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Dr' Hugh Scott, President

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Title: Dr' Hugh Scott, President


1

Community-based Initiatives For Community-based
Solutions
Roundtable Discussion
  • Dr. Hugh Scott, President CEO
  • The Scarborough Hospital
  • April 6, 2006

2
The Scarborough HospitalWho We Are
  • Canadas largest urban community health system
  • 4,000 health care professionals and 800
    volunteers
  • We are employee, patient and community-service
    driven
  • Our priority is outstanding health care for our
    community
  • We are Scarboroughs largest employer

3
Who We Are
  • Two acute care campuses
  • -General Campus Lawrence Ave East and McCowan
  • -Grace Campus Finch Ave East and Birchmount
  • Six community-based centres
  • Bridgepoint Centre Nephrology satellite
  • Corporate Drive Centre
  • Eglinton Avenue Centre
  • Kennedy Road Centre
  • Manse Road Centre
  • Urban Outreach Family Health Centre

4
What We Provide
  • Patient care areas include
  • Cardio-Respiratory Critical Care
  • Emergency Urgent Care
  • Family Medicine Community Services
  • General Subspecialty Surgery
  • Maternal Newborn Child Care
  • Medicine Geriatrics
  • Mental Health
  • Nephrology Dialysis
  • Orthopaedics Rehabilitation

5
Who We Serve
  • TSH delivers care to the worlds most diverse
    community
  • 55 Foreign Born
  • 60 Visible Minority
  • Over 25 different ethnic groups multiple
    languages
  • Top countries of origin Sri Lanka, India, China
  • (Source 2001 Census)
  • TSH delivers health care to over 600,000 people
    in Scarborough and beyond.

6
TSH Evolves with the Community
  • The community of Scarborough continues to change.
  • 10-year growth from 1991 to 2001
  • 12 in total population
  • 18.6 in persons 65 and older
  • 25 in lone parent families

7
What We Do Matters
  • Our priority is outstanding health care for our
    community
  • Innovation
  • TSH is one of only three Ontario hospitals
    selected by the MOHLTC to pilot the Drug Profile
    Viewer system
  • TSH is one of the leaders in Canada to adopt the
    Emergency Department Management (EDM) module
  • TSH is among the top 30 per cent of Ontario
    hospitals to first adopt digital, filmless
    radiology images

8
What We do Matters
  • In 2005-06, TSH increased cataract procedures to
    4500 and has contracted with the Ministry to
    increase this to 5264 in 2006-07 More than
    100/week!
  • In 2003-04 (despite SARS) in Ontario TSH
    performed
  • the 3rd highest number of bowel operations for
    cancer
  • The 6th highest number of mastectomies for cancer
  • The 6th highest number of radical prostatectomies
    for cancer
  • The 10th highest number of hysterectomies for
    cancer
  • For these four procedures combined TSH was the
    7th most active in Ontario
  • TSH is Scarborough based, but does not limit care
    to Scarborough residents
  • Conversely, many people in Scarborough choose to
    obtain their hospital care elsewhere

9
What We Do Matters
  • We understand the diverse community we serve
  • Exceptional Care
  • TSH is a leader in approaches and best practice
    for
  • Multicultural Health Care
  • Multifaith Spiritual Care

10
What We Do Matters
  • TSH staff demonstrate long-standing dedication
  • Pride in Our Work
  • TSH staff, physicians and volunteers have
    dedicated up to 45 years of service.
  • We are performance and results-obsessed and
    continuously measure our work through a balanced
    scorecard approach.

11
A Five Year Overview of Key Indicators
What We Do Matters
Admissions
12
A Five Year Overview of Key Indicators
What We Do Matters
Patient Days
13
A Five Year Overview of Key Indicators
What We Do Matters
Newborns
14
A Five Year Overview of Key Indicators
What We Do Matters
Average Length of Stay
Days
15
A Five Year Overview of Key Indicators
What We Do Matters
Newborn Average Length of Stay
Days
16
A Five Year Overview of Key Indicators
What We Do Matters
Inpatient Surgery
17
A Five Year Overview of Key Indicators
What We Do Matters
Outpatient Surgery
18
A Five Year Overview of Key Indicators
What We Do Matters
Hips Knees
19
A Five Year Overview of Key Indicators
What We Do Matters
Emergency Room Visits
20
A Five Year Overview of Key Indicators
What We Do Matters
Dialysis
21
A Five Year Overview of Key Indicators
What We Do Matters
MRI
22
Where do Scarborough residents get their care?
Steeles Ave
Markham Rd
Victoria Park Ave
23
Central East LHIN
  • Total Population 1.459,800 (close to 1.5
    million)
  • Approx. 40 (600,000) population from Scarborough
    area
  • Projected population growth in CE LHIN is 6.9
    higher than provincial growth rate 5.4
  • South East Corner of the LHIN is a high growth
    area economic growth in Scarborough, Markham
    expansion of 407 in Durham urban sprawl into
    Pickering, Oshawa
  • MOHLTC identifies four high volume hospitals
  • The Scarborough Hospital, Rouge, Lakeridge,
    Peterborough Regional

24
Clinical Priority Setting Process What
  • The Scarborough Hospitals clinical services
    planning
  • Consultative, collaborative and team-focused
    planning process. NOT an economic exercise
  • Updates planning done in 2001
  • Informs our long term clinical service plan and
    defines TSHs clinical priorities over the next
    five to ten years
  • This Clinical Priority Setting Process (CPSP) was
    initiated in 2004

25
Clinical Priority Setting Process Why
  • Ensure resources are being utilized to best meet
    the evolving needs of the community we serve
  • TSH to move forward as one unified, thriving,
    balanced system providing high quality patient
    care.
  • To develop areas of clinical focus for each acute
    care Campus create Centres of Excellence.
  • To create critical mass in programs to sustain,
    recruit and retain health human resources.
  • To position TSH positively with the Ministry and
    within the Central East LHIN

26
Clinical Program Steering Committee (CPSC)
Mandate
  • Develop an evidence based plan of action for TSH
    that
  • Supports the mission, vision and values of the
    Hospital
  • Aligns with the health care needs of our
    community
  • Creates a unified hospital within the larger
    health care sector
  • Has 2 emergency departments operating 24 hours
    per day, 7 days per week
  • Includes the new Emergency and Critical Care
    Centre at the General Campus

27
Current Status
Blue indicates service is provided at one
campus only, it does not imply that theprogram
serves both campuses
28
CPSC Recommendations
  • Two 24/7 Full Service Emergency Rooms
  • Two ICUs New spectacular E.C.C.C. at General
    Campus
  • Two General/Medicine/Geriatrics programs
  • Family Practice at both campuses Urban Outreach
    health centre at General campus

29
CPSC Recommendations
  • Stroke Unit - sited at General Campus
  • Evidence for model of care
  • Service delivery model best supported at General
  • MRI access necessary (General)
  • Orthopaedics and Rehabilitation - Integrated
  • Develop Joint Replacement Centre of Excellence at
    Grace
  • Supports Emergency Services at both campuses

30
CPSC Recommendations
  • Maternal Newborn Child IntegratedPaediatrics
  • Consolidate Inpatient Paediatrics
  • Consolidate Paediatric Same Day Surgery
  • Obstetrics
  • Obstetrics at each campus on budget
  • Neonatal/perinatal services of paediatricians at
    both campuses
  • Maintain and enhance ambulatory Paediatrics at
    both campuses
  • Gynaecology
  • Gynaecology at both campuses
  • Gynaecology Oncology developed at General Campus
    (with Cancer Focus/Womens Health)

31
CPSC Recommendations
  • Mental Health
  • Consolidate Inpatient Psychiatry at the Grace
    with enhanced ambulatory programs at both
    campuses plus in the community
  • Enhanced co-ordination with Rouge Valley and
    Community agencies
  • Cataract Surgery
  • Increased Volume, consolidated for maximum
    efficiency at the Grace campus

32
CPSC Recommendations
  • Cancer Care
  • Develop Comprehensive Cancer Program with
    increased screening and co-ordinated follow-up
    services
  • Increase availability of lung and gynaecologic
    cancer surgery
  • Consolidation of Palliative Care at the General
    Campus in enhanced surroundings with the same
    number of total beds. Enhanced consult service
    for both campuses and greater co-ordination with
    community agencies

33
CPSC Recommendations
  • Regional Dialysis Program to be significantly
    increased due to demand
  • Convert flourishing Vascular Surgery program to
    full Regional Program
  • Maintain Sexual Assault/Domestic Violence Service
    at Grace Campus
  • General Surgery and Endoscopy both campuses
  • ENT/Oral Surgery consolidated at Grace campus,
    Plastic Surgery at the General campus

34
Mental Health
Site TBD
35
Conclusions
  • Total Health Care provided by all sites of TSH
    has grown and evolved dramatically in the past 5
    years
  • All services currently provided will continue at
    least at their current levels at TSH
  • Selective, prudent growth will occur in areas of
  • Demonstrated need
  • Priority areas identified by Ministry, LHIN
    and/or TSH internal processes
  • Where TSH has a demonstrated advantage or niche
  • Feedback throughout this process has been
    invaluable. All has been considered and important
    changes made in response to it

36
Conclusions
  • TSH will continue to evolve with its community,
    with changes in health care, with technologics
    advances in an innovative and efficacious way
  • TSH is determined to be a leader not a follower
    and not a also ran
  • Would the people of Scarborough want or expect
    any less?

37
Discussion
  • Specific questions?
  • Comments?
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