CEO Spring Update
It is now the end of the fiscal year and time to reflect on the past year and plan the direction for the next year. One year ago, a new Strategic Plan for 2009-2014 was launched with five strategic directions on Quality Patient Care, Effective Partnership and Relationships, Quality Worklife, Accountable Governance, Leadership and Financial Management, and Appropriate Infrastructure. The management team developed specific goals to achieve in these areas. Despite many challenges and some set backs, we have made progress and successfully achieved many of the targets for last year. There is still much work to be done and we will need to continually monitor progress. I cannot highlight all of the activities but will mention a few of general interest and proposed future directions.
Quality Patient Care
The last reports sent to Accreditation Canada in December were approved and met the requirements for Accreditation. The last of the reports are due in June and then the cycle repeats with the next Accreditation scheduled for September 2011. Accreditation Canada introduced 21 required organizational practices to enhance patient safety. Two major changes for Stanton were the introduction of the Medication Reconciliation process and a Falls Prevention Strategy. Stanton has established a committee to work on refining the reconciliation process to make it as effective and efficient as possible. The worklife survey as part of the Accreditation identified areas requiring improvement. These have become part of the HR Working Group follow up.
The staff continues to work as a team to provide quality, safe care. Interdisciplinary meetings focus on care planning and delivery. To maintain competency levels and continued quality care, educational sessions on the following topics are being delivered: infection control, wound care, assessment skills and safe medication practices and documentation.
A new Pandemic Plan was developed incorporating the H1N1 experience. We now need to focus on broader emergency preparedness. We are currently working with municipal partners to update plans.
Effective Partnerships and Relationships
A new Communication Plan for Stanton was approved. One of the goals is to increase communication internally and externally. This update is part of that plan and we hope to produce these on more regular basis.
YHSSA and STHA CEO and the Medical Directors meet on a monthly basis to discuss common issues and opportunities for partnerships. I recently met with YHSSA Board and discussed ways that Stanton and YHHSA are working together to improve patient care and utilization of resources. Given that much of the hospital care is provided by YHSSA physicians these are critical relationships.
Stanton is working with Dehcho and Hay River Health Authorities on breast screening initiatives to provide screening outside of Stanton and reduce waitlists. We are also working with Hay River to implement an endoscopy blitz to do approximately 150 scopes in Hay River reducing both their and our urgent cases on the waitlist.
The Stanton Foundation has completed the new donor wall project in the Lobby and recognition wall down the hall towards Radiology. Shortly you will see up to date knowledge on Foundation projects on LCD screens.
Quality Worklife
The HR Working Group continues to work on strategic goals. We had made some improvement in indicators but others have fallen short of the targets. We continue to work with Human Resources to facilitate staffing processes as well as make sure job descriptions are updated to avoid delays in process.
Physician recruitment for Internal Medicine is a critical area and efforts will continue to aggressively recruit for this position.
A critical goal for next year is the development of a long term Physician Resource Plan. This will involve many facets to strategically plan so that we can continue to recruit and fill vacancies for specialist programs.
We are currently in the process of reviewing options for an electronic scheduling system to help support staffing and staff scheduling.
Accountable Governance, Leadership and Financial Management
Paddy Meade, Deputy Minister, Department of Health and Social Services, has actively assumed the role of Public Administrator at Stanton. The CEO meets with Ms. Meade bimonthly and on the other month, the PA meets with the senior management team as part of our senior management meetings. A job description has been developed and reporting structure and relationships established. This has provided an opportunity to clearly present the facts and challenges that Stanton faces. The minutes of these meetings are posted on the website.
Stanton continues to face very real fiscal challenges. One of our greatest challenges is having fiscal responsibility for territorial programs that are co-managed on a system-wide basis and for which the level of service delivery is well beyond our budget capacity. An estimated 60% of our annual operating deficit is directly attributable to these programs. Also, the 2008/2009 Annual Report demonstrated continued growth, in many other Stanton program areas, to a level where the costs to deliver the programs exceed our budget capacity. Of key importance in addressing these challenges is a clearly defined scope and mandate of service delivery for Stanton as a territorial service that is appropriately funded. We hope to see this addressed through the work done under the “Foundation for Change”.
One of our strategic goals is “Stanton is contributing to the achievement of an affordable, sustainable and publicly funded system”. We have already put a number of initiatives in place to help us reach this goal, some of which have been outlined previously in this update. As we continue to look at opportunities within our control to achieve this goal, we will also be working collaboratively with the Department and other health authorities to move forward with opportunities for system-wide gains.
Stanton’s utilization committee has reviewed referral processes and established clear criteria to ensure referrals are appropriate so we can effectively manage waitlists. There will continued review of practices so the most effective utilization of both primary care physicians and specialists are maximized given the pressure on waitlists and access challenges. Physicians have piloted the use of video conferencing to assist in screening consults for Internal Medicine. The initial trial proved to be very effective to provide direction and support to primary care providers and improve access for patients.
Appropriate Infrastructure
The space challenges continue to impact our ability to meet the demands of patient care. The inability to increase capacity in ambulatory care services and provide space for short term care in ER are only a few of the critical issues. CSR has been a long standing issue and is a priority to address. Space and the impact on patient care and privacy are the most frequently cited issues to senior management on walkabouts. This continues to be raised at many forums including a presentation and tour for Yellowknife MLAs. Medical Travel and Finance Staff will be relocating to Center Ice Plaza over the next couple of months. This will allow us to continue to repatriate patient rooms back to clinical use and provide better workspace for staff.
In closing, I would like to thank Stanton’s dedicated staff for their continued efforts and contribution to patient care and Stanton. They play a critical role in the healthcare delivery system. As Stanton is continually challenged to meet the health care needs of the North as a Territorial Referral Hospital, their commitment to improve things and work with the management team to improve service is appreciated.