President and Chief Executive Officer
London Health Sciences Centre
2014 Annual Community Meeting
Tuesday, June 24
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Good afternoon, everyone and thank you for joining us here today.
I would like to start by thanking Ruthe Anne Conyngham and our Board of Directors for their commitment, expertise and guidance.
I would also like to thank Dr. Mark MacLeod, whose leadership of the Medical Advisory Committee has been exemplary.
Mark has been instrumental in helping to lead our budget consultation process and through his efforts our levels of physician engagement continue to increase.
I also want to thank all of our partners who have delivered updates today.
Tracy, Jim and David – through your leadership of Children’s Health Foundation, London Health Sciences Foundation, and Lawson Health Research Institute, you are helping us improve the quality of care we provide to our patients.
Lastly, I would like to thank the people of London Health Sciences Centre. It is my privilege to work alongside some of the most dedicated and innovative people I’ve encountered in my career. Thank you for the support you have shown and for all that you do.
When I came to London Health Sciences Centre, I was drawn by the potential that LHSC had to help lead the sweeping transformation of our health-care system that is now well underway in Ontario.
As a highly innovative academic health sciences centre, LHSC provides acute care services across the spectrum of care to a region that is uniquely self-contained.
As a result, LHSC — and indeed all service providers in this region— are well-positioned to help define, test, and implement new approaches to the delivery of care.
I am excited to be here as we proactively help to define the future of health care alongside a growing number of system partners.
Together, we are working to re-imagine our health-care system so that we can ultimately make care more seamless for patients, both those in hospital and within our community.
In the package you received is an advance copy of the latest edition of Inside, which will be distributed across the region on Saturday.
I am proud to say that this publication, now on its 7th issue, recently won a national health care communications award.
Inside continues to share some of our amazing patient care stories, and in this latest issue we highlight how the research conducted through Lawson has a direct and often immediate benefit to our patients.
Wrapped around that publication is a condensed version of our new online Annual Report where you can go to learn more about our strategic priorities, how our partners contribute to the patient care we provide, and our audited financial report.
From those figures you will see that LHSC continues to maintain a positive financial position, finishing the 2012/2013 fiscal year with a positive margin on our more than $1 billion budget. We will invest our year-end, one-time savings in initiatives that are critical to our strategic priorities and sustainable future.
Those strategic priorities are what will guide all of our work in the midst of the transformation underway in our health-care sector. The term transformation has been used a lot today, and it is not inappropriate given our current circumstances.
With the results of the recent election, we expect the direction of the government will remain unchanged. We look forward to working with the new Minister of Health and Long Term Care Dr. Eric Hoskins.
Ontario is facing fiscal challenges and an aging population. We cannot continue on as we have.
We have to change the way we think about health care, and change how we deliver services. We cannot expect to see the annual 6 -8% funding increases that we have had in the past.
We’ve talked about the future of health care, but in truth the future is now. I have seen more change in the health-care system over the past 2 years than I saw in the last decade. And this is just the beginning.
LHSC has long supported the need for health system transformation. It is the only way to build a sustainable model for the future.
It will require us to look at how we deliver services; how we interact with our community and regional partners; and to streamline and simplify the patient’s journey through the system.
This will be accomplished in part through our strategic priorities which, over the past year, have focused on our Cultural Transformation, the implementation of HUGO, and our Clinical Services Renewal, which I will touch upon in a moment.
Through our Cultural Transformation, LHSC has embarked on a multi-year journey to achieve a culture of engagement, empowerment and accountability that complements and helps achieve our objectives of clinical and service excellence, and patient and family centred care.
By building a positive culture, patients will have a better experience, employees and physicians will enjoy a better work environment, and LHSC will be a higher performing organization.
Many of you may have heard or read about – or experienced – the recent implementation of HUGO at LHSC just a couple of months ago. HUGO – or Healthcare Undergoing Optimization – is part of LHSC’s transformative work to create a fully electronic patient record.
As part of this recent implementation all medication orders and medication histories are now submitted electronically, and bar-coding technology on patient wristbands matched to bar codes on medication is used to decrease medical errors.
When HUGO was implemented it was anticipated it would take 6 – 9 months to work through issues and challenges associated with the new way of doing things. We are in the middle of that process now.
Going forward, HUGO will be part of our Enabling Technology plan, which in 2015 will include further optimization of the HUGO project, and planning for continued advancement towards a fully electronic patient record.
In addition to the implementation of HUGO, LHSC was pleased to recently host the launch of the eHealth Connecting South West Ontario (cSWO) initiative. This is an initiative we are working on with the Ministry of Health and E-Health Ontario.
From family physicians, to hospitals specialists and community health providers, this massive undertaking will enable all health care providers – not just hospitals – to securely and in real time access electronic health record data for patients at any point in their care.
One of the first initiatives being rolled out within cSWO is the Clinical Connect system, a secure online web portal that provides physicians with real-time access to their patients’ electronic medical information from regional hospitals, Community Care Access Centres, and community health centres. Rather than have me try to explain its benefits, I am pleased to show you a video that does that much more succinctly than I could.
ClinicalConnect Video - set to music
Examples such as ClinicalConnect demonstrate that the electronic health world is here, and its implementation, along with initiatives such as HUGO at LHSC, show a very tangible change in our ability to provide safe, effective and high-quality care.
This ability is being strengthened through our final strategic priority. LHSC is in the middle of completing our clinical services renewal plan, which is focused on three areas:
- Clinical Strategy
- Internal Improvement, and
- Partnering in Transformation
The purpose of the Clinical Strategy stream is to define the strategic direction and priorities of the clinical services we provide at LHSC for the next 5 years.
It will increase the productivity and cost effectiveness of those services, and better inform our resource allocation and investment decisions. It will also identify future population health needs that we will need to serve, as well as targeted areas of medical leadership at LHSC that we want to continue building upon as a leading academic health sciences centre.
Delivering clinical service excellence through patient- and family-centred care forms the foundation of our Clinical Strategy work.
The Internal Improvement work stream will review key processes within the hospital and implement improvement opportunities across the five dimensions of quality: Integrated, Safe, Timely, Effective, and Patient & Family Centred Care.
Ultimately, the purpose of this work is to help LHSC find new and innovative ways to improve both the patient experience and the quality of care we provide. It will also create efficiencies that will decrease our overall costs, so that we can invest in our clinical strategy priorities.
Lastly, the Partnering in Transformation work stream represents the collaborative work we are undertaking with community and regional health providers and support services.
Together we will focus on the high users of our health care system. These patients represent 5% of our patient population but they account for almost 68% of total hospital and home care costs.
Through this work stream we are developing improvement strategies and patient and family focused initiatives to improve their care.
Partnering in Transformation will also assess what are known as Quality-Based Procedures, an integral part of Ontario’s health system funding reform.
The goal of QBPs is to standardize care, improve quality, and increase the integration of services across the health-care system. We want patients to receive the best care, managed in the most appropriate location, with the right level of support.
This work will require greater focus on working with community partners, addressing patients’ needs from a systems perspective and managing care needs across the continuum — from primary care to acute, community, and self-care.
One of the most recent examples of this Partnering in Transformation work is LHSC’s purchase of the former Bethesda Centre, which will allow us to extend our care into the community for programs whose patients would be better served outside of a hospital setting.
This centre will become the home of our Adult Eating Disorders Service, a community-based program provided through a strong partnership between LHSC and the Canadian Mental Health Association Middlesex.
Both the outpatient clinic and residential treatment component of the program, which are currently located in separate leased spaces in the community, will be co-located at the new centre.
In addition, our Prevention & Early Intervention in Psychosis (or PEPP) program will be moving from Victoria Hospital into this new community-based setting.
For both of these programs, LHSC will be better able to serve the needs of patients and can do so without increasing costs to the hospital.
Last week we met with members of the Riverforks community where this facility is located to address their questions and present our plans for the property.
There was positive feedback and strong support from residents who also identified issues around traffic flow and safety, parking, and general property aesthetics that we will work through as we finalize readiness for move-in this fall.
LHSC appreciates the warm welcome received and is excited by the mutual desire for an open and collaborative relationship going forward.
While we have a lot planned for the year ahead, I would be remiss if I did not take a moment to recognize the outstanding achievements and accomplishments of our staff and physicians over the past year.
We celebrated an incredible 5 medical firsts this year, including a new world first in the treatment of localized prostate cancer.
With so many other amazing things happening at LHSC, we have prepared this short presentation to share some of the highlights of the year:
Year in Review Video - set to music
Many of the successes we have enjoyed over the past several years – including those you just saw – have necessitated a focus on ensuring we can sustain them.
Moving forward, an additional strategic priority for LHSC will be on Financial and Resource Sustainability to ensure we are able to sustain our human capital, our facilities, and our ability to provide care in this era of fiscal uncertainty.
As you may now have surmised from today’s comments — and even the year in review video — working with our community and system partners is a strong focus for us at LHSC.
We are increasingly looking for patient and family input and, in addition to our Community Advisory Council, LHSC currently has 3 patient and family advisory councils at the program and department level. It is our goal to have more patient advisors involved in all of our decision making, because patients are at the centre of everything we do.
We also continue strengthening our partnerships with community-based health providers including Middlesex London Health Unit and our South West Community Care Access Centre.
Representatives are with us today, including Donna Ladouceur, Senior Director of Client Services from the South West CCAC and Dr. Chris Mackie, the CEO of the health unit.
I would like to take a moment to recognize these people – and their organizations – for their commitment to working together to create a truly comprehensive and seamless health-care system for our patients. Chris, Donna, and members of our advisory councils could I please ask you stand.
In this time of sweeping transformation and change, it’s also a time of stepping up to the plate, and re-thinking how we do what we do.
We have very real and significant challenges at our hospital especially when it comes to patient access and flow. I believe that all of us at LHSC have a desire to improve and change – none of us are satisfied with the status quo.
One example of this can be seen in our Emergency Departments, whose staff have created an Emergency Department Transformation Project with the ultimate goal of making patient care easier, faster, and better.
This grassroots initiative highlights the importance of working together, starting small and thinking big.
With early successes already being realized, our Mental Health Services teams are now beginning to implement the Toyota Production System methodology that the Emerg Department has been following.
Eventually for our health care system, thinking big must include the larger picture of health prevention and working with partners in every walk of life to more broadly understand the social determinants of health.
In 2010 the Hamilton Spectator released an investigative report that looked at the disparity in health and life expectancies of two groups of people in neighbourhoods just 5km apart.
This three-year health-mapping exercise highlighted how the wealth – or lack thereof – of these two populations seemed to have a direct correlation to their health and health outcomes.
The study begged the questions: What does equal access to health care mean? And what barriers do people face within our system, and how do we remove them? Answers to these questions will require tremendous collaboration from a number of sectors.
In London, we are beginning to collect the data that will allow us to better isolate pockets in our city that need more focus and effort to remove barriers to care and a healthier life, and I am confident that our early and ongoing collaborative efforts with community and health-care partners will position us to help address these challenges.
Without a doubt, the greatest strength of our organization is its people and as I conclude my remarks, I would like to take a moment to recognize and thank them.
Our staff, physicians, students, scientists, volunteers, and our patients and families, together with a strong leadership team and committed Board are making a difference every day.
I am excited about the changes ahead, and I am energized and inspired by the people we are working with to make them happen. The future of health care is now, and it’s only just beginning.
Thank you.
