Good quality costs less

By RVHS President and CEO Rik Ganderton 
Presented at RVHS 2012 Annual General Meeting of Members, June 26, 2012

It’s my pleasure to provide my report on the successes of our team in the last year and to describe how we are preparing to meet the future challenges.
One of our favorite themes, as you know, is: Good quality costs less.
At its simplest, it means getting it right the first time. When we get it right the first time your parent, your daughter, son, or friend, doesn't have to stay in hospital for extra days as the result of an infection acquired in the hospital, or doesn't need to be readmitted because of a complication stemming from our care.
Our community will be pleased to know that our focus on infection rates remains strong. One of the simplest and most effective prevention measures for staff, patients and visitors is hand washing. Our hand hygiene compliance rates were at 80 per cent in 2010-2011, and have improved to over 89 per cent compliance in the last fiscal year. We can improve on that, but 89 per cent is a good start. And I thank our staff, doctors and volunteers for that. As patients and visitors you can help by ensuring you wash your hands entering and leaving the hospital and going in an out of your loved ones room.

Less waiting - but more improvement needed

We have continued to focus on emergency department (ED) wait times at both hospital campuses because our patients are waiting longer than they should. Our patient volumes have increased significantly, with 117,000 emergency patient visits last year across both campuses. The amount of time a patient waits in emergency to be admitted to a bed has decreased from 78.8 hours in 2010-11 to 72.8 hours in 2011-12 at RVAP. This is in part reflective of needing more acute care beds to support this campus but also needing to improve our internal processes significantly. By focusing our efforts more on patient flow, from emergency department to a medical bed, we have already seen things improve to less than 40 hours in the three months to June 30, 2012. This is a great improvement, but still more work to do!
The time a patient at Rouge Valley Centenary waits in emergency to be admitted to a bed was 50.4 in 2010-11 which was reduced to 43.1  hours in the fiscal year ended on March 31, 2012. In the last three months, we have reduced that wait to less than 33 hours. Again good improvement but more work to do. Our objective is simple—to have no admitted patients waiting in the ED!
We’ve had many important developments since last year’s AGM that will help us get things right for patients today and in the future.

New medical beds

This spring we opened 10 new short-stay medical beds here at Rouge Valley Ajax and Pickering. Those beds help patients get the attention they need in the right place at the right time, rather than being kept in the emergency department. By reducing the time admitted patients spend in the ED it frees up staff and physician time as well as space meaning patients are seen by a doctor more quickly. We call it patient flow. If it’s your mother, father or family member waiting to see a doctor in the emergency department, you just might call it better care.
The 10 additional beds were approved by the Central East Local Health Integration Network (CE LHIN), and the Ministry of Health and Long-Term Care. We thank them for their continued support of this hospital in meeting growing community needs.
Another of our recent success stories had its one-year anniversary in January. The transitional restorative care program (TRCP) at Rouge Valley Ajax and Pickering is a great example of how the health care system needs to change to improve care and to make the system sustainable.

Collaborative care

Supported again by the CE LHIN, the TRCP, as we call it, is a fine example of collaborative care in action for patients. Collaborative care makes the best use of staff skills and training – better for patients and more engaging for our team members at the same time. The TRCP is configured as a collaborative team of nurses, physicians, personal support workers, physiotherapists, recreational therapists, social workers, and caseworkers from the Central East Community Care Access Centre. That pooling of expertise is all there for patients in one place. This teamwork centres on providing restorative care for frail and elderly patients, enabling them gain strength to return home to their normal lives. The TRCP results in about four patients a week returning to their homes sooner than they would have, and in much better physical shape.

Regional cardiac care

In June 2011, we significantly enhanced the regional cardiac care program, by adding coordinated cardiovascular rehabilitation services in Durham.
We thank the CE LHIN and our partners at Durham Emergency Medical Services and Lakeridge Health for making this program even better. Lakeridge, Rouge Valley and The Scarborough Hospital work together to deliver this regional cardiovascular rehabilitation and secondary prevention program. It provides services to an additional 680 patients a year, to a total of 1,980 residents.
The whole concept of a regional program is another example of how the provincial health care system is changing to better deliver specialized services. The centralised organization of expertise and resources means improved quality care for patients, while maximizing the use of limited tax dollars through avoided duplication.It also improves quality through having a critical mass of highly trained experts working learning and treating patients together in a single location.
For people such as Gary McCormack, of Bowmanville, having that regional expertise available was a lifesaver. Gary had three heart attacks enroute with emergency medical services from Lakeridge Health in Oshawa. He was then taken straight into our catheterization lab at Rouge Valley Centenary. There, he received the timely, highly-specialized care he needed from a cardiologist and staff. That was about two and a half years ago. Thanks to our fast-track cardiac program, called Code STEMI, Gary was well enough to come to the hospital and celebrate the one-year anniversary of Code STEMI at the start of the last fiscal year in April 2011.
The work of our team continues to be recognized externally as well. Just this month, Accreditation Canada recognized a partnership between Durham Mental Health Services and Rouge Valley as a leading practice for providing crisis service outside of the hospital. The services provided in this partnership result in patients receiving the crisis mental health care they need without having to come into the busy emergency department. This is better for mental health patients, who receive the care they need sooner, and better for the hospital’s patient flow. My thanks to all members of our mental health team, as led by acute care services vice-president Cheryl Williams, and our community partner, Durham Mental Health Services.

Great fundraising and community support

In addition to our staff and physician efforts, I’m proud to acknowledge and thank the Rouge Valley Health System Foundation for its support and partnership to ensure the hospital has the best, and most essential, medical equipment for the community. A few weeks ago the community, staff and doctors came out in droves to push old medical beds on a stretch of pavement at the Scarborough Town Centre. They raised $50,000, or 10 medical beds, for the Foundation’s Buy-A-Bed Campaign. Not only that, the entire event, televised live on CTV, connected us further with our communities. We had members of the Toronto Police, the fire department and businesses, such as Best Buy, participating in the event. During the last fiscal year, the Foundation also completed its fantastically successful Image Is Everything Campaign for a new MRI at the Rouge Valley Ajax and Pickering hospital campus. The $5 million MRI came across the 401 for delivery last September. It was community engagement and fundraising at its best.
The reason we were able to install the new, state of the art MRI, relates to another hard won achievement by our Board, our management team, our physicians and our staff. And that is the consistent generation of annual surpluses. For the last five years, Rouge Valley has broken with its past of running deficits, and instead has become more efficient allowing us to reinvest in our facilities. Our surpluses are used to maintain our aging facilities and to buy essential medical equipment, such as the MRI. We were able to purchase the MRI in advance of the completion of fundraising campaign thanks to the efficiency of our team. That meant our community was able to benefit from this MRI scanner years sooner.
As we look ahead to the next three years and more, we know there are many challenges coming. It’s my pleasure to report that Rouge Valley Health System is well positioned to meet these challenges head on for our patients and our communities.

* Read the hospital's 2012 Annual Report.