inspiring innovation
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Holland Bloorview Kids Rehabilitation Hospital 2013 - 14 annual reportTRANSCRIPT
2013 – 14 ANNUAL REPORT
inspiringinnovation
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
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
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.
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3
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A teaching hospital
fully affiliated with
INSPIRING INNOVATION 5
6 7
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INSPIRING INNOVATION 5
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
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
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7
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
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
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)
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
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
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
14 2013 - 2014 ANNUAL REPORT
inspired innovation is everywhere14 2013 - 2014 ANNUAL REPORT
INSPIRING INNOVATION 15INSPIRING INNOVATION 15
Sonja, client, with her mom Nikolett
(right) and registered practical nurse
Emily Nesterov
16 2013 - 2014 ANNUAL REPORT
Anthony, former client, age 19, with his health-care provider at Sunnybrook Health Sciences Centre
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
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
INSPIRING INNOVATION 19
Zoey Faith, client, with Joy Vergara, registered practical nurse
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
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
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
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
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
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
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%.
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.
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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