perhaps as early as April. All collective agreement provisions will be adhered to for unionized staff members. We are committed to minimizing any involuntary departures and will treat staff as fairly as we can.

Q6 - Has the Peer Review team noticed we have a lot of empty space (at RVC)?
The Peer Review team didn't specifically comment on it. But this is a huge strategic asset for us going forward. It's a real opportunity for us four or five years out. We've got all this capacity. It will be easier for the CE LHIN to make use of our capacity than it would be to build a new hospital or expand other hospitals in the Central East area. We recently made use of our capacity in accommodating Lakeridge Health patients displaced by a fire last July at its Whitby site. But our capacity also extends to the 25 acres of land we have at each of our hospital campuses. We've got some short-term pain to go through. But our long-term future at this organization is very bright.

Q7 – Do we have enough patients to sustain the rehab unit?
Yes.

Q8 – What if funding was pulled (for the rehab unit)?
I don’t have an answer on that right now. But I don’t see us closing down any program in the short-term. Those sorts of decisions can’t be made by one hospital in isolation. That kind of decision would be made with the CE LHIN after a great deal of discussion and planning.

Q9 – Have you sent our RVHS plan to the CE LHIN yet?
Not yet. We have submitted reports on our successful initiatives such as Agency Free and on revenue enhancement (examples - preferred accommodations, increased parking rates.) RVHS’ implementation plan will go before our own Board of Directors and then to the CE LHIN Board of Directors before the end of March.

Q10 – In your presentation you talked about maximizing the use of beds. Where will that occur?
I anticipate increasing bed capacity in the short term within the Department of Medicine at both hospital campuses. This will mean at least a reallocation from other services. However we must not lose sight of our key planning parameter – we will maintain our volumes in 2008/2009 at the same levels as in 2007/2008. We will use our resources, including beds, to do this more efficiently

Q11 – Aren’t you just robbing Peter to pay Paul?
If you want to put it that way, yes. We have to figure out how to balance our resources more effectively. The organization has to be appropriately resourced and programs must perform at benchmark efficiency levels. We will not be taking on any other services or programs unless we are funded for them, including wait time initiatives. We will live within our means.

Q12 – How are we going to address this in the community?
We have been meeting, and will continue to meet, with various community groups and healthcare providers in our area. We are working very closely with the LHIN on all our potential initiatives. We are also going to be speaking to the Collaboratives of the Central East LHIN, with each having representatives from many healthcare organizations and community members at one table. We are telling the community that we are going through this recovery process, but that we are maintaining patient volumes, as I said during my presentation. The community has also heard us say that we are maintaining both of our 24/7/365 Emergency Departments at each of our hospital campuses as well as continuing to provide access to Core Services. As you may know we have extra need in the Emergency Departments right now because two of our emergency physicians are seriously ill.

Let me close by saying: Thank you for bringing your skills and commitment to Rouge Valley Health System –and for helping us “Be the best at what we do.”

Rouge begins year of living within our means

By Dr. Naresh Mohan,
Chief of Staff
Rouge Valley Health System

We have started our year of change and renewed accountability at Rouge Valley Health System. Rouge is currently preparing plans to focus our two hospital campuses on Core Services, as aligned with recommendations in the Peer Review Report, which was received and accepted by the Central East Local Health Integration Network (CE LHIN) on Dec. 14, 2007.

RVHS recently held meetings with physicians, staff and volunteers to share information related to the start of this planning. In short, the hospital can no longer spend more than it receives in provincial government funding.

The CE LHIN is providing some support for RVHS, but not enough to eliminate our financial shortfalls. Not by a long shot. We will be receiving one-time funding of $5 million in 2007/08 and $3 million in 2008/09.

The message from the CE LHIN is that Rouge must solve its own problems by being fiscally accountable--living within our means. What we must do as a hospital system is eliminate our massive debt. We have a $40 million working capital deficit and another $38 million in long term debt, making us the equivalent of a family that is mortgage poor.

This constant financial issue could have quality of care implications if we do not address it. That is why 2008 will be a year of focused renewal at Rouge. We will focus on being the best at what we do.

Years of overspending and a previous lack of accountability got us here. Active accountability will get us out.

Core Services

How we deliver services at both hospital campuses will change. At the same time, we will maintain core services at both sites. This includes Labour and Delivery and 24/7/365 Emergency Departments at each campus supported by:

• 24-hour anaesthetic coverage;
• High dependency units (such as ICU);
• General surgery capacity, including day surgery;
• Community-level obstetrical and paediatric services;
  
• General medical and geriatric services;
• Some rehabilitation and mental health services;
• Centres for diagnostics, treatment and ambulatory care.

Central East LHIN staff and board members will now support Rouge Valley's leadership as it designs a plan to address the findings of the Peer Review Report. Our plans on how to implement the Report will be submitted to the CE LHIN Board of Directors in February for its approval.

One of the important themes of our changes will be that RVHS will operate as one hospital system. All resources are corporate, meaning that they will be allocated at the discretion of leadership to maximize quality and efficiency. The "me too" attitude of our campuses, as highlighted by the Peer Reviewers, will end. We will need to deliver the best services we can in the most efficient manner, which may mean consolidated at a single site to improve quality and efficiency. Living within our means will mean much more than being fiscally balanced. It will mean that we will pool our human resources (staff and physicians) and equipment to provide gold-standard care for a given healthcare service in one place -- rather than spreading our resources more thinly across two locations.

Our hospital campuses are 20 minutes apart and therefore accessible to our communities of Whitby, Ajax, Pickering and east Toronto.

Central to our drive to be the best at what we do, Rouge Valley's renewal has begun with these themes:

• We are and will continue to be highly skilled and dedicated;


• We must truly become one hospital system;


• We will no longer try to be all things to all people in healthcare. This past approach is a quality issue and a financial issue;


• We will focus on Core Services, consistent with the CE LHIN, whom we will continue to work with in partnership;


• We are committed to improve our processes for family physicians and their patients in their interactions with the hospital;


• We will continue to communicate with you.

For more information on the Peer Review Report, please visit our public RVHS website page.

Attachment: Town Halls: Jan. 23-24, 2008 (96K PDF)