President’s Blog: Rik Ganderton
I meet every week one-on-one with each member of the senior management team to listen, learn and ask questions about hospital issues and challenges and performance. Most of these meetings occur in an office, usually mine.
I want the senior management team to be much more visible in the organization, and to listen, learn and ask questions about hospital performance and challenges. I am changing the format of my weekly meetings from a review in my office to a weekly, structured walkabout.
In the last week of each month I will to do a full review of Quality, Operational Performance, Risk Management and other Personal Business Commitment items, (to be posted soon by the way) which will be office based.
This is a Lean management technique known as a Gemba Walk. It will allow me and members of the senior management team to review and understand key issues such as flow, wait times, quality care, safety, use of resources, continuous improvement efforts, teamwork and more.
Gemba is a Japanese term meaning the real place. These walks will support a better connection between senior management and the front line, or the real place where our patient care and related work is done everyday.
Getting out of the office and meeting with managers and staff on the floors is also in keeping with our growing Lean culture at Rouge Valley Health System.
The senior management team and I expect to learn from you and will contribute to progress in your department or area.
On the Gemba Walks I will rotate through the areas across both sites so that we visit all locations. On each Gemba Walk I want to review where each area is on meeting minimum Lean standards and what the action plans are to get to those minimum standards.
Minimum Lean standards can be demonstrated through visual management, in the form of:
• Process control boards for at least one key process;
• Evidence of Pareto analysis (demonstrating how you weighted issues in order to monitor and problem solve);
• Action plans to drive process improvement;
• Performance control boards that track progress on key metrics. There should be at least one metric for each of the following dimensions: Access, Service Excellence, Financial Sustainment and Team Engagement;
• Evidence that at least one 6S has been conducted in the department in the last 12 months (6S – safety, sort, straighten, shine, standardize, sustain);
• A3 postings, may be a good means to display this evidence.
I look forward to meeting more of you through this process.
Regards,
Rik
Wednesday, April 7, 2010
Wednesday, March 31, 2010
Senior Management Team changes
President's Blog
Rik Ganderton
We are implementing some changes at the Senior Management Team, effective Thursday, April 1, 2010.
The purpose of these changes is to better align portfolios with the evolving needs of our hospital, our corporate objectives and enhance the strong leadership skill set of our team.
Natalie Bubela will now have the title of Vice-President Regional Programs, Program Integration and Chief Nursing Executive (CNE). As CNE Natalie will have responsibility for the ongoing development and improvement of nursing and allied health professional practice. As VP Integration, she will be responsible for advancing RVHS’ participation in the implementation of the Central East LHIN Clinical Services Plan as well as the development of new program integration and program development opportunities. As VP Regional Programs, Natalie will have ongoing operational leadership for the Cardiac, Cancer and Women’s and Children’s programs.
Sonia Peczeniuk will continue as Vice-President Clinical Support, but will also take on responsibility for the Surgical Program. She will relinquish her role as VP Medical Affairs when our new Chief of Staff starts, likely towards the end of May.
Michele Jordan will be Vice-President Quality Improvement and Transformation. Michele will continue to lead transformation and the deployment of Lean organization wide. She will also take on the role as leading the improvement of quality organization wide. This will include clinical quality, customer service and safety. Michele will also work with me to develop the next iteration of our Strategic Plan on a Page.
John Aldis will continue as Vice-President Corporate Services, but will also take on responsibility for Post Acute Care.
I would also like to welcome Cheryl Williams to the Senior Management Team as Vice-President Acute Care Services. Cheryl will have responsibility for Emergency, Medicine and Critical Care, Mental Health and Patient Flow.
There are no immediate changes to the responsibilities of Darrell Sewell, Rick Gowrie or Dave Brazeau. Dr. Naresh Mohan and Dr. Romas Stas will continue in their roles as key members of the Senior Management Team.
I ask you all to continue to support our new leadership structure and I wish each of our VPs great success in their new roles and responsibilities.
Rik Ganderton
President and CEO
Rik Ganderton
We are implementing some changes at the Senior Management Team, effective Thursday, April 1, 2010.
The purpose of these changes is to better align portfolios with the evolving needs of our hospital, our corporate objectives and enhance the strong leadership skill set of our team.
Natalie Bubela will now have the title of Vice-President Regional Programs, Program Integration and Chief Nursing Executive (CNE). As CNE Natalie will have responsibility for the ongoing development and improvement of nursing and allied health professional practice. As VP Integration, she will be responsible for advancing RVHS’ participation in the implementation of the Central East LHIN Clinical Services Plan as well as the development of new program integration and program development opportunities. As VP Regional Programs, Natalie will have ongoing operational leadership for the Cardiac, Cancer and Women’s and Children’s programs.
Sonia Peczeniuk will continue as Vice-President Clinical Support, but will also take on responsibility for the Surgical Program. She will relinquish her role as VP Medical Affairs when our new Chief of Staff starts, likely towards the end of May.
Michele Jordan will be Vice-President Quality Improvement and Transformation. Michele will continue to lead transformation and the deployment of Lean organization wide. She will also take on the role as leading the improvement of quality organization wide. This will include clinical quality, customer service and safety. Michele will also work with me to develop the next iteration of our Strategic Plan on a Page.
John Aldis will continue as Vice-President Corporate Services, but will also take on responsibility for Post Acute Care.
I would also like to welcome Cheryl Williams to the Senior Management Team as Vice-President Acute Care Services. Cheryl will have responsibility for Emergency, Medicine and Critical Care, Mental Health and Patient Flow.
There are no immediate changes to the responsibilities of Darrell Sewell, Rick Gowrie or Dave Brazeau. Dr. Naresh Mohan and Dr. Romas Stas will continue in their roles as key members of the Senior Management Team.
I ask you all to continue to support our new leadership structure and I wish each of our VPs great success in their new roles and responsibilities.
Rik Ganderton
President and CEO
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.
MRI
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.
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.
MRI
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.
Wednesday, February 17, 2010
Fight heart disease with heart healthy foods
By Valerie Manbeck
Clinical Dietitian, Rouge Valley Health System
Did you know that by changing the foods you eat, you can reduce your chances of heart disease?
By introducing more heart-healthy foods into your diet, you can fight your chances of having a heart attack.
Changing the foods you eat certainly isn’t easy. However, knowing which foods to add and which to eliminate can help kick-start your way towards a heart-healthy diet.
Here are some of the top five easy tips to help you on your way to a more heart-healthy diet:
1. Limit unhealthy fats.
Limiting saturated and trans fats is linked to a decrease in blood cholesterol levels, which lowers your risk of developing heart disease. A high blood-cholesterol level can lead to plaque build-up in your arteries, increasing your risk of a heart attack.
To reduce saturated fats, try cutting down on ‘fatty’ meats like sausages or bacon, and replacing them with leaner meats. Lean meats, like poultry and fish, and low-fat dairy products such as skim or one per cent milk, are good options.
To reduce trans fats, limit foods made with shortening or partially hydrogenated vegetable oil. Instead, choose healthier fats like olive and canola oils. Nuts and seeds also contain healthier fats. But remember that all types of fat are high in calories, eating these foods in moderation is key here.
2. Choose foods with omega-3 fatty acids.
The impact that omega-3 fatty acids have on lowering your chances of heart disease are enormous. These foods can help decrease your overall risk of heart disease.
Eating ‘fatty’ fish such as, salmon, tuna, sardines, mackerel, trout, and herring at least twice a week is a great way to incorporate omega-3 fatty acids into your diet. Good sources include salmon, sardines, and herring.
3. Eat more fruits and vegetables.
A diet rich in fruits and vegetables does wonders for your waistline and helps to thwart heart disease. These two food groups are also low in calories, and full of fiber and anti-oxidants, which are keys to preventing and slowing damage to blood vessels.
Look for colourful fruits and vegetables. For example, mangos, carrots, spinach, broccoli and sweet potatoes are all good choices. Whenever possible, opt for fresh or even frozen fruits instead of fruit juices. Aim for two to three fruit servings a day, and at least four servings of vegetables each day. Try two at lunch and two at dinner, to get your vegetable servings in.
Adding fruits and vegetables to your diet isn’t as hard as you might think. Try keeping veggies like broccoli, carrots or cauliflower washed and cut up in your refrigerator. Choose recipes that feature fruits or vegetables as the main ingredient, such as fruit salads or stir-fry. And try not to cover vegetables with butter, dressings or creamy sauces, as many of these are high in fat.
4. Reduce salt.
Consuming a lot of salt can contribute to high blood pressure, a risk factor for heart disease. So, reducing your salt intake is a key part of a heart healthy diet.
The Heart & Stroke Foundation recommends that you eat less than 2,300 milligrams of sodium (one tablespoon or five mililetres of salt) a day. For those who have been diagnosed with high blood pressure (hypertension), sodium intake should be limited to 1,500 milligrams (two-thirds of a teaspoon) a day.
And while not reaching for the salt shaker is a good start, cutting back on processed foods is even more important. Much of the salt many of us eat comes from canned or processed foods, like canned soups and frozen dinners. Eating fresh foods and making your own soups and stews can help reduce your salt intake. And if you do prefer the convenience of canned foods and frozen meals, look for those with reduced sodium. Also, try other herbs and spices instead of table salt to flavour your food.
5. Go for soluble fibers.
Increasing your intake of soluble fiber is a great way to lower your blood cholesterol. Good sources of this fiber include oats, psyllium-enriched breakfast cereals (e.g. Kellogg’s All Bran Buds), ground flax seeds and citrus fruit. Adding ground flax seeds to your yogurt, apple sauce or hot cereal can be an easy way to add soluble fiber to your diet. Simply grind the seeds in a blender and stir in with a teaspoon.
Clinical Dietitian, Rouge Valley Health System
Did you know that by changing the foods you eat, you can reduce your chances of heart disease?
By introducing more heart-healthy foods into your diet, you can fight your chances of having a heart attack.
Changing the foods you eat certainly isn’t easy. However, knowing which foods to add and which to eliminate can help kick-start your way towards a heart-healthy diet.
Here are some of the top five easy tips to help you on your way to a more heart-healthy diet:
1. Limit unhealthy fats.
Limiting saturated and trans fats is linked to a decrease in blood cholesterol levels, which lowers your risk of developing heart disease. A high blood-cholesterol level can lead to plaque build-up in your arteries, increasing your risk of a heart attack.
To reduce saturated fats, try cutting down on ‘fatty’ meats like sausages or bacon, and replacing them with leaner meats. Lean meats, like poultry and fish, and low-fat dairy products such as skim or one per cent milk, are good options.
To reduce trans fats, limit foods made with shortening or partially hydrogenated vegetable oil. Instead, choose healthier fats like olive and canola oils. Nuts and seeds also contain healthier fats. But remember that all types of fat are high in calories, eating these foods in moderation is key here.
2. Choose foods with omega-3 fatty acids.
The impact that omega-3 fatty acids have on lowering your chances of heart disease are enormous. These foods can help decrease your overall risk of heart disease.
Eating ‘fatty’ fish such as, salmon, tuna, sardines, mackerel, trout, and herring at least twice a week is a great way to incorporate omega-3 fatty acids into your diet. Good sources include salmon, sardines, and herring.
3. Eat more fruits and vegetables.
A diet rich in fruits and vegetables does wonders for your waistline and helps to thwart heart disease. These two food groups are also low in calories, and full of fiber and anti-oxidants, which are keys to preventing and slowing damage to blood vessels.
Look for colourful fruits and vegetables. For example, mangos, carrots, spinach, broccoli and sweet potatoes are all good choices. Whenever possible, opt for fresh or even frozen fruits instead of fruit juices. Aim for two to three fruit servings a day, and at least four servings of vegetables each day. Try two at lunch and two at dinner, to get your vegetable servings in.
Adding fruits and vegetables to your diet isn’t as hard as you might think. Try keeping veggies like broccoli, carrots or cauliflower washed and cut up in your refrigerator. Choose recipes that feature fruits or vegetables as the main ingredient, such as fruit salads or stir-fry. And try not to cover vegetables with butter, dressings or creamy sauces, as many of these are high in fat.
4. Reduce salt.
Consuming a lot of salt can contribute to high blood pressure, a risk factor for heart disease. So, reducing your salt intake is a key part of a heart healthy diet.
The Heart & Stroke Foundation recommends that you eat less than 2,300 milligrams of sodium (one tablespoon or five mililetres of salt) a day. For those who have been diagnosed with high blood pressure (hypertension), sodium intake should be limited to 1,500 milligrams (two-thirds of a teaspoon) a day.
And while not reaching for the salt shaker is a good start, cutting back on processed foods is even more important. Much of the salt many of us eat comes from canned or processed foods, like canned soups and frozen dinners. Eating fresh foods and making your own soups and stews can help reduce your salt intake. And if you do prefer the convenience of canned foods and frozen meals, look for those with reduced sodium. Also, try other herbs and spices instead of table salt to flavour your food.
5. Go for soluble fibers.
Increasing your intake of soluble fiber is a great way to lower your blood cholesterol. Good sources of this fiber include oats, psyllium-enriched breakfast cereals (e.g. Kellogg’s All Bran Buds), ground flax seeds and citrus fruit. Adding ground flax seeds to your yogurt, apple sauce or hot cereal can be an easy way to add soluble fiber to your diet. Simply grind the seeds in a blender and stir in with a teaspoon.
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