June 2018

EspanolaRegionalHospital&HealthCentre

ANNUALREPORT2017/2018

‘OUR PEOPLE’

Mission ~ Vision ~ Values

Vision A Leader in health care and gateway to services

Mission To provide excellent health care programs and

services to all we serve

Values

Patients First Integrity Caring/Compassionate Continuous Quality

Improvement Respect & Dignity Contribution of all Culture of Effective

Communication

Strategic Priorities

Promoting the value of our people

Broadening our Excellent Health Care

Sustaining our Resources

A Message from the CEO & Board Chair

ValuingOurPeople

AttheEspanolaRegionalHospitalandHealthCentre,webelievethatourstrengthisin“ourpeople”.Promotingthevalueof“ourpeo-ple”isakeystrategicgoalwhichguidesourvalues,prioritiesanddecisionmaking.Webelievethatpeoplearewhatreallymatter.OnbehalfoftheBoardofDirectorsandLeadershipTeamweareproudandhonouredtoshowcasetheaccomplishmentsachievedoverthepastyear.Signi icantinvestmentshavebeenmadetoensurethatourteamshavetheknowledgeandtoolstoprovideexceptionalcareandservices.Providingasafeworkenvironmentfreeofviolencehasbeenattheforefrontofmanyimprovementsmadethroughouttheorganiza-tion.Afacility-wideworkplaceviolenceriskassessmentwascompleted,generatinganactionplanwithkeyinvestments.Severalsafetyenhancementshavebeenmadetoareasidenti iedathighormoderateriskinordertoensuresafetyintheworkplace.Theseinvestmentsincludedenhancedvideosurveillanceandpanicalarmsystems.Educationhasbeenprovidedforfrontlinestaffsothattheyhavethetoolsandskillstoknowhowtoactandrespondtoemergenciesandpotentialactsofviolence.Beingreadyandpreparedforanyemergency,whetheritisoccurringinsidetheorganizationorinthecommunityisessential.AnextensiveCodeOrangeexercise(externaldisaster)wascompletedinpartnershipwithlocalcommunityemergencyserviceproviderssuchastheEspanolaRegionalPolice,NorthShoreSearchandRescue,EmergencyMedicalServices(ambulance)andtheEspanolaHighSchool.Theexercisedemonstratedthatweareindeedreadyandabletorespondtoaseriouscrisis.Bypractisingworstcasescenariosweareabletoevaluateourresponseprotocolsandimproveuponthem.Educationandtrainingisakeyinvestmentforallofourteammembers,makingcertainthattheyhavethemostrelevantknowledgeandskillstoprovidethebestcareandservicespossible.Inrecognitionoftheneedsoftheteams,resourceshavebeenallocatedtoensurethatteammembershavethetimeandtoolstoreceivetheeducationnecessarytobeeffectiveintheirroles.Anewanden-hancedLearningManagementSystemhasbeenlaunched,promoting lexibilityincompletingnecessarytraininganddevelopmentneeds.Weareveryappreciativeforthesupportandleadershipofthephysicianswhoprovideexceptionaldedicationandservicesforourpatients,residentsandcommunity.Theyareagroupofhighlytalentedprofessionalswhopersevereattimesindif icultsituationsensuringpatientsreceivethecarethattheyneed.Physicianinputandleadershiphasbeeninstrumentalinmanyofthesuccessesrealizedtodate,theyareinvaluablemembersoftheteam,providingmentorship,educationandguidance.Signi icantfacilityimprovementshavebeencompletedduetotheHospitalInfrastructureRenewalFundandtheHospitalEnergyEf i-cientProgramsupportedbytheMinistryofHealthandLongTermCare(MOHLTC)andtheNorthEastLocalHealthIntegratedNet-work(NELHIN).Improvementstoourinfrastructureareessentialasourfacilitycontinuestoage,requiringsigni icantinvestmentstoensureitismaintainedandfreeofequipmentbreakdownswhichcouldbedetrimentaltothosewhoreceivecareorliveonthehealthcampus.Withtherisingcostsofutilities, indingenergyef icientprogramsandimprovementshasbeenbene icialinourabil-itytocontrolcosts.ChanginglightstoLEDbulbsand ixtureshasproventobeveryeffective.Considerableresourceshavebeenallocatedthispastyeartoenhanceelectronichealthrecordsandinformationsystems.Weareinaneverchangingtechnologicalworldwhichrequiresmanyinvestmentstokeepusattheleadingedge.Improvementshavebeenre-alizedinmanyoftheclinicalareas,includingbeingthe irstsmallhospitalintheNorthEasttoimplementanElectronicMedicationAdministrationRecord.Thesuccessoftheseprojectsrequiredthepurchaseofequipmentandtheadditionofaclinicalinformaticsspecialist.TheRuralHealthHubPilotprojectandtheHealthLinksinitiativescreatedimprovementsinhowthecommunityandourpatientsreceivetheircare.Withtheinvestmentsintechnologyandthedevelopmentofcomplexcoordinatedcareplanswearewellpositionedtofurtherimprovethehealthofthecommunity.Ourcommunityisaging,extensivewaitlistsforhousing,assistedlivingandnursinghomeservicesexist.Inresponsetothesechal-lengesanapplicationfor64additionalnursinghomebedswassubmittedthis iscalyear.Wearehopefulforpositiveresultsaswecontinuetoadvocatetirelesslyforthecommunity.Wewouldliketothankourvolunteerswhogenerouslydonatetheirtimetomakeourhealthcarecomplexabetterplace.Volunteersareessentialinprovidingnotonly inancialsupportbutcareandkindnessforourpatientsandresidents.ThePatientAdvisoryCom-mitteehasbeenessentialinprovidingguidanceandinputinservicedeliveryimprovements.Weareveryfortunatetohavesuchadedicatedgroupofmemberswhotrulykeepthe“Patient”attheforefrontofeverythingthatwedo.WeareveryexcitedtobreakgroundontheTherapeuticGardenproject,whichisbeingledbyvolunteers,andfundedbythegenerouscontributionsmadethroughourFoundation.Thisprojectis100%fundedbydonations,astherearenootherfundingsources.Ourseniorsaresoexcitedandlookforwardto“supervising”theproject.Inadditiontothisproject,theHospitalAuxiliarycontinuestoworktirelesslytoraisefundsforessentialhospitalequipmentsuchaspatientandresidentmechanicallifts,ensuringsafeandeffec-tivecare.WeareextremelyappreciativetotheMOHLTCandtheNELHINforthepermanentandadditionalinvestmentsmadeinBehaviorSup-portsforthoseresidentslivingwithdementia.Duetothispermanentfundingwehavebeenabletoprovideregionalsupportsforfamiliesandresidentsrequiringcare,bothinthecommunityandintheEspanolaNursingHome.Inadditiontotheseinvestmentswearepleasedtoreportthatfundingwasreceivedtoourbasebudgetpermittingustoendtheyearinapositive inancialposition.Inclosing,wethankyoufortakingthetimetoreadthisreport.Weareveryproudofouraccomplishmentsandourpeople.Welookforwardtohearingfromyou-yourfeedbackisessential!Pleaseletusknowhowwerate,whatwedowellandhowwecanimprove.Wearepeopletakingcareofpeopleandourgoalistoprovidetheverybestcarepossible.Pleasejoinusinthispartnership.

Respectfully,

DavePope,BoardChair NicoleHaley,CEO

EXECUTIVECOMMITTEEDavePope,Chairperson

RonMacKenzie,1stViceChair

CliveFitzjohn,2ndViceChair

MaureenVanAlstine,Treasurer

NicoleHaley,Secretary

TRUSTEES

DianeRand

JanetWhissell

LouiseLaplante

MarcSamson

CynthiaTownsend

PatriciaTrudeau

YvesCarriere

KarenLalonde

JeremiahSteele

Leadership Team 2017 –2018

Board of Directors

OurBoardofDirectorsvolunteer100%oftheirtimeanddonotreceiveanhonorariumorstipendforattendanceatBoardmeetingsorfunctions.Boardmembersarerequiredtoreviewavastamountofinformation(i.e.studydocumentsandpublications),togainknowledgeofnewdirectionsinhealthcaretransformations,etc.asitimpactsontheirdecisionmakinginestablishinghospitalpolicy,fundingallocationsandcommunication.

Tofurthertheireducation,Boardmembersattendnumeroustrainingevents,webcasts&informationmeetings,sotheycanbepreparedtomakeinformeddecisions.

WeareveryfortunatethatourBoardhasin-depthskillsandknowledgetoensureourcommunityhasaccesstothebesthealthcarepossible.

Administration

SENIORMANAGEMENT

NicoleHaley,ChiefExecutiveOf icer

KimRoy,ChiefFinancialOf icer

JaneBattistelli,DirectorofClinicalServices

TammyTallon,ExecutiveAssistant

MANAGEMENTTEAM

JanisBond,Laboratory

JonBrunetti,PrimaryCare

MarloDesjardins,HumanResources

KristyDesjardins,FoodServices/Housekeeping

MoniqueGallant,Physiotherapy

JodieGraham,MaterialsManagement

PaulaMitroff,PatientSafety&Quality

TerriNoble,PublicRelations/Foundation

PhyllisParadis,QueenswayPlace/SocialWork

AlRenaud,Maintenance

PaulAinslie,I.T./ClinicalInformatics

TammySmall,AcuteCare/Emergency/Pharmacy

PhilSmith,DiagnosticImaging

LiisaTallon,HealthRecords/Privacy

LeeTurley,LongTermCare

Ourmanagersareactually“working”managersinthattheyalsoper-formfrontline(directandindirect)patientcareinadditiontomanag-ingtheirdepartments.

Thisisnotunusualinsmallhospitals,wheremanagersoftentakeonfrontlinefunctionsduetolackofcriticalmass/economiesofscale.

Whilethatcanadditschallengesittoooffersagreaterdegreeofful ill-mentandsatisfactionastheycanexperiencethedirectimpactoftheirteams’effortsonpatientsandfamilies.

LEADERSHIP

Dr.AndreMichon,ChiefofStaff

Dr.MinYeNgae,MedicalDirector-Lab

Dr.JeffMiddaugh,EmergencyDepartmentMedicalDirector

Dr.HamaSalam,MedicalDirector–LongTermCare

ACTIVESTAFF

Dr.JohnKnox

Dr.KimPerlin

Dr.LianeAinslie

Dr.AlisonMcMillan

Dr.LionelMarksdeChabris

Dr.StevenBignucolo

Medical Leadership

Ourphysiciansmustberecognizedandcommendedfortheireffortsingoingabove&beyondinprovidingquali-tycaretotheresidentsofthecommunitiesweserve.

Weoftentakeitforgrantedthatthedoctorsaretrainedtolookaftereveryaspectofthehealthcareneedsofitscitizens.Inmanylargerurbancommunities,doctorshavethesupportofspecialistsandothermedicalsup-portsreadilyandconvenientlyavailablewithintheirhospitals.Insmallruralcommunities,likeEspanola,ourphysiciansdevelopanenhancedskillsetinordertomanagehigherlevelsofcomplexitiesofcare.

Duetoisolationofruralcommunities,physiciansoftendependontheirownexperience,skillsandjudgmenttomakeadeterminationonapatient’scareplanastheydonothavethatsameaccesstoothermedicalsupportsastheurbancounterparts.Inshort,ourphysiciansareamazing!

Senior Team Kim Roy, CFO * Nicole Haley, CEO * Jane Battistelli, CNO

Notes from the Chief of Staff

ItismypleasuretoonceagainpresenttheChiefofStaff’sannualreporttothecorporatemembershipoftheEspanolaRegionalHospi-talandHealthCentre(ERHHC).Iwilltakethisopportunitytohighlighttheprogress,changesandchallengesthatarepartofthestoryhereatourcampus.Asalwayswearecommittedtoprovidetheutmostqualityofcaretothepatientsweserve.

Medicallearnerscontinuetopassthroughourfacilityaspartofouraf iliationwithNorthernOntarioSchoolofMedicine(NOSM).Bothlearnersaswellasstaffbene itfromthisinteraction.Wecontinuetogrowthisaf iliationwiththemedicalschoolandhavemorethandoubledthenumberoflearnersoverthelastyear.

OurLong-TermCare(LTC)Departmenthaswelcomedanewdirector,Mr.LeeTurley.Hebringsawealthofknowledgeandexperi-encetoLTC.Aswell,anewAssistantDirectorofCare,Mr.DaveAdamzcak,hasrecentlystartedandwewelcomethembothtotheirnewpositions.ThephysiciancomplementofDr.Knox,Dr.McMillan,andDr.Salamcontinuetoprovidegreatcareforourresidents.Togetherwiththeotheralliedhealthprofessionals,thischallengingandvulnerablepopulationiswelllookedafter.Sadly,despiteourefforts,wehaveasmanypatientswaitingforbedsasthereareresidentsinLTC.Furthermore,thesepatientsoccasionallyrequireacutecare.Oncetreated,theyaresometimestooadvancedintheirchronicillnesstoreturntotheirpriorlivingarrangement.TheythenbecomeAlternateLevelofCare(ALC)andoftenstayforweeksandmonthsawaitingabedinLTC.Thisinturnlimitsbedavaila-bilityinthehospital,andmayimpedeorlimitourabilitytocareforthosesufferingfromanacuteillness.Unlesssigni icantfundingchangesoccurthissituationisunlikelytochange.Wearehopefulthattheapplicationfor64newbedsbeapproved,whichwillpro-videthecapacityinourlocalhealthsystemtoprovidethecarethatourcommunitydeserves.

Wehaveimprovedourabilitytoprovideendoflifecare.ThroughfundingbytheNELHINourfacilitywasabletoretro itoneoftheacutecarebedstocreateahospiceservice.Wehaveseenclosetodoubletheneedforpalliativecarethanwasoriginallyexpected.Wecontinuetoadvocateforadditionalfundingtoincreaseourcapacitytoprovideendoflifecare.

OurlaboratorydepartmenthasseenthedepartureoflongtimedirectorDr.Bonin.Hisguidanceandinputwereinvaluabletoourgrowthasanorganization.Hewillbegreatlymissed.WewelcomeDr.MinYiNgaeasthenewdirectorandlookforwardtofuturecollaboration.

Fromastaf ingperspective,Dr.BignucolohassuccessfullycompletedhisEmergencyDepartment(ED)mentorship.Heisnownotonlyapracticingfamilyphysicianinthecommunitybut,aswell,anactivememberofourhospitalistteamandEDstaff.Heisaverywelcomeadditiontoourteam.Dr.AidanWharton,aHealthScienceNorth(HSN)emergencyphysicianhasalsojoinedourlocumgroupofEDdoctors.

IntheEDwebene itfromtheleadershipofDr.Middaugh.Hepossessesexcellentleadershipqualitiesandemergencymedicineexpe-rience.HehasbeeninstrumentalinimprovingthecareandservicesintheED,providingleadershipinmanyareasincludingdisasterplanning.Despiteourrecruitmentefforts,wecontinuetolackthephysiciancomplementtoadequatelystaffourED.Thisisanongo-ingchallenge.Thephysicianfundingenvelope/modelfortheEDhasnotchangedinover10years!Again,wecontinuetoadvocateforadditionalresourcesandfundingtohelpaddressthesegaps.

ImprovementshavebeenrealizedinregardstopatienttransportationduetothefundingreceivedbytheNELHINtoprovideaNon-UrgentTransferservice.Thisisapilotprojectwhichapermanentsolutionisyettoberealized.Wearehopefulthatasustainableservicedeliverymodelwillbeforthcoming.Transportationisnotouronlychallengeasweexperienceincreasedpatientacuity(sickerpatients)oftenrequiringspecializedcarewhichwearenotresourcedtodeliver.Furthermore,informationtechnologygaps,mentalhealthandaddictionsdiseaseburdenandstandardizationrequirementsaddtothestrainoffrontlineproviders.Withthiscomesagreaterchanceforerror.Weneedandwillimplementablamefreeandnonjudgmentalculturetomitigatetheserisks.Westrivetoprovidetheverybestofcareforeachofourpatients,doingourbesttomeetexpectationsanddemographicneed.

Thebarrierstocareremainsigni icant.Ourcommunityisagingresultinginhighdemandsonourhealthcaresystem.Westriveto illthegapstomeettheneedsofourpatients.Wehaveidenti iedmanyareaswheresystemimprovementsarerequiredwecontinuetoadvocatetomakepositivechangesareality.Despitethesechallengestheresiliencyofourgroup,physicians,nursesandouralliedhealthprofessionalsisastounding.Theyrespondtopatientneedswiththeutmostincompassionandexcellenceincarethatyoucouldaskfor.Itismyhopeandwishthatthesupportgoestowhereitisrequiredsothatthequalityofcarewegivecancontinue.

Dr.AndreMichon

ChiefofStaff

Annual Report 2017-2018

This past year has been a busy one as usual. Actually it has been busier than usual as we are able to donate $27,000.00 towards the new ultrasound equipment.

Sales in the gift shop are going strong, we are our own best customers haha, and the Nevada tickets are selling so well that Deb has had to purchase an extra box of one thousand tickets to keep up with the demand. People enjoy playing this and it is their way of supporting the hospital.

Our fundraisers throughout the year included Bake Sales, Soup and Sandwich Days which are well appreciated by the staff and many residents. We try to make this a fun and social experience for everyone. Our last soup and sandwich netted us $590.00 ...the best ever and we thank everyone for their support.

Our other fundraisers include the Mother's Day Raffle, the Pumpkin Pancake Breakfast which is very popular, and our Christmas Tea and Bazaar. We have also had fundraisers and bake sales at the mall and during the car show in May.

This year we are setting up at the Massey Fair as a new venture. Our homemade butter tarts and red pepper jelly are one of our best sellers during these events. We also sell many of our crafts then to.

The Auxiliary members set up and decorate the Christmas trees for the residents of the Queensway Place and is much appreciated by everyone there. Staying with the Christmas theme we continue to make and sell Christmas balls for the In-Memoriam Tree placed in the hospital lobby during the Christmas season. The balls have become so popular that many are sold as home decorations or gifts. These are a very successful fundraiser.

The Bridge Club continues with their support and we thank them with an annual tea and luncheon at the close of their season, which is well enjoyed. There are currently 36 members.

This year we are holding an in-house membership drive. It is getting a good response. We are making sure that anyone can join, even if in name only, The more support we get the better.

We look forward to another busy and productive year and continue in our endeavours to support the Espanola Regional Hospital in any way we can.

Sincerely on behalf of all volunteers,

Diane Rand, President

THE AUXILIARY

ESPANOLA REGIONAL HOSPITAL

Diane Rand

Last year the Auxiliary donated funds for the purchase of a Neonatal Transport Incubator

Financial Report

News from the Finance Team Did you know that the each year ERHHC’s Finance Team is responsible for:

Financial and statistical reporting for the Hospital, Nursing Home, Foundation, Queensway Place, Family Health Team and Non-Profit Housing;

Invoicing 8,500 claims to the Ontario Health Insurance Plan (OHIP), 1,300 resident and tenant billings, 1,000 ambulance co-payment fees and 750 other patient related charges;

Maintaining 5,700 general ledger accounts;

Issuing 3,200 cheques to vendors; and

Recording 1,100 manual journal entries?

Statement of Operations

ERHHC Team 2017 - 2018

Laboratory WehavebeenverybusyservingEspanolaandthesurroundingcommunities.WewouldliketowelcomeournewLabDirector,Dr.MinYiNgae.

InJuneof2017theLabwentthroughaccreditationwithonly5minornon-conformitiesand98.8%compliant.

Weperform:

156,142inhousetests

12,533referredouttests

2,832ECG’s/holters

23,897patientscollected

ThePhysiotherapydepartmentcontinuestoprovideservicesatalllevelsofcarewithinthehealthcarecontinuumofERHHC.Staffisinvolvedinprovidingoutpa-tientservices,treatmentinacutecareandevensometimesintheemergencyde-partment,NursingHome,CardiacRehabilitation,andcommunity itnessinitia-tives.Fiscalyear2017-2018sawapproximately5500patientvisitsthroughthedepartmentand350newpatientassessments-notincludingouractivityinLongTermCare,tenCPRclassesdeliveredforstaff,approximately256000stepstakenwhileurbanpoling,andmilesoftreadmillhourslogged,tonsofweightsliftedandlotsofbodypartspushed,proddedandencouragedintonewandwonderfulposi-tions!Wehaveoverhauledoursupplyofmobilityequipmenttoensureitissafeandthatwecanaccommodateavarietyofshapesandsizesandconnecteditwithamaintenanceprogramforupkeep.Wehavebeeninvolvedinstaffreturntowork,ergonomics,crutch/equipmentrecyclingthroughEDwhereneeded,andamyriadofotheroddsandends.WeareajackofalltradesandcontinuetodoalittlebitofeverythinghereatERHHC.

Physiotherapy

Health Records / Registration

TheHealthRecordsDepartmentisresponsibleforthecollection,use,securityanddisclosureofyourpersonalhealthinformation(yourhealthchart).WedothetranscriptionformanyConsultations,Clinics,Emer-gencypatientsandAcuteCarepatients.WealsosubmitalldiagnosisandstatisticalinformationfromEmergencyandAcuteCarevisitstoacen-tralregistrycalledCIHIandtotheMinistryofHealth.TheRegistrationDepartmentisyourcentralregistrationandinfor-mationsource.Last iscalyearweregistered39,032outpatientsand588inpatients.AverybusydepartmentwhoalsoreceivesmostofthephonecallsandassiststheEmergencyDepartmentandtheHealthRec-ordsDepartment.

Patientsandtheirfamilieshavetherighttotrusttheirprivacywillbeprotectedbythehealthcareprovidersuponwhomtheydepend.Wetakethisveryseriouslyanddoourverybesttoprotectyourprivacyandyourinformation.Weconductregularauditsandhavepoliciesandpro-ceduresinplaceshouldtherebeabreachofyourpersonalhealthinfor-mation.Everyemployeealsosignsacon identialitycontract.

CARDIOLOGY

Echocardiography September 2017 ERHHC received a 3 year accreditation from Corhealth for our Echocardiograms (Ultrasound of the heart). We were one of the first in the north to be accredited and remain one of only a few. Corhealth is an organization Partnering with facilities to find improvement opportunities by providing a six-step certification process to ensure that facilities that chose to participate align with the Standards for Provision of Echocardiog-raphy in Ontario. These provisions are guidelines that were reviewed by a geographically and professionally diverse group of individuals involved in the practice of echocardiography, addressing all components of service delivery and were intended to ensure the utility, reliability and safety of echocardiography examinations. This was a process that involved a lot of work setting up protocols, policies and optimizing our equipment settings and routines. Espanola Regional is lucky to have a dedicated and experienced sonographer, Marilyn Laing and a supportive Cardiologist, Dr C. Hourtovenko so that these accomplishments could be achieved effectively and efficiently. This is a huge win for cardiac patients in our communi-ty. This accreditation is a process and even though we are now accredited, the work continues and we already have our sights set on further goals and enhancements to the program leading into the 2020 accreditation. Cardiac Clinics Doctor Hourtovenko continues to provide us 2 clinic days per month this year. There has been a positive improvement on wait times, however, de-mand is very high and wait times still exist. Rest assured all referrals are vetted and prioritized by Dr Hourtovenko upon receiving them. Often he orders testing ahead, which is quickly accommodated with results being sent to him expediently, aiding further prioritization. Patients requiring urgent attention are fit in to see him. On occasion, ERHHC patients may be seen at Dr Hourtovenko’s office to facilitate more urgent cases. Joanna Hearn RN has been assigned to work with Dr. Hourtovenko during the cardiac clinics which provides consistency and improves continuity of care. Joanna, in many cases, is familiar with the patients because she also works in primary care at the Family Health Team as the main lead for the Heart Health Program. She is currently specializing for these roles in Cardiac Care and Rehab, by taking Cardiac Nursing on-line from MacEwan University. Heart Health Program Espanola Regional Hospital and Health Centre along with the Espanola and Area Family Health Team have assembled a multidisciplinary team to aid in the treatment and management of cardiac disease. This consists of exercise programming, smoking cessation, registered dietician, social worker, certified diabetic educator, physiotherapy rehab, hypertension management, medication review, cardiac education sessions, cardiology consultations and diagnostic testing. Once a patient is referred, a case manager will then do a thorough intake assessment and coordinate their appointments with the appropriate health care professionals to assist with lifestyle modifications for optimal cardiac health and wellness. This pro-vides a more complete health/social history for individuals enabling a more focused assessment which ensures the patients are getting the re-sources that they need. DIAGNOSTIC IMAGING We continue to offer a wide variety of services here at ERHHC. While many other small sites no longer offer Gastrointestinal studies, ERHHC has managed to maintain this service. With our visiting specialist, Dr Sloan, we perform these as well as some other procedures such as joint injections weekly. Very rare for a small hospital, we also provide a full range of noninvasive vascular testing. Along with our general ultrasound and Xray as the backbones of the department, we continue to be busy with just under 12,000 studies last year. We also partner with College Boreal by provid-ing training for Xray students. We need to thank the auxiliary for their aid in raising funds for our new vascular ultrasound unit. This effort is ongoing. The equipment is very ex-pensive and the local support is key to keeping state of the art equipment in our community hospital.

Diagnostic Imaging / Cardiology

Diagnostic Imaging Manager Phil Smith

Emergency / Acute Care

Pharmacy

ACUTECARE: Total#ofadmissions:558Averagelengthofstay:6daysTotalPatientDays:4577ERHHCismotivatedtoincorporateinnovativetechnologyenhancementsforcontinualimprovementthatwillbene itpatientsandclinicalstaff.In2016theAcuteCareunittransitionedsmoothlyfrompapertoelectronicpatientcaredocumentation.In2017wesetouttoevolvetoelectronicdocumentationofmedicationadministration(eMAR).UnliketheelectronicdocumentationforpatientcarewhichhadbeenimplementedinmanyoftheNorthEasternOntarioNetwork(NEON)hospitalstheelectronicmedicationdocumentationhadnotbeenimplementedinanyofourthirtyNEONpartnerhospitals.ERHHCwasthepioneerforthisinnovationwhichmeantthatmanyprocessesandproceduresonutilizationwererequiredtobeinvestigatedandworkedthrough.Afterextensivetestinganddevelopmentoftheprocesses/procedures,eMARwassuccessfullylaunchedinDecember2017.Inthese irstfewmonthssincelaunchingeMARwehaveidenti iedareasofef icienciesaswellasprocesschangesandemployeeeducationtoen-surethatwecontinuetomeettheOntarioCollegeofPharmacist(OCP)standardsforsafemedicationpractices.EMERGENCYDEPARTMENT:Total#ofvisits:13,896AverageLengthofStayforComplexpatients:2.72hours,ERHiswellbelowtheprovincialtargetof8hoursAverageLengthofStayforNonComplexpatients:1.54hoursiswellbelowtheprovincialtargetof4hoursERHHCnowhasatrainedinstructorforNonviolentCrisisIntervention(NVCI)whohaseducated75%ofourED&AcuteCareclinicalstaffonearlyinterventionandnonphysicalmethodsforpreventingandmanagingdisruptivebehavioraswellasmethodsofleastrestraintorholdingskillsthataretaughtasalastresortwhenanindividualbecomesanimmediatedangertoselforothers.Thegoalisthat100%ofED&AcuteCareclinicalstaffwillhavereceivedNVCItrainingbytheendof2018andwillberecerti iedeverytwoyearsmovingforward.HOSPICE:2017/18wasEspanolaRegionalHospital’sHospice irstfullyearofoperationwhere32patientsandfamilieswereprovidedEndofLifeCare.WhentheNELHIN irstapproachedERHHCwiththefundingfora1bedHospicesuite,theyindicatedthatapproximately18patientsandfamilieswouldreceivethisspecializedcareduringtheirendoflifejourney,thisnumberhasbeenexceededwhichindicatestheneedforthisser-viceinourcommunity.ERHHCisworkingwithourcommunitypartnersongrowingandstrengtheningaCommunityPalliativeCareprogram.

PHARMACY:TheOntarioCollegeofPharmacists(OCP)returnedintheFallof2017foraninspectionofthehospitalpharmacywhichresultedinERHHCreceivingaCerti icateofAccreditation.ERHHCpharmacystaffcontinuestomakeimprovementsinprocesschangestoensurethattheevolvingstandardssetbytheOCPforsafemedicationpracticesarebeingmet.

Pharmacy Technician Angie Scheel

Quality Improvement

TheQualityImprovementPlan(QIP)fortheHospital,FHTandLTCrequiresmuchdatagather-ingandplanning.The2018/19integratedQIPwascompletedundertheleadershipandguid-anceofPaulaMitroff.ParticipationfromtheED/AcuteClinicalManager,FHTManager,DirectorofLTCandtwomembersoftheirfrontlinestaffhavebeeninstrumentalindevelopingtheQualityImprovementPlanfortheupcomingyear.Asateam,wearelookingatwaystocollaborate, indef icienciesandcreatenewprogramsthatwillfurtherenhancethecareandservicesweofferthepatients,residentsandcaregiversinourcommunity.

EspanolaRegionalHospitalandHealthCentrestronglysupportsthephiloso-phythatembracesallstaffhavetherighttoworkinasafe,healthyenviron-ment.Signi icantpriorityhasbeenplacedonimplementingmeasurestoassiststaffwithmanagingincidentsofviolenceshouldtheyarise.InJanuaryof2018weconductedafacilitywideworkplaceviolenceriskassessmentwhichhasledtotheidenti icationofriskswithinourorganization.MockCodeWhite(violentperson)andCodeSilver(threateningweapon)Drillsareperformedannuallywhichalsohelpedtoidentifygapsinourprocesses.Severalstrategieshavebeenexecutedtoaddresstheserisksthroughouttheorganization.

Enhancementsweremadetoexistingcamerasystemtoimprovepicturequalityanddistance.Inotherareasofthehospitalcameraswerein-stalledtoexpandvisuals

PanicAlarmswereinstalled&ifactivatedlocalpolicearedispatchedandrespondimmediatelytoassistwithdangeroussituations

WearablePersonalAlarmswerepurchasedforstafftouseduringhighrisktimeswhenworkingalone

Saltolocks,ourinternalsecuritylocks,wereinstalledinseveralareaswithinthebuildinganddoorbellsweremountedsoonlystaffwouldhaveaccess

75%ofstaffinAcute&EmergehaveattendedNonviolentCrisisInterven-tion(NVCI)onhowtomanageviolentbehavior&learnstrategiestode-escalateaggressivepersons

Prevention of Workplace Violence

PatientEngagementistobehighlightedasoneofthegreatestaccomplishmentsoverthispastyear.OurPatientAdvisoryCouncil(PAC)wasestablishedinJuneof2016andhasgrownthispastyearto7advisorswhoarepas-sionateadvocatesforqualitycareintheservicesweprovide,ensuringapatient/familyqualityperspective.Forasmallruralcommunitythereisexceptionalengagementandsupportfromthepatientsandfamiliesinourcommu-nitywhoareparticipatinginthePAC.ERHHC'sContinuousQualityImprovementManagerleadsthePACanden-gagesthememberstoobtaininputandsuggestionsfromapatientandfamilyperspectiveontheinitiativesandim-provementsthatimpactAcuteCare,Long-termCareandPrimaryCare.Thegoalofourorganizationistofosteracultureofempathythatrecognizespatient,familyandpublicfeedbackasthecenterofmakingeffectivechange.Withpatients,familiesandhealthcareprovidersactivelycollaboratingtoimproveourlocalhealthcaresystem,thereisanopportunityforimprovementsnotonlyinprogramsandservices,butastrengtheningoftherelation-shipbetweenthehospitalandcommunity.

Patient Engagement

Quality Improvement Manager Paula Mitroff

Laundry / Housekeeping

Dietaryprepares111,525meals/year.

EspanolaNursingHome-64residentspermealx3/day=192x365=70,080

AcuteCare-15patients/dayx3meals=45X365=16,425

QueenswayPlace-20residentsx3meals/day=60X365=21,900

MealsonWheels-20meals3xaweek=60x52weeksperyear=3,120

Housekeepingdid116,218kglaundrylast iscalyear.

Dietary

Information Technology / Clinical Informatics

Inthepastyear,thepositionof‘ClinicalInformaticsSpecialist’wascreatedand illedbySherylFlynn.Thisposition,sharedbetweenEspanolaandNorthShore,isresponsibletoprovidesupportforallaspectsofimplementation,planningandevalua-tionwithourHealthInformationSystemsandElectronicMedi-calRecord.

LucPelland,joinedusinJuneasthenewITTierIITechnician,andcomeswithexperiencefrompositionsatHealthSciencesNorthandEastlink.

Thewirelessnetworkthroughoutthehospitalhasbeenreplacedwithamoremodernsystemthatgiveswiderrangeofcoveragetoeliminatesomedeadzoneswehadpreviously.Staffusethewirelessnetworktoprovidepatientcareusingmobiledevicesinallareasofthehospital,forexampleduringmedicationadmin-istrationinAcuteCare,pointofcarelaboratorytestingintheEmergencyDept.orPSWcaredocumentationinLTC.Thewire-lessnetworkalsoprovidesaccessforpatientsandvisitorstoaccesstheinternetfromthecommonareas,patientrooms,andmeetingroomsaroundthebuilding.

Inthepastyearthedepartmentcompleted3241supportrequestsfromstaffmembers,andhasreplaced33newpcs,andintroduced12newiPads.

CSRhasundergonemanynewimprovementsthisyear.Inprepa-rationforaccreditation,oursterilizationroomunderwentatransformationtoreplaceexistingshelvingandcabinetswithnewstainlesssteelworktablesandshelvingunits.Ourstoreroomalsosawseveralnewupgradesincludingnewgravityfedivcartswhichhelpensureasafework low.Wealsoreceivedase-curitycamerasystemaspartoftheworkplaceviolenceassess-mentwhichnowgivesusaccesstoviewwhoweareallowingintothefacilitywhenacceptingdeliveries.Newelectricreceivingbaydoorsaswellashydraulicloadingdockswereamongtheotherinvestmentswithinthedepartmentthathaveallcontribut-edtoamuchsaferworkingenvironmentsothatoursmallteam.

Central Supply / Receiving

Queensway Place

Queensway Place Assisted Living

QWPfocusthisyearwasaboutsafety.Ontwoseparateoccasions,QWPresidentsengagedinamock iredrillonethattookplaceduringthedayandanotherovernight.Oneofthedrillsincludedanevacuation.Followingthemockdrill,residentswereinvitedtoattendadebrie ingmeet-ing.InMay,Espanolapoliceheldain-serviceaboutfraud.InformationwasprovidedtoresidentsincludingtheCanadianAnti-Fraudhotline(1-888-495-8501)toin-quireaboutscamsandtoreportaconcern.

Espanola Nursing Home

WhatayearforLongTermCare,withmanyinvestmentstoimprovethelowofcareforourresidents!

WehaveimplementedanewPointofCare(POC)documentationsystemforourfrontlinestafftoutilize,whichinturnimprovesthecoordinatedcareplansforourResidents.Thisrealtimedocumentationsystem,allowsstafftheabilitytodocumentastheygoand lowinformationintoourPointClickCaresystemforef icientquarterlyassessments.

AllofourPersonalSupportWorkers(PSW)andRegisteredPracticalNurs-es(RPN)wereprovidededucationonthenewPOCsystemandtheintegra-tionofthesystemintoourdailyroutines.TheRPN’swerealsoprovidededucationinJanuaryforourPointClickCaresystemandResidentCarePlanningtoensurethatourassessmentsandcareplansarecurrentwithrelevantinformationspeci ictotheircareneeds.

WithourMaintenanceTeamandfundingprovidedbytheNorthEastLocalHealthIntegrationNetwork(NELHIN),wewereabletodevelopanewRe-gionalBehaviourSupportsofOntario(BSO)of ice.Thisnewspacewillpro-videourBSOteamwithanareaneededtoensurepropercollaborationtofacilitatetimelyindividualassessments.Wewerealsoprovidedwithper-manentfundingforourRegionalBSOClinician,JenniferSavicky.JenniferwillcontinuetobebasedoutofourLongTermCareBSOOf iceasshepro-videsservicestoourlocalandsurroundingcommunities.

Director of Care Lee Turley

Assistant Director of Care David Adamczak

Ithasbeenabusyyearinthemaintenancedepartment.Ourbiggestprojecthasbeenthereplacementofourchillerplant,controls,circulatingpumpsandpiping.Thechillerplantkeepsthehospitalcoolinthesummer.Ouroldchillerwasoriginaltothehospitalandwasduetobereplaced.Wehavesuccessfullyreplacedouroldinef i-cientchillerplantwithabrandnewenergyef icientunit.Thiswillkeepallofthepatients,residentsandhos-pitalstaffcomfortableduringthesummermonths.Wearealsocompletingotherenergyef iciencyprojects.Wereplaced52inef icientrooftopexhaustfanswithnewvariablespeedunits.Wereplaced2garagedoorsinourCSRdepartmentaswellas2inourmaintenanceshop.Duringthewintermonthsthiswillhelpkeepthewarmairinthehospitalandthecoldairout.WearealsointhemidstofupgradingthehospitaltoLEDlights.Wehavecompletedphase1.Phase1wasthereplacementofthefrontparkinglotlightstoLEDaswellastheinstallof1600LEDtubestoreplaceour luorescenttubesthroughoutthefacility.Sincetheselightshavebeenup-gradedwehaveseenasigni icantdeclineinourhydrouse.Wearenowinphase2oftheLEDupgrade.WewillbeupgradingmoreofourlightstoLEDincludingthekitchenandemployeeparkinglot.

Family Health Team

TheFHThasundergonesomepositivechangethispastyearthatincludesaddinganadditionalPrimaryCarepractitionerDr.Ste-phenBignucolo,andafull-timeSocialWorkerBeckySonghurst.Weareextremelypleasedwithhowwellthenewstaffmembershaveintegratedintoourteam,andlookforwardtoprovidingprimarycaretoagreaternumberofpatients.CurrentlywearedevelopingnewandinnovativeStressandWell-Beingprogram-ming.Asaresultofthenewteammemberswehaveundergoneconstructiontoprovidenewof iceandclinicalspace.AdditionalconstructionattheFHTincludedanewventilationsystem,androofreplacement.

Maintenance

Espanola Regional Hospital Foundation

WewouldliketothankeveryonewhohasdonatedtotheFoundationoverthepastyear.WithyourgenerousdonationswewillbeabletomakedreamscometrueforourNursingHomeresidents,withtheirTherapeuticGarden.Wehavealsobeenabletopurchasesomenewequipmentforthehospital.Noneofthiswouldbepossiblewithoutyou!

Foundation Board Chair Michael Dunn

A few of our generous donors! THANK YOU

825McKinnonDr.,

Espanola,ONP5E1R4

705‐869‐1420

www.erhhc.on.ca