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Keynote Speeches

2009 Annual General Meeting Tuesday, June 23rd   Message from Cliff Nordal, President and Chief Executive Officer London Health Sciences Centre

Check against delivery.

Thank you, Bob. It is a pleasure to welcome you again at South Street Hospital in the Education Building. It was formerly known as the Victoria School of Nursing and Nurses Residence.

We recently found some photos of this neighbourhood that show before and after shots of the nursing school from the 1960s. I want to remind all of you that even when South Street Hospital closes, this building and this auditorium will continue to be important facilities for LHSC. A number of research and administrative functions will continue to call this building home.

I am always amazed at how transformed this gym looks during the Annual General Meeting. Holdsworth Auditorium, as it is properly known, has had many transformations over the years.

It’s been a place for celebrations, dances, hospital volleyball leagues, telethons, long service awards, meetings, luncheons, VIP visits, and news conferences.

Just last week the Growing Concerns Daycare hosted a graduation for some of the children here at the Holdsworth Auditorium.

Last year at the AGM I told you the unforgettable story of Nurse Ione Holdsworth, for whom this auditorium is named. The tale had all the elements of a tragic romance novel – grateful millionaire patient, sea voyage, exotic lands, a tragic accident and gestures of honour. Last year, Holdsworth Auditorium proved an excellent venue to help us remember and honour the over one hundred and thirty years of care London Health Sciences Centre has provided to the community.

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Today, I want us to look forward and celebrate the future, which is why we have papered the walls with construction images. And our future will be here before we know it! Granted, I have often commented that we are in year twelve of a five year project but you can see from these photos how close we are to completing a major hospital restructuring milestone in our community.

In less than two years we will have realigned and consolidated most of the clinical and support services between LHSC and St. Joseph’s. Each hospital will have a defined and distinct role – reducing duplication of work and improving the overall patient care environment.

This second major phase of restructuring known as Milestone 2 – Phase 2 will mark multiple program moves including the move of both the Perinatal/Neonatal Intensive Care programs from St. Joseph’s Hospital and the Acute Mental Health program from this aging site across the street to the new North Tower at Victoria Hospital.

The redevelopment of both LHSC and St. Joseph’s is the largest construction project in London. With the construction of the North Tower and renovations at other sites, there are an estimated 425 construction workers spread across both organizations on any given day. The total cost of this second phase of construction is estimated at over $340M for both organizations

These facility changes give us the opportunity to improve building infrastructure, our technology and improve workflow all at the same time. Recently, Dr. John Yoo, the chief of Otolaryngology, offered the following comments about the new ENT clinic at Victoria Hospital.

Quote “The new facilities are enabling the delivery of highest quality of care in a patient-focused way. This move has allowed us to consolidate the entire department at VH into one space, enabling patient accessibility to key allied health services and state-of-the-art equipment. I know that change can sometimes be difficult, and moves are stressful. But this "restructuring" has been only positive for our patients and staff.” End quote

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The theme of today’s Annual General Meeting and our 2009 Annual Report, “Caring for You. Innovating for the World”, is also our tagline. Last year we asked staff and physicians what they thought about our proposed tagline as part of our brand development consultations. They told us that it sums up LHSC’s uniqueness. LHSC staff and physicians provide compassionate care to our patients in an environment that fosters research, teaching and innovation.

It is our dual role as both a community hospital and a regional referral centre offering highly specialized care, that makes this hospital such a special place in the hearts and minds of Londoners.

You will see in this year’s Annual Report some noteworthy examples of the best in caring and innovation and I am pleased that some representatives from the featured programs, Clinical Neurological Sciences, Regional Trauma and Sterile Processing are here today.

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LHSC is also defined by its values – RESPECT, TRUST and COLLABORATION. Values are fundamental to everything we do. They define how we work together and how we serve others. Our values provide us with a clear understanding of who we are and what our hospital stands for.

You heard earlier from our Board Chair about his personal experience as a patient. Let me read you an excerpt from a letter I recently received that speaks to our values in action:

Quote “Last month I underwent Surgery at Victoria Hospital and I came away from the experience with a profound appreciation of your staff and the incredible job they do. I cannot overstate my admiration and appreciation. They are truly an incredible group of people; caring, attentive and unfailingly cheerful. I was deeply impressed by their level of dedication, not to mention their ability to remain calm in what I’m sure most people would consider a very challenging workplace”. End quote.

This patient’s experience is a great testimonial from someone who has experienced one of LHSC core values, RESPECT. To respect someone is to treat other’s in any similar circumstances, in no less a manner than you want to be treated. This letter is a vivid demonstration of the powerful and positive impact values embodied in staff service can have on an individual patient. There is also an impact on our students as we model behaviour for our future caregivers.

To help celebrate and acknowledge how values shape our work, we expanded the original President’s Award for Community Service by adding two new awards for Living Our Core Values - How We Work Together and How We Serve Our Patients. Earlier this month, we honoured all the nominees and the three recipients of the President’s Award at a reception. They were:

Heather Fisher for Outstanding Community Service
Cathy Mawdsley for Living Our Core Values: How We Serve Our Patients
And Dr. Glenn Bauman, for Living Our Core Values: How We Work Together.

Glen could not join us, but Heather and Cathy are here. Please stand so that we can congratulate you again.

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While our values guide how we do our work, our strategic plan identifies what our priority projects are going forward. This year we completed year one of our three-year strategic plan. Bob spoke earlier about the four broad direction categories and I would now like to update you on our progress.

I’ve already talked about our construction and renovation projects which are essentially our Program and Facility Development strategic direction so I will now focus on our other three strategic directions.

Care and Performance Improvement is a major focus area. This past year we completed a number of projects that will improve patient access and enhance patient safety.

In February, LHSC launched an online adverse event and near-miss occurrence reporting system, replacing the previous paper-based system. In addition to capturing each adverse and near-miss event, this new version also allows for better tracking of issues to ensure follow-up and easier identification of trends thus helping us to make ongoing improvements.

Also in February we became the first hospital in Ontario to publicly post detailed and daily information regarding Emergency Department wait times. I am proud of LHSC leadership in public accountability and encourage everyone to visit the Accountable to You section of our public website.

In addition to meeting or exceeding public reporting requirements for wait times and patient safety indicators, you will find more detailed performance information about how we care for patients, staff and the environment.

Of course, there is still significant work to be done. On almost a daily basis we face a shortage of acute care beds and long waits in our Emergency Departments. We continue to address this challenge on multiple fronts using a combination of approaches such as predictive discharge and reducing variation in our surgical caseload.

However, improving patient access is not an issue unique to our hospital, Regional system-level strategies are required to help to ensure patients are in the right care setting at the right time and that more of our limited acute care bed capacity is available to those patients who truly need acute care. We work daily with our partners at the CCAC to find appropriate community based care options for our patients. We were also pleased that funding was provided for a transitional care unit at St. Joseph’s Parkwood Hospital.

And yet, even with all this, I believe that the defining issue for health care for this and our next generation will be managing the growing rate of infections and infectious disease. The world has learned a great deal from SARS and more recently, H1N1 influenza.

Still, there is no doubt that in an age where travel to most parts of the world can be achieved in a day and where most people now live in large, densely populated urban settings, vigilance unlike anything humankind has seen before will be necessary.

Hospitals are at the epicentre of infectious disease management and as such, we must ensure leading, unrelenting best practice – starting with hand hygiene. The simplest, most effective, universal way to prevent the spread of disease – and like global environmental stewardship, hand hygiene begins with you and me.

Every person who enters a hospital today and does not stop at a dispenser to clean their hands is putting other people at risk. When care providers don’t adhere to the four key moments of hand cleaning during the course of each patient’s care, we are putting people at risk. When patients and families do not feel comfortable asking care providers if they have cleaned their hands, people are at risk.

Since we completed the hand hygiene audit in August 2008, we’ve done a tremendous amount of education and substantially increased the number of hand cleansing stations. We know our compliance rates are improving; nevertheless, we still have to be vigilant because having even one patient with a hospital-acquired infection should be unacceptable to us.

In fact, as I speak we have auditors in our facilities measuring our current compliance with hand hygiene. We will be sharing the results with staff and the public as soon as they are available.

To support our hand hygiene efforts, we have also established a Clean Team that is dispatched to hospital units where a patient has been identified with an infection to super clean the care area before another patient is admitted to the unit. To date, the team’s efforts have helped to reduce infection transmissions.

We also continued to advocate and champion safe patient care for every patient by hosting the second annual patient safety summit. The goal of the conference is to bring different perspectives together including patient and family stories to raise awareness and enhance patient safety.

This unique approach to encouraging dialogue around patient safety was spearheaded by Ellen Rosen, vice president of Women’s and Children’s Services, who retired in April after 35 years of dedicated service and leadership.

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A healthy workplace is another key strategic initiative. Healthy organizations are those in which employees feel valued and recognized, are connected and committed to a shared purpose, and have some degree of control and sense of making a difference through their contributions.

In 2008 the Healthy Organization Team, or HOT as we like to call it, prepared a report developed from the recommendations and feedback of more than 500 staff, physicians and volunteers. We have hired a leader to coordinate our implementation of the recommendations and many of these initiatives are underway.

Advancing our teaching and research mission is the fourth strategic direction for LHSC. The projects under this strategic direction are aimed at establishing LHSC as a recognized centre for simulated learning in collaboration with our academic partners. We have also implemented the first phase of the Lifecycle Research Network with our research partners.

To that end, construction began in May on the Brent & Marilyn Kelman Centre for Advanced Learning which will fall under the scope of LHSC’s Internationally Accredited Canadian Surgical Technologies and Advanced Robotics program or CSTAR.

Last year, we also unveiled the Lindros Legacy Research building. As most of you already know, in 2007 Eric Lindros announced his retirement in London along with a $5-million donation to LHSC which is the largest one-time charitable donation from a Canadian sport figure.

These strategic projects represent some of the key transformational projects for the organization. However, they do not represent ALL the accomplishments at LHSC over the past year.

This year we continued our recruitment efforts and in 2008-2009 we have hired almost 400 new nurses, including Rio Paler who shares the cover of our Annual Report with one of our patients. Since July 1, 2008 thirty-six (36) new physicians joined LHSC, including 11 new paediatric physicians from around the world including Australia, Germany and Switzerland, and local cities such as Ottawa, Toronto and Owen Sound.

We are also delighted that Laurie Gould has joined the LHSC senior leadership team in the position of VP Women’s and Children’s Services. Laurie is from the Fraser Health Authority in Surrey, British Columbia.

LHSC has a strong tradition of medical breakthroughs that make a positive difference to patients not only in our community but throughout the world. We can add to our list of accomplishments another world first.

Last July, LHSC conducted the world’s first robotically-assisted intestinal bypass surgery for a patient with superior mesenteric artery syndrome (SMA), a duodenal obstruction. By using the da Vinci® robot, Dr. Christopher Schlachta, CSTAR Medical Director and minimally invasive and robotic surgery specialist, assisted by Dr. Andreana Bütter, pediatric surgeon, and Dr. Shiva Jayaraman, robotic surgery fellow, successfully completed this procedure.

LHSC also become the first hospital is North America to use a robotic-arm neuro-angiogram machine in an operating room. I’d like to share with you a short video, produced by London Health Sciences Foundation that powerfully demonstrates how we are caring and innovating to make a difference to our patients.

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I’d like to end my remarks today by talking about the biggest non-healthcare story of the year – the global economic crisis. Thankfully, the Government of Ontario has sustained hospital funding for the 2009/10 fiscal year and preserved spending on hospital infrastructure projects.

However, as we move into budget planning for 2010/11 and 2011/12, we can expect minimal, if any, funding increase to offset our inflationary cost pressures.

The good news is that we ended the last fiscal year with a small operating margin of 2.4%. We can be proud of the fact that we have in the past three years improved our working capital deficiency from over $206 million in February 2006 to just under $18 million at the end of March. This significant improvement has helped to create a more stable financial position while paying off most of our debt. We have also invested in the future with additional capital equipment replacements and our redevelopment program. The complete audited financial statements are available on-line on our website and we also have copies available at the registration table just outside this room.

We are committed to maintaining our financial health with balanced budgets, clear performance commitments and further planned capital investment. I am looking forward to working with our government partners and funders to continue to secure a strong financial future for London Health Sciences Centre.

We will also be working with the South West LHIN on their Blueprint Initiative. The goal of this project is to provide direction about how services can best be organized and delivered across the LHIN to meet the future health care needs of all communities and residents.

The Blueprint project is bringing all care providers together to work on critical common issues – such as recruiting and retaining health care professionals, reducing wait times for critical services, and keeping the health care system sustainable into the future. The initiative is an opportunity for the LHIN to work much more closely with all health care providers, to develop viable solutions to the health care challenges we all share.

In closing, I would like to sincerely thank our Board Chair, Bob Siskind for his leadership and commitment to good governance, financial stewardship and high quality health care.

My thanks as well to all the members of London Health Sciences Centre’s Board of Directors who have volunteered their talents, expertise and countless hours to ensuring LHSC is advancing healthcare in our community.

Of course, I need to also thank the Board of Directors at St. Joseph’s Health Care. As you know, the shared CEO role was created and announced by the Boards of both LHSC and St. Joe’s in December 2005. It is through the on-going collaboration and support of both Boards that St. Joseph’s and LHSC continue to work more closely than ever before to tackle the healthcare challenges of our community and region.

The pages of this year’s annual report highlight examples of what LHSC does - caring for our patients and staff, while also contributing to the future of health care by teaching students from around the world, by conducting ground breaking research, and by delivering medical firsts with global impact. “Caring for You. Innovating for the World”.

As our symbol suggests, people are at the centre of everything we do. My sincere thanks to our leaders, physicians, researchers, staff, students, and volunteers for their passion and commitment to the patients and families we serve.

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