The Spirit of Giving

The Christmas season is a special time when family and friends come together and reminisce about times past, both good and bad. It is a time when we make sure we have reached out to one another and made time for each other. It is also a time when we think about all that we have and all that we are grateful for. It is also a time to reflect on the fact that not everyone is so blessed and to give back to those who are less fortunate.

People who work in health care are caring people who want to help others. Our hardworking staff, physicians and volunteers at Muskoka Algonquin Healthcare give of themselves each and every day they come to work. Many people will be working at the hospitals over the holiday season. At this time of year, I know that they give even more to comfort those in need and to lift the spirits of patients who cannot be with their families over the holiday season even though they themselves are away from their families.

Looking back on 2013, I am overwhelmed with pride for everything our hospitals in Bracebridge and Huntsville have accomplished. Extensive work has gone into improving the people-focused care and the environment at Muskoka Algonquin Healthcare.

In April, we achieved full accreditation from Accreditation Canada after both hospital sites were evaluated on more than 1,600 standards. Our entire team across MAHC played a role in the success of this process which demonstrates our commitment to ongoing quality improvement.

We have recruited new physicians and have introduced a new gynaecological surgical service in Bracebridge. We have trained more staff from a variety of departments in the LEAN methodology, which is a process improvement tool that helps to eliminate non-value added steps and improve efficiency in our processes. We have developed partnerships with numerous providers, such as Family Youth Child Services of Muskoka and Muskoka-Parry Sound Mental Health Services, as well as Telehealth partnerships with Sick Kids Hospital and Orillia Soldiers’ Memorial Hospital. And these are just a few examples of the good work that is being done.

But what is most rewarding is hearing from our patients about their experiences with us here at MAHC. Through Patient Satisfaction Surveys and individual letters, we continue to receive positive feedback about the above-average quality of care we deliver.

The spirit of giving is core to the work that we do at Muskoka Algonquin Healthcare. And at this time of year, we give a little more to make sure everyone’s day is a little bit brighter. On behalf of the Board of Directors for Muskoka Algonquin Healthcare, I commend all of our dedicated staff, physicians and volunteers for the significant role you’ve played in making this a successful year. Please accept my sincere appreciation and thanks for the care you provide to our relatives, friends and neighbours each and every day of the year and best wishes for a very happy, healthy and safe holiday season and all the best in 2014.

Giving the Gift of Life

Today, 11 people in North Simcoe and Muskoka are waiting for a life-saving organ transplant. They are registered on a list with 1,500 others across the province who are also waiting for a miracle: the gift of life. These individuals may be our friends, our family, our colleagues or our neighbours, but more often than not, they are complete strangers to us. Every three days one of these people will die waiting because the call saying that a transplant match is available didn’t come in time.

If you knew you could save up to eight lives and transform as many as 75 others with one selfless act of kindness, would you?

Muskoka Algonquin Healthcare (MAHC) is very proud to join Trillium Gift of Life Network (TGLN) in working to save lives through organ and tissue donation. On November 19, 2013, we became a designated hospital under the Trillium Gift of Life Network Act legislation. By implementing policies and procedures around what they call “Routine Notification”, we are required to report impending patient death to TGLN so that their specially trained staff can identify potential donors and approach families to re-affirm consent.

By implementing this formal program, we hope that more lives will be saved through donation. This legislation has been implemented at other hospitals in Ontario and has been successful in increasing donations. Over the past five years, 11 people in the area serviced by our hospitals have received a life-saving organ transplant, and through this program, I’m confident that number will continue to grow.

We also hope that by participating in this program we can raise more awareness about the need for organ and tissue donors and inspire more people to register their donation decision in the donor registry. Across our region, the donor registration rate varies among communities. In Bracebridge, 41% of eligible health card holders have signed up to be an organ or tissue donor. In Gravenhurst, 36% have registered their consent, and in Huntsville the number is 40%.

MAHC supports a culture that enables every Ontarian to make an informed decision about organ and tissue donation and supports health care professionals in implementing those decisions.

Please help us lead by example. Just one more registered donor can mean everything for the family of someone on the waiting list, because when registered, 90% of the time families honoured their loved one’s donation decision. When not registered, only 60% of families consent to organ and tissue donation.
 
Have you registered your consent for organ and tissue donation? I encourage you to take the time to consider becoming a donor. It’s quite amazing when you think that one donor can mean the difference between life and death for someone on the waiting list.

Our organization is committed to doing our part and we're asking everyone at both of our hospital sites in Bracebridge and Huntsville to consider registering their consent for organ and tissue donation. We're also asking them to ask their friends and family to register as well. Please visit our Be A Donor campaign drive webpage at http://beadonor.ca/mahc and help give the gift of life by becoming an organ and tissue donor today!

You may also visit any ServiceOntario centre to register your consent, or fill out a Gift of Life consent form and mail it in. This ensures that your donation decision is accessible when needed. For more information, please visit www.giftoflife.on.ca.

Enhancing Patient Safety in Obstetrical Care

The Obstetrical Units at MAHC’s hospital sites have joined the MORE^OB program as part of our ongoing commitment to deliver safe, high-quality care. From left are Dr. Sandi Adamson; Lori Steele, Midwife; Dr. Tina Kappos; Shelly McMurray, RN; Dr. Bill Hemens and Mary Boyer, Manager of Inpatient Services. Missing from photo is Anne Handley, RN.

I am excited to announce that Muskoka Algonquin Healthcare is now part of the MOREOB program. As part of our ongoing commitment to delivering safe, high-quality care, the Obstetrical Units at our two hospital sites have launched a three-year professional development program to enhance their obstetrical practice.
 
Managing Obstetrical Risk Efficiently, also known as the MOREOB program, is designed to create a culture of improved patient care within the obstetrical unit through emphasis on patient safety, quality improvement and professional development. MOREOB integrates evidence-based practice standards and guidelines in developing effective teamwork and communication amongst all obstetrical care providers. Many of the focuses of the MOREOB program are in perfect alignment with MAHC’s organizational values and strategic areas.

I am especially proud of the dedication and commitment already shown by our core teams, which include family physicians and midwives who care for obstetrical patients, nurses who work in the unit and administrators. They are all participating in this program that has been designed to improve clinical outcomes, decrease the risk of adverse events and to improve the quality of work life. They will be able to share knowledge and promote collaboration with trust and respect.


The Obstetrical Units at MAHC’s hospital sites have joined the MORE^OB program as part of our ongoing commitment to deliver safe, high-quality care. From left are Malcolm Eade from MORE^OB; Dr. Sheena Branigan; Katie Zammit, RN; Alicia Taylor, RN; Dianne Smith, Midwife; Kristen Bell, RN; Robert Alldred-Hughes, Chief Executive Human Resources & Support Services.

The program aims to improve patient safety and developing a team with shared knowledge that promotes a consistent level of care among all providers. It’s a way of making sure that everybody has the same degree of basic knowledge, so during deliveries or when looking after moms-to-be, the doctors and nurses and anybody else helping has the same understanding as to what’s going on, what to expect and how to expect and avoid complications.

So how do they accomplish these skills?

The program consists of three modules, with each module including theory chapters, skills drills for rehearsing scenarios and practicing the physical handling of different equipment, workshops, personal learning projects, and so on.

I am very excited to be joining the hundreds of hospitals that are part of the MOREOB program. With this initiative, we will continue to build a culture that puts patient safety at the forefront, ensures evidence-based practices are utilized at the bedside, and enhances the patient experience to be the best it can be.

Goals of Care: respecting patients' wishes for treatment

Each and every one of us has a very personal sense of who we are, what we like to do, and what brings the greatest meaning and value to our lives. Having control in our lives is very important to most of us. When we are faced with a significant illness and the possibility that we could die, we make choices for our treatment and care based on our diagnosis, prognosis, the potential benefits and risks associated with various treatments, as well as our personal priorities and values.

Our patients and their families have very personal hopes and goals for their lives. Respecting your wishes is very important to us at Muskoka Algonquin Healthcare (MAHC). As part of our commitment to patient focused care, we will discuss advance care planning with you upon admission, so our health care professionals have a clear understanding of your wishes.

Advance care planning is the process of thinking about, talking about, and documenting your wishes for health care should something happen and health interventions are required. Many of us think health care planning is what we do when we are near the end of our lives. However, life-changing events can happen in an instant. In order to be fully prepared, we are asking you to take the time to document your wishes.

Establishing your aims for care, which we refer to as Goals of Care, ensures you and your health care team are striving for the same outcomes in accordance your values and health aims. It also ensures the health care team is not providing unwanted treatment or therapies.

If you are admitted to the hospital, your Goals of Care will be determined in conjunction with your most responsible care provider. The Goals of Care include three categories that provide different amounts or levels of care for a patient while in hospital: resuscitative care, medical care and comfort care. These designations cover things like the “do not resuscitate” orders and/or the option to be admitted to our Intensive Care Unit, or make an informed decision about organ and tissue donation, for example.

Your Goals of Care designation clarifies treatment priorities and becomes a permanent part of your medical record so the information is readily available to all care providers at the bedside. Should your situation and/or wishes change, you can revise your Goals of Care at any time in conjunction with your most responsible care provider.

At MAHC, we are proud to support a culture that ensures patient centered decision-making and respects the wishes and values identified in these crucial conversations.

For more information about Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.   

New gynaecological surgery coming to Muskoka

For some time now, women have had to travel outside of Muskoka for different types of gynaecological surgery. But all of that is about to change this fall. Muskoka Algonquin Healthcare (MAHC) is enhancing services closer to home for residents of Muskoka.

Starting September 5, 2013, gynaecological surgery will be available at the South Muskoka Memorial Hospital Site in Bracebridge one day per week on an ongoing basis. The new service is being established by Dr. Khaled Abdel-Razek, Chief of Obstetrics at Orillia Soldiers’ Memorial Hospital (OSMH). Dr. Abdel-Razek has been practicing as an Obstetrician & Gynaecologist at OSMH since December 2004 and has served as the hospital’s Chief of Obstetrics for the past two years. He is a respected surgeon who has provided exemplary obstetrical and gynaecological care to his patients, and we are delighted that Dr. Abdel-Razek has decided to enhance our surgical team at MAHC so we can provide a much needed service in Muskoka.

Months of planning and collaboration have brought this partnership to fruition and we are proud to be partnering with OSMH to provide this important service closer to home. Arrangements are also underway to bring in a second gynaecologist/obstetrician from OSMH to support the surgical program and share the Operating Room duties on the gynaecology surgical day.

The addition of gynaecological surgery is just one example of how MAHC is trying to grow local health care services and use innovative ways to bring new services to the Muskoka region.

For more information about the services offered by MAHC, please visit our website at www.mahc.ca.

Planning for the future at MAHC

The health care needs of our population are always changing and so are the ways that we take care of them. Research and technology are improving the way that patients are treated, prolonging lives and improving the quality of life for many.

In order to prepare for changes, new technologies and equipment, Muskoka Algonquin Healthcare is currently working on a master program and a master plan. Both are required by the Ministry of Health and Long Term Care for any major decisions around programs, services and the use of the property. It is a lengthy process and one that is part of prudent planning for the future.

Our master program will outline the type and extent of health care services to be delivered by our facilities. It will include projected programs, staffing and departmental space requirements over a 25-year timeframe. The master plan supports and demonstrates potential for developing our sites and is a high level design view of how our sites could be developed to meet future requirements over the next 50 years.

We know that our facilities, due to their age, are not consistent with current standards and pose challenges in regards to space right now. We are also looking at long-range plans to best accommodate the services we should be providing as acute care hospitals to service our patient base.

The master planning exercise also allows us to consider development options as they relate to partnership opportunities with other health care services. This planning process will guide us in building and strengthening our services and may also show us that we need to make some adjustments so we are well positioned for the future.

In the meantime, MAHC is working to maintain our hospitals through renovations as funds are available. The emergency department at Huntsville District Memorial Hospital Site was recently renovated and renovations to the Dialysis unit are currently underway. These upgrades allow us to provide better care to our patients and improve workflow and infection control measures.
News about MAHC and improvements to our facilities can be found online at www.mahc.ca.

Investments in people drive better patient care

At Muskoka Algonquin Healthcare, we are always looking for ways to improve our patients’ care. Our people – the staff, physicians and volunteers at our hospitals in Huntsville and Bracebridge – are our greatest asset, and we strive to ensure they have all of the skills and tools they need to perform at their best.

Especially in a hospital setting, knowledge is power and the more knowledge our staff has, the better equipped they are to help our patients. That’s why we have substantially increased the number of education hours for our staff, from over 3,000 in 2011 to 11,000 in 2012. Education opportunities are available both inside and outside the two hospitals.

Last year, we brought in experts to teach our staff about neonatal resuscitation, trauma nursing and emergency paediatric nursing. We have also developed several in-house programs that were made available to our staff. For example, our Clinical Nurse Educator recently developed an emergency room nurse training program and critical care nurse training program. These programs gave our nurses the opportunity to expand their skills and knowledge and the flexibility to work in different units of the hospital.

This year we revised and implemented a new performance management system. The management team and frontline staff got together to brainstorm ideas. In addition to providing safe, quality care, we really focus on individual productivity and how it impacts the team as a whole.

A new Leadership Development Program will start in May for both our formal and informal leaders at MAHC. We used the Ontario Health Association Leadership Development Model to put the program together. Managers will spend four hours a month working through 15 competencies. The program includes reading materials, videos, classes and workshops.  Throughout the session, our managers will be able to strengthen their leadership skills. The program will also be open to other staff members who would like to increase their leadership abilities.

Our doctors, nurses and support staff are tasked with providing a high standard of quality care, so it’s a priority for us that they are given the opportunity to learn and grow.

To learn more about Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.

Muskoka Algonquin Healthcare sets new quality goals for 2013-2014

Every year, Muskoka Algonquin Healthcare creates a new Quality Improvement Plan (QIP) that focuses on setting safety and quality targets for us to achieve. The provincial government mandates through the Excellent Care for All Act that this plan be created each year.

The 2013-2014 plan commenced on April 1st, and the full details of the plan are available on our website. Throughout the year, the progress and results will be reviewed by our Quality Council and the Quality and Safety Committee of the Board of Directors.

This year’s Quality Improvement Plan is important to all of us at Muskoka Algonquin Healthcare. We are committed to maintaining and improving a culture of quality and safety, and we continue to explore new ways to provide care as we know the importance of meeting our patients’ expectations and improving their hospital experience through the provision of safe, quality care.

In the year ahead, we will be working at strengthening different areas of our organization, including access, effectiveness, integration, being patient centered and safety. We have set specific objectives that we want to meet, including reducing emergency room wait times; unnecessary time spent in the hospitals and unnecessary readmissions, improving compliance in hand hygiene and medication reconciliation at admission/discharge, and our ongoing commitment to decrease hospital-acquired infections, like C. Difficile. The majority of our QIP indicators this year have focused the organization on improvements to the safety of the care we provide and will assist us to improve the quality of care our patients receive and deserve.

Last year’s QIP helped us reduce the number of hospital-acquired infections like C. Difficile to below the provincial rate, avoid patient falls, reduce the number of alternate level of care days and receive above average results in patient satisfaction.

You can follow our progress on our QIP indicators online with our Balanced Scorecard. Those interested can also view the 2012-2013 Quality Improvement Plan’s year end progress report.

For more information on Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.

Muskoka Algonquin Healthcare goes green

Two years ago the team at Muskoka Algonquin Healthcare (MAHC) began looking at how efficiently our hospitals in Bracebridge and Huntsville were running and where there were opportunities to do better.

MAHC joined Greening of Healthcare, a cooperative that works with partner hospitals to lower energy costs and raise environmental performance. This gave us the tools we needed to obtain, manage and assess data and compare it to other organizations. It is also a place to share best practices and learn ways to plan and implement improvements.

Experts were engaged and helped to identify significant savings through a number of different initiatives. This team of experts, including energy advisors, engineers, architects, and project managers, broke down the opportunities for savings and efficiencies into projects by looking at areas that had the biggest expenditure of energy.

Benchmarking the current practice has also helped us to identify the anticipated utility savings, which are estimated at 22 per cent at the Huntsville site and 25 per cent at the Bracebridge site. The total savings between both hospitals is estimated at $350,000 annually. The energy efficiency projects will focus on upgrading to more efficient ventilation systems, domestic hot water heating, lighting and automation and will cost $2.8 million.

In February, the MAHC Board of Directors approved these initiatives and the first phase is scheduled to begin in May 2013 using a staged approach, with the heating systems being upgraded during the summer and the cooling systems in the winter. The project is expected to take 18 months to complete, and the hospitals will start to achieve the full benefits by the end of summer 2014.

The project will be funded through a bank loan that will be repaid over seven and a half years using the savings the efficiencies will produce. Once the loans have been repaid, the savings will be reinvested into programs and services, providing greater care for patients.

We are excited for the project, as it will not only reduce our hospitals’ environmental footprint and save money, but will also increase the comfort level for both patients and staff.

For more information on other initiatives at MAHC, please visit our website at www.mahc.ca.

You can help make MAHC better

At Muskoka Algonquin Healthcare, patients are always our top priority. It is our goal that the patients we see each and every day are receiving the best care possible in a safe environment.

We are always looking for ways to improve the services offered to our patients, which is why we have begun to develop a customer service excellence program. In addition to training our staff and implementing programs to improve our service, we also welcome feedback from our patients and their visitors – positive or negative.

If you have a concern about your care or the care of a loved one, your first approach should be engaging your health care team. Speak to one of the doctors, nurses or other health care professionals directly involved in providing the care about any concerns you have. Good communication with your health care providers is essential and helps to ensure the highest quality of care.

If you are unable to resolve your concerns with your health care team, you can ask to speak to the manager or shift leader and have them help you find a resolution. You also have the option of contacting the administration at any of our sites, either over the phone or in writing.

If a serious issue arises with the wellbeing of one of our patients, be assured that we provide full disclosure of the events and repercussions of the incident. We plan meetings with the patient and the patient’s family to review what happened and what steps will be taken to correct the problem in a transparent manner.

MAHC is also committed to the highest standards of professional, ethical and legal behaviour by employees, medical staff, volunteers and students and has a whistleblowing policy to handle complaints associated with a breach of professional, ethical, financial or legal behaviour.

At MAHC, all feedback is greatly appreciated and we take every compliment and complaint seriously. The information we get from you, our patients, helps us form our programs and policies to better serve you.

For more information about how you can provide feedback, please visit our website at www.mahc.ca.

At MAHC, infection control is everyone’s responsibility

Many people are wary about entering a hospital, as they are afraid of getting sick. While broken arms are not contagious, there are many patients that come to the hospital with colds, flus and other contagious infections, which could potentially make the facility a hotspot for illnesses and bacteria.

That’s why infection control is so important to Muskoka Algonquin Healthcare. All of our facilities have policies and procedures in place to minimize the spread of infection and to keep our patients and staff safe.

Many infections are transmitted indirectly through touch and environmental surfaces, which is why proper hand washing is so important. All staff at MAHC maintain strict hand hygiene protocols, but it’s also important for visitors to ensure their hands are properly cleaned. Most people don’t wash their hands long enough to kill bacteria. In order to be effective, you should rub your soapy hands together for at least 15 seconds. Try humming the “Happy Birthday” song twice to help you keep count.

MAHC also has alcohol-based hand sanitizer throughout all of our facilities and visitors are asked to use it upon entering and exiting the building or a patient room and throughout their stay. Masks are also available for those with respiratory infections, colds and flus. Wearing the mask can prevent viruses from being spread to others when we cough or sneeze.

In addition, MAHC has an Infection Prevention and Control program that includes surveillance, education, policy development and review and continuous quality improvement.

If you feel unwell or are ill with a cough, fever, respiratory infection or diarrhea, please do not visit the hospital until you are feeling better. It is also wise to take precautions against influenza and get your flu shot annually.

For more information on MAHC’s facilities, policies and procedures, please visit our website at www.mahc.ca.

Understanding Health System Funding Reform

The way that Ontario hospitals will be funded has changed. Last year, the provincial government introduced Ontario’s Action Plan for Health Care, which will be implemented in all hospitals over the next several years.

Hospitals previously received funding as one lump sum that would cover their services. The new funding system is designed to be more patient-centric and hospitals will be funded based on the number of patients they see, the services they deliver, the evidence-based quality of those services and the specific needs of the broader population they serve. This strategy will also see a shift of health care dollars into the community setting and hospitals may begin to consider specialities and focus on what they do best, so in other words not all hospitals will do all things.

At Muskoka Algonquin Healthcare, we support these changes to funding. The new plan uses evidence to inform health spending so that money truly follows the patient and drives quality improvement. We feel that funding reform is necessary to ensure that funding is provided where the population needs exist and achieves the best value. Over the next few years, we will be working to meet the challenge of this new funding system.

The new funding program will be implemented in stages over three years and is made up of two components: Health Based Allocation Model (HBAM) and Quality Based Procedures. Both are funded at pre-determined best practice rates and are based on the volume of procedures performed.

Beginning in the 2012/13 fiscal year, HBAM funding will account for 40 per cent of MAHC’s funding. Quality Based Procedures include hip and knee replacement surgery, cataract surgery and chronic kidney disease in 2012/13 and will account for up to six per cent of the hospital’s funding. Over the next two years, the number of procedures included in the category will increase until it represents 30 per cent of the hospital’s funding.

With help from the Ministry of Health and Long-Term Care, we will be working to meet the challenge of the new funding plans. As always, patients will be our first priority every step of the way.

Read more about Health System Funding Reform.