Helping your allergic child through the fall season

By Dr. Audrey Segal, paediatrician and allergist

The fall can be a particularly challenging time for children with allergies and their families. In addition to an increase in outdoor allergens, kids have returned to school and the potential of being exposed to allergens there as well.  I hope you’ll find the advice below helpful.

From mid-August until the first frost, there is an increase in pollen in the air, especially from ragweed. For those with ragweed or other weed allergies, the fall can be a miserable time of year. Reactions can include itchy, watery eyes; a runny, itchy nose; lots of sneezing; worsening of asthma; and worsening of eczema. Avoiding pollen is impractical (and impossible!), but there are things you can do to help your child through the allergy season. If there is a known pollen allergy:

• Give your child an over-the-counter antihistamine. Just make sure it is the non-drowsy variety or your child will have a hard time staying alert during the day! 
• Make your home a “safe place.” Keep pollen out as much as possible, by closing windows and using air conditioning when necessary. Take your shoes off at the door, and change your clothes if you have been walking outside, especially if you have brushed against plants.

If you suspect an allergy and it hasn’t been diagnosed, start with a visit to your doctor to get a referral to an allergist. While you are waiting to see your allergist, you can follow the above tips to lessen exposure.

Food allergies

In addition to pollen and other environmental allergies, I also treat children with food allergies at Rouge Valley’s allergy clinic. Parents of children with food allergies can be especially worried at back-to-school time, thinking that their children may be exposed through other students’ food. Though reactions at school are rare (thanks to vigilant school policies!), there are ways to ensure that your child remains safe while outside your home:

• Educate your children. Teach them what they can’t eat and not to share their food.
• Always have them carry their epinephrine auto-injector (Allerject or EpiPen). Having this locked up in an office or in a teacher’s desk does not allow your child immediate access to this life-saving injection. As soon as an allergic child is exposed to a known allergen, caregivers should be prepared to give the epinephrine immediately if symptoms appear.
• Show teachers or those caring for your child how to use the epinephrine auto-injector.  Not being sure how it works, or wondering if the child requires an injection, can create a delay in getting the child the life-saving epinephrine that he or she needs. Different brands of auto-injectors give instructions on how to administer the shot, whether with words and pictures, or by talking you through each step. It is a very simple process to learn. And, reassure those looking after your child that it is always better to inject than not (the risks of untreated anaphylaxis are much greater than the risks of giving the epinephrine if it wasn’t truly necessary).  Of course, once your child is old enough, he or she will know how to use the injector.  Don’t forget to call 911, or visit the emergency room, after using the epinephrine. 

So to sum up, if there is a known food allergy, and a child is exposed to this known trigger, be prepared to use the epinephrine auto-injector immediately if necessary. If your child has a reaction to something for the first time (with symptoms including, but not limited to: hives; swelling of the tongue, lips or face; difficulty breathing; profuse vomiting; lethargy; or any other worrisome symptoms) call 911 or see your doctor for immediate medical attention.

If you think your child has an allergy, talk to your family doctor or paediatrician about getting a referral to an allergist who can perform skin testing to the allergic trigger in question. 

In the meantime, I hope you and your family get through the fall with minimal sniffles!

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Dr. Audrey Segal works in the paediatric allergy clinic at Rouge Valley Centenary hospital campus. The clinic runs weekly on Tuesdays and Wednesdays from 8:30 a.m. to 4 p.m. Patients are referred to the clinic from community physicians, through the emergency department, or after discharge from the hospital. The clinic sees more than 1,000 patients a year, from infants to age 18, with environmental, food, and/or drug allergies. For a referral to the paediatric allergy clinic, please have your doctor call 416-281-7013, or fax to 416-281-7102.

Patient-centred care at Rouge Valley

On Aug. 25, 2015, Andrée Robichaud, president & CEO of RVHS, made her first speech to members of the Ajax-Pickering Board of Trade (APBOT). Here is her informative speech on recent news and progress at RVHS, with particular focus on the Rouge Valley Ajax and Pickering hospital campus.

... 

Good afternoon and thank you for inviting me to meet you all today.

It is my pleasure to provide members of the Ajax-Pickering Board of Trade with an update on your community hospital.

First, please allow me to introduce myself to you. I joined Rouge Valley Health System in mid-May of this year.

Until May, I was the president and CEO of the Thunder Bay Regional Health Sciences Centre, since 2010 and CEO of the Thunder Bay Regional Research Institute since November 2014.

Prior to that, I was the president and CEO of one of the two Regional Health Authorities in New Brunswick, and previously held senior government positions within the Ministry of Health in that province.

It’s my pleasure to bring that experience to Rouge Valley, an excellent, innovative community hospital with two hospital campuses: one in Ajax; and the other in Scarborough.

Rouge Valley Health System is always growing to meet and anticipate the needs of patients and families in our growing communities.

Andrée Robichaud, third from right, with APBOT members

The hospital continues to develop for the future by expanding programs and adding new ones to best serve the needs of our population.

Please allow me to mention a few examples.

Our team of staff and cardiologists have expanded the Rouge Valley-led regional cardiovascular rehabilitation and secondary prevention service, in the Central East LHIN (Local Health Integration Network). This service is now available in Ajax, Whitby, Oshawa, Port Perry, Bowmanville, Cobourg, Lindsay, Trent Hills and Scarborough.

Our new Care After The Care in Hospital program, also at both hospital campuses, is helping to reduce readmission rates for patients once they are discharged. Nicknamed CATCH, the program helps our patients better manage their own conditions at home, and to be aware of the supports available to them right here in the community. Patient education from nurses and physiotherapists, combined with doctor follow-up by a general internist at the hospital, makes a difference to patients. In short, they have fewer complications and need to return to hospital less. It’s patient centred care.

Women receiving care at Rouge Valley Ajax and Pickering hospital campus are returning to active lives sooner thanks to laparoscopic hysterectomies. This less invasive procedure means twice-as-fast recoveries, lower infection rates and less scarring, compared to traditional hysterectomies. The majority of our obstetricians and gynecologists at the Ajax and Pickering hospital campus are now offering this specialized procedure, through the leadership of Dr. Eltayeb  and Dr. Rubabaza.

Since last year, Rouge Valley Ajax and Pickering also offers a chronic disease education program for those living with arthritis, osteoporosis or chronic obstructive pulmonary disease, or who are at risk of developing one of these conditions. The Living Well program, as we call it, teaches these patients to create healthier lifestyles, educates family members on supporting them, allows patients to live more independently, and helps them prevent their condition from getting worse.

A new pre-habilitation program at Rouge Valley Ajax and Pickering continues to improve outcomes for shoulder surgery patients. The program provides patients with physiotherapy to strengthen them before receiving their surgical procedures.

With the support of the RVHS Foundation, the surgical program has introduced modern, high-tech GreenLight lasers for much less invasive prostate surgeries at both hospital campuses. This has greatly increased the success of these procedures and minimized patient discomfort and recovery time.

We continue to work on:

• Decreasing patient wait times;
• Enhancing the quality of care and the patient-family experience overall; 
• Increasing physical activity for our longer-term patients, which helps them recover more quickly;
• Increasing our staff engagement, which in turn improves how we care for patients; and 
• Work on our internal patient flow.

In addition, we continue to improve our current programs.

A Cancer Care Ontario report in December showed that women receive the fastest breast screening cancer care in the province in the Central East Regional Cancer Program, that Rouge Valley is proud to be an active part of at both hospital campuses. By calling the program, family doctors can bring women in for a screening almost immediately. Pathology reports from the tests are also quickly completed to minimize a patients’ anxiety and to begin any treatment that may be necessary.

Our emergency department annual patient volumes have grown from 49,500 five years ago to almost 62,000 as of March 31 of this year.

Our outpatient clinic services saw 57,000 patients in 2010, compared to almost 98,000 patients in the last year. Only five years ago we didn’t have an MRI machine. This last year, just over 8,000 patients got their MRI scan done at Rouge Valley Ajax and Pickering’s state-of-the art MRI scanner.

All of these new and continuing excellent services wouldn’t be possible without the terrific team of doctors, staff and volunteers, whom I’m proud to lead and work with into the future.

I’ve seen that the last 12 months have provided Rouge Valley with an opportunity to step up even more for the community in times of crisis.

Our hospital staff and doctors went into action immediately following a fire at a Whitby long-term care home one morning in late October. Their staff safely evacuated the 192 residents of Fairview Lodge, with 27 of them safely accommodated the same day at both Rouge Valley campuses. Other residents were placed with several community organizations, who also came to their rescue.

All this information is to illustrate how we are keeping up to, and anticipating, the needs of our growing community.

Our new three-year Strategic Plan is aligned with those community needs.

During the last 12 months we have developed with the community, doctors, and hospital staff, a new, clear and exciting strategic plan. The plan features a new vision statement and new strategic directions.

Since October of 2014, the hospital, through the leadership of our past chair Joan Wideman and our Board of Directors, has been involved in extensive research, focus groups, surveys and interviews with more than 1,500 people, plus information sharing with more than 115,000 people on social media.

Those engaged in our Strategic Plan process included community members, political leaders, staff, doctors, volunteers, members of the Hospital and the Foundation Board of Directors.

All of this work culminated in our new plan, approved by our hospital Board of Directors in June and unveiled last month by our new Board Chair Fred Clifford. Fred, who lives in Courtice, is a long-serving Rouge Valley board member and senior partner at Ernst and Young LLP.

Our new vision statement represents Rouge Valley’s ongoing work as a leader in quality patient care for our communities.

Our new vision statement is:
Together – the best at what we do.

What this new vision means is that we will be the best at what we do:

• Together — With patients, families, staff, professional staff, volunteers, committees and government;
• Together — As a system working with other healthcare providers, local partners, and government to deliver services for patients and their families. 

To achieve that vision, the hospital has set out three strategic directions under the themes of:

• Innovators of a Quality Patient Experience; 
• Champions of a Connected System for Patients; and 
• Workplace of Choice.

Some of the strategic goals are:

• We plan to develop a palliative care program, which our patients and families told us they want. They told us this at nine of our end-of-life care community engagement focus groups earlier this year. 
• The hospital must also become more senior friendly, ensuring that we have the proper supports in place when seniors are admitted for an acute episode.
• Our team of staff and doctors is focusing on decreasing our wait times for patients. 
• We are also working to increase services in our cancer care program. 

We are strengthening our reputation as the workplace of choice and we’ve recently announced the addition of four sought-after physician specialists to our team at our Rouge Valley Ajax and Pickering hospital campus:

• Cardiologist Dr. Sarah Ipekian, who comes to us from a University of Toronto fellowship in echo-cardiology and cardiac imaging, and is a graduate of medical school and residency at the University of Western Ontario; 
• Radiologist Dr. Maneesh Gupta, a University of Toronto graduate who recently completed a body imaging fellowship at Northwestern Memorial University in Chicago; 
• Neurologist Dr. Elena Sokolova, a graduate of medical school in Russia who completed her residency at the University of Texas and the University of Calgary; and 
• Anesthesiologist Dr. Alim Mansoorali Punja, who is a specialist in interventional chronic pain. He completed his medical training at the University of Calgary and the University of Ottawa, with a fellowship at the University of Toronto. 

These specialists chose Rouge Valley as their place to practice and I can see why.

Our goals are in their infancy and may evolve as we implement our Strategic Plan to best meet the needs of patients and families.

You will be seeing, hearing and reading more about the new Strategic Plan throughout the rest of the summer and into the fall as we engrain it into all that we do for patients and families at Rouge Valley.

Thank you to the Ajax-Pickering Board of Trade. You are the voice of business in the community and we appreciate your support.

We look forward to working together with you as we build an even better hospital for the community.

Thank you.

Strategic Plan Part 3: Our Values

Talking About Our RVHS Strategic Plan 2015-18 Blog Series — Part 3: 
Our Values 

By Dr. Naresh Mohan, Chief of Staff, RVHS

It is my pleasure to discuss perhaps the most important part of our new Strategic Plan 2015-18 – our Values. The Values are the foundation for our Vision, Mission and Strategic Directions.

Our Values are spelled out succinctly and clearly in the Strategic Plan.

“In all that we do, we will be guided by our Values:
• Responsive, respectful and caring for our patients, colleagues and community;
• Value the diversity of our organization and community;
• Honest, trustworthy and accountable for our resources, our services and our behaviours;
• Strive for innovation, high performance and commitment to continuous learning.”

Please allow me to explain what that means to us at Rouge Valley. Our hospital is “responsive, respectful and caring for our patients, colleagues, and community.” Patients and their families wish to be more informed and engaged than ever. Our focus at Rouge Valley Health System in the coming years will be on enhancing their experience. We will offer comfort and empathy to those who entrust their care and their loved ones to us, while working together with patients and their families to help them play a more involved role in their care.

We “value the diversity of our organization and community.” We celebrate that Rouge Valley serves a multicultural community, and that this diversity is reflected in our hospital team as well. We want all of our patients to feel a part of our hospital equally, from making multilingual communication as seamless as possible, to supporting accessibility and religious needs.

We are “honest, trustworthy and accountable for our resources, services and behaviours.” We are not afraid to critically review our actions in order to improve the patient and family experience, as well as our workplace environment and culture. We will anticipate, identify and review issues and challenges that may arise, and implement strategies to make our hospital safer and better for our patients and staff.

At Rouge Valley, we strive for “innovation, high performance and commitment to continuous learning.” Looking ahead, we will continue to invest in new technologies, innovative solutions and in our staff and physician team. We will find creative ways to improve the journey of care at our hospital for patients and their families, working together to meet our targets with respect to patient wait times, access and best practices.
We will also continue to welcome bright, talented and caring health professionals and staff who are the future of your community hospital. We will coach and mentor them as they build on their skills as part of our Rouge Valley community.

I would like to thank all physicians, staff, RVHS Board members, all volunteers, patients and community members who participated in our robust development process of our new Strategic Plan.

It is our pleasure to start making that plan a reality for you and your families. Please know that patients and families will continue to be engaged.

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Read Part 1 of the Strategic Plan Blog Series by our Board Chair Fred Clifford
Read Part 2 of the Strategic Plan Blog Series by our President & CEO Andrée Robichaud

Download a copy of Rouge Valley’s new Strategic Plan 2015-18. To learn more about the strategic planning process that led to the new plan, please visit www.rougevalley.ca/strategic-plan.

Strategic Plan Part 2: Our Strategic Directions

Talking About Our RVHS Strategic Plan 2015-18 

Blog Series — Part 2: Our Strategic Directions  

By Andrée Robichaud, President and CEO, RVHS

Having launched our new Strategic Plan 2015-18 on June 23, we have proudly announced the kind of community hospital that we aspire to be in our new Vision Statement: Together—the best at what we do. 

As our Board Chair Fred Clifford said in his introductory blog in this series, this vision means that we will be the best at what we do:  

• Together — With our patients and families to best meet their needs;

• Together — As a system working with other healthcare providers, local partners and government to deliver services for patients and their families;

• Together — As a team of staff, doctors, and volunteers.

This is who we are committing ourselves to be. The question is how will we achieve this? Our Strategic Plan spells this out in three Strategic Directions: 

1) Innovators of a quality patient experience; 

2) Champions of a connected health system for patients; and 

3) Workplace of choice. 

Here is what we have committed to in our Strategic Directions, as presented in the new Strategic Plan.  

• Innovators of a quality patient experience: As the provider of choice, we will consistently offer exceptional quality services that exceed the expectations of patients, families and our communities through innovative practices and technological solutions. Across the country, Rouge Valley Health System will be known for innovation, collaboration and professional care.
• Champions of a connected health system for patients: We will ensure that the patient’s perspective drives a more unified journey of care — a true system that is easier for patients and families to navigate. As a trusted partner, we will work with other hospitals and community providers toward development of a seamless system of care.
• Workplace of choice: We will promote innovation, excellence and continuous improvement throughout Rouge Valley Health System by attracting and keeping talented healthcare practitioners and professionals, administrative and support staff, and volunteers, who are focused on creating a positive patient and team experience. We will be recognized by our team, partners and community for creating a healthy, safe, respectful and diverse workplace that supports continuous learning and development of our people.

We will be Innovators of a quality patient experience

Rouge Valley is building on its hospital-wide philosophy of continuous improvement for our patients. Innovation is a fundamental element of this Strategic Direction. It is a matter of looking at the journey of patients coming to receive care and their families, and finding ways to change key points of their journey that can positively impact their experience with us. This includes what services we offer and how we deliver them, including at all touch points such as registration, reducing wait times, and their stay at the hospital, right through to discharge.

With this first Strategic Direction, we will be reframing how we go about innovation by increasingly bringing our patients and families to the table to discuss and come up with new ideas and solutions together. Their engagement and participation in their healthcare will be key to deciding how to change our processes, improve delivery of care, and improve our hospital environment in order to achieve the best quality patient experience. 

We will be Champions of a connected health system for patients

We know that our patients’ health and healthcare go beyond Rouge Valley. We are part of a larger system of other providers, funders and decision-makers. We understand that it will take all of us working together to ensure the best experience for patients. That is why we want to be more than role players within the health system; we will be “Champions,” promoting increased connectivity and partnership to make service delivery better and simpler for patients. We will be looking at how our services can best tie into related care provided by other organizations in our communities, and what opportunities there are for collaboration to make it easier for patients to get the care they need. 

We will be a Workplace of choice

Our workforce team will be one of the keys to the success of our Strategic Plan during the next three years. We will be a workplace where expert, caring and compassionate healthcare practitioners and professionals, administrative and support staff, and volunteers want to come to share their talents together as a team. In addition to our processes to attract and keep the best, we will also focus on how we shape our hospital spaces and culture. 

We will become the hospital that everyone would choose to work at. We strongly believe that continuing to improve our team environment for staff, physicians and volunteers will improve patient care. And that’s what it’s all about. 

Next steps

During the next few months, our focus will be on setting the groundwork for the implementation of the Strategic Plan. We will do this by first defining a set of very specific strategic goals for each of our three Strategic Directions. This will include goals such as: 

• Innovators of a quality patient experience — Offering exceptional quality services to patients while applying The Rouge Valley Way of caring in each of our day-to-day actions, empowering patients and families to best meet their needs – together; 
• Champions of a connected health system for patients — Reviewing our model of care for complex continuing care and rehabilitation. Reviewing how we deliver these services, and developing our role with the regional palliative care program. (Our Community Advisory Group’s recent Report on End-of-Life Care Patient/Family Experience provided valuable patient and family insights on this subject);
• Workplace of choice — Expanding our teaching affiliation agreements with current academic partners and new ones, while providing the best quality environment within our hospital.

We will use these goals to build departmental work plans that will outline how our Strategic Plan will be operationalized across all areas of the hospital.

This summer and fall will continue to be an exciting time for us as we roll out the new Strategic Plan. We will continue to keep our community and stakeholders informed on our progress as we go forward.

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Download a copy of Rouge Valley’s new Strategic Plan 2015-18. To learn more about the strategic planning process that led to the new plan, please visit www.rougevalley.ca/strategic-plan.  

Talking About Our RVHS Strategic Plan 2015-18 Blog Series — Part 1: Our Vision

By Fred Clifford, Chair, RVHS Board of Directors

Presenting the hospital's new Vision Statement
at the Strategic Plan unveiling event, held on
July 7, 2015 at Rouge Valley Ajax and
Pickering hospital campus.

On June 23, Rouge Valley Health System introduced our new Vision Statement, as part of our 2015-18 Strategic Plan. The plan was approved that morning at our Board of Directors meeting, and shared for a first time publicly that afternoon at the Annual General Meeting of Members.

The new Vision Statement of the Strategic Plan represents Rouge Valley’s ongoing work as a leader in quality patient care for our communities.

Our new Vision Statement is Together – the best at what we do.

This statement builds upon Rouge Valley’s previous vision statement with the simple, but powerful, addition of one word: Together.

If you were to look up the word “together” in a dictionary (or these days, you may be more likely to Google it online), you would find a few meanings, such as:

– A group or collection in one place as a whole; 

– In proximity, contact, connection with others; 

– Simultaneously, in agreement or harmony.

All of this — whole, connection, harmony — is what we are so proudly stating about the kind of hospital we will be with our community. Our Vision Statement means that we will be the best at what we do:

– Together — With our patients and families to best meet their needs; 

– Together — As a team of staff, doctors, and volunteers;

– Together — As a system working with other healthcare providers, local partners and government to deliver services for patients and their families.

There’s one more meaning for “together” that I really like. It’s a little more colloquial, but is fitting as we embark upon this new Strategic Plan — and that meaning is: confident, organized, able to use your abilities to achieve what you set out to do. As in, “Rouge Valley is a very together community hospital.” Health care is changing, and we are ready to help shape that change.

With our Strategic Plan and our vision to be the best, we have set an ambitious course for the next three years. We know we can accomplish this, but we understand that it is only possible if all of us — healthcare team, patients and family, and health and community partners — are actively collaborating, partnering, getting engaged and being there for each other. I look forward to us achieving this together.

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Download a copy of Rouge Valley’s new Strategic Plan 2015-18. To learn more about the strategic planning process that led to the new plan, please visit www.rougevalley.ca/strategic-plan.

Growth, integration and investments in community needs are on the horizon

By Rik Ganderton, Interim President and CEO 

CEO's Message and introduction to 'The Blue Book'  
RVHS Operating and Capital Plan 2015/2016  

My thanks to all staff, physicians, midwives and volunteers for continuing to grow and integrate high quality services for our communities at Rouge Valley Health System (RVHS) during the previous fiscal year. Every year brings a mix of the predictable challenges, but also some new ones.  

In 2014/15, our teams managed through several difficult issues including: Ebola preparedness; accommodating 27 residents who lost their homes due to a fire at a Whitby long-term care home; a privacy breach; a tough flu season; a strike by nurses at the Community Care Access Centre; and surges in the volume of patients presenting to our emergency departments.

Despite these challenges, Rouge Valley is in a position to initiate new and much-needed investments for our ever-growing communities of Scarborough, Ajax, Pickering, Seaton and Whitby in the 2015/2016 fiscal year and beyond. Due to fiscally responsible management that has led to year-end budget surpluses in each year since 2008, we’ve earned the enviable reputation of being able to invest in new and future hospital services.

Rouge Valley is planning to meet the future needs of the soon-be-developed Seaton community in north Pickering, which will be home to some 70,000 people in about five years. At its public board of directors’ meeting in December 2014, the Central East Local Health Integration Network (LHIN) Board of Directors endorsed our early-stage pre-capital planning submission to continue planning in order to meet Seaton’s future needs. 

The Central East LHIN also endorsed two other significant early-stage pre-capital submissions: 

• Redevelopment of Rouge Valley Ajax and Pickering (RVAP) hospital campus, which has already surpassed the 60,000 annual emergency department visits it was expanded for in 2011; 

• Renovation of emergency department facilities at Rouge Valley Centenary (RVC), which community demand has significantly outpaced during the last 20 years. RVC receives more than 66,000 emergency visits a year in a space built for 20,000 visits.

We are also planning related extensive redevelopment at RVC in: surgery; inpatient units; ambulatory services; and diagnostics. 

Our pre-capital planning submission assumes that during the next 20 years, significant redevelopment of existing hospital capacity at RVC will be required to meet the healthcare needs of residents residing in the Scarborough cluster of the Central East LHIN. Planning data suggests a requirement for 1,100 to 1,200 beds by the year 2031. An opportunity exists to renovate, reconfigure and add capacity to the existing inpatient units at the RVC campus. This would bring the total bed complement to 550-plus beds, in an attempt to minimize the necessity for the entire replacement (e.g. new facilities) of all the hospital sites within the Scarborough cluster. (This assumes that one hospital in the range of 500-600 beds would then meet roughly one-half of the 1,100 to 1,200 bed requirements for the Scarborough cluster, exclusive of any repurposing of physical buildings required to support the delivery of ambulatory care services.) 

Integrations

One of our greatest strengths is our willingness and ability to work with other healthcare providers to create accessible and connected care for patients and their families. 

Thanks to new funding from the Central East LHIN earlier this year, Rouge Valley was able to transfer funds for a new full-time nurse to work with mental health patients in the community.

The new full-time nursing position at Durham Mental Health Services (DMHS) is now integrated with Rouge Valley’s Assertive Community Treatment Team (ACTT) in its Stepped Care service. The program helps people live in the community while receiving mental health care, without having to come to a busy emergency department. 

The latest initiative between RVHS and DMHS builds on their recent history of collaboration. Since 2011, RVHS transfers $200,000 a year to DMHS toward staffing a community crisis location in Ajax, again allowing people to be treated in the community rather than having to come to the hospital. DMHS also has a full-time staff member at RVC’s emergency department in our hospital-to-home program. 

Our regional cardiac care program also continues to be a beacon to others of integration potential as it exemplifies what can be done for patients accessing specialized care, such as Code STEMI, throughout Scarborough and Durham. The program also offers its regional cardiovascular rehabilitation and secondary prevention service now to Kawartha Lakes, as well as in Scarborough and Durham. 

The February 2009 Central East LHIN Hospital Clinical Services Plan identified the need for integrated cardiac rehabilitation services using a “hub and spoke” service delivery model, with common standards to establish local access to consistent, high quality services. In 2011, RVHS and Lakeridge Health (LH) submitted a Regional Cardiovascular Rehabilitation and Secondary Prevention Voluntary Integration Proposal using a hub and spoke model, with RVHS being the hub and LH the first spoke. The Central East LHIN approved $1 million of incremental funding, which enabled the following: 

A) Integration of the existing programs at RVHS and LH; and 

B) Harmonized referral criteria with centralized referral. There are now nine satellite sites across Scarborough, Durham & Kawartha Lakes. 

In December 2014, the Central East LHIN approved $1 million of funding toward the expansion of the cardiovascular rehabilitation program and establishment of the heart function management program, to serve additional patients, provide additional sites, and enhance support for patients with heart failure.

Setting the stage 

In the previous fiscal year, we set the stage for more growth and modernization of several patient care services. 

With the support of the RVHS Foundation, our surgical program has introduced GreenLightTM lasers for prostate surgery, greatly increasing the success of these procedures and minimizing patient discomfort and recovery time. The Cancer service has implemented the Prostate Diagnostic Assessment Unit to help men get faster diagnosis and treatment for prostate cancer. It is a multidisciplinary clinic staffed by urologists, radiation oncologists, medical oncologists, and a nurse navigator. The aim is to shorten the wait times for consultation and time to biopsy, pathology results, and treatment.

We have also recently set the stage for keeping wait times below three months for orthopaedic surgical patients (hips, knees, shoulders).  We’ve set a 90-day target from the time patients are referred to the day they have their surgical procedure done.  With proper funding, orthopaedic patients can get access to assessment and surgical or non-surgical treatment in 90 days or less. This is less than half the provincial target time from referral by a family doctor to the patient receiving the surgery in medically suitable cases. 

We have also developed and implemented a standardized process for hip and knee replacement and shoulder care that provides an improved patient/provider experience, lower system cost with high quality outcomes, and lower wait times for patients overall.

Our orthopaedic program continues with its innovative “prehab” approach for major joint replacements. We are also starting to work with our primary care colleagues in hip, knee and shoulders to introduce care pathways that span the typical silos. 

We continue to grow and develop our Women’s and Children’s program.  In 2014, we launched an extensive marketing campaign to promote this program. Since 2011, our Rouge Valley Centenary site has been a designated level 2C facility for maternal and neonatal care and is currently the only facility in Scarborough with the authorization to deliver and manage newborns as young as 30 weeks gestation.  To support our commitment to developing specialized expertise, we have opened a Maternal Fetal Medicine (MFM) clinic so that mothers at risk can access this service in their home community.  

Leveraging the expertise of our large complement of paediatric subspecialists and our close relationship with SickKids, we continue to expand our paediatric clinics to provide our community with access to paediatric specialty care close to home. 

Last year we introduced a new paediatric constipation clinic bringing the number of paediatric clinics to 17. In 2015, we will benefit from ‘twin’ family lounges generously donated and built by Ronald McDonald House – the first time they have ever implemented two lounges in one hospital at the same time.

Enhanced physiotherapy services were introduced last year at both of our hospital campuses for high-risk inpatients, especially the frail elderly, during the winter months. Additionally, the 2015/16 operating plan includes a significant budget investment of $400K for increased allied health services for weekend and vacation coverage.

One of our newest initiatives is helping to reduce readmission rates for patients once they are discharged from hospital. Studies have shown that inadequate support following discharge home contributes to a longer hospital stay, higher risk of negative health outcomes, and readmissions. Our Care After The Care in Hospital (CATCH) program is designed to fix that. It works to improve patient flow connecting physicians, nurses and rehabilitation therapists to work together to help reduce the patient’s chances of being readmitted for the same medical issue. Patients are referred to CATCH when they are discharged from hospital so they can manage their care at home without a setback forcing them to return to hospital.

 

Surpluses are vital 

Maintaining our ability to reinvest in our facilities, equipment and services is key to meeting community needs so we can grow with them. As we look to future growth and integration opportunities, it is important to maintain our resolve to generate annual operating surpluses. I’d like to emphasize that we need operating surpluses in order to:  

• Maintain and upgrade our facilities infrastructure, which was cash-starved over many years of operating deficits before we implemented the successful deficit elimination plan (2008-11); 

• Fund our capital equipment needs. Our annual capital list, excluding facilities items, includes $17 million in front-line patient care equipment, clinical support equipment, diagnostic imaging, and information systems, which are vital to the safe and efficient functioning of our hospital and achievement of our strategic directions; in 2015 we will acquire a new MRI and two new CTs as well as other types of new equipment; and 

• Fund future strategic growth initiatives. 

Capital and operational reinvestment will continue to take priority during the next fiscal year. However, sustaining this level of financial performance promises to be increasingly challenging as growth in volumes, in particular our emergency department visits, puts pressure on our bed capacity and cost structure. As emergency visits grow, our admissions grow. This can necessitate the opening of unbudgeted inpatient bed capacity.  

Managing volume growth in an efficient and effective manner will be a critical success factor for RVHS in the 2015/2016 fiscal year. We strongly believe that good quality costs less and continue our relentless focus on quality to support not only high quality care, but also fiscal responsibility. Our hospital has sustained its commitment to Lean thinking for over six years.  We continue to reap the benefits of this approach to continuous quality improvement, which underpins our 2015/16 Quality Improvement Plan.

We can proudly say that our track record is strong and sustained at Rouge Valley. Let’s make sure that we stay focused and aligned as a team. 

My thanks to all involved in the creation of this year’s Blue Book. All the best to the entire Rouge Valley team as plans and actions take shape this year and into the future.