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ANNUAL REPORT

2015-2016

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REPORT OF THE BOARD CHAIR Janet Gow 2015 -2016 has been a year of some notable changes. At last year’s annual general meeting we welcomed new board members Dick Rabishaw, Yevgeniya Le and Chris Carroll. We bid farewell to Jeff Bishop, Ian Towner and

Megan Chartrand. Then in the early fall we accepted, with regret, the resignation of our CEO Gary Sims. We wish him well in his new role in Kirkland Lake. We undertook the pro-cess of recruiting, and in mid-May welcomed Richard Bedard as our new CEO. We thank the executive team – Kate Kobbes as interim CEO, along with Stacey Mortson and André Vigneault – for their leadership over the six month period.

Our vision that “every client’s healthcare experience will be exceptional” would not be possible without the dedication and compassion of the entire hospital staff – from those in support services to front line workers, leadership and the executive team. We are also privileged to have an equally dedicated, competent medical staff who often extend them-selves to ensure 100% coverage of the emergency depart-ment and inpatients.

Our hospital continues to perform at a high level. For the third consecutive year we received a gold level Quality Healthcare Workplace Award from the Ontario Hospital Association. Patient satisfaction remains high and our wait times in the emergency department are lower than provincial targets. A major accomplishment this year was receipt of a four year accreditation with an overall score of 97% . This was an endeavour that required many months of preparation and involved the commitment and time of the entire hospital staff including the Board. Examples of the comments re-ceived from the surveyors were “there is a commitment to quality and safety throughout all levels of the organization”, and “patient and family centeredness is evident in all deliv-ery areas”.

We continue to follow our Strategic Plan which will be for-mally reviewed over the coming year. Being committed to involving our clients in determining our future direction, the Board has developed a new policy regarding community engagement and is in the process of formalizing a Patient and Family Advisory Committee.

We are partners in several new regional programs such as “North Renfrew County Health Link” whose purpose is to improve the delivery and coordination of health care for patients with complex needs. Another program is “cNEO” which will improve communication of patient information between health care providers throughout Northern and Eastern Ontario.

Unfortunately this year has also had its challenges. Funding continues to be a concern. As you will see in the financial report, provincial government restraints combined with in-

creasing hospital costs have resulted in a significant deficit this past year. We are presently awaiting information from the LHIN as to the impact this will have on our proposed budget for the current year. There is a constant seeking of revenue from other sources and this year there has been the installation of solar panels which are now operational and generating revenue.

Unfortunately we were not able to reach a mutually accept-able lease agreement with the Town of Deep River for the proposed primary care building. Our Board was disappointed, but it was necessary to make our decision in keeping with our financial obligations to the hospital and to the community. We have not abandoned our goal and will be exploring other options in establishing such a facility for our town. High quali-ty patient centered health care is vital and we recognize that retaining and attracting physicians is critical to that purpose.

Funding for capital equipment is essential to the operation of the hospital and we sincerely thank the Hospital Auxiliary for their ongoing financial support as well as their volunteer hours in serving patients within our facility. We also appreci-ate the work and commitment of the Hospital Foundation and its donors and third party fundraisers. Without these two organizations we would be unable to purchase new or replace aging health care equipment.

Finally, on a personal level, I would like to thank my fellow members of the Board of Directors for their commitment of time and their diligence in supporting the hospital in fulfilling its mission “to provide a broad range of high-quality health care services for our local communities.”

Janet Gow Board Chair

VALUES

Caring Safety Partnering

Excellence Innovation Integrity

VISION

Every client’s healthcare experience will be exceptional.

MISSION

To provide a broad range of high-quality healthcare services for our local communities.

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REPORT OF THE CHIEF OF STAFF Dr. Barbara Bushby Having assumed the role of Chief of Staff in April 2015, I have recently been elected by the physician group to continue in this role for the next year, presently until June 2017. Dr. Hanene

Ben Amor has been re-elected President of the Medical Staff for this upcoming year.

The past year has brought significant change again to our facility. In the past year, we bid farewell to Gary Sims, our CEO, and participated in the search, and now the welcoming, of our new CEO, Richard Bedard. He brings a wealth of expe-rience to his new role and the physicians are looking forward to working with him in the upcoming year.

Despite change all around us, our complement of seven local physicians has remained unchanged in this past year. The Deep River Family Health Organization, which includes Drs. Tom Greenfield, Elizabeth Noulty, Terry McVey and myself continues as previous. The North Renfrew Family Health Team, under the guidance of its new Executive Director, André Vigneault, and Dr. Gina Corrigan as the Team’s Physician Director, is continuing to evolve. Although there have been some staffing changes that have affected many of the Family Health Team patients, the group prac-tising at the FHT including Drs. Corrigan, Kathy Kipp, and Hanene Ben Amor welcome the recent addition of a Commu-nity Mental Health Worker to their team and will be welcom-ing a new Nurse Practitioner in the summertime.

With the support of many external physicians, our group keeps our Emergency Department staffed and open 24 hours a day. Of course, we could not do this without the dedication of the Emergency Room nursing staff. What great staff to work with! The nursing staff on our Acute Care Inpatient Unit are also sec-ond to none and continue to provide exceptional care in which we all take pride. The caring staff at Four Seasons Lodge (FSL) continue to provide that same exceptional care. Our communi-ty continues to reap the benefits of these truly professional men and women. Thank you.

The IT group in our facility is busy ensuring that our transition for inpatient Electronic Medical Records stays on track. As the vision of an integrated Electronic Health Record across Ontario continues to evolve, the work of our dedicated IT team has been growing exponentially. Hats off to them. Deep River Physiotherapy has welcomed a new director/ practising physio-therapist, a second physiotherapy assistant and, most recently, a new full-time physiotherapist. With that full complement, we are excited to see an increase in physio availability for both inpatients and outpatients.

Although many things have changed this year, some things have remained the same. The medical staff continue to be proud of the health care team of which we are a part, both within the hospital (be it in ER, in FSL or on the acute care ward) and within our community practices. I am proud to be part of this medical staff.

Barbara Bushby Chief of Staff

REPORT OF THE CHIEF EXECUTIVE OFFICER Richard Bedard I began my tenure as CEO at Deep River and District Hospital on May 16, 2016. My first month has passed quickly. I want to express my sincere thank you to not only the Board of

Directors but also to the staff, volunteers, physicians and most importantly the community. I enjoy the relaxed lifestyle and the friendly personalities, and look forward to the years ahead.

I am excited about the future of healthcare in the region. We are working diligently with the LHIN and partnering stake-holders to ensure exceptional care for all we serve.

The success of the organization requires a complex blend of skills coordinated in their delivery through the contribution of staff, physicians, volunteers and generous donors who help to make care delivery and improvements possible.

As CEO, I sincerely want to thank:

Our Auxiliary and volunteers for their boundless enthu-siasm and enduring support

The Foundation and all those supporting the Foundation whose generosity ensures the ongoing sustainability of the organization

The Board of Directors who voluntarily provide of their time and expertise to guide the organization into the future in a demanding and ever changing environment

Our physicians and staff, whose service and dedication provide healthcare to meet the needs of those we serve and who make the community a better place to live.

Thank you for your confidence and ongoing support and all that you do to help us ensure that everyone’s healthcare experience is exceptional.

Richard Bedard President and CEO

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This past year, the Hospital Auxiliary has been very busy with the Whistle Stop and the Gift Shop. Appreciation goes out to the many committed volunteers without whom these operations would not see such success. The Breast Screening Program and the Palliative Care volunteers are very dedicated individuals who donate their time and energy throughout the year. The Four Seasons Lodge along with the Evening Nutrition Program benefit from dedicated volunteers.

The Auxiliary continues to provide an annual donation of $10,000 for the Sprouting Speech Preschool Speech and Language Program for the area children. In addition, this year there was support to purchase new window blinds for the patient rooms on the medical floor as well as two new Holter Cardiac monitors used in the diag-nosis of specialized cardiac conditions in the outpatient community.

Thank you to all of the Hospital Auxiliary members.

Hospital Auxiliary

Palliative care is an important resource in small communi-ties, and is often assisted greatly with the help of volun-teers. At the Deep River and District Hospital, we offer pal-liative care for patients and families. Our program is greatly supported with volun-teers who have palliative care training. This is a brief look at how our volunteers work with us to provide this important community service.

First, we recognize that the grieving process for patients and families can begin with the diagnosis, so this is where training begins for volunteers. With experienced staff to han-dle the physical elements of

palliative care, our volunteers focus on sup-porting quality of life.

Volunteers concentrate on improving quality of life

by offering emotional and mental support. Often, a terminally ill person has un-certainties (a fear for the future or what may happen to their families) which they find uncomfortable discuss-ing with their family. A vol-unteer can be a more com-fortable person to speak with in these situations. Vol-unteers also respect diverse spiritual beliefs and religious customs that may differ for a patient and their family members. Each situation is unique and volunteers iden-tify needs and respect the requests of the patient and family.

The Incredible Value of Palliative Care Volunteers

So often when a patient is diagnosed with a terminal illness, the illness becomes their identity. No longer are they first a mother, father, friend, or a child, but a per-son with a terminal disease such as cancer, ALS or heart failure. Volunteers look be-yond the illness to see the person for who they are, beyond the disease they have. Volunteers help by hearing the celebrations of a person’s life —their memo-ries, their milestones and mostly who they are.

Often families do not realize how tending to a loved one can take a physical and emo-tional toll on themselves. Experienced volunteers pro-vide relief to ensure care continues while the caregiv-er takes an opportunity to rest. Volunteers are caring, understanding, empathetic and compassionate. They become every patient and family’s friend. This relation-

ship contributes to the care of the palliative patient.

Volunteers in palliative care hold a special role in the lives of individuals, whether they are the patient or a member of the family. Volunteers help ensure the patient is never alone. They listen and most importantly, having helped others in the past, understand the emotions that are often felt at this time in a person’s life.

Being a palliative care volun-teer helps those who are ter-minally ill, but the true gift lies in what the volunteer receives in return.

This article appeared in the Health Matters Magazine — Summer, 2016 Edition By: Tammy Blimke

Whistle Stop

Evening Nutrition New Blinds

Gift Shop

Palliative Care Volunteers

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Telemetry Unit

Campaign Update

Total Cost =

$74,000

As a result of the

efforts and

contributions of

the entire

community, we

have raised

$70,092

in donations

designated for

Telemetry

(as of June 2016)

and have

almost reached

our goal.

THANK YOU!

Recent Capital

Purchases: Physio Upright Bicycle: $4,600

Bariatric Mattress: $3,000

Pediatric Immobilizer: $5,000

Defibrillator: $20,000

More recent purchases as well as upcoming needs can be

found on the Foundation’s website at

drdhfoundation.com

Check out the “About Us” page to read our quarterly newsletter, Giving Matters.

The Deep River and District Hospital Foundation raises funds for equipment to sustain the excep-tional services offered at DRDH. Since our hospi-tals do not receive government funding for the purchase, replacement or repair of Capital Equip-ment, we rely on the generosity of our community to ensure our hospital has the equipment it needs.

If you would like to join us in supporting our hospi-tal, please contact us at 613-584-1266 x 203 or foundation@drdh.org

Thank you to all our generous donors!

Solar Project Completion After much planning, approvals, and ultimately a cold, wintery installation, the solar project was completed this spring. As of April, the project is generating electricity, and revenue, for the hospital.

Photo: Aubrey Fletcher

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Healthy Foods in

Champlain Hospitals The Healthy Foods in Champlain Hospitals initiative is spearheaded by the Champlain Cardiovascular Disease Prevention Network (CCPN). The program promotes healthy eating by supporting and encouraging the increase of healthy alternatives so the healthy choice is easy for staff, physicians, visitors, patients and volunteers. Congratulations to the team at DRDH who have worked together to help the hospital achieve Bronze Status. The Bronze Level involves key changes in

cafeterias, vending machines and gift shops. Those changes include providing calorie and sodium information for soups and entrees, increasing availability of whole grains, vegetables, and fruit, removing deep fryers and deep fried foods, reducing the variety of chocolate, chips, coated granola bars, candy, and pretzels, reducing sodium in soups,

and decreasing portion sizes of high-calorie beverages.

DRDH Achieves Accredited Status

Congratulations to the staff, leadership and the Board of Directors on achieving a score of 97% on the 2015 accreditation. This was the focus for many staff as evidence was gathered and policies were reviewed to meet nearly 1500 standards.

“Organizations that become accredited with Accreditation Canada do so as a mark of pride and as a way to create a strong and sustainable culture of quality and safety.

Accreditation Canada commends Deep River & District Hospital / Four Seasons Lodge for its ongoing work to inte-grate accreditation into its operations to improve the quality and safety of its programs and services.”

The 2015 Quality Healthcare Workplace Awards mark the sixth year of recognition by the Ontario Hospital Association and the Ministry of Health and Long Term Care for workplace achievements of Ontario health care organizations.

The awards program allows for organizations to self-evaluate, learn and improve efforts in ways that contribute to the providers' quality of work life, care and services they deliver.

Deep River and District Hospital was recognized at the Gold level for the third year running. These awards are proudly displayed inside the hospital’s main entrance.

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Goal 1 - DRDH is a recognized rural health leader in quality and patient safety.

DRDH is embracing innovation and technology to provide safe patient care and continually improve quality. Implementation of the EMR, Pharmacy Automation and continued expansion of telemedicine and outpatient services are operational strategies currently in place.

Goal 2 - DRDH is the driving force of an exemplary patient/client journey.

We continue to develop our partnerships with specialists, hospitals and other community organizations and we leverage technologies to communicate patient information to improve coordination of care.

Goal 3 - DRDH is an innovative and resource-conscious provider of exceptional patient/client care.

Through this year’s approach to budget development with the management team, we set the bar higher, asking them to formulate their department budgets with a 10% cut in expenses. We engaged staff for the generation of cost saving ideas and have developed mitigation strategies to manage future constraints and offset costs of ongoing licensing for technologies implemented with one time funding (ie. no ongoing operational funding).

Goal 4 - DRDH is a small rural hospital employer of choice.

Management and the Executive team have been active over the last year and a half in leading staff through and assisting them in adapting to change. There have been significant changes in leadership and several technological advances that have affected workflow of front line workers. In 2015, there have been several surveys used to assess staff morale, engagement and satisfaction - results have been lower than previous DRDH surveys, and in line with provincial average. This past fall, we engaged staff in reviewing and vali-dating results of surveys, and identifying trends on which to focus. We are currently working with staff in co-creation of an action plan to address concerns.

Goal 5 - DRDH is the local leader in enhancing population health.

We continue to align with Health Links and similar programs to meet population health needs.

Goal 6 - DRDH is seamlessly integrated with all partners.

We continue to develop partnerships, work towards integrated Boards and Operational Services. Funding is moving towards integrated models of care, episode of care funding.

Three Year Strategic Plan 2015-2018

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INDEPENDENT AUDITOR'S REPORT

We have audited the accompanying financial statements of Deep River and District Hospital, which comprise the state-ment of financial position as at March 31, 2016, and the statements of operations, changes in net assets and cash flows for the year then ended, and a summary of significant accounting policies and other explanatory information.

Management's Responsibility for the Financial Statements

Management is responsible for the preparation and fair presentation of these financial statements in accordance with Canadian accounting standards for not-for-profit organizations, and for such internal control as management deter-mines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

Auditor's Responsibility

Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with Canadian generally accepted auditing standards. Those standards require that we comply with ethical requirements and plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement.

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor's judgment, including the assessment of the risks of mate-rial misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the organization's preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the organization's internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by management, as well as evaluating the overall presentation of the financial statements.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Opinion

In our opinion, the financial statements present fairly, in all material respects, the financial position of Deep River and District Hospital as at March 31, 2016, and the results of its operations and its cash flows for the year then ended in accordance with Canadian accounting standards for not-for-profit organizations.

Pembroke, Ontario June 22, 2016

LEACH BRADBURY ACCOUNTING PROFESSIONAL CORPORATION

Authorized to practise public accounting by The Chartered Professional Accountants of Ontario

DRAFT

Financial Report April 1, 2015 to March 31, 2016

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Summarized Statement of Operations

40%

12%

1%1%

19%

3%

2%10%

12%

ExpensesSalaries, Wages andemployee benefitsMedical staffrenumerationMedical and surgicalsuppliesDrugs and medicalgasesOther supplies andexpensesAmortization onequipment

56%

7%2%

11%

3%

1% 8%

12%

RevenueMinistry of Health

Patient Revenue

Differential and co-paymentrevenue

Other income and recoveries

Amort. Of deferred revenue

Amort. Of deferred revenueon building

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Committees of the Board

GOVERNANCE COMMITTEE The mission of the Governance Com-mittee is to ensure that appropriate governance processes are in place for the operation of the Corporation. This includes the Hospital, the Board and associated groups.

The Committee establishes an annual work plan based on input from the committees, the Board Chairperson, the Chief Executive Officer and the Chief Nursing Officer. It annually evaluates the Board and its committees’ perfor-mance in relation to their mandate, responsibilities, goals and objectives.

In this year, in cooperation with the Chief of Staff and the clinical staff, it has established within the board policies a defined role with associated goals and objectives . This was somewhat in response to a perennial note from the OHA that the DRDH did not have such a recorded policy.

The committee has analyzed the OHA report on Self- Assessment.

The required reviews of the By Law were carried out and some editorial amendments were agreed to by the Board. Certain policies were also reviewed as required.

Mike Ward, Chair

QUALITY AND PATIENT SAFETY COMMITTEE The Quality and Patient Safety Com-mittee is responsible for monitoring the quality performance of the organization to ensure that the quality of care, hospi-tal services, and patient safety are at their highest achievable levels. This is achieved through our annual Quality Improvement Plan (QIP) which is admin-istered by Health Quality Ontario (HQO) and our hospital's Balanced Score Card (BSC). In both of these programs, items for improvement are identified, targets set, and appropriate programs devel-oped in each area. The results of both the QIP and the BSC in 2015-16 were

very good. Key achievements were reducing unnecessary hospital readmis-sion’s, improving our assessment of falls through the Interdisciplinary Fall Prevention Team and completing the EMR data sharing between ER, the FHT and the FHO. In previous years both our Family Health Team and the Four Sea-sons Lodge were required to develop and submit QIPs to HQO. For 2016- 2017 they are all combined into the DRDH QIP.

An essential part of each program is in identifying items that need improve-ment through the use of surveys. The Hospital uses National Research Corpo-ration Canada to survey patients about their satisfaction with their experience at DRDH and also staff about their satis-faction with the workplace. Since only a fraction of our patients are surveyed by NRCC Picker, we have introduced our own patient surveys in order to get better feedback. DRDH received excel-lent scores in the most recent NRCC Picker patient satisfaction survey and we have also received very positive feedback from our own patient surveys. To further improve feedback from patients, we are in the process of form-ing a Patient and Family Advisory Coun-cil that will report to this committee.

Please access the DRDH website at www.drdh.org for more information about the Quality Programs.

Brian Cheadle, Chair

RESOURCE AND AUDIT COMMITTEE

The principal function of the Resource and Audit committee is to provide over-sight on the uses of financial, physical and human resources of the hospital. It achieves this by reviewing quarterly financial statements and examining various metrics on the Balanced Score-card. It recommends the annual budget to the Board for approval. The com-mittee is also engaged in the year-end audit process through meetings with the external auditors to discuss internal controls and financial reporting.

As with most hospitals in Ontario, 2015-2016 has proven to be a challenging year from a fiscal standpoint resulting in a year end deficit for 2016. This will be the primary focus for this committee in the coming year as the committee and staff work to eliminate the deficit and put the hospital on a stable financial footing for the future.

Chris Carroll, Chair

STRATEGIC PLANNING AND PARTNERSHIP (SP&P) The SP&P committee is responsible for ensuring that a strategic plan is in place, developing relationships with other health care providers, and communi-cating with stakeholders - for example, patients, community representatives and the public.

As part of its on-going monitoring of DRDH operations, this committee is also responsible, in collaboration with the DRDH executive, for defining and track-ing the targets covered by the Service Integration/Collaboration portion of the DRDH Balanced Score Card. I am pleased to report that all 2015-16 targets were met.

The main focus for this year was recruiting a Chief Executive Officer to replace Gary Sims who moved to the Kirkland and District Hospital as CEO last December. A search firm was engaged, potential candidates were identified and interviewed, and an offer was prepared and made to the preferred candidate. I am pleased to report that the preferred candidate, Richard Bedard, accepted DRDH’s offer and joined DRDH May 16.

As we look forward to 2016-2017 fiscal year, the committee plans to refocus its efforts on enhancing relationships with community and partner organizations, and implementing plans designed to meet the 2015-2018 Strategic Plan goals - a copy of the 2015-18 Strategic Plan is posted on the DRDH website.

Ross Judd, Chair

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Community Members Appointed to Board Committees

Patti Kinghorn, Quality and Patient Safety Committee

Judith Cloutier, Resource and Audit Committee

Mariah Tennant, Strategic Planning and Partnership Committee

Richard Bedard Kate Kobbes Stacey Mortson Dr. Barbara Bushby

Executive Leadership Team

Richard Bedard, Chief Executive Officer

Kate Kobbes, Chief Nursing Officer (and Interim CEO)

Stacey Mortson, Chief Financial Officer

Dr. Barbara Bushby, Chief of Staff

Elected Board Members

Janet Gow, Board Chair

Ross Judd, Vice-Chair and Chair of Strategic Planning and Partnership Committee

Brian Cheadle, Treasurer and Chair of Quality and Patient Safety Committee

Chris Carroll, Chair of Resource and Audit Committee

Michael Ward, Chair of Governance Committee

Ken Philipose, Dick Rabishaw, Yevgeniya Le

Brian Cheadle

Ken Philipose Yevgeniya Le

Janet Gow Ross Judd Mike Ward Chris Carroll

Dick Rabishaw

Board of Directors 2015-2016

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