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2015 Annual Community Meeting
Monday, June 29
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Good afternoon, everyone and thank you for joining us here today.
I would like to begin by thanking our Board of Directors for their commitment and expert guidance over the past year. In particular, I would like to acknowledge our Board Chair, Ruthe Anne Conyngham, whose term ends today. Ruthe Anne, thank you for your vision, leadership, and steadfast belief that LHSC can and will be at the forefront of change.
I also welcome and look forward to working with the incoming Board Chair, Tom Gergeley, as he assumes our governance leadership.
I would be remiss if I did not take this opportunity to acknowledge Dr. Mark MacLeod, whose medical leadership and vision remains exemplary at LHSC.
In his remarks, Mark spoke about the changes in physician accountability that are critical to the success of system transformation. Already we are beginning to shift in this direction with very positive results, and Mark’s support and leadership has been instrumental in helping move us forward.
I also want to thank LHSC’s key partners who you heard from earlier. Children’s Health Foundation, London Health Sciences Foundation, and Lawson Health Research Institute play a very important role in helping LHSC’s staff and physicians to continue providing patients and their families with high-quality, compassionate and innovative care.
Some examples of that care can be found in the package you received on your way in, which includes the latest edition of Inside, our community publication that continues to share some of the remarkable patient care stories happening every day at LHSC.
And wrapped around that publication is a condensed version of our Annual Report. I encourage you to go online to learn more about LHSC’s strategic priorities, and our year in review including the audited financial report.
You will see from our financial statements that LHSC finished the year with a $4-million dollar surplus which, given the size of our operating budget, can be considered essentially a balanced budget.
This accomplishment did not come without challenge and sacrifices.
For each of the past 3 years, we have faced a roughly $30 million funding shortfall, a trend which we expect to continue in the coming years. If we continue with traditional cost reduction measures, like across-the-board saving targets, we will begin to impact the standard of service we have today.
The fact is, there is a move afoot to increasingly reduce the reliance on acute care hospitals in Ontario. As Mark alluded to earlier, a key part of health system transformation is providing the right care in the right place at the right time.
Today, patients frequently come to the hospital because required services are not available in the community, or because they do not know how to access services that are currently available.
On any given day we also have 50-80 patients in a hospital bed waiting for a placement in the community. They are in that bed because they have no access to community resources.
This reality will only increase as our population ages and medical conditions become increasingly complex.
To address this reality, heath funding increases in Ontario – while lower than in the past – are shifting from hospitals to instead support community health service providers.
While reduced funding growth for LHSC is a real challenge, we support the need for community-based services to grow to better meet the demands of our health system, and we believe that stronger care closer to home will also mean reduced reliance on acute care hospitals down the road.
This health system transformation is necessary to ensure we have a high quality and sustainable health system in Ontario and these changes are here to stay.
At LHSC we recognize that we must fundamentally change the way we deliver services; we must re-imagine how we provide care so that we can continue to meet the growing health needs of the communities and regions we serve.
And the way we will approach this change is through one word: partnerships. Today I would like to talk to you about partnerships and how they are going to play a pivotal role in the future of London Health Sciences Centre.
Strengthening our partnerships has been a key focus for the past two years at LHSC.
This goal has been embedded in our strategic priorities that have focused on renewing our clinical priorities, improving staff engagement and accountability, and increasing the patient and family voice in decision-making.
Last year, our strategic priorities focused on Clinical Services Renewal, Cultural Transformation, implementing our Enabling Technology Plan, and Financial and Resource Sustainability.
The focus on these priorities helped us to lay a solid foundation to help lead the health-system transformation, built upon our strong partnerships both within and outside the hospital’s walls.
The goal of our transformation work is to create sustainable changes that will:
One of the most recent examples that encompasses all of these goals can be seen in the work underway at LHSC using the Toyota Production System methodology.
TPS has been applied to some of the major transformation work underway in large clinical areas, including Medicine, Mental Health, and our Emergency Departments.
Many of you here today may be aware of the construction underway in both of our Emergency Departments. These renovations are needed to enable us to phase-in a new model of ED care beginning this fall, which is part of a much broader redesign of the way care is provided at LHSC.
The changes now underway represent the culmination of 18 months of effort, planning, and partnerships amongst front-line staff, physicians, patients, their colleagues throughout the hospital as well as partner agencies within the region.
Together, these groups have redesigned the way clinical services will be offered inside LHSC, and also the way transitions in care in the broader health system will improve for many patient groups.
Most visible will be the new ED model of care which will be phased in after the renovation work ends, starting this fall.
In this new ED model, patient care will be provided across three Care Bubbles (Front, Middle and Back) each designed to address specific patient needs and acuity in the most timely and effective manner possible.
Ongoing modeling and refinement has validated the significant potential of this new model of care and as I mentioned, the Mental Health and Medicine teams are also in various stages of modeling and executing new practices to support the EDs, including working as an integrated part of the Care Bubble teams.
Initial patient and provider reaction to the simulated model of care has been very positive.
We are also working with our partners at CMHA-Middlesex to ensure a Mental Health Crisis Centre becomes a reality in London.
These partnerships and the incredible transformative work that is coming out of them will help us achieve the “big dot” goal in the upcoming fiscal year that Ruthe Anne spoke to earlier: to achieve 95% occupancy in our hospital while maintaining or improving quality and safety.
When occupancy creeps over 100%, the stress on the system becomes obvious – we end up spending valuable time and resources trying to find beds for admitted patients who need our care.
To ensure we have a sustainable system for the future, we are focusing on finding solutions that will help us achieve 95% occupancy targets, while also ensuring that quality and safety are never compromised to achieve it.
I am convinced that as we improve the access and flow into and through the hospital, we will also see long term improvements in quality, safety and the patient and provider experience.
A great deal of LHSC’s transformation is dependent on a culture of empowerment and accountability. We need to empower our staff and physicians to hold one another – and themselves – accountable for their decisions, actions, and behaviours, in order to achieve sustainable culture change.
As part of that new culture, we are asking our patients and their family members to also hold us accountable by being a part of our decision-making processes.
As Ruthe Anne mentioned earlier, LHSC currently has over 100 Patient Advisors who are each contributing to how LHSC is improving the patient- and family-centred care experience.
It seems so obvious: patients are at the heart of what we do at LHSC and their voices are essential. However, health care has a legacy of “we know best” and in order to successfully transform we need to acknowledge that patients and their families have an incredibly valuable perspective to add.
I would like to thank these individuals for their dedication to improving care, including the members of our Community Advisory Council whose input is helping to shape our decisions at the corporate level. Please join me in thanking these dedicated advisors.
Traditionally, hospitals have focused on caring for the sick and injured that arrive on their doorstep. But to me, a huge part of transformation is looking outward beyond our traditional hospital-centric mode and working with key community and system partners to help improve the wellbeing of the communities we serve.
To that end, LHSC is proud to be participating in a population-based health initiative being jointly led by the Middlesex London Health Unit’s Dr. Chris Mackie, and the United Way London & Middlesex’s Andrew Lockie.
With representation including a wide range of community direct service providers – and not just those related to health care – this group is using data and their collective experience to help identify disparities in socio-economic factors that negatively impact wellbeing.
The solutions to improving the quality of life for many in London and the region who are vulnerable will be multi-faceted, but I am energized by the enthusiasm from leaders around that table who are committed to finding solutions as a team.
I want to share with you a quick story that I think helps to illustrate the power of partnerships in improving health.
We had a patient at LHSC who, in one year, frequented our Emergency Department almost daily – and sometimes multiple times a day.
When we ran the numbers on how many interactions this individual had with Emergency Services, London Police Services, Social Services and our ED in a year, it equated to a system cost impact of nearly one million dollars.
This so called “Million-Dollar Man” needed help and needed a coordinated team.
So, with representatives from around the community including LHSC, the South West CCAC, InterCommunity Health Centre, Thames Valley Addiction Services and Canadian Mental Health Association Middlesex – among others – a strategy was developed to wrap supports around this individual and help him access supportive and affordable housing – since homelessness was causing a domino effect on his health and wellbeing.
By providing him supportive housing – at a cost of roughly $30/day – his nearly daily ED visits in the previous year decreased to just three Emergency Department visits this past year, and virtually no interaction with the London Police Service. He is now on a new path that previously he could not imagine.
This is an incredible story and to me, illustrates the powerful impact that teamwork – built on strong partnerships and a mutual desire for change – can have on a someone’s life.
This is just one example of the incredible work that happened in London last year.
I would love to tell you about all of the milestones, medical firsts, celebrations and incredible work that have taken place, but I suspect you’d appreciate seeing them for yourself rather than having me discuss them in detail, and so we have prepared this brief Year in Review presentation to highlight the remarkable past year at LHSC.
Play Year in Review - set to music
Over the past year, I have visited the majority of clinical units to speak with front-line staff, physicians, patients and family members. It reminds me what an incredible range of services our 14,000-strong team provides at LHSC.
I am impressed by their dedication and accomplishments, and always inspired by their insights and ideas on how we can continuously improve.
London Health Sciences Centre is a remarkable organization, filled with remarkable people working together to push the boundaries as we strive to provide care, teaching and research excellence.
I want to thank the staff, physicians, students, scientists, volunteers, our patients and families, who – together with a strong leadership team, dedicated foundation and research partners, and a committed Board – are making a positive difference and helping to achieve a strong and transformed health-care system for generations to come.