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In 2009/10, University Health Network (UHN) began development of a new strategic plan to guide the organization over the next five years. UHN’s new strategic plan builds on Strategic Directions 2011: Exemplary Patient Care and Global Impact. UHN Strategic Directions 2016: Global Impact – Local Accountability continues UHN’s focus on achieving global impact, while ensuring exceptional healthcare is provided to our local communities.

UHN’s five-year plan is grounded in an assessment of the demographic changes that we expect will change our community’s healthcare needs. The plan is also informed by the advice of healthcare, political, government, university, and business leaders on UHN’s role in Ontario’s health system and incorporates feedback from our patients, families, staff, students, and volunteers about the services UHN currently provides, how these services are provided, and what they expect in the future.

At its core, UHN’s new strategic plan is designed to enable the innovative ambitions of our clinical programs and allow our staff to participate in shaping and owning UHN’s future. UHN Strategic Directions 2016: Global Impact – Local Accountability is fundamentally informed by the shared priorities of UHN’s clinical programs.

Through these nine programs, UHN provides comprehensive healthcare services to our patients. Each of UHN’s programs is comprised of departments and elements that focus on specific patient populations. The development of UHN’s nine clinical programs make UHN what it is today – a thriving, entrepreneurial, and accountable local system leader focused on achieving global impact.

Introduction

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Concurrent to the development of UHN’s strategic plan, the organization’s nine clinical programs developed their own strategic plans in 2009/2010, to articulate their key priorities and areas of focus for the next five years.

These program strategic plans evolved through an extensive iterative process of program and department focused discussions at Senior Management Team and UHN Board of Trustees meetings.

This document provides a summary of each program’s comprehensive strategic planning efforts. The sum-maries are organized according to UHN’s five Balanced Scorecard (BSC) domains, consistent with the organiza-tion’s approach to aligning strategic activity to our BSC and purpose statement. The strategic summaries also provide clearly articulated milestones for each program over the next five years.

The Essence of UHN’s Balanced Scorecard Domains

We Our commitment to enabling excellence in our people

Caring Our dedication to providing the best care for our patients

Creative Our focus on translating research discoveries into clinical practice

Accountable Our pledge to fiscal responsibility and stewardship

Academic Our passion for training the most exceptional healthcare professionals

Inpatient Inpatient Day Surgery Day Surgery Ambulatory Program Separations Weighted Cases Cases Weighted Cases Visits

Arthritis Program 1,644 3,872 2,742 616 61,942

Joint Department of Medical Imaging NA NA NA NA 4,204

Krembil Neuroscience Centre 2,587 7,905 3,283 698 106,787

Laboratory Medicine Program NA NA NA NA NA

Medical and Community Care 7,277 12,470 0 0 390,749

Multi-Organ Transplant Program 1,457 6,255 0 0 17,765

Peter Munk Cardiac Centre 5,900 17,220 348 190 40,781

Princess Margaret Cancer Program 4,155 7,126 0 0 255,971

Surgical Programs and Critical Care 8,101 16,311 22,658 2,306 87,470

Unassigned* 0 0 0 0 303

Total 31,121 71,159 29,031 3,811 965,972

Program Strategic Planning

* Patient discharged from a unit that does not belong to any particular program group

Arthritis Program 4

Joint Department of Medical Imaging 8

Krembil Neuroscience Centre 12

Laboratory Medicine Program 16

Medical & Community Care 20

Multi-Organ Transplant Program 24

Peter Munk Cardiac Centre 28

Princess Margaret Cancer Program 32

Surgical Programs & Critical Care 36

UHN’s Clinical Programs

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Vision

The Arthritis Program (AP) must build a new tomorrow that will change the lives of its patients forever. This future is guided by the vision of “one team in motion, towards achieving global impact” by bringing together our unparal-leled team of nationally and internationally acclaimed care providers, researchers, and educators.

The AP must continue to build on its reputation in care, research, and academics to recruit and retain the very best clinicians across all disciplines and professions. The goal is to make the program the best place to work and invest in, by building tomorrow’s leaders and ensuring that the AP maintains its leadership position nationally and globally. This will require a focus on all program elements and will require the AP to expand its presence in both national and international training programs.

The AP will be known for transforming the care it delivers through an unparalleled commitment to excellence and innovation with a focus on partnerships and collaboration. We will view the care continuum as extending beyond UHN’s walls by supporting effective transition plans across the broader continuum of care, making targeted invest-ments in health promotion and self-management, nurturing expansion of leading services, and increasing our academic affiliations with national and international teaching institutions.

Successes

Canada’s largest comprehensive program in arthritis

Provincial and local leadership in complex joint reconstruc-tion and minimally invasive surgical techniques

Provincial leadership in upper extremity replant procedures

International recognition for innovation in bone strength assessment

Driving a commitment to groundbreaking scholarly inquiry through our focus on basic and applied research

Achieving international recognition, through our affiliation with the University of Toronto, for our role in training health professionals from all over the world

Provincial leadership in the Total Joint Network, bringing together 43 organizations to standardize care

“Among all North American Universities (public and private), the Rheumatology Division of the University of Toronto is number ONE in both peer reviewed publications and citations.” David Naylor, President, University of Toronto, 2009

Arthritis Program Enhancing the lives of patients with bone, joint and connective tissue disease

Strategic Thrusts

In order to achieve the vision, mission, and reach our milestones, AP will focus on three strategic thrusts:

Alignment: Leveraging our past synergisticallyLeadership: Fostering positive change and innovation

Collaboration: Transforming together through common goals

A Burning Platform for Change

Increasing demand for services due to the aging population and increasing life expectancy

Rising healthcare costs that are outpacing the growth in provincial revenues

Changing approaches to service delivery due to innovations in diagnosis and treatment, development of new models of care, and increased focus on prevention, promotion, and self-management

Program Facts

2,187 inpatient separations

4,465 OR visits

942,966 outpatient visits

Leveraging and Building on Our Past to Realize Our Future

Being the Centre of Excellence in Arthritis

Research through integration and alignment

of Rheumatology, Orthopeadics, Hand/

Plastics, and Osteoporosis

Leveraging existing and investing in future-enabling technology and information

Nurturing a culture of innovation and leadership

for transformation

Program Elements

Rheumatology

Orthopaedic Surgery

Hand/Plastics Program

Osteoporosis Program

One team in motion towards achieving global impact

Caring

We

Clinical Program Strategy 5

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In order to achieve our vision, the AP will be recognized as a world leader in arthritis research. The program will create the Canadian Centre for Arthritis Research (CCAR) shaping the future of arthritis care, locally, provincially, nationally, and globally. In addition, AP will leverage the Krembil Discovery Centre (KDC) to: further develop a unified, programmatic research strategy based on scientific and clinical research that produces streams of peer-reviewed and co-investigator research programs stretching across all program elements; expand on our national and international training and research capacity; capitalize on existing research efforts from the bio-banking da-tabases; and develop new partnerships to further our scholarly inquiry.

In order to achieve the AP’s vision, the program will be known for delivering the best care in a timely, effective and efficient manner by meeting our patients’ needs while acknowledging the value of fiscal stewardship. We will focus on streamlining access to care based on patient population needs, ensuring internal resources are organized to facilitate effective and safe outcomes, and leveraging innovative models of care to deliver services in the most appropriate setting.

The AP will accomplish its goals by fostering an environment that attracts the brightest and best staff, teachers, inves-tigators and partners, because the program is known as a great place to work and learn. Ensuring the sustainability of the AP’s workforce through a focus on recruitment, retention, and development of staff will be an area of focus within the program.

Implementation of innovative patient and family education models, investment in interprofessional education and a commitment to investing in tools and new education strategies for our staff and stakeholders will also be pursued.

Arthritis Program Enhancing the lives of patients with bone, joint and

connective tissue disease

Our Opportunities

Leveraging our existing partnerships with the Krembil Discovery Centre and

MaRS to provide the necessary resources and capacity to further drive our efforts

in research and education, ultimately resulting in innovative care treatments

and potential cures for our patients

Leveraging new models of care by build-ing highly effective, interprofessional

care teams

Enhancing collaboration and coordina-tion amongst our program elements and

our partners to approach care, treat-ment, and research across the entire

musculoskeletal continuum as opposed to within silos

Extending current work in genomics and proteomics to lead to breakthrough

discoveries

Focussing on outcomes research to provide necessary evidence to support clinical

evaluation

MilestonesThe AP has identified four overarching areas of focus

in which to anchor its strategic activity over the next five years.

Access to the Best CareIncrease access and improve the delivery of timely,

effective, and efficient care for our patients.

World Leader in Arthritis ResearchThe AP will be recognized as a world leader in arthritis research.

Best Place to Work and LearnThe AP will have a reputation as the best place to work and learn for stu-

dents and all health professionals.

Partnerships in ExcellenceThe AP will transform care through partnerships in

excellence.

Creative

Accountable

Academic

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Three Hospitals

University Health Network

Mount Sinai Hospital

Women’s College Hospital

Who We Are

One of the largest medical imaging departments in Canada

• 600 employees

• 80 residents & fellows

• 70 staff radiologists

• $100 million spent annually

- UHN - $65 million

- MSH - $27 million

- WCH - $9 million

• 640,000 scans in 2008/09

- 11 MRI machines (12% of exams in Ontario in 2006)

- 17 CT machines (8% of exams in Ontario in 2006)

• Over 130 research studies conducted annually

• 30 base & elective students trained each year

Joint Department of Medical ImagingDelivering excellence in patient care, research, and education today, while defining the landscape of tomorrow

JDMI History

In 1997, prior to the formation of UHN, the medical imaging departments of Toronto General and Toronto Western Hospitals (then known as The Toronto Hospital) and Princess Margaret Hospital joined forces with medical imaging at Mount Sinai Hospital.

The partnership increased the critical mass of sub-specialized radiologists in downtown Toronto and allowed for medical imaging alignment between hospital specialty programs.

In 2007, Women’s College Hospital joined the partnership to form the Joint Department of Medical Imaging.

In five years, JDMI will be:

A clinically integrated program that provides “sight

and insight” into disease management

Transforming diagnosis and treatment of patients through

technology and research

Known for quality and excellence in providing

medical imaging solutions

Seven Academic & Clinical Divisions

Abdominal Imaging

Breast Imaging

Cardiothoracic Imaging

Musculoskeletal Imaging

Neuro-Interventional Radiology

Vascular-Interventional Radiology

Molecular Imaging

The Joint Department of Medical Imaging (JDMI) is comprised of more than 600 staff and 70 sub-specialized radi-ologists spanning five hospital sites. Specialized, multidisciplinary teams perform 640,000 medical imaging stud-ies and consultations per year.

The JDMI’s model of “one team” means an integrated medical imaging program across hospitals, modalities, and traditional departments. The JDMI is the employer of choice for medical imaging professionals because of our focus on leadership, training of advanced techniques and skills, and access to state-of-the-art imaging technology.

The JDMI is a regional hub for sub-specialized imaging in Ontario and is one of the top medical imaging depart-ments in North America. The program is comprised of an interprofessional team of physicians, technologists, nurses, clerical staff, and administrators, that provides patient-centred, high quality diagnostic imaging and im-age-guided interventions.

The JDMI’s vision is to fully integrate patient care, providing imaging solutions from diagnosis to treatment. This will be accomplished by collaborating with other hospital programs to create integrated care models for patients. All of our clinical work will focus strongly on quality, safety, and access agendas.

Clinical Integration and Partnerships

Peter Munk Cardiac Centre (PMCC)

Multi-Purpose Operation Room (MPOR)

Centre of Excellence for Skeletal Health Assessment

(CESHA)

Centre of Excellence in Obstetrical Ultrasound (CEOU)

Centre of Excellence in Nuclear Cardiology (CENC)

Gattuso Rapid Diagnostic Centre (RDC)

JDMI’s Clinical FutureProper Access

Reduce wait times

Improve appropriateness of access

Improve Quality and Safety

Communication of urgent findings

Management of adverse events

Pain management in Interventional Radiology

Measurement of quality and outcomes

Growth in Key Modalities

Interventional Radiology

Molecular Imaging and Radiopharmacy

MRI and CT

Create Greater Clinical and Academic Integration

Vascular, Cardiac, Neuro, Cancer, Surgery, Emergency Department, Radiation Medicine

JDMI’s IT platform underlies its clinical future

VisionOne team achieving excellence and innovation

Caring

We

Strategic Partnerships

Strategic partnerships create opportunities that

support clinical, research, and educational activity within

the JDMI


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Joint Department of Medical ImagingDelivering excellence in patient care, research, and

education today, while defining the landscape of tomorrow

Advanced Imaging and Education Centre Opens

In October 2009, in partnership with the University of Toronto, the Advanced Imaging and Education

Centre (AIEC) opened its doors to its first group of students. The Centre is located at Toronto General Hospital

and provides a state of the art educational environment for local,

national, and international students to learn advanced imaging techniques.

Supported by a world class faculty from U of T and the JDMI staff, the AIEC

is positioned to be an international leader in radiological education that

satisfies all levels of advanced imaging training. It will also be a pioneer in

the development and application of competency based training, standards, and guidelines in the field of radiology.

MilestonesThe JDMI has three strategic milestones that support the program’s growth

and evolution. Each of the milestones was developed in alignment with, and support of, the vision of the JDMI’s partner sites and the University of

Toronto.

One TeamThe JDMI will increase access and improve the delivery of timely,

effective, and efficient care for our patients.

Clinical IntegratorThe JDMI will function as a platform for clinical integration, providing

imaging solutions for disease management in partnership with hospital programs.

Technology and Research InnovatorsThe JDMI will transform the diagnosis and treatment of patients through

imaging technology and research.

Imaging services are provided to over 80 researchers at JDMI hospital sites and approximately 50 internal research studies are conducted each year. The JDMI’s clinical research is critical to understanding cardiac diseases, neuro-logical diseases, cancer, and for improving patients’ treatment options.

Medical imaging is a field built on innovation and it is important that the JDMI define itself as a leader. New imag-ing technology made possible through research funding, donor support, and IT development, will continue to drive UHN’s international reputation as an innovator in this field.

Through a single department model, the JDMI is able to optimize budget, space, equipment, and staff. We con-tinue to build on this model by:

• pursuing opportunities for greater integration/harmonization of management and governance;• implementing a business performance management strategy to facilitate informed management decision-

making; and• leveraging our process improvement expertise to optimize our operations and share best practices across our sites.

Dedicated to building innovative training programs, the JDMI recently opened the University of Toronto Advanced Imaging and Education Centre (AIEC), which is the first of its kind in Canada to provide state-of-the-art education in advanced imaging techniques.

Every year the JDMI trains:

• 40 of the 60 residents at the University of Toronto• 45 of the 80 clinical and research fellows at the University of Toronto (80% from outside Canada)• 30 technologists

We also strongly support professional development through our imaging symposiums.

Seven Imaging Modalities

CTGeneral Radiography (X-Ray)

Interventional RadiologyMammography

MRINuclear Medicine & PET-CT

Ultrasound

Creative

Accountable

Academic

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KNC Partnerships

Toronto Western Research Institute

University of Toronto

Kensington Eye Institute

Toronto Rehab Institute

Toronto Central Community Care Access Centre

Canadian Stroke Society

Ontario Neurotrauma Foundation

Epilepsy Canada

Parkinson Society of Canada

CritiCall

GTA Rehab Network

Acquired Brain Injury Network

Krembil Neuroscience CentreTransforming the future of neurological and vision care

Building on Success for a Stronger Future

KNC must leverage and build on its past, including:

Being a Centre of Excellence

Philanthropy and fundraising success

Strong fiscal stewardship and ongoing financial stability

Synergies with UHN corporate expertise and resources

Investments and successes in technology and information

Bench to Bedside

Our research is truly impacting our patient care. Innovations in treatment modalities in deep brain stimulation, regenerative technologies for spinal cord repair, leadership in minimally invasive treatment modalities, advances in the treatment of glaucoma and corneal transplants, advances in the stroke strategy in Ontario, and molecular-based treatment for brain cancer are just a few

examples.

Program Facts

70 beds

103,892 clinic visits


5,293 OR cases

9.1% of UHN cases

Achieving our Vision

Through a focus on:

Integration

Leveraging all of our work to converge on

excellence

Leadership

Fostering positive change and innovation

Collaboration

Transforming together through common goals

Program Elements

Brain and Spine Oncology

Epilepsy

Neuro Degenerative Diseases

Neurovascular Therapeutics

Complex Eye Disease

Spine and Spinal Cord Injury

Krembil Neuroscience Centre’s (KNC) people are what make the program a system leader in clinical care, teaching, and research. The KNC has continued to be successful in attracting and retaining neuroscience leaders across all disciplines and consists of 256 interprofessional team members dedicated to transforming the future of neurological and vision care.

Moving forward, the KNC must lead by attracting and developing leaders for tomorrow. An investment in re-tention, development, and ongoing recruitment must be enabled by access to resources that support necessary growth. A more integrated KNC team will be nurtured by clearly identifying areas of strengths and successes and developing ways program elements can work together to leverage the enormous intellectual capital within the program.

The KNC is focused on the diagnosis and treatment of diseases that affect the central and peripheral nervous sys-tem and its sensory and motor connections, including vision. As Canada’s largest combined clinical, teaching, and research neuroscience centre, KNC is internationally renowned for its expertise and scope of services.

To achieve the program vision and mission, KNC will transform care through innovative delivery models and col-laborative partnerships. We will continue to enhance the patient and family experience by: providing an interdisci-plinary and holistic approach to care; streamlining access to care across the broader continuum from the first con-tact with the KNC; and leveraging innovative models of care which deliver services in the most appropriate setting.

VisionOne mind, towards achieving global impact

Caring

We


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Krembil Neuroscience CentreTransforming the future of neurological and vision care

A Clear Need for Action

1 in 6. Neurological disorders affect up to 1 billion people worldwide according to the World Health Organization. This translates to one out of every six people in the world.

1 in 8. An estimated 6.8 million people die every year due to neurological disorders. This translates to one out of every eight deaths.

1 in 3. One in three (10 million) Canadians will be affected by a neurological or psychiatric disease, disorder or injury at some point in their lives.

Most common cause of mortality. Neurotrauma, including traumatic brain and spinal cord injury, is the most common cause of mortality up to the age of 50.

Every 12 minutes in Canada, someone develops blindness or vision loss. About 75 percent of vision loss in Canada is avoidable through prevention and treatment.

A billion dollar problem. Six million Canadians suffer from a neurological disease. Neuroscience-related diseases cost Canadians $35 billion per year.

Vision loss has the highest direct health costs of any disease category in Canada, higher than diabetes, all cancers, or cardiovascular disease.

MilestonesKNC has four overarching areas of focus that will support the program’s growth and evolution. Each of these areas was developed in alignment with, and in support of, UHN’s goal of becoming an internationally re-

nowned research hospital.

Innovative Care Delivery ModelsDevelop and implement innovative delivery models and expand collabora-

tive partnerships.

Interprofessional Practice and Education Models

Further develop and strengthen interprofessional practice and education models.

Research IntegrationFurther integrate basic and clinical neuroscience and vision research

through the development of novel translational strategies.

System LeadershipProvide increased system leadership for the advancement and innovation

in neuroscience and vision care.

The KNC has achieved translational research success through leadership in the development of the Krembil Discovery Centre (KDC), clinical trials, regenerative neuroscience, the establishment of the largest brain tumour bank in the world, and our commercialization efforts.

In order to achieve global impact, the KNC is striving towards becoming recognized world-wide for integrating basic and clinical neuroscience and vision research by developing novel translational strategies. The program will leverage the Toronto Western Research Institute, KDC, and MaRS to further develop a unified, programmatic research strategy based on scientific and clinical research, expand on national and international training and research capacity, capitalize on existing research efforts with a focus on outcomes research, and develop new partnerships to further our scholarly inquiry.

The KNC’s people are what make the program a system leader in clinical care, teaching, and research. The KNC continues to be successful in attracting and retaining neuroscience leaders across all disciplines, who are dedicated to transforming the future of neurological and vision care.

The KNC program is proud of its strong international presence that attracts foreign clinical fellows and international students, and its support for international aid and medical philanthropy. The program is a leading centre for continuing medical and post-graduate education through its international conferences. KNC is consistently viewed as a first choice training program.

Enabling academic excellence and leadership through strong interprofessional practice and educational models is a strategic priority for KNC. The program will: support the development of new educational strategies to advance practice and learning; invest in tools and new education strategies that assist education at the bedside and beyond; enhance relationships with national and international teaching institutions; and foster an environment that attracts the brightest and best staff and teachers.

Creative

Accountable

Academic

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Strategic Competitive Strengths

UHN’s clinical, teaching, and research programs provide an un-paralleled forum for innovation and collaboration

“Early adopter” culture provides opportunities to enhance care, teaching, research, and attract investment

Strategic location: Toronto is the creative centre of Canada

LMP in 2016

One Laboratory Medicine Program in Toronto

- Single governance - UHN’s largest stakeholder - $250 M operating budget

World Centre of Excellence

- Telepathology Centre of Excellence

- Network established with all provinces and territo-ries in Canada

Largest Biobank in Canada networked with major banks in North America and Europe

Construction begins on the new International Laboratory Institute Tower in Toronto

All Ontarians have equitable access to expert laboratory medicine

Laboratory Medicine ProgramEnsuring equitable access to laboratory medicine expertise

Who We Are

The LMP is the largest diagnostic lab in Canada. Every patient is impacted by the tests performed at LMP. As such, we continue to

work seamlessly with all other clinical programs.

• 20,000 tests done per day • Focus on translational research and new technologies, like

telepathology

LMP HighlightsCanada’s largest hospital diagnostic lab

One of the largest academic labs in the worldSpecialist approach to laboratory medicine to align with clinical programs and specialties

Medical Directorship of 15 other hospital laboratories across OntarioLaboratory medicine services provided to over 150 hospitals across Canada

Recognized world leader in adoption of telepathology

Key Partnerships

Ontario & Federal Governments

Cancer Care Ontario

Province of Newfoundland & Labrador

Province of Manitoba

Local Health Integration Networks (LHINs)

Canadian Partnership Against Cancer (CPAC)

Public Health Agency – provincial labs

Canadian Blood Services (CBS)

Trillium Gift of Life Network


Michener Institute

Ontario Institute for Cancer Research (OICR)

Accreditation Canada

Ontario Medical Association (OMA)

Ontario Buys

Canada Health Infoway

Ontario Laboratory Accreditation

Program ElementsHistocompatibility Laboratory

Transfusion MedicinePathology

MicrobiologyBiochemistryHaematology

Genetics

With over 425 staff, including 60 medical and scientific staff, the Laboratory Medicine Program (LMP) is the largest diagnostic lab in Canada and one of the largest academic labs in the world. Team members provide high-volume, complex testing and contribute to program development through their participation on committees, research and education initiatives.

High priority is placed on health human resources. As the program continues to grow, human resources and con-tinuous learning opportunities will be required to provide high quality services and safe care to patients.

The success of the LMP will be built on our ability to attract and retain the best people, so that we can create new knowledge and innovation. Since the LMP is a global leader, the recruitment and retention strategies must be competitive on an international level.

“As is your pathology,

so goes your clinical care.”

Sir William Osler 1890

VisionTo create a world-leading laboratory medicine program through the provision of knowledge-based and specialty laboratory medicine services

We


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Creative

Accountable

Laboratory Medicine Program Ensuring equitable access to laboratory medicine

expertise

Shared Services

Shared Microbiology Lab and Director with Mount Sinai Hospital

Shared Biochemistry Director with Mount Sinai Hospital

Regional Cancer Genetic Laboratory Testing Program

Shared Toxicology Leadership with SickKids and the Centre for Addictions

and Mental Health (CAMH)

Regional Histocompatibility Lab with SickKids and St. Michael’s Hospital

Shared Haematology Director with Sunnybrook Health Sciences Centre

Transfusion Medicine Collaborative

Shared Lab and Medical Director with Lakeridge Health

Joint Executive Director with Sunnybrook Health Science Centre

Partnering with Eastern Health to enhance laboratory medicine in

Newfoundland and Labrador

MilestonesThe LMP has four overarching milestones that will support the program’s

growth and vision of becoming an international model of laboratory services. We are committed to ensuring equitable access to laboratory

medicine expertise.

Strengthen Presence Regionally, Provincially, and Globally

Participate in provincial, national and global laboratory medicine initiatives and establish key partnerships with other laboratory medicine programs.

Leverage “Early Adopter Advantage”Provide the most advanced and highest quality laboratory services and support innovation in laboratory medicine (i.e., telepathology and bio-

banking).

Establish Best PracticeEstablish best practices in molecular diagnostics and the histocompatibility

laboratory (HLA).

Enhance the Healthcare ContinuumDevelop and participate in initiatives to enhance the care provider profile and technologies for information capture, dissemination, and evaluation.

Develop an informatics strategy to support all strategic thrusts.

Each year, the LMP performs over 15 million tests for UHN’s hospitals, and other healthcare centres across Canada. Our staff are dedicated to providing the most advanced and highest quality lab services, as well as supporting new and innovative approaches in lab medicine.

These approaches include the UHN telepathology system, which enables pathologists to diagnose patient slides online. Within seconds, the system transmits digitized whole samples from physicians in rural and northern hos-pitals to specialized pathologists at UHN, enabling fast and accurate diagnosis for all Ontario patients, regardless of where they live.

The LMP will continue to focus on research and development of new laboratory medicine tests and services, trans-lating research into clinical practice.

The LMP is at a pivotal stage in its growth. As an “early adopter”, the program provides many opportunities to enhance clinical care, teaching and research, and to attract government funding and private-sector investment.

Achieving a balanced budget and meeting accountability commitments is a priority for the LMP.

The LMP is committed to training the next generation of laboratory professionals and to promoting interdisciplin-ary education with other clinical programs.

Academic

Laboratory medicine plays an integral role in the delivery of quality patient care at UHN. Clinicians rely on medical laboratory professionals to provide vital information on patient health – up to 85% of decisions about diagnosis and treatment are based on lab test results.

Every patient at UHN is impacted by the laboratory medicine services provided by the LMP. The LMP must work seamlessly with all other clinical programs. We will continue to meet the demand for routine and specialized testing in response to the clinical needs of our patients. We are committed to providing and ensuring safe, efficient, and high quality laboratory medicine services.

Caring

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The Medical and Community Care (MCC) program has 13 program elements, each of which contributes to UHN’s purpose of transforming healthcare for its patients, communities, and the world. While each program element is a leader in its own right, bundled together, the MCC program is quickly changing the face of hospital medicine.

Through its program elements, the MCC program continues to shape tomorrow’s care to positively impact the lives of patients. The MCC program will make this vision a reality by building the hospital of the future by bringing together our unparalleled team of nationally and internationally acclaimed care providers, researchers, and educa-tors working collaboratively with other UHN specialty programs and other care providers.

Building Tomorrow’s Hospital

Provide care that only MCC can provide

Care for patients in partnership with other UHN

programs

Partner with external providers to support care

across the continuum

Program ElementsEmergency Medicine

General Internal Medicine

Endocrinology/Diabetes

Nephrology

Psychiatry

Family & Community Health

Respirology

Dermatology

Hepatology

Infectious Diseases

Bioethics

Palliative Care

Spiritual Care

Providing Care for the Future

3 million Canadians are affected by diabetes

1 in 3 Ontarians live with one or more chronic diseases account-ing for 70% of all deaths

1 in 5 Canadians will develop a mental illness at some time in their lives

An average of 14 Canadians learn daily that their kidneys have failed

Many of the 70,000 heart attack patients and 50,000 stroke pa-tients in Canada receive their immediate care in the ED and GIM

The Core Business of

the Hospital

Transforming the Delivery of Complex Medicine

Caring for the Acutely Ill Patient

MCC will ensure acutely ill patients progress through the care environment and receive the care they need, where and when it is required. Through ongoing investments to

further improve access and flow, delivering safe, high quality care, and reducing bottlenecks in flows and long lengths of

stay, MCC is dedicated to caring for today’s complex medical patient.

Preventing and Managing Chronic Diseases

MCC will pursue innovative strategies to manage and prevent illnesses, establish pioneering approaches to

education, and relentlessly pursue research advancements to effectively and efficiently manage chronic diseases.

Medical & Community CareTransforming care for complex medical patients

Chris Jarvis: Olympic Athlete and Diabetes Advocate

Age 14 Onset of excessive urination, hunger, and dramatic weight loss.

Age 14-21 Type 1 diabetes management in community hospitals.

Age 22 Referred to TGH insulin pump program.

Age 22-26 Two world cup golds in pairs rowing. Raced in Athens Olympics. Won gold in the Pan Am games.

The MCC program brings together a vast, diverse, and complementary set of program elements to care for tomorrow’s increasingly complex medical patients.

The MCC program is the safety net for patients at UHN and is responsible for the core business of our hospitals, which is providing care for the increasingly complex medical patient.

The MCC’s strategic planning efforts are based on its desire to truly transform care for complex medical patients. This desire has led the program to focus on two key areas, which are the foundation of the MCC strategic planning framework caring for the acutely ill patient and preventing and managing chronic diseases.

VisionBuilding the hospital of the future

Caring

We


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Medical & Community Care Transforming care for complex medical patients

MilestonesTo help facilitate the translation of the MCC’s strategic priorities into action,

four milestones have been set to anchor strategic activity over the next five years, and the 13 program elements will develop initiatives to support these four milestones. It is expected that emergent initiatives will be devel-

oped over the next five years, as dictated by program and organizational priorities and external factors.

The MCC’s four milestones were developed in order to provide a strategic link between the overarching goals and the specific initiatives that will be

undertaken by each program element.

Improve Access and FlowNurture partnerships to improve access and flow across the care

continuum.

Transform Patient CareTransform the patient experience through a focus on patient-centred care.

Improve OutcomesLeverage novel therapies and innovative models of care to improve

outcomes.

Research and Education Advancements

Cultivate and expand educational advancements and scientific research discovery.

A key characteristic of the MCC program is innovation and leadership in research and clinical care. Numerous ground-breaking initiatives have been developed in order to provide optimal care for our patients. These include the Emergency Mobile Nursing Service, home dialysis, the virtual ward, and the psychiatric component of deep brain stimulation to treat depression.

The MCC program is already a leader in advancing knowledge through research. The next five years will see an increased focus on complex medical patients who require innovative care solutions. In many areas, such as endo-crinology, nephrology, respirology, dermatology, and hepatology, UHN is a pioneer and world leader in research solutions to complex medical conditions.

The MCC program is committed to fiscal responsibility within its program elements. By focusing on internal col-laboration and external partnerships, the program strives to promote the efficient use of resources while simulta-neously achieving exceptional outcomes.

The MCC program is acutely aware of, and aligned to, the strategic directions of our funding bodies. As such, our priorities are influenced by our external accountabilities, which include a dedicated focus on emergency depart-ment wait times, chronic disease management, and mental illness.

The MCC program will also continue to collaborate with UHN’s Foundations to secure funding for research and innovations in clinical care.

Through its deep linkages with the University of Toronto, the MCC program is recognized internationally for teach-ing through innovative programs and new interprofessional education models. The program also supports an impressive community of scholars, most of whom work at the critical interface between bench and bedside.

The MCC program has garnered numerous education-based awards, including several for its General Internal Med-icine post-graduate educational program, which is the largest educational program at UHN.

In Conclusion...

MCC is the core business of UHN.

MCC’s activities are aligned closely with federal and provincial priorities.

MCC is the safety net for patients at UHN.

MCC is producing innovations in clinical care.

MCC’s 13 program elements are transforming the delivery of complex

medicine.

Creative

Accountable

Academic

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Caring

Multi-Organ Transplant ProgramLife, pass it on

MOT Highlights

World’s first reconditioned double lung transplant

North America’s first islet cell transplant into a patient with

Type 1 diabetes

Canada’s first successful kidney transplant program

World’s first successful single and double lung transplants

Largest living related liver program in North America

Highly successful live donor liver and kidney transplant

programs

Canada’s largest program for lab-based and clinical

research in solid organ transplantation

Who We Are

60% of Ontario transplant activity

631 operating room cases in 2009/10

15,619 inpatient days

14,785 clinic visits


2,980 day/night care visits

40 beds

21 funded investigators

$10-15 million/annum in research funding

83 (5.3%) papers in top journals

Interactions within UHN

Medicine and Surgery

Imaging (Radiology)

Laboratory Medicine Program

Peter Munk Cardiac Centre

PMH Cancer Program

MOT in 2016

Establish Transplantation Institute

5 fully funded research chairs

A talented and dedicated team of physicians, surgeons, nurses, and allied health professionals makes UHN a leader in transplantation worldwide. Team members contribute to program development at the unit, program, and organizational levels, participating in various program committees, research, and education initiatives.

High priority is placed on health human resources. As the program grows, so too must the multidisciplinary human resources and continuous learning opportunities required to provide patient care and promote patient and staff satisfaction.

At the heart of the Multi-Organ Transplant (MOT) program’s commitment to excellence is our dedication to the lifelong patient-team relationship. It begins with helping patients manage while they wait for transplantation. It continues as we support them through the transplant procedure and continuing care post-transplant. At every stage, patients are the centre of the transplant team. Through education and information, we support patients and their families in making informed decisions about their healthcare.

Patient education is a top priority for the MOT program. We have developed numerous educational materials to assist patient learning and self-care including manuals, videos, and internet-based patient teaching tools.

The complexity of managing patients who are immuno-suppressed requires the program to provide or participate in follow-up care for the remainder of the patient’s life. The MOT program has established a transplant day hospital where patients can be treated effectively as outpatients, rather than inpatients, for conditions such as biopsies, acute rejection episodes, and infection. Substantial increases in transplant volumes and survival rates mean that the need for the day hospital will continue to grow.

Devices Currently Being Used at UHN

Left ventricular assist devices (LVADs)

Novalung (artificial lung device)

Ex-vivo perfusion of organs

Program Elements

HeartLung

Heart and LungKidney

PancreasLiver

Small BowelMicrosurgical Repair/Tissue

VisionTo be the international model of a transplant institute – exhibiting superior clinical outcomes, new knowledge creation, and educational leadership

We

Research Initiatives & Partnerships

Bridge to Transplant

Paired Kidney Exchange

The “HELP” Project (Human Ex-vivo Lung Perfusion)

Human Leukocyte Antigen-G

Expansion of Human Regulatory Cells

The Industrial BioDevelopment Laboratory (IBDL)

CIHR Training Program in Regenerative Medicine (TPRM)

University of Toronto Transplantation Institute

National Biorepository

The Applied Health Research Centre

The Organ Repair Centre


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Multi-Organ Transplant Program Life, pass it on

The Transplantation Institute

An external review of the MOT program recognized the important accomplish-ments of the program and recommend-ed that it become an Extra-Departmental Unit (EDU-C) or Institute within the Uni-versity of Toronto.

The Transplantation Institute offers un-paralleled academic and clinical oppor-tunities including the ability to:

• Develop new innovative national and international education programs

• Advance research by developing more effective partnerships with members of the basic departments, departments in the Faculty of Medicine, and fully af-filiated teaching hospitals, to achieve international stature as the “world’s foremost transplant program”

• Recruit and retain the brightest and the best faculty and students

• Advance, commercialize, and translate scientific discoveries through the In-dustrial BioDevelopment Lab, MaRS, and industrial partners

• Increase fundraising through private sector partnerships

• Partner with MOHLTC and Health Cana-da to develop healthcare policy for sig-nificantly enhanced delivery of trans-plantation services both provincially and nationally

MilestonesThe MOT program has four overarching milestones that will support the

program’s growth and vision of becoming an international model of a transplant institute.

Increase Funding OpportunitiesSecure appropriate funding to address the actual cost of transplant proce-dures, long-term patient management, and ancillary programs including

increased diagnostic costs (laboratory HLA and medical imaging).

Leadership & Innovation in Transplantation

Address increases in transplant volumes as transplant procedures are ex-pected to increase by 50 procedures per year over the next five years.

Innovative TechnologySupport development of leading edge research that will promote tolerance induction and research that will result in innovative technology to prolong life through bridge therapy and use of organs that are presently deemed

unsuitable.

EducationContinue to provide leadership in patient and interprofessional education.

With an international reputation as a leader in advancing care and research, the MOT program attracts students from around the world.

Education is aimed at training physicians and surgeons and promoting a multidisciplinary, collaborative approach to transplantation through the training of nurses, allied health professionals, pharmacy staff, and clinical techni-cians.

Academic accomplishments include:

• Canada’s only Canadian Institutes of Health Research (CIHR)-funded training program in regenerative medicine;• MOT fellowship program recruits national and international medical and surgical fellows; • Nursing transplant education initiative: career ladder, partnership with Ryerson University, nursing fellowships,

and certification of transplantation as a nursing specialty; and• An international transplant education program for Internists.

Since its inception, the MOT program has experienced unprecedented growth in clinical activity. Transplant vol-umes will continue to grow over the next 10-20 years to meet increased demand for solid organ transplants. This demand is due to an increase in chronic disease, an aging population, and the longer life expectancy of transplant survivors.

Costs, in part, can be offset by new funding opportunities such as increased volumes, new clinical initiatives, re-search grants and contracts, and philanthropy. The MOT program has a proven track record in commercialization opportunities from bench to bedside to marketplace.

The MOT program is committed to high quality, multidisciplinary research which has contributed to the success of the program. Research initiatives include those in the basic science of immunology and transplantation and active clinical trials which evaluate new immuno-suppressive agents.

The MOT program also has its own clinical trials unit and research team. To date, several clinical studies have exam-ined quality-of-life issues and predictive clinical outcomes.

Creative

Accountable

Academic

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Peter Munk Cardiac CentreDefining excellence in cardiovascular care

Forward Thinking: The PMCC in 2016Magnetic resonance imaging (MRI) positron emission tomography (PET)

Robotics – Advanced endovascular aneurysm repair (EVAR)

Transplant and bridge to transplant growth

Chronic care models

Cardiac “Well Heart” programs

Continued integration and system leadership

Bridge to Life - A young heart transplant recipient recounts her journey

Andrea Clegg, a civil engineer from Cambridge, Ontario was a healthy and active young woman, but in May 2008,

a virus attacked her heart, leading to a diagnosis of cardio-myopathy, a disease that weakens the heart muscle and can

result in an irregular heart beat. Andrea had a pacemaker implanted, a small device placed in the chest to help control

abnormal heart rhythms.

On May 30, 2009, Andrea and fiancé Shaun Clegg were mar-ried. During her speech, the pacemaker fired three times to

correct the abnormal rhythm and she collapsed. “It felt like a bomb went off inside my chest,” Andrea recalls.

Andrea was rushed to St. Mary’s Hospital in Kitchener where she was stabilized, but within months her health deterio-rated, she was diagnosed with heart failure and needed a

heart transplant.

Andrea was referred to the Peter Munk Cardiac Centre where she received a Left Ventricular Assist Device (LVAD), which took over 90 per cent of her heart’s left ventricle function.

“The LVAD saved my life,” says Andrea, who waited just over a year before a suitable donor heart became available, an approach called “Bridge to Life,” that was pioneered at the

Peter Munk Cardiac Centre.

In December 2010, Andrea received a call that there was a donor heart ready for her. Now with her new heart, Andrea is regaining her strength and health, and calls Drs. Heather Ross, RJ Cusimano, Vivek Rao and Jane MacIver, her heroes.

Program ElementsHeart Failure

Vascular Disease

Congenital Heart Disease

Ischemic Heart Disease

Valve Diseases

Heart Rhythm Disorders

Who We Are143 beds

Three hospital sites


48,753 visits

96,939 procedures

$90M budget

25% of UHN weighted cases

The PMCC provides world-class, leading edge care to patients with all levels of acuity. We are a world leader in treating adult congenital heart disease, electrical disorders of the heart, heart transplant, and complex aneurysms. However, the PMCC also provides the full spectrum of standard care for cardiovascular disorders, consistent with its mission to support teaching and research mandates, in addition to care for local populations.

Leadership in innovation and technology adoption is a key characteristic of the PMCC. In addition to system lead-ership across Toronto (i.e., the Toronto Heart Attack Collaborative and the UHN/St. Michael’s Hospital Vascular Centre of Excellence), the PMCC employs a highly integrated approach to care provision, where radiologists, cardi-ologists, and cardiac and vascular surgeons converge and work in synchrony; this approach has led to exceptional patient outcomes and a gold standard of clinical care.

The Peter Munk Cardiac Centre (PMCC) is made up of more than 800 dedicated staff, including medical doctors, ad-vanced practice nurses, registered nurses, allied health professionals, and technical and support staff. The PMCC’s talented, multidisciplinary care teams provide exemplary patient-centred care for its diverse and complex patient populations.

The PMCC is dedicated to providing continuous learning opportunities for staff and ensuring that the program’s human health resources needs are fully supported. As such, strategies will be leveraged to attract, recruit and re-tain, promote talent management, and build a culture based on success and satisfaction.

VisionTransforming the future of cardiac and vascular care through an unparalleled commitment to integration of, and excellence in, clinical care, research, innovation, and teaching

Caring

We


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Peter Munk Cardiac Centre Defining excellence in cardiovascular care

In Conclusion...

Cardiovascular disease remains the #1 killer of Canadians.

Both standard and advanced care is necessary to sustain all elements. There is a strong degree of interdependence to

enable highly complex care.

Innovation and the use of leading-edge technologies is essential to our vision

and mission.

The human resources, infrastructure, and expertise within the PMCC ideally posi-

tions the program to manage all aspects of cardiovascular disease.

MilestonesThe PMCC has identified six overarching areas of focus in which to anchor

its strategic activity over the next five years.

Transforming CareBecome the centre of choice for patients with cardiovascular disease.

BrandingCreate a highly recognized quality brand that will increase our profile and

facilitate fundraising.

Our PeopleInvest in our people by creating an environment and culture that supports

their professional needs.

PartnershipsDevelop and expand internal and external partnerships that create

opportunities for growth.

InnovationIdentify and evaluate innovations that will define the future of

cardiovascular care.

Research and EducationBecome a centre of excellence for cardiovascular education and research.

Funding innovation is a key priority for the PMCC. Innovation and technology assessment is enabled largely through dedicated Foundation support. Highlights of this funding include transcatheter therapies, left ventricular assist devices, and advanced endovascular aneurysm repair (EVAR).

The PMCC is also a leader in clinical and information integration. The PMCC’s leadership is demonstrated by the new CT/Angio operating room which is believed to be the only one of its kind in Canada, the I3 initiative (Imaging, Intervention, Innovation) and integration between medical imaging and cardiovascular care.

Education and training within the PMCC involves many healthcare professionals across numerous disciplines, including nursing, allied health, and undergraduate and post-graduate medicine. The PMCC program elements are consistently among the top choices of students from the University of Toronto and attract top trainees from around the world. The PMCC also continues to be a leader in the interprofessional education agenda at UHN.

Highlights of the PMCC’s education programs include:

• Medical education• 45 fellows• 38 residents• 96 nursing students (28,851 hours)• 133 new nursing grads/orientees (32,538 hours)• 53 allied health students (5,202 hours)

There is a considerable breadth of research activity within the PMCC, leading to significant innovations for patients with cardiovascular disease. With a rich tradition of leading-edge research projects in cardiology, cardiovascular, and vascular surgery, research excellence is a staple of the PMCC.

Some research highlights include:

• 66 scientists• 68 new protocols per year• 647 papers (articles and reviews)• 7789 citations to 2004-2007 papers

Creative

Accountable

Academic

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New Patients

Genitourinary – 1,694

Gastrointestinal – 1,639

Breast – 1,518

Other – 981

Lung – 891

Gynaecology – 718

Leukemia – 598

Central Nervous System and Eye – 530

Head and Neck – 510

Lymphoma – 502

Thyroid – 440

Melanoma – 404

Sarcoma – 238

Program Components

Cancer Registry

Screening

Imaging

Cancer Pathology

Surgical Oncology

Radiation Medicine

Medical Oncology

Haematology

Oncology Nursing

Psychosocial Oncology and Palliative Care

Patient Education

Survivorship

Program Facts

399,506 total outpatient visits

7,421 total inpatient admissions

18,022 new patients

29,300 outpatient chemotherapy treatments

9,780 courses of radiation treatment

6,291 cancer surgeries

245 stem cell transplants

130 inpatient beds at PMH

75 surgical beds across UHN

541 clinical trials currently accruing cancer patients

3,794 patients accrued to clinical trials in 08/09

350 half-day clinics/week

Caring

We

Princess Margaret Cancer ProgramTranslating the science of cancer into practice

The Princess Margaret Cancer Program (PMCP) is the largest cancer program in Canada. Along with its research arm, the Ontario Cancer Institute (OCI), the PMCP has achieved an international reputation as a global leader in the fight against cancer.

The PMCP is comprised of over 2,000 dedicated staff, including physicians, surgeons, oncology nurses, radiation therapists and other allied health professionals, as well as technical and support staff. These interdisciplinary care teams provide exemplary patient-centred care to complex patient populations.

The PMCP provides educational and career development opportunities for its staff and consistently scores well on its employee opinion surveys; the most recent data indicates PMCP achieving the highest score of any UHN pro-gram. The program continues to develop strategies to attract, recruit, and retain the best talent locally, nationally and internationally, and works on maintaining a culture of respect, inclusiveness, and continuous development.

The PMCP offers comprehensive, multidisciplinary cancer care in 12 disease sites, with expertise across the spec-trum of cancer care at all levels of clinical acuity.

The PMCP provides cancer patients with radiation therapy in the largest radiation treatment centre in Canada, and one of the largest treatment facilities in the world. The program ranks among the top centres in the world for bone marrow transplantation. The PMCP has a long-standing international reputation for excellence in clinical care, research, and education. Leadership in innovation and technology adoption is a key characteristic of the PMCP.

The program has a regional leadership role across Toronto and throughout the province, and employs a highly integrated approach to care provision, which offers exceptional interprofessional clinical services to our patients. The quality of this program has resulted in international partnerships, such as in Italy and Kuwait. The PMCP also has a 12-bed acute palliative care unit, daily psychosocial oncology and palliative care clinics, and is constructing a 10-bed residential hospice in partnership with the Kensington Health Centre.

VisionTo achieve global impact as one of the top five comprehensive cancer programs in the world


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Princess Margaret Cancer ProgramTranslating the science of cancer into practice

Creative

Accountable

Academic

To Achieve Global Impact PMCP will

Increase investment in space and new technologies for translational research

Develop innovative therapy, imaging and guidance technologies

Expand the drug development program

Develop state-of-the-art molecular imaging

Attract new patients into clinical trials

Develop and implement a comprehensive quality and safety

program

Develop and maintain a Bio-specimen bank

Redesign the ambulatory care patient experience

Enhance communication with patients and stakeholders

Integrate supportive care for our patients earlier in their care experience

MilestonesThe following are the key outcomes to be achieved over the next five years,

in support of PMCP’s vision of achieving global impact as one of the top five comprehensive cancer programs in the world.

Transform Patient CareEstablish innovative models of care, integration of treatment and

supportive care, and engage patients and their families as partners in care.

Correlative Cancer BiologyDevelop a leading-edge program of correlative biological research to

facilitate the development of novel therapies.

Guided TherapeuticsCreate a state-of-the-art clinical and research facility for molecular and

nanotechnology-based imaging, and image-based assessment of clinical response.

Novel TherapeuticsSupport a robust clinical trials infrastructure and the implementation of

enabling technologies for conception and translation of new therapeutics for cancer.

Outreach and PartnershipsBe a value-added partner in our community, province, country, and the world and improve the standards of cancer care through leadership and

collaboration; leverage new experience, resources, and knowledge through international collaboration.

Strengthening Core Programs and Infrastructure

Establish the infrastructure (resources, processes and systems) needed to facilitate delivery of high quality patient-centred, comprehensive cancer

care.

OCI, the research institute at PMH, conducts research in genomics, proteomics, structural biology, molecular biology, biophysics, stem cell biology, and in psychosocial oncology and palliative care. OCI has over 200 researchers, 425 trainees, 620 technical/support staff and 373,000 square feet of research space.

In 2008/09, its faculty had over 750 publications and brought in over $100M in external research funding. The OCI faculty has won many prestigious national and international awards, and the institute has successfully fostered col-laborations with other institutes and pharmaceutical companies.

The PMCP has an impressive clinical research enterprise where approximately 25% of Princess Margaret Hospital (PMH) patients are enrolled in clinical trials. There are over 540 clinical trials currently accruing cancer patients within the program and 25% of all clinical studies at PMH in 2009 were investigator initiated. The PMCP has the highest proportion of new cancer patients enrolled in clinical trials, which is twice or more than any other cancer centre in the province. The PMCP has Phase I and Phase II clinical trial programs competitively funded by the National Cancer Institute in the US. In addition to therapeutic intervention trials, various clinical research projects are assessing quality of life, survivorship intervention, assessment of new technologies, and more. The newly redesigned cancer clinical research unit will facilitate the growth of clinical trials by encouraging development of institutional infrastructure to maximize the quality and competitiveness of clinical trials.

The quality of care in the PMCP is regularly assessed by the multidisciplinary Cancer Quality Committee, which meets quarterly to review trends and prepare an annual report to the UHN Quality Committee of the Board.

The program has also developed a standardized and consolidated incident report to look at incidents trends across the entire program, including a specific review process for severe/critical and near-miss incidents.

The PMCP reports regularly to Cancer Care Ontario on its treatment volumes and wait times, and is ranked in the an-nual cancer system quality index according to its performance on indicators such as safety, accessibility, integration, and efficiency.

The PMCP provides comprehensive and excellent training for fellows, residents, as well as graduate and undergraduate trainees. The program attracts top students from around the world, with more than half of fellows coming from outside of Canada. The PMCP offers unique educational programs in each oncology professional area. For example, PMCP col-laborated in the development of the De Souza Institute for Oncology Nursing, aimed at building intellectual capacity in oncology nursing through continuing education and support for graduate and post-graduate training to further advance specialty practice. Specialized training is also provided in areas such as physics, radiation therapy and allied health.

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Surgical Programs and Critical Care (SPCC) is comprised of dedicated, multidisciplinary staff, including surgeons, nurses, allied health professionals, and technical and support staff.

SPCC focuses its efforts on recruitment of academic surgeons and clinical staff to optimize performance and pa-tient safety. This ensures that adequate numbers of competent professionals are available to care for an increas-ingly complex patient population.

Surgical Programs & Critical CareGrowing academically, technologically, efficiently, and safely

Strategic PartnershipsStrategic partnerships create opportunities

that support clinical, research, and educational activity within SPCC

Who We Are22,481 total operating room

cases in 2009

63,691 operating room hours in 2009

3 hospital sites

41 operating suites

3 PACUs

16 inpatient units

2 pre-admission units

2 med/surg day units

2 endoscopy units

2 cystoscopy units

1,556 surgical services papers

11,984 cites to 2006-2009 papers

83 (5.3%) papers in top journals

SPCC Successes

People

High staff satisfaction

TGH & TWH Perioperative Services team charter recognition-awards – Respect in Motion (RIM)

Nurse Practitioner-Anaesthesia Program (only one in Canada)

Patient Safety

Surgical Services Balanced Scorecard

Safer Healthcare Now! Initiatives

Antimicrobial Stewardship Program

Outpatient Parenteral Antimicrobial Therapy Program

Safety Checklists

Duocheck Patient Safety System

Clinical Anaesthesia Information Management System (CAIS)

Innovation

Minimally Invasive Surgery (MIS)

Guided Therapeutics Program (GTx)

I3 Program

MOVES Transport Life Support System

Information Management

Surgical Information Management Mapping

Anaesthesia Information Management

Safety Checklists

Surgical Services Balanced Scorecard

Surgical Efficiencies Target Program (SETP)

Operating Room Whiteboards

Education

Completion of competency-based program for all TGH CPD staff

16 continuing education activities offered to local, provincial, national, and international audiences

357K funding for teaching/educational scholarship

Program Elements

General Surgery

Orthopaedic Surgery

Neurosurgery

Urology

Plastic Surgery

Cardiac Surgery

Thoracic Surgery

Vascular Surgery

Patient safety is a prime driver of patient care in SPCC and includes all pre-, intra-, and post-operative activities and patient education. Best practices are the standard of care offered to all surgical and critical care patients.

Not only is excellence in patient care and safety articulated in our vision and mission, it is also assessed with reli-able metrics and reported regularly on the Surgical Services Balanced Scorecard and through relevant clinical initiatives.

The critical care component of SPCC is a vital and strategic strength and supports all other programs at UHN, in-cluding transplantation and neurosciences which occupy almost half the critical care beds at TGH and TWH.

UHN provides leadership to the Toronto Central Local Health Integration Network and the province in system re-design; UHN leaders are helping to promote the integration of services and academic activities across the system. This is evidenced through the implementation of the seven components of the critical care transformation strat-egy, including the creation of the critical care response team concept.

Interdisciplinary Programs

Multi-Organ Transplant Program

Head & Neck Program

Spinal Program

Hand Program

VisionTo provide exemplary care delivery through clinical innovation, technological enhancements, education and research

Caring

We


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Surgical Programs & Critical Care Growing academically, technologically, efficiently, and

safely

Clinical Integration and Partnerships

Joint Department of Medical Imaging (JDMI)

Shared Information Management Services (SIMS)

Provincial Critical Care Secretariat

Mount Sinai Hospital

Toronto Central Local Health Integration Network (TC LHIN)


SPCC in 2016

Robotics – advanced endovascular aneurysm repair (EVAR)

Bridge to transplantation (heart, lung, liver)

GTx completion

TWH operating room completion

MilestonesSPCC has three overarching areas of focus that will support the program’s

growth and evolution. Each of the three areas was developed in align-ment with UHN’s vision of becoming an internationally renowned research

hospital.

Information SystemsDevelop and implement the surgical program information retrieval and

enabling system (SPIRES).

Advance TechnologyBecome recognized as a world leader in minimally

invasive surgery.

InfrastructureCreate state-of-the-art operating rooms at TWH that will transform care de-livery practices in neurosurgery, spinal, orthopaedic, and general surgery.

The outstanding level of academic excellence attained and perpetuated through a culture of learning in SPCC is vital to its future success.

Key initiatives include:

• maintaining national and international leadership in research and education;• maintaining, improving, and monitoring fellowship experiences while strengthening residency programs;• expanding innovative education tools such as simulation; and• enhancing interprofessional education.

SPCC participates in a large volume of clinical trials in support of UHN’s strategy to be recognized as a research hos-pital. Through CIHR and UHN’s partners, industry-sponsored multi-centre clinical trials and investigator-initiated research protocols continue to evolve.

The further development and support of minimally invasive surgery is critical to SPCC. It demands specialized skill sets and results in superior patient care and reduced length of stay. We will focus on supporting a fully func-tioning minimally invasive surgery program and on supporting the guided therapeutics program (GTx), which is dedicated to developing new technologies for diagnosis and ablative treatment enabled by real-time imaging and minimal access surgical approaches.

Information management is a critical element for SPCC in facilitating operational decision-making and quality improvement. The implementation of the clinical anaesthesia information management system (CAIS) tool has led to improved efficiency, less duplication, enhanced patient safety, and documentation of patient outcomes. The proposed creation of an office of surgical information management will be responsible for the integration of information management and information technology.

SPCC addresses changing clinical volumes in a collaborative and consultative manner, serving the UHN popula-tion while investigating opportunities to increase revenues through additional activity.

Creative

Accountable

Academic

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