Title: Dr' Hugh Scott, President
1Community-based Initiatives For Community-based
Solutions
Roundtable Discussion
- Dr. Hugh Scott, President CEO
- The Scarborough Hospital
- April 6, 2006
2The 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
3Who 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
4What 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
5Who 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.
6TSH 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
7What 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
8What 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
9What 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
10What 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.
11A Five Year Overview of Key Indicators
What We Do Matters
Admissions
12A Five Year Overview of Key Indicators
What We Do Matters
Patient Days
13A Five Year Overview of Key Indicators
What We Do Matters
Newborns
14A Five Year Overview of Key Indicators
What We Do Matters
Average Length of Stay
Days
15A Five Year Overview of Key Indicators
What We Do Matters
Newborn Average Length of Stay
Days
16A Five Year Overview of Key Indicators
What We Do Matters
Inpatient Surgery
17A Five Year Overview of Key Indicators
What We Do Matters
Outpatient Surgery
18A Five Year Overview of Key Indicators
What We Do Matters
Hips Knees
19A Five Year Overview of Key Indicators
What We Do Matters
Emergency Room Visits
20A Five Year Overview of Key Indicators
What We Do Matters
Dialysis
21A Five Year Overview of Key Indicators
What We Do Matters
MRI
22Where do Scarborough residents get their care?
Steeles Ave
Markham Rd
Victoria Park Ave
23Central 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
24Clinical 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
25Clinical 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
26Clinical 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
27Current Status
Blue indicates service is provided at one
campus only, it does not imply that theprogram
serves both campuses
28CPSC 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
29CPSC 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
30CPSC 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)
31CPSC 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
32CPSC 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
33CPSC 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
34Mental Health
Site TBD
35Conclusions
- 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
36Conclusions
- 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?
37Discussion
- Specific questions?
- Comments?