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2013 – 14 ANNUAL REPORT inspiring innovation

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Holland Bloorview Kids Rehabilitation Hospital 2013 - 14 annual report

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Page 1: Inspiring Innovation

2013 – 14 ANNUAL REPORT

inspiringinnovation

Page 2: Inspiring Innovation

2 2013 - 2014 ANNUAL REPORT

“As I conclude my time as CEO at Holland Bloorview, I want to thank all the children, youth, families, employees, students, trustees, volunteers and donors that I have had the honour to work with in the past 18 years,” says Sheila. “You have inspired me to lead Holland Bloorview to new heights. I am leaving my role knowing that the future looks bright for children with disabilities here and around the world.”

2 2013 - 2014 ANNUAL REPORT

Page 3: Inspiring Innovation

INSPIRING INNOVATION 3

Innovation creates hope for the future. Defined

as the art of introducing change or something

new, innovation is in our DNA at Holland

Bloorview. If you ask anyone at Holland

Bloorview what their inspiration is, the answer

is unanimous: the children, youth and families

who we work with every day.

Our commitment to innovation, quality and

excellence has put us on the international

stage this year. From launching one of the first

pediatric concussion research centres, to being

honoured with four prestigious workplace

awards, to seeing many of our employees being

recognized for their outstanding contributions,

2013-2014 has been a stellar year.

One of our proudest accomplishments came

in October 2013, when Holland Bloorview was

awarded Exemplary Standing from Accreditation

Canada, having achieved or exceeded 100

per cent of the national safety and quality

standards. This remarkable rating exemplifies

our commitment to excellence, and clearly

demonstrates our leadership in the field of

childhood disability.

The external recognition of our leadership

and achievements motivates us to do even

better. More importantly, it’s an affirmation

for the families and children that walk through

our doors that they are getting the best care

available.

Innovation transcends all aspects of our work. In

this report, you’ll read about how advancements

in our research, teaching and learning,

client and family engagement, community

partnerships and even employee recruitment

are breaking new, innovative ground.

Our Strategic Plan, Leadership in Childhood

Disability, provided a roadmap for the past

couple of years, and will continue to guide us in

the coming three years. With a clear focus on our

four key strategic pillars: Transform Care, Lead

the System, Accelerate Knowledge and Inspire

our People, we are creating an inspiring place

where we can offer a world of possibilities for

our clients and families every day.

Dear friends,

Sheila Jarvis

President and CEO

Julia Hanigsberg

Chair, Board of Trustees

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

Page 4: Inspiring Innovation

4 2013 - 2014 ANNUAL REPORT

A MESSAGE FROM THE CHAIR

Under the leadership of Sheila Jarvis, Holland Bloorview has become an international beacon in the field of childhood disability.

Earlier this year, Sheila announced her intention to step down as CEO

after 18 years. The organization that Sheila agreed to lead many years

ago is unrecognizable from what Holland Bloorview is today. From the

historic merger of two organizations into a single leading children’s

rehabilitation hospital, to gaining fully affiliated teaching hospital

status with the University of Toronto, to the opening of a state-of-the-

art facility, to opening the Bloorview Research Institute and paving the

way for international impact in the field, to launching the Teaching and

Learning Institute, our progress has been truly astounding. On behalf of

the Board, clients, families, employees, students, volunteers and donors

– thank you Sheila. As a tribute to Sheila, we have highlighted a few of her

many accomplishments through this photo collection.

Julia Hanigsberg

Chair, Board of Trustees

Photos

1. Holland Bloorview’s state-of-the-art facility opens in 2006.

2. In 2002, Holland Bloorview gains teaching hospital status, fully affiliated with the University of Toronto.

3. In 2010, a historic $20 million donation is received from the Holland family. Bill Holland is pictured.

4. The Bloorview Research Institute is created in 2005, fostering unprecedented research investment in the field of

childhood disability.

5. Holland Bloorview’s Teaching and Learning Institute is launched in 2010.

6. Holland Bloorview successfully achieves Exemplary Status from Accreditation Canada in 2010 and 2013.

7. Six University of Toronto Research Chairs are created with donor support.

8. One of the first concussion research centres in the world for children and youth is established in 2013.

9. Holland Bloorview has received a number of awards recognizing our outstanding workplace.

2

3

4

1

A teaching hospital

fully affiliated with

Page 5: Inspiring Innovation

INSPIRING INNOVATION 5

6 7

8

9

5

INSPIRING INNOVATION 5

Page 6: Inspiring Innovation

6 2013 - 2014 ANNUAL REPORT

Holland Bloorview

SNAPSHOT 2013 – 2014

TEACHING AND LEARNING STATS

83% of students rated their experience as excellent or very good

79% of students strongly agreed that the feedback they received from their supervisor was helpful

89% of students indicated that they often or very often had the opportunity to apply new knowledge during their placement

46% of staff contribute to the academic agenda

30% of students involved in interprofessional education

65,467 527 54.7 days 6,551

Outpatient visits

Inpatient admissions

Average length of stay

Total clients

907 80% 1010

Total employees

Employee engagement rate

Active volunteers

112

Family leaders

Number of students

508

Number of students 508

Nursing 194

Clinical (other) 172

Research 75

Medicine 67

Page 7: Inspiring Innovation

INSPIRING INNOVATION 7

Bloorview Research Institute

SNAPSHOT 2013 – 2014

Tom Chau VP research and director, Bloorview Research Institute

Senior scientistsBarbara Gibson Gillian King Patricia McKeever Steve Ryan Virginia Wright Unni Narayanan

ScientistsAmy McPherson Azadeh Kushki Elaine Biddiss Jan Andrysek Nancy Thomas-Stonell Sally Lindsay

Clinician scientistsEvdokia Anagnostou Nicholas Reed

Senior clinician scientists Darcy Fehlings Michelle Keightley

Clinician investigatorJessica Brian

Clinical study investigatorsLaura McAdam Molly Malone Sharon Smile Shauna Kingsnorth

Clinical team investigators Peter Rumney Keith Adamson Pam Green Kim Bradley Golda Milo-Manson Ryan Hung Sarah Keenan

SCIENTISTS AND INVESTIGATORS AT THE BLOORVIEW RESEARCH INSTITUTE

Age Religion Top 4 ethnic groupings Top 4 diagnosis inpatients

EXTERNAL RESEARCH FUNDING BY SOURCE: $5.6 MILLION

Provincial $2,266,194.96 41%

Donations $959,226.29 17%

Tricouncil grants $758,117.83 14%

Subgrant collaborations $629,678.09 11%

National $418,871.28 8%

International $242,864.46 4%

Canadian Foundations,

Societies and Associations

$176,740.40 3%

Industry $129,671.75 2%

Royalties $7,875 0.1%

NUMBER OF SCIENTISTS: 29(15 full-time equivalents)

NUMBER OF TRAINEES: 114

Post-doctoral fellows 12PhD students 24Master’s (doctoral stream) students 20

Undergraduate students 31Clinical master’s/MD students 27

PEER REVIEWED PUBLICATIONS: 77

2013-2014: 772012-2013: 492011-2012: 462010-2011: 662009-2010: 45

Clinical investigators

Clinician scientists

Senior clinician scientists

Scientists

Senior scientists

122

2

6

7

Page 8: Inspiring Innovation

8 2013 - 2014 ANNUAL REPORT

Caleb Jones and his mother Susan have been

coming to Holland Bloorview for over a decade.

Diagnosed with cerebral palsy at two years

old, Caleb, now 13, receives therapy from a

multidisciplinary team of experts. Right from

the beginning, Susan has been an active part

of her son’s care, attending every swim therapy

session, every speech therapy appointment

and every follow-up visit.

Engaging families has always been a top

priority at Holland Bloorview, but the hospital

is now taking that engagement to the next

level. Holland Bloorview’s most important

stakeholders – our clients and families – are

inspiring innovation by getting involved in each

step of the research process.

“You simply can’t conduct research in isolation

anymore,” says Dr. Tom Chau, VP of research and

director of the Bloorview Research Institute (BRI).

“Applied research requires engagement from all

stakeholders, especially those who depend on the

results to improve their quality of life.”

The BRI – Canada’s only hospital-based

childhood disability research institute – has

established a Family Engagement Committee

(FEC). This is a groundbreaking move, opening

up client and family involvement beyond

participation in studies or focus groups.

“The parent perspective brings real value to

the research process, especially at Holland

Bloorview because of the applied nature of

the research,” says Gideon Sheps, a parent of a

child with autism. He is the founding co-chair

of the FEC, alongside Nadia Tanel, manager of

research operations with the BRI.

Established in late 2012, the FEC is modelled

after the hospital’s groundbreaking Family

Advisory Committee. It is made up of 10 family

leaders and 10 hospital staff. The committee

meets monthly and follows a formal leadership

structure with family and staff co-chairs, a

vice-chair, Geoffrey Feldman, and a secretary,

Kate Wilson.

Every committee member brings their unique

perspective to the table, but each has one thing

in common: a desire to work alongside the

hospital’s scientists – world leaders in areas

of applied research for acquired brain injury,

autism, prosthetic devices and communications

technologies, among other fields – to bring

about real change in the lives of children

affected by childhood disability.

From Gideon’s perspective, it’s a win-win

scenario. “Researchers tap into the wealth of

knowledge that families bring, but it also helps

create broader awareness of the research that is

being done at Holland Bloorview.”

Family and youth members undergo a rigorous

recruitment and training process so that they

can represent the diverse populations at the

hospital. Committee members contribute

in many ways, such as identifying possible

research topics and helping to ensure research

information is understandable for families.

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

Family Engagement CommitteeINSPIRATION THROUGH PARTICIPATION

Page 9: Inspiring Innovation

INSPIRING INNOVATION 9

What does family input look like? For Susan and

Caleb, they were able to review an early prototype

for an interactive waiting room entertainment

system called ScreenPlay. The technology

generates large, colourful images on a projection

screen when kids move across a pressure-

sensitive carpet. Caleb and his older brother Jonah

suggested that the carpet be divided into different

tiles to help kids get a better sense of where their

bodies were in space. It was a great idea that

helped make the device a mainstay in the second

floor waiting area at Holland Bloorview.

The FEC continues evolving. To date, the

20-person committee has focused primarily

on understanding the scope and creating a

framework of family engagement in research

practices. Going forward, the committee will

facilitate family engagement including examining

ways for virtual family participation and sharing

research findings with families in accessible,

understandable ways, including using the

hospital’s website and social media channels.

Elaine Biddiss, Bloorview Research Institute scientist, with Caleb, client

Page 10: Inspiring Innovation

10 2013 - 2014 ANNUAL REPORT

Holland Bloorview is leading the way to more

effective recruiting practices for health-care

professionals by introducing an innovative

approach to hiring.

To hire seasonal staff for the 2013 Spiral Garden

summer program, an integrated outdoor, art

garden and play experience, Holland Bloorview

piloted an interview circuit instead of the

traditional hiring methods.

Interviewing using simulation INSIGHTFUL INTERVIEWING

Marcela Gatica, volunteer resources coordinator (left), with Carolyn, volunteer (middle), and Laura, volunteer candidate (right)

Page 11: Inspiring Innovation

INSPIRING INNOVATION 11

“The traditional way of interviewing takes a lot

of time and resources, and we don’t always find

the staff that instinctively know how to engage

effectively with children with disabilities,”

says C.J. Curran, the hiring manager for Spiral

Garden. “We wanted to see our potential

summer staff in a real life setting. That’s why

we created an interview circuit.”

Holland Bloorview’s concept, called the

Interview Simulation Cycle, builds on the

research by the Michael G. DeGroote School of

Medicine at McMaster University that shows

that Multiple Mini Interviews (MMI) give a

more authentic and complete representation

of the candidate.

C.J. collaborated with colleagues from the

Teaching and Learning Institute and Human

Resources and Organizational Development

departments to create interview stations to

evaluate communication, interpersonal skills,

teamwork and conflict resolution abilities.

There were eight stations, and each mini-

interview lasted five minutes, with a two-minute

preparation period preceding the interview.

Holland Bloorview added role play simulation

that included client and family participation

within the interview circuit. A combination

of clients, employees and parents were the

interviewers and raters, and were equal partners

in decision-making.

At one station, real life scenarios from the Spiral

Garden program were used to role play with the

candidates. “The top candidates became evident

very quickly,” says C.J. “Their interpersonal

and communications skills came through

immediately, based on how they approached

each scenario.”

Holland Bloorview’s experience using an

interview circuit shows great promise.

Eighteen candidates were interviewed in three

hours, with extraordinary results. The employee

satisfaction evaluation completed after the

summer showed that ratings on all measures

including teamwork, collaboration and

communication doubled over the year before.

Not surprisingly, seven out of 10 employees

hired last year are returning this summer.

Administratively, there was an 83 per cent

reduction in direct interview time, and a

30 per cent increase in efficiency related to

pre and post interview activities.

The initial results of the Holland Bloorview

pilot show that the Interview Simulation Cycle

has the potential to be a leading technique

for recruiting health care professionals. From

C.J.’s perspective, it is an ideal way to see the

candidates’ potential beyond the hard skills.

“The interview circuit gives you immediate

insight into interpersonal skills – skills like

conflict resolution, teamwork and creativity –

which are critical in health care.”

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

Page 12: Inspiring Innovation

12 2013 - 2014 ANNUAL REPORT

“I come to work every day committed to

making a difference in the lives of children

with disabilities,” says Lindsey Stewart,

registered practical nurse, Brain Injury Rehab

Team (BIRT). “I’m extremely appreciative that

Holland Bloorview offers a work environment

that supports employees to learn, be

innovative and show their passion through

their work.”

It’s not only the employees that appreciate

Holland Bloorview’s commitment to supporting

our people, recognizing their accomplishments

and offering opportunities for growth and

development. This past year, Holland Bloorview

was recognized with four prestigious

workplace awards.

“We are honoured to be recognized,” says Sheila

Jarvis, CEO at Holland Bloorview. “The awards

are an acknowlegement and recognition of our

team of dedicated employees, who create a

world of possibilities for our clients and

families every day.”

Being recognized for our excellence sends a

powerful message to the children, youth and

families that come to Holland Bloorview. It is a

confirmation of the high quality, compassionate

care that we provide each day.

Our top honours this year included:

• Canada’s 10 Most Admired Corporate

Cultures 2013 award: This program recognizes

best-in-class Canadian organizations for

having a culture that has helped them enhance

performance and sustain a competitive

advantage.

• Canada’s Top Employers for Young People

2014 award: This special designation

recognizes employers that offer the nation’s

best benefits for younger workers.

• Greater Toronto’s Top Employers 2014

award: This special designation recognizes

Greater Toronto employers that lead their

industries in offering exceptional places to work.

• Quality Healthcare Workplace Award, Gold

2013 (Ontario-wide): This program recognizes

organizational efforts to improve health-

care workplaces in ways that contribute to

providers’ quality of work life and the quality of

the care and services they deliver.

At Holland Bloorview, we know that providing

an inspirational workplace is key to our success

as a leader in childhood disability. We work

hard to offer an exceptional work environment

that encourages our employees to bring their

best to work every day. We are proud that our

employees are among the best and provide

outstanding care to our clients and families.

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

An inspiring place to workA YEAR OF RECOGNITION

Page 13: Inspiring Innovation

INSPIRING INNOVATION 13

This year, a number of employees and Holland Bloorview projects were also honoured with awards for excellence.

Darlene Hubley, interprofessional education (IPE) leader at Holland Bloorview, received the Individual Award of Merit for Excellence in Interprofessional Education Teaching from the University of Toronto Centre for Interprofessional Education. This award is given to a team or individual that demonstrates enthusiasm, commitment and knowledge for interprofessional education.

Dr. Golda Milo-Manson, vice president of Medicine and Academic Affairs, received an exceptional service award from the Royal College of Physicians and Surgeons of Canada. She was recognized for her work in strengthening specialty education to help meet society’s needs, and her tireless work on a number of the Royal College’s committees driving initiatives such as accreditation, examination and credentials for specialists entering the health-care field.

Holland Bloorview’s BLOOM Blog, a blog about parenting kids with disabilities, was awarded first place in the Activism and Social Justice category of the 2013 Canadian Weblog Awards, and also ranked as high as 33rd in the top 150 non-profit blogs by Top NonProfits in 2013.

Canada’s Top 40 Research Hospitals This year, the Bloorview Research Institute was recognized as one of Canada’s Top 40 Research Hospitals. This annual list is published by Research Infosource, an organization dedicated to highlighting Canada’s most innovative universities, corporations, hospitals and colleges.

Holland Bloorview Employee Appreciation Day

Holland Bloorview employees celebrate the win of Canada’s 10 Most Admired Corporate Cultures 2013 Award

Page 14: Inspiring Innovation

14 2013 - 2014 ANNUAL REPORT

inspired innovation is everywhere14 2013 - 2014 ANNUAL REPORT

Page 15: Inspiring Innovation

INSPIRING INNOVATION 15INSPIRING INNOVATION 15

Sonja, client, with her mom Nikolett

(right) and registered practical nurse

Emily Nesterov

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16 2013 - 2014 ANNUAL REPORT

Anthony, former client, age 19, with his health-care provider at Sunnybrook Health Sciences Centre

Page 17: Inspiring Innovation

INSPIRING INNOVATION 17

Celebrating your 19th birthday is a milestone,

but for some youth, it doesn’t always come

with the same excitement that it does for other

teenagers. For youth with disabilities, turning

19 means the safety-net of the pediatric health-

care system is no longer available to them. It

marks the inevitable transition to the adult

health-care system.

“When people think about transitioning to

adult services, they often just think about it as

the transfer of care,” says Connie Castillo, nurse

practitioner in the Spina Bifida Adolescent Clinic.

“The truth is, it’s so much more than that.”

The Spina Bifida Adolescent Clinic is a pilot project

funded by the Toronto Central Local Health

Integration Network (TC-LHIN). The initiative is

built on a partnership between Holland Bloorview

and the Anne Johnson Health Station (AJHS) to

effectively transition clients with spina bifida from

pediatric to adult health care.

The project is designed to set up young adults,

like Anthony Protomanni, for success in the

adult system. Anthony is a 19-year old Fitness

and Health Promotion student at Humber

College, who has spina bifida. Ever since he was

six-months old, Anthony has come to Holland

Bloorview for most of his health-care needs

related to spina bifida. Over those years he

developed bonds with his health-care team.

When asked about the transition process,

Anthony explains, “It involves building a rapport

with new health-care providers, but it can also

involve education. With Connie’s help, there’s

a team approach to the transition so everyone

gets comfortable with the new relationships.”

Connie starts working with youth who have

spina bifida when they are age 13 or 14. Many

youth with spina bifida also have cognitive

issues, and are simply not ready to transition

on their own at age 18 or 19. Through this

partnership, Connie can follow these clients

after they transition until they are 25 years old.

“We work with the clients to prepare them

and assist them to gain the skills they need,

to advocate for themselves and manage their

medical care independently,” she says. “We want

to help them function better in society and the

community.”

When Anthony was having health issues, he and

his mother Barbara turned to Connie to help

direct them to the right care providers.

Anthony particularly appreciates the lasting

relationship he has enjoyed with Holland

Bloorview employees. “Without Connie, I would

feel lost,” he says. “I think I would have slipped

into bad habits, because I wouldn’t be able to

find people to help me. She’s there to support

me through the transition.”

This connection is not lost on Connie. She

immediately points to it when asked to identify

the most rewarding part of her role. “Being

able to ease the anxiety of the youth and their

parents, about the transition,” she says.

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

Easing the transition to adult services

Page 18: Inspiring Innovation

18 2013 - 2014 ANNUAL REPORT

Amanda Mintenko and Mathew Lamarche

wanted what all parents want – a happy and

caring home for their kids. But staying home

became a challenge when their daughter Zoey

Faith was born with spina bifida, paralysis of

her vocal chords and apnea, which required

around the clock care, including monitoring

of a breathing tube.

Zoey Faith’s journey began with a year-long

stay in Toronto – seven months at SickKids

Hospital and four months at Holland Bloorview.

Doctors in their hometown of Thunder Bay

were concerned because the local hospital had

never treated a ventilator-dependent child. They

suggested the family may need to re-locate to

Toronto to get Zoey Faith the treatment she

required. It was a stressful time.

Thanks to Holland Bloorview’s innovative

transition plan, Zoey Faith and her family are

together again – in their Thunder Bay home

– enjoying each other’s company and giving

her the care she requires. A unique approach

to knowledge-sharing and communications

technology brought together Toronto and

Thunder Bay in a circle of care that addressed

the family’s needs.

By using Ontario Telemedicine Network’s

videoconferencing, team members in Thunder

Bay attended family meetings throughout

Zoey Faith’s entire stay at Holland Bloorview.

“The technology was amazing,” said Holland

Bloorview respiratory therapist Robert Gagnon.

“I could easily zoom in with the camera and

move it around to show detailed equipment

examples as I was explaining specifics.”

Amanda and Mathew were trained on all

aspects of their daughter’s care, including how

to quickly care for their daughter’s tracheotomy,

ventilator and stomach-feeding tube. Equipped

with this experience, they helped train via

videoconferencing the nurses and respiratory

therapists in Thunder Bay on the equipment

and daily physiotherapy activities.

“Having the family show Zoey Faith’s care right

at the bedside at Holland Bloorview helped the

Thunder Bay team visualize what they need to

do,” says Maryanne Fellin, Holland Bloorview

clinical resource leader. “It allowed the Thunder

Bay team to get to know the family, see how

Zoey Faith would react in a real setting and then

have a discussion during the videoconference.”

The day for Zoey Faith to return home finally

came. Amanda and Mathew went home first to

get everything ready, and Zoey Faith – then one

year old – flew to Thunder Bay with a Holland

Bloorview nurse and respiratory therapist. The

entire family greeted her arrival and was thrilled

to have her home.

Zoey Faith is now comfortable and happy in

her home surroundings. Amanda is the primary

caregiver, and they have seven hours of nursing

care every night so the parents can sleep. Even

with the in-house support, Amanda and Mathew

like knowing that Holland Bloorview is only a

phone call away. Amanda explained, “If I have

a question, I’ll call and speak to a respiratory

therapist and they’ll share their insights.”

Transform Care | Lead the System | Accelerate Knowledge | Inspire our People

Technology enables Zoey Faith to go home

Page 19: Inspiring Innovation

INSPIRING INNOVATION 19

Zoey Faith, client, with Joy Vergara, registered practical nurse

Page 20: Inspiring Innovation

20 2013 - 2014 ANNUAL REPORT

Becky Quinlan: Developing meaningful teaching tools

Becky Quinlan, a parent of a Holland Bloorview

client, along with other family leaders were

actively involved in developing four simulation

scenarios on client and family centred

care that are now embedded into new

employee orientation.

The scenario development started with a day-

long creative process in which participants

like Becky shared their personal stories. Over

the course of the following year, these stories

were refined and developed into simulation

scenarios, through further engagement with

Becky and members of both the Client and

Family Integrated Care and Teaching and

Learning Institute teams.

These scenarios, based on authentic family

experiences in the health-care system, were

developed to ensure new employees understand

the four core principles of client and family

centred care: dignity and respect, collaboration,

participation and information sharing.

“Understanding the four principles and the desired

behaviours associated with them will help improve

the consistency of care,” says Becky.

For Becky, being included in the simulation

development process means that Holland

Bloorview is committed to putting client and

family centred care into action.

“I’ve learned how dedicated everyone at Holland

Bloorview is at keeping families part of the

process and planning. I’ve been fully engaged,”

she says, adding “I feel my voice is completely

valued here.”

Family leadershipEverywhere you look at Holland Bloorview, you can see the impact of the family voice. Family members are equal members of the team at Holland Bloorview, and their involvement ranges from participating in the hiring process, to providing input into program changes, to fundraising in support of new initiatives to help families. Here are just a couple of examples of the huge impact that family leaders have at Holland Bloorview.

Becky Quinlan, family leader

Page 21: Inspiring Innovation

INSPIRING INNOVATION 21

Fred Char: Fundraising to improve the care experience

Fred Char is a passionate advocate, fundraiser

and supporter of Holland Bloorview. His

daughter, Krystal, has been an inpatient ever

since a severe seizure left her without the use

of her torso or limbs many years ago.

With so much history at Holland Bloorview

because of his commitment to being an active

part of his daughter’s care, Fred agreed to

become a member of the Family Advisory

Committee (FAC) in 2009. His FAC

participation sparked his interest in

getting even more engaged.

It started with his active involvement in creating

inpatient welcome kits to support families new

to Holland Bloorview. His support went beyond

being a family leader on this project. He also

fundraised over $10,000 to pay for the kits.

One of Krystal’s favourite activities is music.

“Music gives Krystal a means of expression and

independence,” says Fred. She has been able

to benefit from Holland Bloorview’s Virtual

Music Instrument, and can play it by moving

her shoulder. Fred and Krystal are also research

participants in a music therapy study looking

at the synergy between a parent and child

through music.

Most recently, Fred raised another $10,369

to support the Therapeutic Recreation and

Life Skills program. He gets a real sense of

accomplishment in partnering with Holland

Bloorview. As Fred says, “It’s very empowering

and amazing.”

Client and Family Integrated Care By the numbers (April 1, 2013 – March 31, 2014):

112 registered volunteer family leaders are involved in:

• 35 standing committees • 17 special projects • 6 external partnerships • 29 external presentations • 7 poster presentations at conferences

• 21 education sessions for parents • 44 inpatient parent talk sessions• 51 articles reviewed through the health

literacy program

Fred Char, family leader, with his daughter Krystal

242 Spotlight awards given to employees by families

4569 Total hours contributed by family leaders since 2011

Page 22: Inspiring Innovation

22 2013 - 2014 ANNUAL REPORT

A year in review

NEWS HIGHLIGHTS

Accreditation success

In October 2013, Holland

Bloorview achieved the highest

rating possible from Accreditation

Canada. We achieved an overall

rating of 100 per cent, following an

intensive on-site review, because

we met or exceeded all of the

required organizational practices

and standards. Accreditation

Canada, a national, voluntary

peer-review organization,

conducts surveys of health-care

organizations and measures their

quality and safety practices against

standards of excellence.

“Our top accreditation standing

is a clear recognition of our

commitment to providing the best

possible care for our young clients

and their families every day,” said

Sheila Jarvis, Holland Bloorview’s

President and CEO.

In addition to our Exemplary

Standing, Accreditation Canada

also recognized Holland Bloorview

earlier in 2013 for four leading

practices in the health-care field:

• The client/family voice in

decision-making: our Family

Leadership Program

• A value-based employee

recognition program, integrated

with client and family care

experience

• Use of simulation education to

facilitate adoption of point of care

technology

• Medication management in a

non-clinical environment

Anxiety Meter for autism

Holland Bloorview is developing

an innovative solution for helping

kids with Autism Spectrum

Disorder (ASD). It is estimated

that 40 per cent of kids diagnosed

with ASD also suffer from an

anxiety disorder. Under the

guidance of Dr. Azadeh Kushki of

the Bloorview Research Institute,

Holland Bloorview is developing

the Anxiety Meter, a smartphone

or tablet-based device that aims

to help children with autism

recognize their own anxiety levels

and manage symptoms. The

Anxiety Meter will be an effective

tool for warding off the debilitating

symptoms that exacerbate the

effects of ASD.

Disney trip for Holland Bloorview clients

In June 2013, 36 children from

Holland Bloorview joined more

than 35 children from SickKids

Hospital for a one-day trip of

a lifetime. The kids were flown

to Walt Disney World thanks

to the support of the Sunshine

Foundation of Canada and the

Ontario Automotive Recyclers

Association.

“It was incredible to see all these

kids forget about their daily

challenges and have the chance

to be princes and princesses for

the day. It was wonderful to be

part of such a magical day in these

kids’ lives,” said Breanne Mathers,

Holland Bloorview child life

specialist.

AN INSPIRING YEAR

Maureen Campbell, accreditation coordinator, and Daniel Scott, therapeutic playroom coordinator

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INSPIRING INNOVATION 23

NEWS HIGHLIGHTS

For the children who were unable

to make the trip, Disney princesses

Cinderella and Ariel came to

Holland Bloorview taking photos

and signing autographs with the

kids. It was a magical day

all around.

Creating better access to child development services

Holland Bloorview led the way in

streamlining child development

services in the GTA community, to

better serve children with complex

medical conditions such as cerebral

palsy, spina bifida, Duchenne

muscular dystrophy, autism or other

developmental concerns.

The Child Development Clinic

at North York General Hospital

(NYGH) transitioned its assessment

and diagnosis services to Holland

Bloorview on April 1, 2014. The

children from NYGH’s wait list and

catchment area will now

be seen by Holland Bloorview’s

Child Development Program.

In addition, Holland Bloorview

merged two former satellite clinics

– the North York General Hospital

Branson site and the St. Joseph’s

Hospital site – and launched

our Eglinton West Satellite Child

Development Clinic. By bringing

these clinics together, waitlists will

be reduced, offering families more

flexibility around appointments by

providing access to two teams in

the new space.

In October 2013, Holland

Bloorview launched our

Concussion Research Centre, one

of the first in the world dedicated

to studying concussions in children

and youth. The centre is generously

funded through grants from the

Canadian government and a

$1 million gift from the Trillium

Automobile Dealers Association

(TADA).

“Until now, concussion research

has largely focused on adults,

but we know that the brains and

bodies of youth and children are

continually developing,” says Dr.

Michelle Keightley, senior clinician

scientist, Bloorview Research

Institute. “This makes them

significantly more vulnerable

to the effects of a concussion.”

Through the work of this centre,

Holland Bloorview hopes

to transform the way kids’

concussions are managed locally,

nationally and internationally.

Dr. Nick Reed, clinician scientist, and Dr. Michelle Keightley, senior clinician scientist, lead of the Concussion Research Centre

Pediatric Concussion Research Centre launched

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24 2013 - 2014 ANNUAL REPORT

NEWS HIGHLIGHTS

Hospital-University endowed research chair appointments

Holland Bloorview and the University of Toronto announced four chair appointments and renewals, with generous support from the Holland Bloorview Kids Rehabilitation Hospital Foundation and its donors.

Dr. Barbara Gibson was appointed the Bloorview Kids Foundation Chair in Childhood Disability Studies. Dr. Gibson’s research examines quality of life, community participation and social inclusion of children with disabilities.

Dr. Darcy Fehlings not only received a renewed appointment as the Bloorview Children’s Hospital Foundation Chair in Development Paediatrics, but also became a full professor in the Department of Paediatrics at the University of Toronto. As both a senior clinician scientist leading BRI’s Cerebral Palsy Discovery Lab and the physician director of the

Child Development Program at Holland Bloorview, Dr. Fehlings researches interventions for children with cerebral palsy, and aims to help children with physical disabilities achieve the highest quality of life.

Dr. Michelle Keightley was named the inaugural holder of the Holland Family Chair in Acquired Brain Injury. Funded by the Holland family, this hospital-university endowed research chair will support groundbreaking research in the field of acquired brain injury. Dr. Keightley, who leads the Concussion Research Centre in the Bloorview Research Institute and co-leads the hospital’s Centre for Leadership in Acquired Brain Injury, was chosen for her focus on identifying, assessing and managing various forms of acquired brain injury in children and youth.

Dr. Tom Chau, VP of research and director of the Bloorview Research Institute, was recently appointed

as the Chang Family Foundation Chair in Access Innovations. The mission of the hospital-university endowed Chair is to improve quality of life for children who are unable to speak or move, and to increase accessibility to care and devices for non-verbal children on a larger scale. Dr. Chau was selected for his expertise in developing novel access pathways for children who are non-verbal.

Improving how we schedule appointments

Holland Bloorview is committed to ensuring scheduling appointments is as easy as possible for our clients and families. Over the past year, we streamlined how we schedule appointments to help reduce the anxiety felt by clients and families trying to navigate the scheduling process.

We created a central point of access for families when they are

scheduling their first appointments in most non-physician clinics. Also, we now aim to call families within two days from when we receive their referral for non-physician appointments, so they are kept informed about the process.

While these changes are a step in the right direction, the hospital continues to review our appointment services to identify

further improvements.

Health Quality Ontario Champion

Family voices come first at Holland

Bloorview, and the hospital’s

commitment to involving families

has been recognized as a Health

Quality Ontario (HQO) Champion.

Over the years, Holland Bloorview

set out to rejuvenate our Family

Leadership Program by analyzing

best practices for client and

family centred care, identifying

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INSPIRING INNOVATION 25

key areas for family involvement

and creating unique roles for

family leadership functions. The

Family Leadership Program is now

a transformational partnership

that is flourishing with families

participating in decision making

across the hospital.

Onsite legal assistance available

A new legal assistance program

offered at Holland Bloorview has

helped 59 low and moderate-

income clients and families since

September 2013. Through a

medical-legal partnership between

Pro Bono Law Ontario (PBLO) and

Holland Bloorview, onsite legal

advice is available on non-medical

issues that may impact a child’s

health or a family’s capacity to care

for their child.

The onsite lawyer can provide

free legal information, basic legal

advice, a brief service or a referral

to offsite legal assistance on

topics such as housing, education,

immigration and employment

law-related needs. Depending on

the case, offsite legal assistance

may include a referral to a legal aid

clinic or lawyer who is willing to

also provide free legal assistance.

Engaging our employees

Every two years, Holland Bloorview

seeks feedback through an

employee engagement survey

to ensure we are providing an

exceptional workplace that meets

the needs of our outstanding

employees. A positive employee

experience is associated with

improved clinical outcomes, better

workplace safety and increased

recruitment and retention rates, all

areas in which Holland Bloorview

strives to excel.

In 2013, Holland Bloorview had

an exceptional overall employee

engagement rate of 80 per cent,

well above the health-care sector

benchmark of just over 50 per

cent. In fact, Holland Bloorview

was rated consistently higher than

the health-care benchmark for

every workplace dimension in the

survey. Employee feedback informs

organizational action plans that

help us continually improve our

work environment.

Launch of the new website

Holland Bloorview launched an

upgraded, accessible and user-

friendly version of our website:

www.hollandbloorview.ca in March

2014. This new site makes it easier

for clients and families, and all

stakeholders, to find information

about our programs and services

and learn about exciting news

and developments at Holland

Bloorview.

Visit our new website at www.hollandbloorview.ca

Page 26: Inspiring Innovation

26 2013 - 2014 ANNUAL REPORT

Holland Bloorview is always looking for better ways to measure our performance and communicate how we are doing. Here is an at-a-glance report of our performance. Our ratings were determined through input from representatives from the Provincial Council for Maternal and Child Health (PCMCH), GTA Rehab Network, Institute for Clinical and Evaluative Sciences (ICES) and Holland Bloorview’s Family and Youth Advisory Committees.

For 10 years the ‘How We Measure Up’ report (HWMU) has been a critical element of our quality improvement program. It provides an external lens on our performance and ensures we are establishing targets that lead to improved quality, clinical care, academic and research excellence.

Guideline: Fair = H (1) Good = H H (2) Excellent = H H H (3)

‘ How We Measure Up’ report

STRATEGIC GOAL MEASURES BENCHMARK ACTUAL SCORE

Transform Care

Generate, adopt and share new evidence for clinical care to achieve outstanding client and family outcomes.

Provide exceptional client and family-centred care, embracing authentic partnerships with families and ensuring the ‘voice of the client’ is heard.

Harness emerging technologies and the latest processes to improve efficiency and enhance the quality of care to children with disabilities.

Build, strengthen and grow our Centres for Leadership in Acquired Brain Injury, Child Development and Participation and Inclusion.

Achievement of goals set by the client and/or therapist using Goal Attainment Scaling:

• Average achievement score for goals set by client and/or therapist1

• % of goals achieved to expectations (T-Score between 45 and 55)• % of goals exceeding expectations (T-Score above 55)

T-score between 45-5535%30%

5342.7%33.3%

H H H

% of families who rate Holland Bloorview excellent or good2 95% 96.2% H H H

% of family leaders who rate their experience as an authentic partnership3 90%a 88% H H H

% of complaints with initial contact and interview commencing within 2 business days

95% 100% H H H

Average rating within each category of the CanChild Measures of Processes of Care (MPOC). The MPOC is the tool for family feedback that Holland Bloorview uses as part of their client and family satisfaction tool “Tell Us What You Think”2

• Co-ordinated Care (out of 7)• General Information (out of 7)• Partnership (out of 7)• Respectful Care (out of 7)• Specific Information (out of 7)

5.55.55.55.55.5

5.85.05.86.05.7

H H

Annual infections per 1000 inpatient days4 3.4 per 1000 3.09 per 1000 H H

Reported medication adverse events (mild to moderate) per 1000 inpatient days5

0.3 per 1000 0.29 per 1000 H H

% complete medication reconciliation on inpatient admission 100%b 97.8% H H H

% complete medication reconciliation on outpatient clinic visit 95% 97.7% H H H

% compliance to hand hygiene across 4 moments of care6 95% Moment 1 – 91.7%

Moment 2 – 97.3%

Moment 3 – 94.6%

Moment 4 – 91.4%

H H H

Total margin (a comparison of consolidated revenues versus expenses)7 0.5% 1.1% H H H

Current ratio of short term assets and liabilities8 1.0 1.26 H H H

Benchmark notes: a. This is an internal target based on our own survey tool. The lowest acceptable performance score is 81%.b. The target is the theoretical maximum. The lowest acceptable performance score is 85.5%.c. The target for wait times in fiscal year 2014/15 will be reduced to reflect the improvement.d. Staff engagement is measured every two years and is an aggregate of six questions. Holland Bloorview’s response rate was 77%.

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INSPIRING INNOVATION 27

STRATEGIC GOAL MEASURES BENCHMARK ACTUAL SCORE

Lead the System

Create new, innovative models of care in collaboration with system partners to support improved navigation and timely access to appropriate services for children with disabilities.

Forge new linkages with partners in community, health and education sectors to facilitate seamless transitions to adulthood.

Advocate for a provincial focus on equity in access and removal of barriers for children with disabilities and their families.

Wait in days for new autism clients9

80% seen in 182 daysc

Q1 - 133 daysQ2 - 131 daysQ3 - 139 daysQ4 - 147 days

H H

Wait in days for new neuromotor clients

80% seen in 137 daysc

Q1 - 84 daysQ2 - 102 daysQ3 - 98 daysQ4 - 106 days

H H

Wait in days for new augmentative communication clients

90% seen in 121 daysc

Q1 - 60 daysQ2 - 56 daysQ3 - 76 daysQ4 - 89 days

H H H

Wait in days for new writing aids clients

90% seen in 61 daysc

Q1 - 64 daysQ2 - 56 daysQ3 - 37 daysQ4 - 41 days

H H H

Wait in days for new inpatient rehabilitation clients

90% seen in 3 daysc

Q1 - 0 daysQ2 - 0 daysQ3 - 0 daysQ4 - 0 days

H H H

Average Electronic Medical Record Adoption Model (EMRAM) Score10

2.7036 (LHIN)1.4840 (Peer)

4.2280 H H H

Accelerate Knowledge

Conduct transformational research in paediatric rehabilitation, with a focus on areas of strategic clinical importance, such as brain science.

Become a recognized leader in attracting and training the very best of the next generation of experts in childhood disability by embracing best practice models in teaching and learning and providing an exceptional student experience.

Generate new linkages with academic, industry and system partners to accelerate knowledge generation, translation and evaluation, and commercialization of innovations.

% of professional health discipline and nursing students that rate their clinical experience as excellent11

50% 55% H H H

% of professional health discipline and nursing students who indicated they participated in inter-professional education on the TAHSN-E survey (sometimes, often and very often)12

90% 83.2% H H

Number of peer reviewed publications per investigator13 5.5 5.1 H H

H index (measuring research impact)14 23.6 24 H H H

Research funding by investigator15 $400,000 $374,416 H H

# of research students per investigator16 2.3 3.7 H H H

Inspire our People

Foster meaningful engagement among employees, clients and families to co-create models of collaboration and shared decision-making.

Create an environment where the spirit of inquiry is demonstrated everywhere, every day.

Become a magnet hospital for clinical, education and research talent.

Build a culture that empowers employees to engage in teaching, learning and research initiatives that advance the care of children with disabilities.

% of staff that indicated they were engaged and committed to Holland Bloorview - using the staff engagement survey17

52% d 80% H H H

Employee turnover rate18 7.12% 5.8% H H H

% of eligible employees with academic status appointments (professional health disciplines –speech language pathology, occupational therapy, physical therapy)

80% 97% H H H

Measure notes: 1 Based upon peer-reviewed literature on

Goal Attainment Scale (GAS) goals. Average improvement is not adjusted for acuity.

2 Results are from the ‘Tell Us What You Think’ patient satisfaction survey using the CanChild Measure of Processes of Care (MPOC). The response rate in 2013/14 was over 16% with responses from over 649 surveys.

3 The Family Leadership Program has over 110 families who are surveyed twice a year to measure level of authentic partnership.

4 Infections are ‘hospital acquired infections’. 5 Based on the World Health Organization

scaling of adverse events. 6 Hand hygiene measures 4

moments in the care process.7 Target based on Toronto Central

Local Health Integrated Network (TC-LHIN) standards.

8 A ratio that measures whether or not a firm has enough resources to pay its debts over the next 12 months.

9 The measure for wait in our autism population went from 187 days to 147 days while referrals doubled.

10 Ontario Hospital Association derived benchmark. Scale 0-7.

11 There is no industry benchmark that measures ‘excellent’ only. The industry benchmark for very good and excellent is 75-80%.

12 An internal target has been set this year while the Toronto Academic Health Sciences Network Education (TAHSN-E) survey is being formalized.

13 Number of peer-reviewed publications benchmark is a median value of all other TAHSN hospitals from 2011. Per investigator is based on BRI FTEs (15).

14 The H-index measures both the productivity and impact of the published work of a scholar. Our goal is to reach a minimum H-index of 38 by 2018. The current target is based on a linear extrapolation leading to 2018.

15 Total amount of research funding by investigator is the median value of all other TAHSN hospitals from 2011. Per investigator is based on BRI FTEs (15).

16 The number calculates FTE (15) scientists and investigators to number of Masters, PhD and post doctoral fellows. Average value across TAHSN hospitals from 2011.

17 Our target reflects the survey provider’s health industry average.

18 Turnover rate is based on the Ontario Hospital Association benchmarking survey from 2012.

A full explanation of our measures is available on our website.

Page 28: Inspiring Innovation

28 2013 - 2014 ANNUAL REPORT Writing, Project Management: Christa Haanstra, clarityhub.ca | Design: Sara Purves www.rubinered.ca | Principal photography: William Suarez www.williamsuarez.ca

Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8

T: 416-425-6220 F: 416-425-4531 E: [email protected] www.hollandbloorview.ca

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