Wednesday, 31 October 2018

Gearing up for Accreditation 2018

MAHC is counting down the days until our 2018 Accreditation Canada survey in early December. Our teams have been busy gearing up for this external review where independent surveyors come to our sites to assess and measure our services and practices against national and international standards of excellence.

Hospitals voluntarily participate in the Accreditation Canada program to help ensure they are providing the best standards of care through a survey cycle every four years. Participating in the accreditation process is about constantly improving the quality of care we provide to patients by ensuring we are meeting national standards of care and receiving recommendations on how we can improve. These standards examine all aspects of health care – from patient safety and ethics, to staff education and training, governance and partnering with the community.

During our Accreditation Canada survey, surveyors will measure Muskoka Algonquin Healthcare against specific Required Organizational Practices within more than 100 best-in-class standards established by the Health Standards Organization. Required Organizational Practices are an essential practice that organizations must have in place to enhance patient safety and minimize risk. These are categorized into six patient safety areas, each with its own goal, as follows:

Safety Culture: Create a culture of safety within the organization;

Communication: Promote effective information transfer with clients and team members across the continuum of care;

Medication Use: Ensure the safe use of high-risk medications;

Worklife/Workforce: Create a worklife and physical environment that supports the safe delivery of care and service;

Infection Control: Reduce the risk of health care-associated infections and their impact across the continuum of care; and

Risk Assessment: Identify and mitigate safety risks inherent in the client population.

To achieve an ‘Accredited’ decision, an organization must meet a minimum of 80% of all criteria, and a minimum of 70% of high-priority criteria and Required Organizational Practices in every standard set.

Participating in the accreditation process demonstrates our commitment to meeting best-practice standards and ensuring safe, high-quality patient care. It’s about quality improvement, every day, with everyone who walks through our doors. Accreditation has evolved to focus greater importance on the patient voice and this is very much in line with our own focus at MAHC to centre care around patients and families.

We are looking forward to meeting the four surveyors who will be with us December 3-7, 2018. While they are here, they will be engaging with our staff and physicians, and even patients and families to test our compliance.

Our theme for Accreditation 2018 was chosen through a contest where staff submitted ideas. The winning idea was modeled after the 2018 Olympic Winter Games. As part of our internal promotion, we adapted the Olympic motto “Citius, Altius, Fortius”, which is Latin for “Faster, Higher, Stronger”. We at MAHC have been working toward “safer care, higher standards, stronger teamwork” so that your time with us is the best it can possibly be.

Friday, 24 August 2018

Two Acute Sites Model Selected for the Future! Now What?


In August, the Muskoka Algonquin Healthcare (MAHC) Board of Directors supported the recommendation from the Capital Plan Development Task Force for a Two Acute Sites preferred service delivery model for the future, replacing the Board’s 2015 recommendation for one hospital. The Two Acute Sites model includes a full range of emergency, inpatient and surgical services at each site, 61 more inpatient beds including a new stroke rehabilitation unit, and also proposes the addition of MRI technology. 

Some people have asked why a different model was recommended in 2018 compared to 2015. Quite simply a different process led to a different result. In Stage 1 planning MAHC followed a more inclusive, community- and system-focused process that looked beyond the MAHC organization. The past year’s work has involved a broader membership at the decision-making table, including municipal representatives. The criteria used to evaluate the potential models were different, including land-use planning and economic impact, which may be outside of the health care purview but were determined to be important considerations when planning for the future. Perhaps the most influential finding was the land-use planning study that resolved that a central location between Bracebridge and Huntsville was not recommended. The analysis recommended that hospitals exist in urban centres, which meant if a One Site model was only in Bracebridge or only in Huntsville, average travel times in Muskoka would become some of the longest in the province. It could also negatively impact MAHC's market share. Access to care has always been critically important. We also know from extensive community engagement that the Two Acute Sites model was preferred by most people. One of the key deliverables for a Stage 1 Proposal is a Local Share Plan that demonstrates how we collectively (the community) will pay our 10% ‘local share’ of the redevelopment project. No model would ever be completed if those responsible for helping fund the model were not supportive of it.

Now that a model has been selected by the Board, the consultants will prepare Part A of the Stage 1 Proposal, which gets submitted to the North Simcoe Muskoka LHIN for review and comment. Part A is essentially a Service Delivery Model Report made up of a refreshed Master Program looking out 8, 15, 20 and 30 years, a Human Resource Plan for a five-year timeframe and a preliminary operating cost estimate.

The next step is Part B where the Task Force will study the bricks and mortar needed to support the programs and services identified in Part A. We know the Two Acute Sites will be in the two urban centres of Bracebridge and Huntsville. Part B will look at specifically where they will be located. Will we reuse all or parts of the existing sites? Will it happen as large projects or be split into phases? What is the cost of the best approach and how will the community pay for the required local share? The Task Force will continue to oversee this work over the fall and winter, engage stakeholders and communicate our progress. Once that analysis is completed next year, the Task Force will make a further recommendation to the Board on the infrastructure approach and Part B will be completed by the consultants. Then the entire Stage 1 Proposal (Part A & B) is submitted to the Health Capital Investment Branch of the Ministry of Health and Long-Term Care for review and approval for MAHC to go on to the next stage of the five-stage capital planning process.

We are still very much at the front end of a long process that all hospitals have to go through. The important point for all of us to remember is that every stage in the Ministry’s process is an opportunity, and really an expectation, that the planning gets refined or adjusted based on the best information available at that time. We need to be near the top of the Ministry’s queue and convince the Ministry of Health that a two-site hospital is what Muskoka and East Parry Sound needs and deserves in the future.

Monday, 25 June 2018

Another year of achievements to celebrate


The Annual General Meeting of Muskoka Algonquin Healthcare is an opportunity to celebrate the great work of our staff, physicians and volunteers and to recognize the remarkable things we have achieved together over the past year.

Looking back on 2017-2018, I am overwhelmed with pride when I am reminded of everything our teams in Bracebridge and Huntsville have accomplished to further our commitment to outstanding patient- and family-centered care.

From process improvements to reduce our bottom line to initiatives that positively impact the patient care provided at MAHC, there are a number of success stories to share. Here are some of my favourites:
Influenza Immunization Challenge certificates

  • We earned silver in the 2017/2018 Influenza Immunization Challenge for achieving 87% immunization for staff, physicians and volunteers, a 13.2% increase over the previous year’s rates. MAHC had the highest rate of immunization among acute care facilities in the North Simcoe Muskoka region.  
  • The SMMH Emergency Department was recognized as the community hospital with the largest improvement in wait times. And for complex emergency cases – where the patient is admitted directly from the emergency department – both of our Emergency Departments are currently at half of the provincial wait time, thanks to the good work of our Emergency practitioners.
  • We partnered with the Canadian Mental Health Association to have mental health crisis workers in our Emergency Depts.
Dr. Jonathan Rhee and the new urology laser
  • In response to a significant surge in ill patients here and across Ontario, MAHC was able to scale our beds up by 13 at each site to ensure our patients were admitted in a timely manner to receive care. Our inpatient teams worked tirelessly to manage exceptionally high occupancy without compromising patient care.

  • We expanded our urology program to perform more advanced, less invasive kidney stone surgeries using a state-of-the-art laser, alleviating the burden of travel outside of the region for patients and helping us to recruit a second urologist to the area.

  • We introduced a new surgical service: reconstructive plastic surgery that is being supported by a locum plastic surgeon from Sunnybrook. Our goal is to grow this program through plastic surgeon recruitment efforts.

  • Through grassroots cost-cutting efforts as well as advocacy for additional funding by the Board of Directors and Administration, we achieved another balanced budget position – our sixth in the last seven years.
  • Our teams exceeded hand hygiene targets achieving 94.8% compliance ‘before’ patient/environment contact, and 94.5% compliance ‘after’ patient/environment contact; 
SMMH ranks #1 in Canada for
Green Hospital Scorecard waste category
  • MAHC earned silver in the Green Hospital Scorecard for our energy reduction and waste diversion efforts. The Bracebridge site ranked in the top five in both the energy and waste categories, and was #1 in Canada for the waste category. The Huntsville site received two awards from Greening Health Care – one of which recognizes a 5% decrease in energy use over the previous year.  
  • Environmental Services implemented a reusable sharps and pharmaceutical waste container program; 
  • Food & Nutrition Services continues our commitment to serve more than 30% local Ontario food in patient meals; 
  • Our physicians supported 100 medical learners through MAHC’s affiliation with the Northern Ontario School of Medicine;  
  • Our staff facilitated more than 17,000 student placement hours in various clinical areas for high school and post-secondary students; 
  • Our Facilities staff coordinated and completed $1.4 million in investments in our aging buildings through repairs and renovations, and projects focused on improving staff and patient safety and access; 
New Panda Warmer donated to HDMH
  • Through the incredible fundraising efforts of our two hospital foundations, over $2.7 million has been invested in equipment, technology, education and infrastructure, all of which is critical to ensure our providers have the tools they need to provide the best quality of care. 
  • And thanks to the dedication of approximately 340 volunteers across both sites, our Auxiliaries put in nearly 44,000 hours of service to improve the patient experience and support our teams, while also raising funds for equipment.
On behalf of Muskoka Algonquin Healthcare, I commend all of our dedicated staff, physicians and volunteers for the significant role they’ve played in our success and offer my sincere thanks and appreciation for the work they do each and every day to proudly serve our communities with compassion and deliver the best patient outcomes.

Tuesday, 29 May 2018

Make your vote count for acute care

MAHC Board Chair Evelyn Brown
Evelyn Brown,
Board Chair
This blog has been prepared by Evelyn Brown, Chair of the MAHC Board of Directors.

Throughout this election campaign, health care has been at the forefront, and it should be. A high-functioning public health care system should be important to each and every resident of Ontario. We count on the provincial government to fund and facilitate safe, high-quality care. We want to know that it will be there when we need it – whether it’s having access to a primary care provider like a family doctor or nurse practitioner, being able to obtain home care so seniors can stay safely in their own homes, ensuring there is capacity in facilities like nursing homes for those transitioning to long-term care, or being able to sustain acute and emergency care in the hospital.

The Ontario Hospital Association has summed it up well, saying Ontario’s hospitals are on the brink. Many hospitals are under enormous pressure to provide care to a growing and aging population. The provincial funding formula for hospitals poses significant and unique challenges for medium-size hospitals and needs substantial change now. The formula also fails to recognize, adapt to and support the unique challenges of rural multi-site hospitals like Muskoka Algonquin Healthcare that have additional infrastructure, staffing and other expenses to deliver core services where we have fewer community health resources. Where amalgamations have occurred to drive efficiency, like here in Muskoka, we have not been adequately supported to stay afloat and in the black.


We are fortunate to have amazing health care professionals supporting inpatient and outpatient care across two hospital sites. But we can’t do it without appropriate support from the province and a long-term solution to operating challenges. Significant investments in hospitals and across the continuum of care are required, as well as a plan to adequately prepare for patient needs – now and in the future. A deliberate and purposeful strategy must be identified to ensure that medium-size hospitals are able to provide and sustain the services that our community deserves.


We offered each of the candidates an opportunity to sit down for some open dialogue about funding and capacity challenges facing Ontario hospitals and how these challenges relate to MAHC. No matter which Party is elected in June, now is the time for urgent action on health care. Now is the time to increase funding, reduce wait times, and put an end to hallway medicine so that patients can continue to receive the highest quality of care in the environment that they deserve. When you cast your ballot on June 7, think of your hospital and who will meet the growing health care needs of Muskokans and our fellow Ontarians.

Evelyn Brown

Wednesday, 14 February 2018

Building a Case for a Reserve Fund for Health Care Capital Needs in Muskoka

This blog has been prepared by Evelyn Brown, Chair of the MAHC Board of Directors.


Board Chair Evelyn Brown
The Muskoka Algonquin Healthcare Board of Directors is drawing attention, through our political leaders, to the need for Muskoka ratepayers to start making investments now for future health care capital needs.
On January 19, Phil Matthews, Vice Chair of the Board, and I appeared before the District of Muskoka’s Corporate & Emergency Services Committee to encourage the creation of a reserve fund for health care capital needs. Phil referred to this reserve fund as “a major asset that we don’t have today”.
The timing of our presentation was based on the immediacy of 2018 budget deliberations by the District. The purpose of the presentation was to highlight the capital needs of the health care system and to demonstrate the importance of broad financial support, both today and in the future. Our presentation concentrated on MAHC’s current capital needs and also referenced an order of magnitude for future redevelopment costs.
Our presentation was not for a specific figure or sum of money, but rather was asking consideration be given to creating a health care capital reserve fund supported annually by taxation.
What we know today:
There are significant needs at MAHC today to safeguard and sustain the quality of care we provide. Our presentation indicated that our needs over the next three to five years are estimated at $39 million for equipment, technology and aging building infrastructure. Future redevelopment needs, regardless of the model selected, will be even more substantial (hundreds of millions of dollars over time) and will compound this challenge for our communities.

Currently, there are insufficient funds available to MAHC for replacing capital needs – MAHC relies on the community through donations to our Foundations and Auxiliaries to replace aging infrastructure, and buy new equipment to keep pace with technology. Unfortunately, today’s capital needs outpace community contributions, meaning there are insufficient funds available now to fix aging buildings, let alone to bank toward any future needs.

We also know today that the capital building cost (bricks and mortar) of hospital redevelopment is shared by the Ministry of Health and Long-Term Care, which contributes approximately 90%, and what the Ministry calls the community’s “local share”, which is the remaining 10%. Other infrastructure costs, such as parking lots, new equipment and furnishings, are also expected to be paid for by the community through donations, like they are today. These could add up to an additional 14% or more of the building costs of future redevelopment.


Our presentation referenced the potential order of magnitude of the community share of a future redevelopment. MAHC’s 2015 Pre-Capital Submission to the Ministry of Health and Long-Term Care included the cost surveyors’ estimate of the potential local share plus infrastructure costs of the three models that were previously developed for hospital redevelopment ranging from $84 million to $114 million (shown in the table below).
What we know about the future:
The Capital Plan Development Task Force has been struck by the MAHC Board of Directors to recommend the best model for future hospital care that ensures high-quality, safe and sustainable care for future generations. The task force is committed to a thorough and comprehensive process to look at potential models for the future, even if they are unpopular, to satisfy the requirements of the Ministry of Health and Long-Term Care.
The task force is researching three potential models and developing what programs and services could be provided through each of the models. This process continues and is a new chapter in MAHC’s future planning work and the ending to that chapter has yet to be written. The timeline for the Stage 1 submission is dependent upon doing it right and taking the time that is necessary to ensure appropriate engagement and thorough analysis.
No decisions have been made about the preferred model of delivering acute care in the future.
The task force is aiming to bring its recommendation of a preferred model to the MAHC Board of Directors this spring, and to submit the Stage 1 (Part A & B) to Capital Investment Branch of Ministry by the end of 2018.
Most importantly, we know that regardless of the model recommended by the task force and selected by the Board, it is prudent for Muskoka to begin investing in this multi-million-dollar fund now. Quite simply we can start to incrementally put aside funds now, or massively pay later. By asking our local leaders for prudence and forethought for the Muskoka ratepayers to support the needs of the health care system today and in the future, we do not believe we are undermining the Stage 1 future planning work that is underway. We are helping our local leaders to understand the role the community will need to play in building the future health care system.