nhh 2010-2014 strategic plan vf

8/17/2019 NHH 2010-2014 Strategic Plan VF

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October 7, 2010

Strategic Plan2010-2014


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Northumberland Hills Hospital Strategic Plan 2010-2014

Table of Contents

Foreword ........................................................................................................................................ 1 Context ........................................................................................................................................... 2

The System............................................................................................................................... 2

The Environment ..................................................................................................................... 4

The Organization ..................................................................................................................... 6

Mission, Vision, Values and Mandate ......................................................................................... 12

Our Mission ............................................................................................................................ 12

Our Shared Vision .................................................................................................................. 12

Our Core Values ..................................................................................................................... 13

Our Service Values ................................................................................................................. 13

Our Service Mandate ............................................................................................................. 14

Strategic Directions, Goals and Objectives ................................................................................. 15

Strategic Direction #1: Patients First ........................................................................................... 17

Strategic Direction #2: Our Team, Our Strength ......................................................................... 21

Strategic Direction #3: Operational Excellence ........................................................................... 23

Strategic Direction #4: Collaborative Networks .......................................................................... 25

Strategic Direction #5: Building a Sustainable Future ................................................................ 27

Dependencies and Enablers ......................................................................................................... 29

Partners ................................................................................................................................. 29

Continuing Engagement ........................................................................................................ 29

Alignment with the MOHLTC and CE LHIN .................................................................................. 32

How We Are Aligned .............................................................................................................. 32

Alternate Level of Care Patients, Wait Times and Vascular Disease ..................................... 33

Appendix A: Definitions of Our Service Values ........................................................................... 34

Appendix B: Key Reference Documents ...................................................................................... 35


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Northumberland Hills Hospital Strategic Plan 2010-2014 Page

Foreword

Since opening its doors in 2003, Northumberland Hills Hospital has become an organization recognized

for its exceptional patient care, strong community linkages, and dedicated individuals who take pride inwhat they do. We have achieved this success by making our patients the focal point in everything we do;

by visionary thinking; by attracting a highly skilled and motivated team of clinicians, support staff,

managers and volunteers; and, by investing in state-of-the art medical and information technologies.

Serving the health care needs of our community is a privilege we take very seriously. Health care is

constantly changing. To achieve the best possible health outcomes, our Hospital must continually seek

innovative ways of delivering services, ensure value for money with our limited resources, invest in our

people, engage our community, and collaborate with our health care partners.

Now is the time to set a new direction for our Hospital that will enable us to achieve continued success.

NHH’s Strategic Plan 2010-2014 is guided by a new Mission, a Shared Vision and a strong set of Core

Values. It is a comprehensive, long-range road map that takes a multi-pronged approach in transforming

NHH to meet today’s challenges and take advantage of tomorrow’s opportunities. It is anchored on our

commitments for quality, safety, transparency, and leadership. This Plan will allow us to continue to

flourish as a community hospital and fulfill our mission of providing Exceptional Patient Care. Every time.

John Hudson Robert F. Biron Dr. David Broderick

Chair of the Board of Directors President and CEO Chief of Staff


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Context

Northumberland Hills Hospital (NHH) opened in 2003 and is located approximately 100km east of

Toronto where it serves a population of 60,000 residents living in west Northumberland County.

The System

Like most hospitals, NHH plays an important role in improving and maintaining the health of its

surrounding citizens. But it does not do so in isolation. NHH provides services in the context of both a

larger system and an environment that support and place pressures on the Hospital every day. The

system consists of the Ministry of Health and Long-Term Care (MOHLTC), Local Health Integration

Networks (LHINs) across the province, and numerous health care providers and partners that provide

citizens with a range of services to meet their care needs.

Quality and Safety

Accreditation Canada defines quality as “the degree of excellence; the extent to which an organization

meets clients needs and exceeds their expectations.” The Ontario Hospital Association adopted the

Agency for Healthcare Research and Quality (AHRQ) definition of quality as meaning “Doing the right

thing, at the right time, in the right way, for the right person – and having the best possible results.” At

NHH, quality health care means providing service excellence to our patients and the community.

While the health system and NHH have always focused on providing such care, there has nevertheless

been a renewed focus on quality and safety in recent years. The findings of the Canadian Adverse Event

Study , often referred to as the Baker Report, as well as more recent reports from the Canadian Institute

of Health Information (CIHI) and other health agencies have highlighted opportunities for improvementin the quality of health care services.

The Baker Report1 estimated that approximately 7.5% of all acute care hospital admissions in Canada

result in Adverse Events (AEs), which are “…unintended injuries or complications resulting in death,

disability, or prolonged hospital stay.”2

1 G. Ross Baker, Peter G. Norton, Virginia Flintoft, Régis Blais, Adalsteinn Brown, Jafna Cox, Ed Etchells, William A. Ghali, Philip

Hébert, Sumit R. Majumdar, Maeve O'Beirne, Luz Palacios-Derflingher, Robert J. Reid, Sam Sheps and Robyn Tamblyn (2004).

The Canadian Adverse Events Study: The Incidence of Adverse Events Among Hospital Patients in Canada. Canadian Medical

Association Journal , 170(11), pp. 1678-1686. 2 Baker et al. (2004), p. 1688.

The report also found that approximately 37% of these events

were preventable or the result of medical error. In practice, at the time the report was issued, this

meant that approximately 185,000 AEs happened every year in Canada, and that as many as 70,000 of

them could have been prevented.

More recently, the Ontario Health Quality Council published key findings in the Quality Monitor, 2010

Report on Ontario’s Health System. These findings indicated that although some improvements have

been made in the province during the past few years, there is room for improvement in various areas,

including:


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• patient flow through the system from emergency department to hospital to long-term care

facilities;

• chronic disease management;

• electronic medical records; and,

•

reducing hospital-acquired infections.

Enhancing the quality of care that patients receive is a top priority in Ontario’s health care system.

Numerous initiatives and improvements have been implemented by hospitals in the past decade,

including mandatory public reporting of patient safety indicators. The MOHLTC now requires hospitals

to report hospital-acquired infection rates and other quality indicators, such as hand hygiene, wait times

and surgical safety checklist compliance.

As well, many hospitals, including NHH, have adopted quality improvement methods to reduce waste

and unnecessary steps in their processes. Accreditation Canada has introduced its Qmentum

accreditation program in 2008 to provide organizations with a “roadmap for quality,” which emphasizes

best practices in patient safety. New legislation, such as the The Excellent Care for All Act (Ontario,

2010), further extends the commitment to quality and establishes explicit accountabilities for quality

improvement by health care providers.

Coupled with this emphasis on the quality and safety of acute care services, the MOHLTC and LHINs are

also focusing on the efficiency of the system by reducing emergency department (ED) wait times and

reducing the number of alternate level of care (ALC) patients in hospitals. ALC patients are those who

cannot be discharged from an acute care hospital because the appropriate community-based care is not

yet available.

NHH is a strong supporter of all these initiatives and priorities. Clearly, with health outcomes so closely

related to quality and safety, the Hospital cannot compromise on either of these elements in the

services provided.

Financial Outlook

Excellent health care costs money. However, the Province of Ontario, like so many other governments

around the globe, made clear in its 2009-10 Budget that it has entered a new period of fiscal restraint. 3

The MOHLTC has consequently entered a period of fiscal restraint as well, not least because the

provincial government spending for the health sector comprises $43 billion or 39% of the province’s

total expenses and 43% of its program spending. 4 As recent studies have made clear, the share of

government spending devoted to the health care sector is expected to grow at an alarming rate, such

that there is intense pressure to “bend the cost curve”. 5

In Ontario, the MOHLTC gives funding envelopes and authority over health spending to 14 regional

LHINs, which in turn distribute those funds to hospitals, community care access centres, community

3 Ontario Ministry of Finance (2009). 2009 Ontario Budget: Budget Papers. Toronto: Queen’s Printer for Ontario, p. 85.

4 Ontario Ministry of Finance (2009), p. 102.

5 Ontario Association of Community Care Access Centres, Ontario Federation of Community Mental Health and Addiction

Programs, and Ontario Hospital Association (2010). Ideas and Opportunities for Bending the Health Care Cost Curve: Advice for

the Government of Ontario.


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health centres, long-term care homes and numerous other health care providers. In return for the funds,

the LHINs enter into Service Accountability Agreements with health care providers that specify the

services they will provide. The MOHLTC and the LHINs take an integrated, system-wide view of how

health is funded and delivered. Care happens at many different times and places, and a variety of

organizations have important roles to play in providing that care. Through planning, funding, and

performance monitoring, the LHINs oversee the system in each region.

The system as a whole is under pressure. In addition to new budget constraints and strong cost

pressures, Ontario’s population is ageing rapidly, placing demands on the health system and reducing

the number of workers who support it with taxes from employment. These pressures create

tremendous challenges for the system as a whole and the organizations that operate within it, and

hospitals are no exception to that rule. The system must operate on a financially sound basis if it is to

survive.

At the same time, NHH will not compromise on quality and safety. This means that all organizations

must make choices about which services they will provide in this uncompromising fashion. No health

care provider can be everything to everyone. It is, therefore, imperative that NHH work collaborativelywith other health service providers in the community to ensure quality of care and health system

affordability.

The Environment

NHH encounters these system-wide pressures and choices in the specific environment of the Central

East LHIN (CE LHIN), which stretches from Victoria Park Avenue in Scarborough up to Algonquin Park.

More precisely, the CE LHIN encompasses parts of Scarborough, Durham region, the Kawarthas,

Haliburton Highlands, Peterborough and of course, west Northumberland County. The LHIN is the 6th

largest by geographic area and 2nd largest by population in Ontario, covering over 11% of the Ontario

population.6

6 Central East Local Health Integration Network (2009). Integrated Health Service Plan 2010-2013.

Within the CE LHIN, NHH serves the catchment area known as west Northumberland

County highlighted in Figure 1.


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Figure 1: NHH Catchment Area

West Northumberland County encompasses approximately 60,000 residents in the Town of Cobourg,

Municipality of Port Hope, and the townships of Hamilton, Alnwick/Haldimand and Cramahe. The

populations of Cobourg and Port Hope represent 60% of the people served by NHH.

NHH’s catchment population is relatively advantaged with respect to the demographic factors that are

associated with positive health outcomes.7

The core health challenge faced by many in NHH’s catchment is age and its associated health

complications. The population is relatively old when compared to the CE LHIN and the province as a

Relative to the CE LHIN and the province, people in theHospital’s catchment are also less likely to be lone parents, have low incomes, or be unemployed. NHH

also serves an aboriginal population which tends to be disadvantaged in its health outcomes relative to

the rest of the population.

7 Data discussed in this section comes from HCM (2009). Northumberland Hills Hospital Environmental Scan.


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whole: 18% of the people in NHH’s catchment are 65 or older, compared to just 14% in the CE LHIN and

Ontario. The proportion is even higher (24%) in the Town of Cobourg, which represents roughly one

third of NHH’s catchment population. These percentages are all expected to grow dramatically over the

next 25 years.

Age is consequently a key driver of the primary health challenges that NHH’s population faces – injuries,

immobility and disability, high blood pressure, heart disease, strokes, and cancer. This reality has

informed NHH in updating its service mandate, which is described below in more detail.

The Organization

Background and Strengths

The local community relies upon NHH heavily for its health needs. As Figures 2 through 5 below

demonstrate, NHH provides the significant majority of the acute care in the west Northumberland

catchment area in terms of inpatient cases (3,346 in 2008-2009), newborn cases (609), and emergency

department visits (31,764).

At the same time, NHH functions as part of a broader system. While NHH provides the most inpatient

surgeries for the catchment area (473 cases in 2008-2009 or 31.6% of the market share), it does not

provide a majority of them – regional centres play a significant role as well. Hence, there are

opportunities for NHH to provide expanded acute care services, particularly in the surgical program.

NHH can position itself as a viable and strong partner within the acute care network of hospitals in the

CE LHIN to help improve access and reduce wait times across the entire LHIN geography.

Today, the primary demand for NHH’s services is in acute care services, which include:

• inpatient and outpatient surgical program;

• emergency department;

• surgical and medical inpatient program;

• intensive care unit; and,

• maternal child care.


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Figure 2: Catchment Share of All Inpatient Cases Except Newborns

59%

13%

5%

4%

2% 3%

13%

Catchment Share of All Inpatient Cases

(Except Newborns)

2008-2009

Northumberland Hills Hospital - 59%

Peterborough Regional Health Centre - 13%

Lakeridge Health - 5%

Kingston General Hospital - 4%

Quinte Health Care - 2%

St. Michael's Hospital - 3%

All Other Hospitals - 13%

Figure 3: Catchment Share of Newborn Cases

70%

13%

5%

1%

3%3%

5%

Catchment Share of Newborn Cases

2008-2009






Mount Sinai Hospital - 3%



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Figure 4: Catchment Share of Emergency Department Visits

87%

2% 2%

2%1%

4%

Catchment Share of Emergency Department Visits

2008-2009





Campbellford Memorial Hospital - 1%


Figure 5: Catchment Share of Adult Inpatient Surgery Cases

32%

25%9%

5%

4%

6%

20%

Catchment Share of Adult Inpatient Surgery Cases

2008-2009






Sunnybrook Health Sciences Centre - 6%



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In addition, NHH provides outpatient services which include:

• ambulatory care clinics;

• community mental health and addictions;

•

a satellite chemotherapy clinic; and,• a satellite dialysis clinic.

NHH also provides a full range of diagnostic imaging services using digital imaging technology that

support both inpatient and outpatient care, including:

• magnetic resonance imaging (MRI);

• computed tomography (CT);

• radiology (X-ray);

• ultrasound;

• nuclear medicine;

•

mammography; and,• bone mineral densitometry;

Finally, NHH also provides post acute care services, which currently include:

• interim long-term care;

• complex continuing care (occupied by alternative level of care and long-term care patients);

• inpatient rehabilitation; and,

• palliative care.

NHH has traditionally been exceptionally strong in its ability to engage the community (for more detail,

please see the Relationship with the Community subsection below and the Continuing Engagement

section later in the document) and to attract highly qualified and engaged volunteers. Accreditation

Canada noted in their recent Report that NHH’s volunteers’ “…presence and engagement with the

hospital is remarkable.”8

These operating deficits have contributed to the short- and long-term debt load of $5.0M at the end of

2008-2009, and $7.1M at the end of 2009-2010.

NHH’s ability to attract volunteers allows it to broaden and extend the reach of

its services. In recent years, teamwork has also been an area of strength, contributing to the sustained

improvement in a number of patient safety indicators.

Financial Challenges

For three fiscal years ending March 31, 2010, NHH experienced significant budgetary pressures, many of

which stem from the system-wide pressures discussed above. NHH incurred operating deficits of

approximately $560K in 2007-2008, $1.1M in 2008-2009, and $423K in 2009-2010. Restructuring costs

associated with improvement efforts have then added to costs, resulting in overall deficits of over

$2.0M in 2008-2009 and $2.6M in 2009-2010.

9

8 Accreditation Canada (2010). Northumberland Hills Hospital Accreditation Report , p. 2.

9 Short- and long-term debt load calculated as working capital deficit plus long-term debt, excluding other long-term liabilities.

These debt loads threaten the long-term viability of


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Northumberland Hills Hospital Strategic Plan 2010-2014 Page 1

the Hospital. Going forward, NHH must balance its budget and put itself in a position to pay back its

debts in a sustainable manner. This Strategic Plan identifies real opportunities in meeting these financial

challenges, while enhancing quality of care and patient safety.

In December 2008, NHH began a collaborative budget initiative – Shared Challenge, Shared Solution – to

identify opportunities for cost savings through operating efficiencies. This process has highlighted the

fact that NHH operates as part of a larger system. Coordination among health care providers is essential

to ensure quality of care and health system affordability, and many services can be provided most

efficiently and effectively within the community. NHH has therefore made difficult decisions to realign

certain services into the community, including the Hospital’s Diabetes Education Clinic and its

Outpatient Rehabilitation program in April 2010.

NHH has also begun and will continue to build formal relationships with other health care providers –

particularly regional hospitals – to provide other types of services. The development of these and other

relationships are opportunities to build local expertise, enhance service quality and improve access to

services that could not otherwise be delivered in our community. This Strategic Plan positions NHH not

only as a viable community hospital, but also as one that it is an integral part of the CE LHIN acute caresystem.

Relationship with the Community

NHH has had strong and deep links to the local community since its earliest days. The NHH Foundation

led a very successful fund raising campaign to build the Hospital, which opened in 2003. Local financial

support has since continued to be generous to help ensure that the Hospital is equipped with the latest,

state-of-the-art medical technologies.

In addition, the NHH Auxiliary – our volunteer organization – has been successful in recruiting and

retaining a very significant base of active volunteers. Involved in most facets of the Hospital, thevolunteers provide needed support to patients and staff. The Auxiliary has also raised significant funds

for capital equipment through various revenue generating operations and special events.

No doubt, NHH is blessed with a generous and supportive community.

And it is for this reason that the Hospital Board undertook a comprehensive and innovative community

engagement exercise in 2009-2010. The approach included the Hospital’s first Citizens’ Advisory Panel;

members were selected through a civic lottery. Its mandate was to provide the NHH Board advice on

service prioritization. This initiative is discussed in detail in the Continuing Engagement section below

and reflects NHH’s intent to sustain and further enhance its relationship with the community.

NHH is proud of its exceptional record of community engagement, particularly because this record has

continued in the face of the difficult service choices made in early 2010. Indeed, it is at such times that

community engagement is the most important. As the CE LHIN has said, the challenge “…is not ‘whether

to involve’ but how to involve well.”10

10 Central East Local Health Integration Network (2006). A Framework for Community Engagement and Local Health Planning,

p.1.

NHH has found many ways to “involve well”.


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Strategic Planning Process

The results of NHH’s community engagement activities have informed, both informally and formally, the

development of this Strategic Plan. Developing this plan has been an intensive process, involving a

variety of internal and external consultations, including the Citizens’ Advisory Panel, LHINrepresentatives, service providers, physicians, front-line staff, management, and the Board over the past

year. NHH first used these consultations to understand the needs of the system and its environment, in

addition to commissioning research on the demographic factors affecting west Northumberland County.


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Mission, Vision, Values and Mandate

Our Mission

Everything NHH does is anchored in its Mission, Vision, and Values. Our Mission is what we exist to do

for the people of west Northumberland County:

Exceptional patient care. Every time.

As a publicly funded organization, NHH’s community and patients expect to receive value for money

from NHH. In other words, the Hospital is expected to provide quality services – local access, short wait

times, pleasant encounters, health improvement, safe care – through the effective and efficient use of

its limited resources. Patients expect this kind of service and performance for every encounter they have

with NHH.

As demonstrated by its 2010 Accreditation results, NHH excels as a community hospital. The Hospitalmet 97% of 1,411 standards, including all Required Organizational Practices which focus on patient

safety practices. The NHH team is committed to setting and achieving an even higher performance

standard: to achieve excellence in patient-centred care for every patient at every encounter.

Our Shared Vision

To deliver on this Mission, the NHH team has agreed upon a Shared Vision.

Leaders and partners creating health care excellence.

This Shared Vision statement situates NHH in its broader context within the health system, and it alsospeaks to what the Hospital aspires of its team members. It also describes how NHH wishes to continue

to engage, as partners, its internal and external stakeholders and other health care providers.

Health care in Ontario is changing in many ways, and today’s hospitals are embedded in this large,

changing system as never before. Coordination between health service providers is essential to ensuring

quality of care and health system affordability. In west Northumberland County, NHH is not the single

source of health services, and nor should it be. Our Shared Vision therefore emphasizes that providing

quality health services to our community means being a leader and a partner within the broader health

care system.

The words “leader” and “partner” are deliberately plural. The entire NHH team – the Foundation, theAuxiliary, the physicians, the front-line staff, the management team, and the Board – must all

demonstrate leadership in their respective circles of influence and responsibility. As leaders, NHH

representatives must also work collaboratively with other health services providers, patients,

community, and funding agencies to partner and strengthen the health care system so that it is better

integrated, more seamless and affordable, and improved in terms of patient safety and quality

outcomes.


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The community expects NHH to be a leader, and in doing so, NHH will not shy away from innovative and

creative solutions that improve patient care and overall health system performance. It takes courage

and strong leadership to implement new solutions, and NHH is up for the challenge.

Our Core Values

Our Mission and Shared Vision are grounded in our Core Values:

• Integrity

• Quality

• Respect

• Collaboration

• Compassion

Our Service Values

In January 2010, the NHH Board held a strategic planning retreat where it initiated the first iteration of a

Decision Making Framework for Service Prioritization. Subsequently, additional iterations of the

Framework were developed with input from other stakeholders, including representatives from our

physicians, staff, Auxiliary, and Foundation. The final version of the Framework was completed by the

Citizens’ Advisory Panel, which provided the community and patient perspective.

In essence, the Framework is a set of Values that are used as lenses or filters when prioritizing or

evaluating services. These Service Values were used extensively in preparing the 2010/11 Operating andService Plan that included the realignment of services into the community. The Decision Making

Framework for Service Prioritization and the related Service Values will continue to be used as a

resource tool for future decision making.

Our Service Values are:

Accessibility

Collaboration

Community Needs and Responsiveness

Effectiveness, Safety and High Standards

Relationships and Public Trust

Sustainability

For detailed definitions on our Service Values, please refer to Appendix A.


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Our Service Mandate

Our Mission, Shared Vision and Values are important statements about what NHH does and will do over

the long term. Today more than ever, these statements must be translated into tangible decisions that

are supported by the community.

In the spring of 2010, NHH’s Board of Directors had to make a most important decision: what core

services should the Hospital continue to provide, given its budgetary pressures? Drawing from

consultations with the full range of stakeholders, the Board developed a new Service Mandate for the

Hospital, which takes into account the geographic, environmental, and service provision demands

discussed earlier. In March 2010, the Board approved the following Service Mandate:

NHH is a community hospital providing acute care services to the west Northumberland

community. In addition, when financially feasible and appropriate, in order to improve

local access, our Hospital partners with other health service providers to deliver advanced

or specialized health services.

NHH is committed to continuously explore and implement delivery models that will

integrate services across the health care system in order to enhance quality of care,

improve access to services and ensure effective use of resources.

This Mandate reflects the strong consensus that NHH’s core services must focus on acute care. It reflects

what the health system and community needs, what the environment demands, and what NHH can best

provide. NHH cannot be all things to all people. Hence, the Hospital must work collaboratively with

community providers to ensure local access to services. And NHH must also partner with regional

centres to ensure coordination for advanced specialty services, to bring in and access expertise not

available locally, to ensure that quality and safety are never compromised, and to ensure that all of theservices are provided in a sustainable manner.


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Strategic Directions, Goals and Objectives

NHH’s Vision is to be leaders and partners creating health care excellence. To deliver on this vision, NHH

has developed a set of Strategic Directions which will drive its Goals and Objectives over the next four

years. Those Strategic Directions are:

1. Patients First: Through our culture of service excellence, we will: deliver safe patient care every

time; design quality into all elements of our care and service; engage patients and families in

their care; and, actively seek innovative ways to improve our care and services.

2. Our Team, Our Strength: Though our commitment to health, teamwork and learning, we will:

retain and attract exceptional people; engage each other in creating a dynamic, healthy and safe

environment; create and promote opportunities for growth, development and mentorship; and,

enable the full potential and scope of practice of all team members.

3.

Operational Excellence: Through our commitment to continuous improvement and highstandards of performance, we will: achieve solid financial performance and a culture of

accountability; pursue leading practices and evidence based decision-making; align ourselves,

our processes and financial resources to achieve our goals; and, leverage information

technology to improve decision-making and patient safety.

4. Collaborative Networks: Through our work to create a seamless health care system for our

community, we will: engage our community and partners for their valued input; anticipate and

respond to the population’s changing health care needs; build networks and relationships with

other providers; and, enhance patient care through interprofessional practice, collaboration and

care.

5. Building a Sustainable Future: Through our responsibility to ensure the long-term viability of

our hospital, we will: foster a culture of learning and knowledge sharing; adapt to our changing

environment in a timely fashion; create new and sustainable revenue streams; and, pursue and

choose environmentally responsible solutions.

For each of the Strategic Directions, NHH has set out an Outcome for 2014 along with Goals designed to

bring it about. In essence, the Goals outline what NHH must do to realize its Vision. For each Strategic

Goal, NHH has also specified short-term Objectives it must achieve. These Objectives are the specific

actions that NHH, its departments and people must undertake to move toward realizing the Hospital’s

Vision. Some of these Objectives will be achieved in a year or less, while others will require longer

timeframes to complete. Regardless of how long they take to achieve, they are important because theyrepresent discrete actions on which progress can be made day in and day out.

Figure 6 below maps out these ideas and acts as an overall guide for the rest of this section. The figure

also highlights the role that Dependencies and Enablers play. As discussed in the next section, NHH’s

success will depend upon the support of its Partners and be enabled by its own Continuing Engagement

with the community.


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Figure 6: Strategic Directions and Goals Toward the Vision

The Goals and Objectives for each of NHH’s Strategic Directions are set out below.

Our Team,

Our Strength

Collaborative

Networks

Operational

Excellence

Building a

Sustainable Future

Patients

First

1. Culture of Service 2. Culture of Qua lity and

Safety

3. Patient-Centred

Model of Care

4. Responsive to Unique

Needs of Population

5. Best Prepared

Workforce

6. Progressive, Healthy

Work Environment

12. Engaged Community 13. Integrated Network

of Partners

14. Collaborative Inter-

professional Culture

7. Team Leading the

Transformation

9. Strong Financial

Performance, Stability

10. Integrated Decision

Support Model

11. Fully Leveraged

IT and EHRs

15. Culture of Inquiry

and Innovation

16. Clear Mandate

17. Reduced Reliance on

Government Funding

18. Environmental

Leader

Strategic

Directions

Strategic

Goals

Leaders and partners

creating health care excellence.

Our Shared

Vision

Dependencies

and EnablersPartners

Continuing

Engagement

8. Partnership with the

Physician Community


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Strategic Direction #1: Patients First

Improving the health of Ontarians in west Northumberland County means improving both the

status and quality of their health one patient at a time. By 2014, NHH expects to achieve the

following Outcome:

NHH is recognized for its culture of customer service and quality patient-centred care.

Discussion

A significant amount of foundational work was completed in 2009-2010 that will guide and foster a

culture of customer service, quality and patient-centred care.

Improving customer service in health care organizations has been linked to better patient care, satisfied

staff, and a reduction in preventable medical errors.11

As defined by the Institute for Healthcare Improvement (IHI), patient-centred care “considers patients’

cultural traditions, their personal preferences and values, their family situations, and their lifestyles. It

makes the patient and their loved ones an integral part of the care team who collaborate with health

care professionals in making clinical decisions. Patient-centred care puts responsibility for important

aspects of self-care and monitoring in patients’ hands — along with the tools and support they need to

carry out that responsibility. Patient-centred care ensures that transitions between providers,

departments, and health care settings are respectful, coordinated, and efficient

A customer service strategy will be introduced to

the organization that focuses on three key factors to improve customer satisfaction: understanding,managing and exceeding our customers’ expectations; communicating effectively to both our internal

and external customers; and, obtaining feedback and using the feedback to improve our processes.

Supporting its strong commitment and focus on quality , the Hospital published its Quality and Safety

Framework: A Commitment to Quality in February 2010. This Framework provides an organizational

definition of quality and safety, describes the structures that the Hospital will use to monitor quality,

describes risk management processes, and outlines criteria for prioritizing quality initiatives.

The four cornerstones of the NHH’s Quality and Safety Framework are Quality Attributes, Safety, Risk

Management, and Performance Monitoring. With the implementation of this Framework, the

interprofessional and quality teams throughout the Hospital are equipped with the necessary expertise;

are supported by the necessary processes and structures; and have the tools necessary to support them

to integrate the quality principles into the care and service they provide on a daily basis.

12

To successfully achieve IHI’s principles of patient-centred care, it will require the active participation andcommitment of NHH’s team of regulated health professionals. NHH will introduce an Interprofessional

Patient-Centred Practice Framework that will complement the goal of patient-centred care. Through a

culture of interprofessional practice, the care team responds to patient and family goals; opens

mechanisms for continuous communication; fosters mutual respect; and, collaborates among health

.”

11 O’Hagan, Joshua and Persaud, David, Healthcare Management Forum, Making Customer – service a priority in health care

organizations , p 27, Winter 200812

www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCeneredCareGeneral/. June 2010.

http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCeneredCareGeneral/http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCeneredCareGeneral/http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCeneredCareGeneral/http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCeneredCareGeneral/


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care professionals. The outcomes of this practice include improved workload management, reduced

wait times for patients, and reduced adverse outcomes to care.

A significant component of Interprofessional Patient-Centred Practice is the team’s uncompromised

focus on streamlining and enhancing care processes with the view of making them more patient-

centred. Recent initiatives include:

• a focus on reducing the number of ALC patients that will positively impact ED wait times, critical

to the viability of NHH’s acute care services;

• the implementation of the LHIN-funded Hospital to Home Program that supports timely

discharge home;

• as a component of NHH’s commitment to creating a centre of excellence in geriatrics, the

Hospital Elder Life Program (HELP), which will be introduced with the goal of maintaining the

mental and physical function of at-risk adults while they are at NHH;

• a commitment to the introduction of Restorative Care beds focused on returning individuals to

their highest level of independence before they return to the community; and,

•

the emergency department’s recent LEAN process improvement initiatives, which have resulted

in ED wait times being reduced by 30% on a sustained basis.

NHH has set four Goals to ensure a culture of service and patient-centred care.

Goal #1: A Culture of Service that creates and delivers the ideal patient and

customer experience.

Patients not only receive but also experience care when they come to NHH. Putting them first,

therefore, means providing an experience as close as possible to their individual ideal. To deliver

this experience, NHH needs to create a culture of service.

To achieve a culture of service, NHH must accomplish the following objectives:

• Objective #1: Identify a customer service model that aligns with our Vision, Mission,

Values and Mandate.

• Objective #2: Develop a plan to adopt this service model across the Hospital.

• Objective #3: Commence implementing the service model to high priority service

areas.

• Objective #4: Update and implement an Accessibility Plan for persons with disabilities

to improve accessibility to our facility and services.


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Goal #2: A Culture of Quality and Safety that guides the delivery of patient

care and services.

Excellent patient experiences and care do not happen through processes alone. They require a

hospital to have a culture of quality and safety that guides how people make decisions whenthey are facing multiple pressures.

To achieve a culture of quality and safety, NHH must accomplish the following objectives:

• Objective #1: Develop and implement the Hospital’s Quality and Safety Framework.

• Objective #2: Develop and implement an Annual Quality and Safety Plan based on the

Quality and Safety Framework.

Goal #3: A Patient-Centred Model of Care.

With a commitment to foster a culture of Interprofessional Patient-Centred Care, as described

above, it is essential that the Hospital align its services to reflect the unique needs of the

community it serves. This alignment will enhance the Hospital’s capacity to provide quality, safe,

patient-centred care and achieve our Mission of Exceptional Patient Care. Every time.

To ensure that it is meeting the unique needs of west Northumberland County, NHH must

accomplish the following objectives:

• Objective #1: Identify and establish a model of care that supports patient-centred care

and aligns with the interprofessional practice model.

• Objective #2: Develop a plan to inform, educate and receive feedback from patients

and families about their role as it relates to their care.

Goal #4: A Hospital that is Responsive to and meets the Unique Needs of our

Population.

Hospitals monitor the needs of their patients and communities because they must be prepared

to respond to them in a timely and effective manner. By forecasting needs, hospitals can also

ensure that changes in population needs can be responded to in a timely and proactive manner.

To ensure that it is responding to its population, NHH must accomplish the following objectives:

• Objective #1: Identify the unique needs of our community as articulated in the

environmental scan/population demographics analyses.

• Objective #2: Establish innovative patient-centred clinical/service practices, systems

and processes that meet the needs of our population.


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• Objective #3: Complete program plans (short- and long-term) that project future

population needs and align resources through service, operating and

capital plans, as necessary.


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Strategic Direction #2: Our Team, Our Strength

If NHH is to have transformational leadership that produces health quality and safety for patients, it will

need to be able to describe itself in terms of the following Outcome in 2014:

NHH is a community of individuals and teams who are fully engaged and inspired to

achieve excellence in everything we do.

Discussion

NHH will need to be vigilant in strengthening its team over the next several years, particularly as the

number of employees eligible for retirement grows. An updated Human Resources Plan is expected to

be completed in the fall 2010, which will provide the necessary road-map and detailed actions necessary

to achieve the Goals outlined below.

For the future, NHH has set itself three Goals to ensure that it has strong teams and strong leadership.

Goal #5: The Best Prepared Workforce that delivers quality patient care in a

culture of continuous learning and high performance.

Excellent care is not delivered by the Hospital so much as the people that comprise it. To ensure

that patients receive the best care, NHH must ensure that its staff are continually learning and

performing at the highest level possible.

To have the best prepared workforce, NHH must accomplish the following objective:

• Objective #1: Develop and implement a comprehensive Human Resource Plan.

Goal #6: A Progressive, Healthy Work Environment that complements the

unique culture of our hospital.

Even when individuals across the organization are performing their best, they have lives outside

of it. They also want to feel they are a part of the organization. A progressive and healthy work

environment is critical for ensuring that people continue to be at their best at work and at

home.

To have a progressive and healthy work environment, NHH must accomplish the following

objectives:

• Objective #1: Develop and implement a plan to enhance and support a positive quality

of worklife.

• Objective #2: Develop and implement strategies to improve staff communication and

engagement in decision-making.


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Goal #7: A Team Leading the Transformation with the necessary

competencies.

The health care system today requires transformational leadership. Leaders cannot transforman organization on passion and drive alone, however. NHH needs to ensure they have the

necessary competencies, skills and time to develop into the best leaders they can be.

To have a leadership team that has the necessary competencies to lead transformation, NHH

must accomplish the following objective:

• Objective #1: Develop and implement a talent management plan that includes

education, skills development and succession planning for our leadership

team.

Goal #8: A strong Partnership with the Physician Community to support andenhance patient care in hospital-based services.

NHH is fortunate to have a dedicated complement of medical professionals that support patient

care services at the Hospital. A full complement of family physicians and specialists is essential in

ensuring the long-term sustainability of NHH. Given the ageing physician workforce, it will be

necessary for NHH to enhance its retention and recruitment strategies.

To ensure a continued strong partnership with the physician community, NHH must achieve the

following objectives:

•

Objective #1: Develop and implement a comprehensive Physician Human Resource

Plan. The Plan will address opportunities for recruitment and retention

for family physicians and specialists.

• Objective #2: Enhance opportunities for family physicians to continue to practice

hospital-based patient care.

• Objective #3: Renew the medical leadership structure to be further aligned with Board

governance, legislative requirements and best practices in quality and

safety.


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Strategic Direction #3: Operational Excellence

Operational excellence for NHH is essential for achieving long-term sustainability and an integrated

health care system. In 2014, NHH expects to achieve the following Outcome:

NHH is financially healthy and provides “value for money” – quality services through the

effective use of our limited resources.

Discussion

As described above, NHH has already made some key decisions to ensure that it returns to strong

financial performance and stability. The collaborative budget strategy, Service Mandate, and

realignment of certain programs reflect NHH’s resolve to balance the budget and preserve the Hospital’s

core services. NHH must continue with this focus and work to develop an integrated decision support

model and leverage technology to improve patient care.

For the future, NHH has set itself three Goals to ensure that it is achieving operational

excellence.

Goal #9: A hospital that has Strong Financial Performance and Stability

through comprehensive service, operating and capital plans.

Strong and stable financial performance for services, operations, and capital investments can

only be achieved through sound financial planning, taking into consideration the resources

available to the Hospital.

To have comprehensive plans creating strong financial performance and stability, NHH must

accomplish the following objectives:

• Objective #1: Develop and implement strategies to expand traditional revenue sources.

• Objective #2: Leveraging the Hospital’s capital life cycle plan and anticipated needs,

develop a strategy to ensure timely renewal of the Hospital’s

infrastructure and equipment.

• Objective #3: Develop and commence implementing a debt repayment plan.

• Objective #4: Pursue opportunities to maximize operating efficiency.


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Goal #10: A Decision Support model that is Integrated into our practices to

improve evidence-based decision making, operating efficiency,

quality and safety.

Strong organizational cultures can help hospitals make the right decisions. But people’s

determination to make the right decisions need to be supplemented by an integrated decision

support function that supplies the data and information necessary to maximize efficiency,

quality, and safety.

To have an integrated decision support model, NHH must accomplish the following objective:

• Objective #1: Establish a decision support framework (or plan) and identify preferred

processes, tools and skills that integrate with other programs, including

quality and safety.

Goal #11: A hospital that has Fully Leveraged information technologies (IT)

and electronic health records (EHRs) as essential tools and

enablers in achieving our strategic goals.

IT and EHRs can save time and enhance patient safety by reducing errors and ensuring that

critical information is always available and visible. Leveraging these tools is important for any

hospital to achieve its strategic goals.

To have a hospital that has fully leveraged IT and EHRs, NHH must accomplish the following

objective:

• Objective #1: Develop and implement IT and e-Health plans that support the

achievement of our patient goals.


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Strategic Direction #4: Collaborative Networks

Improving access to care for Ontarians requires service and system integration. NHH expects to achieve

the following Outcome by 2014:

NHH has teams and partnerships that enable seamless health care within our Hospital

and in our community.

Discussion

In the 2009-2010 fiscal year, one of NHH’s most significant achievements has been the voluntary

integration of its Mental Health program with that of Ontario Shores Mental Health Centre. The joint

administration of these functions by the two organizations has been widely regarded as a success from

an access, care, and community partner perspective.

NHH continues to collaborate in other areas as well. The Ontario Breast Screening Program is offered at

NHH. It offers to eligible women aged 50-74 without charge and without a doctor’s referral a high

quality mammogram along with their results, educational materials and access to follow up care. NHH

also provides chemotherapy services as a satellite from the regional centres in Kingston and Oshawa

with the assistance of Cancer Care Ontario. NHH is also strengthening the role it plays in the Regional

Renal Program affiliated with the Peterborough Regional Health Centre.

Because seamless care involves community engagement, NHH also needs to build formally on its recent

successes. One of these successes is the Volunteer Chaplaincy program initiative in 2010 to serve

patients and families from many faiths.

For the future, NHH has set itself three Goals to ensure that it creates a seamless health caresystem for the community.

Goal #12: An Engaged Community and hospital team in planning for our

community’s health care system.

NHH has an exceptional track record of success in engaging the surrounding community (for

more detail, see the Continuing Engagement section). NHH needs to build on this success to

ensure that the population’s needs are met by the system as a whole.

To have an engaged community, NHH must accomplish the following objective:

• Objective #1: Develop and commence implementing an Engagement Framework and

strategy.


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Goal #13: An Integrated Network of Partners that provide seamless health

care services in our community.

System and organization pressures have forced NHH to make hard choices about what services

it provides. This does not mean, however, that NHH’s population cannot receive the services itneeds. By building an integrated network of partners, NHH can ensure its population receives

the care it requires, regardless of which organizations actually provide it.

To have an integrated network of partners, NHH must accomplish the following objectives:

• Objective #1: Implement alternative models of service delivery in collaboration with

other service providers and government agencies by leveraging the

Hospital’s redefined services and the LHIN Making Choices Framework.

• Objective #2: Continue to respond to the recommendations of the CE LHIN Clinical

Service Plan, and continue to participate in other regional serviceplanning activities.

Goal #14: A Culture of Interprofessional practice, Collaboration, and care

that enables quality patient care and a healthy workplace.

Health care is becoming ever more complex, and a great variety of professionals are needed to

ensure that patients receive the right type of care at any given time. This reality demands that

NHH develop a culture of interprofessional practice, collaboration and care. The goal will, in

turn, support the Hospital’s staff retention and recruitment efforts.

To create a culture of interprofessional collaboration, NHH must accomplish the following

objectives:

• Objective #1: Design and implement an interprofessional and ethical practice model.

• Objective #2: Identify and build upon organizational structures and processes that

enable interprofessional practice, collaboration and care.


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Strategic Direction #5: Building a Sustainable Future

Building a Sustainable Future means creating a future that is financially, operationally, and

environmentally sustainable. By 2014, NHH expects to be able to say that:

NHH has realized new opportunities to ensure long-term sustainability.

Discussion

NHH has adopted a Decision Making Framework for Service Prioritization using a values-based model

and it has developed a new Service Mandate outlined previously in this document. In the coming

months, NHH will take concrete actions to produce a genuinely sustainable future.

For the future, NHH has set itself four Goals to ensure the long-term sustainability of the organization.

Goal #15: A Culture of Inquiry and Innovation that enables the timely

adoption of leading practices, concepts and ideas.

Hospitals need to constantly expand the stock of knowledge they use, even while they face

challenges in integrating what they already know into their practice. NHH therefore needs to

foster a culture of inquiry and innovation to ensure that it is always aware of the best ideas

available.

To create a culture of inquiry and innovation, NHH must accomplish the following objectives:

•

Objective #1: Investigate and identify key success factors of innovative organizations.Establish a plan to foster a culture of innovation that is appropriate for

our Hospital.

• Objective #2: Establish a multi-year plan that will support and reward staff for

innovation.

• Objective #3: Pursue opportunities for student training (medical, clinical and non-

clinical professionals), particularly in high-need areas.

Achieving the objectives identified under Strategic Goal #4 (Responsive Hospital) will also help

to achieve a culture of inquiry and innovation.

Goal #16: A Clear Mandate that defines the scope of services the hospital is

able to provide to its community.

Recent financial pressures have created a demand for clarity about what NHH can provide and

what it cannot. A clear mandate is essential if the Hospital is to deliver on its Mission and Vision.


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To have a clear mandate, NHH must accomplish the following objectives:

• Objective #1: Finalize and adopt NHH Decision Making Framework for Service

Prioritization.

• Objective #2: Redefine the core services for NHH in a transparent, inclusive and

proactive manner.

This goal and these objectives are essentially complete by June 2010. Please refer to the above

sections entitled, “Our Service Values” and “Our Service Mandate.” However, NHH will need to

reference these tools from time-to-time in its decision making and consider refinements as

deemed necessary by the Board.

Goal #17: A hospital that has Reduced Reliance on Government agency

Funding by pursuing non-traditional hospital revenues.

As the MOHLTC and CE LHIN experience their own pressures, the logical next step for NHH is to

pursue non-traditional revenue sources.

To have a hospital less reliant on government agency funding, NHH must accomplish the


• Objective #1: Identify, pursue and secure new non-traditional funding sources.

• Objective #2: Leverage the Hospital’s property assets to develop new revenue streams.

Goal #18: An Environmental Leader in our community and in the hospital

sector in choosing responsible solutions.

Hospitals place heavy demands on the environment, but those demands can lighten when

people are environmentally conscious and creative in how they do things. NHH wants to be a

leader on this front.

To be a leader in choosing environmentally responsible solutions, NHH must accomplish the


•

Objective #1: Develop an Energy Conservation Plan to reduce the Hospital’s carbonfootprint and reduce operating costs.

• Objective #2: Update the Hospital’s procurement policies and procedures to reflect

environmental considerations.


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Dependencies and Enablers

While NHH is largely responsible for whether or not it achieves its strategic directions, success is also

dependent upon and enabled by other parties.

Partners

The MOHLTC and CE LHIN are key partners in supporting NHH in achieving its success, not least because

they provide the majority of the Hospital’s funding. As provincial, system and hospital budget pressures

increase, the MOHLTC, CE LHIN and NHH will need to work collaboratively with one another to ensure

alignment of goals and strategies.

In addition, NHH has established good working relationships with its labour unions, specifically the

Canadian Union of Public Employees (CUPE), the Ontario Nursing Association (ONA), and the Ontario

Public Sector Employee Union (OPSEU). It is imperative that a spirit of collaboration continue as theHospital responds to new expectations in health policy and legislation, and as the MOHLTC and CE LHIN

guide system-wide transformational changes that are expected in the coming years.

By working closely with its partners, NHH will succeed in achieving its strategic directions.

Continuing Engagement

Renewed community engagement is a Strategic Direction for the MOHLTC, and it has been an important

priority for the CE LHIN, as evidenced by its 2006 Framework for Community Engagement and Local

Health Planning. NHH has also had success in engaging the community, and must continue to do so

going forward.

Building from the Citizens’ Advisory Panel

The Citizens’ Advisory Panel (CAP) has been referenced throughout this document because it represents

a model upon which NHH will build in future. NHH will strive to incorporate its core elements – inclusive,

transparent and proactive – in all of its engagement activities going forward. The CAP process is

summarized below to better understand how NHH intends to build on its success.

In August 2009, the Board of Directors passed a resolution authorizing the CAP process. To oversee and

support this community engagement initiative, a Collaborative of expertise was established:

• NHH Board of Directors;

• External consultants, MASS LBP;

• Researchers from Queen’s University’s School of Business; and

• The Northumberland Community Futures Development Corporation.


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The CAP’s terms of reference were to develop a Decision Making Framework for Service Prioritization

and apply it to develop recommendations about which services should be regarded as “core” and “non-

core” for purposes of providing strategic direction to the Hospital.

To select the panel members a civic lottery was used. NHH retained a firm to mail invitations to 5,000

households, chosen at random, in west Northumberland County. Of the nearly hundred people that

volunteered, 28 were chosen to ensure that the sample was balanced by gender, age and geography.

This ensured a reasonably representative sample of the community and, given the methodology, as

legitimate a sample as anyone could expect.

The selected citizens (the CAP) were required to attend five Saturday sessions (between October and

December 2009) during which they were supported in learning about the health system and the hospital

sector. The sessions included many guest presentations, including: local physicians, the CE LHIN, the

Ontario Hospital Association, the Central East Community Care Access Centre (CCAC), the Port Hope

Community Health Centre, and a health planner who provided demographic analyses of the west

Northumberland community.

The CAP finalized the Service Values for making decisions about prioritizing services (see Appendix A for

definitions):

• Accessibility

• Collaboration

• Community Needs and Responsiveness

• Effectiveness, Safety and High Standards

• Relationships and Public Trust

• Sustainability

Subsequently, the CAP held a series of deliberative sessions to develop their recommendations,including a Public Round Table that was held in Port Hope. The Round Table was attended by

approximately forty citizens.

The CAP then developed a list of potential services that could be considered core and non-core

services.13

To evaluate the process, NHH also retained researchers from Queen’s Monieson Centre to evaluate the

process as a whole. As the researchers’ final report noted, “The final decisions on service cuts made by

the NHH Board closely mirrored the advice from the CAP.”

Finally, the CAP voted on which services they deemed “core” and “non-core”. The “non-core”

services the panel arrived at included the two services NHH recently realigned into the community.

14 The report also concluded that “…the

community engagement process followed by NHH achieved its major goals, and must be considered asuccess.”15

13 For additional detail, see Northumberland Hills Hospital Citizens Advisory Panel on Health Service Prioritization (2010). Final

Report .14

The Monieson Centre (2010). Report on the Community Engagement Process, p. 3215

The Monieson Centre (2010), p. 33.


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In April 2010, NHH’s CAP process was recognized by the Hon. Deborah Matthews, Minister of Health and

Long-Term Care: “I also want to take a moment to talk about the citizens' advisory panel. I think this is a

very innovative approach that Northumberland Hills Hospital took in this case. They actually brought

together citizens and gave them very intense education into what some of the choices were in the

hospital. There is no question that these are tough decisions, but the citizens' advisory panel was

something that I think other hospitals may wish to explore, because it does actually ask the people in

the community what they need to protect and what could be done better outside…” 16

16 House Hansard. Ontario Legislative Assembly. Issue L022, Oral Questions, Health Care Funding. April 27, 2010.

Overall, this kind of innovative, open and transparent process is something that NHH continue to build

on for the future, particularly as it makes decisions about how to deliver patient services in a

coordinated fashion with other health service providers in an integrated health care system.


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Alignment with the MOHLTC and CE LHIN

Health services in Ontario are delivered through a system designed to ensure that health organizations

are accountable to the government and the citizens that elect it. To ensure that NHH provides services

that are both needed by citizens and well integrated into the broader spectrum of care provided by the

system, its vision and strategic directions should be well aligned with those of those of the MOHLTC and

CE LHIN.

How We Are Aligned

Like NHH, the MOHLTC and CE LHIN have both articulated Visions for the system and how it will operate

in throughout the region. As Figure 7 shows, NHH’s Vision is well aligned with their Visions.

Figure 7: Aligning Visions

The Visions above are powerful statements about what these organizations will produce in the coming

years. The consistency among them is also clear – what is it to create health care excellence but to

deliver good care, engage people, help them stay healthy, and do so in a sustainable manner?

This consistency also holds when one looks more closely at the handful of Strategic Directions that each

organization has set out to keep its Vision front and centre as it moves forward. Figure 7 places NHH’s

Strategic Directions in the context of those charted by the MOHLTC and CE LHIN. 17

17 The Strategic Directions for the Ministry and CE LHIN come from the CE LHIN’s 2010-2013 Integrated Health Service Plan. For

presentational purposes, the two organizations’ Strategic Directions have been abbreviated and the order in which they are

presented changed to demonstrate their consistency with NHH’s Strategic Directions.

MOHLTC Vision

A health care system that helps people stay healthy, delivers good care to them

when they need it, and will be there for their children and grandchildren.

CE LHIN Vision

Engaged Communities. Healthy Communities.

NHH Vision Leaders and partners creating health care excellence.


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Figure 8: Aligning Directions

Figure 8 demonstrates the progression and consistency of Strategic Directions across the organizations.

The clusters of Strategic Directions overlap extensively with one another while permitting each

organization to speak directly to the concerns of its particular stakeholders.

This consistency of Vision and alignment of Directions provides the basis for ensuring that the chain ofaccountability is preserved to ensure that the authorities, responsibilities, services and funding that

cascade down the system are properly exercised.

Alternate Level of Care Patients, Wait Times and Vascular Disease

The MOHLTC and CE LHIN have placed strategic emphasis on three initiatives or aims: reducing the

number of ALC patients; reducing ED wait times; and, reducing the impact of vascular disease.18

18 Central East Local Health Integration Network (2009). Integrated Health Service Plan 2010-2013.

As

discussed in the Patients First section, NHH has a number of initiatives underway to reduce the number

of ALC patients, including the Hospital to Home Initiative and the Hospital Elder Life Program (HELP). In

addition, NHH and the CE LHIN are working with the Aging At Home Program to maintain existing

interim Long-Term Care (iLTC) and Restorative Care beds as part of NHH’s ALC strategy. Reducing ALCpatients in the Hospital will ensure that acute care services are not compromised by ensuring that beds

are available for acute surgical and medical patients when needed. Finally, NHH is recognized by the CE

LHIN as a partner in its Strategic Aim of reducing the impact of vascular disease. NHH works through its

inpatient and primary care programs to provide the prevention, screening, and early detection that will

help bring this reduction about.

MOHLTCStrategic Directions

CE LHINStrategic Directions

NHHStrategic Directions

Renewed Community

Engagement

Improved Health Statusfor Ontarians

Equitable Access to Careand Services

Improved Quality ofHealth Outcomes

Establish Framework forSustainability

TransformationalLeadership

Our Team,Our Strength

Quality andSafety

Service and System

Integration

FiscalResponsibility

CollaborativeNetworks

OperationalExcellence

Building a SustainableFuture

PatientsFirst


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Appendix A: Definitions of Our Service Values

As described in the final report of the Citizens’ Advisory Panel, NHH’s Service Values are:

•

Accessibility.

Services and patient care are considered accessible if they are delivered in a timely

manner, are easy for patients to navigate and do not impose costs on the patient. “User-

friendly” patient care stems from having a streamlined process throughout the continuum of

care. This process must ensure timely diagnosis, treatment, and follow-up care.

• Collaboration. Services are considered collaborative if they work with other services and health

providers, both within the Hospital and within the wider community, to enhance patient

outcomes and increase service efficiencies. Collaborative services share knowledge, costs,

promote teamwork and ultimately work towards providing patients with fast, effective, and low-

cost care.

•

Community Needs and Responsiveness. Services are considered responsive to community needs if they use mechanisms to gather and use information about the community to pro-

actively respond to current and future community health needs.

• Effectiveness, Safety and High Standards. Services are considered effective if they lead to the

best possible patient outcome, safe if they are adequately resourced to respond to patients’

needs in a timely manner and safe environment, and of a high standard if they use leading

practices, information and technology.

• Relationships and Public Trust. Services that inspire public trust, and that nurture a positive

relationship between the Hospital and the community, provide care that is approachable,

respectful, and strives to keep up to the highest standards. Highly trained staff and state-of-the-art equipment help to ensure that patients trust the Hospital to give them the best care

possible.

• Sustainability. Services are considered sustainable if they respond to the community’s needs as

these needs change, using partnerships with other health providers whenever it is appropriate

and possible. Sustainability requires maintaining the fiscal, human and technical resources

required to provide high-quality services. In particular, relationships with local health care

providers are important for sustaining services.


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Appendix B: Key Reference Documents

Throughout this Strategic Plan, NHH has referred to a variety of internal and external documents. For

interested readers, Table 1 below lists and provides links to the publicly accessible reference documents.

In the electronic version of this plan, a direct link to each document is provided in the title.

Table 1: Key Reference Documents

Author(s) Year Document Title Website

Baker et al. 2004 Baker Report (Canadian

Adverse Events Study)

www.cmaj.ca/cgi/content/full/

170/11/1678

CE LHIN 2009 Integrated Health Service

Plan, 2010-2013

www.centraleastlhin.on.ca

CE LHIN 2006 A Framework for Community

Engagement and Local

Health Planning

www.centraleastlhin.on.ca

NHH 2009 Citizens’ Advisory Panel

Terms of Reference

www.nhh.ca

NHH (CAP) 2010 Citizens’ Advisory Panel on

Health Service Prioritization

Final Report

www.nhh.ca

NHH (HCM) 2009 Environmental Scan www.nhh.ca

Ontario Ministry

of Finance

2009 2009 Ontario Budget: Budget

Papers

www.fin.gov.on.ca

OACCAC,

OFCMHAP, and

OHA

2010 Ideas and Opportunities for

Bending the Health Care Cost

Curve

www.oha.ca

http://www.cmaj.ca/cgi/reprint/170/11/1678http://www.cmaj.ca/cgi/reprint/170/11/1678http://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/IHSP_for_posting.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/IHSP_for_posting.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.nhh.ca/SharedChallengeSharedSolution/CitizensAdvisoryPanelTermsofReference/tabid/313/language/en-US/Default.aspxhttp://www.nhh.ca/SharedChallengeSharedSolution/CitizensAdvisoryPanelTermsofReference/tabid/313/language/en-US/Default.aspxhttp://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/LinkClick.aspx?fileticket=FApAINpx9N8%3d&tabid=358http://www.nhh.ca/http://www.fin.gov.on.ca/en/budget/ontariobudgets/2009/papers_all.pdfhttp://www.fin.gov.on.ca/en/budget/ontariobudgets/2009/papers_all.pdfhttp://www.fin.gov.on.ca/http://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.oha.ca/http://www.oha.ca/http://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfhttp://www.fin.gov.on.ca/http://www.fin.gov.on.ca/en/budget/ontariobudgets/2009/papers_all.pdfhttp://www.fin.gov.on.ca/en/budget/ontariobudgets/2009/papers_all.pdfhttp://www.nhh.ca/http://www.nhh.ca/LinkClick.aspx?fileticket=FApAINpx9N8%3d&tabid=358http://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/LinkClick.aspx?fileticket=jpyxIoXLcDQ%3d&tabid=317&language=en-UShttp://www.nhh.ca/SharedChallengeSharedSolution/CitizensAdvisoryPanelTermsofReference/tabid/313/language/en-US/Default.aspxhttp://www.nhh.ca/SharedChallengeSharedSolution/CitizensAdvisoryPanelTermsofReference/tabid/313/language/en-US/Default.aspxhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/Framework.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/IHSP_for_posting.pdfhttp://www.centraleastlhin.on.ca/uploadedFiles/Home_Page/Integrated_Health_Service_Plan/IHSP_for_posting.pdfhttp://www.cmaj.ca/cgi/reprint/170/11/1678http://www.cmaj.ca/cgi/reprint/170/11/1678http://www.cmaj.ca/cgi/reprint/170/11/1678


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In addition, the following chart summarizes the various reference documents (plans, frameworks,

models, etc.) that support the Strategic Plan. These reference documents are primarily tactical or

operational in nature and specifically address the Strategic Objectives outlined in this Strategic Plan.

Our Team,

Our Strength

Collaborative

Networks

OperationalExcellence

Building a

Sustainable Future

Patients

First

Quality and Safety

Framework

Interprofessional

Practice Model

Customer Service Model

Human Resource PlanPhysician

Human Resource Plan

Community Engagement

FrameworkRegional Program Plans

for Mental Health,

Dialysis and Cancer

Services

Talent Management Plan

Capital Life Cycle Plan Information andCommunications

Technology Plan

Financial Plans for

Revenues and Debt

Repayment

Decision Making

Framework for Service

Prioritization

Campus

Development Plan

Energy

Conservation Plan

Strategic

Directions

Strategic Goals and Objectives

(Reference Documents)

NHH 2010-2014 Strategic Plan

Central East LHIN

Clinical Service Plan