every day, every moment. - southern health-santé sud · 2 about us the red river 26 42 11 river...
TRANSCRIPT
2014-2015
ANNUAL REPORT
Every Day,Every Moment.
“Every day each of us experiences a few li le moments that have just a bit more resonance
than other moments – or maybe we have a small experience that pulls us out of
ourselves, if only briefl y …. So just maybe it is these small silent
moments which are the true story-making events...”
Douglas Coupland
In Southern Health-Santé Sud, there
are countless moments every day that have the poten al to make an enduring diff erence in someone’s life.
Every Day, Every Moment.
Moments of
integrity…compassion…excellence…respect.
About Us2
Programs & Services4
Board of Directors5
Governance6
Organiza onal Structure12
Our Stories14
French Language Services49
Making Milestone Moments... building for the future
52
Crea ng New Moments... challenges & future direc ons
55
Numbers at a Glance56
Auditor’s Report60
Contact Us64
Capturing our
Moments
CONTENTS
2
About UsThe Red River
26
42
11
River
RIV
ER
RE
D
ne
Point
ayMariapolis
St. Alphonse
nora
Clearwater
La Riviere
ress River
Bruxelles
Swan Lake
Landseer
Holland
Pratt
Sidney
Firdale
Austin
Helston
Keyes
Plumas
Grass River
Amaranth
Tenby
Waldersee
Alonsa Silver
Harcus
Ridge
BaySandy
Langruth
Westbourne
Lakeland
Woodside
Bagot
Dakota
Dakota Tipi
Long Plain
PlainsLavenham
Rossendale
Rathwell
Altamont
SnowflakeMowbray
Windygates
Miami
Darlingford Thornhill
Roseisle
Graysville
Edwin
Macdonald
Lily Bay
Deerhorn
MinnewakenLundar
Clarkleigh
Oak Point
Tin Town
St. Marks
St. Ambroise
Poplar Point
High Bluff
Reaburn
Newton Oakville
Haywood
Elm Creek
Blumenort South
Horndean
Roland
Homewood
Sperling
Brunkild
Fannystelle
Elie
St. Eustache
Marquette
FrancisLake
St. LaurentHarperville
Ideal
Lillesve
Chatfield
BenderNarcisse
Sandridge
Inwood
Erinview
ArgyleWoodlands
Balmoral
Warren
Woodroyd
Rosser
Meadows
Gordon
Grosse Isle
Oak Bluff
St. Francois Xavier
Headingley
Starbuck
Springstein
Sanford
Rosenort
Lowe Farm
Rosenfeld
St. Joseph
Letellier
Ridgeville
Halbstadt
Dominion City
Dufrost
St. JeanBaptiste
Otterburne
Ste. Agathe
St. Norbert
La Salle
Domain
Rivercrest
StonyMountain
Clandeboye
Petersfield
Gunton
Fraserwood
Foley
Komarno
Malonton
Meleb
Rembrandt Arnes
Berlo
Camp Morton
HusavikSandy Hook
Netley
Matlock
Ponemah
Chalet Beach
Whytewold
Fullers
East Selkirk
Pine RidgeBirds Hill
Lockport
Oakbank
Dugald
Lorette
St. Adolphe
DufresneIle des Chenes
Landmark
NewBothwell
Kleefeld
Grunthal
Roseau River
Arnaud
St. Malo
Rosa
Green Ridge
Tolstoi
Vita
Stuartburn
Gardenton
Sarto
GirouxBlumenort
AnolaGlass
Tyndall
HazelridgeCloverleaf
Lydiatt
Ladywood
Brokenhead
Walkleyburg
Cromwell
Green Oak
Libau Dencross
Beaconia
ReserveBrokenhead
Belair
Hillside Beach
Grand MaraisGrand Beach
Victoria Beach
Bay
Fort Alexander
Pine Falls
Traverse
Silver Falls
Spring WellGlenmoor
Stead
Thalberg
Brightstone
Lowland
Allegra
Greenwald
Seddons CornerMolson
St. Ouens
Vivian
Richer
La Broquerie
Marchand
Sandilands
Zhoda
Sundown
Menisino Piney
Woodridge
Spruce Siding
Hadashville
Elma
Whitemouth
Sisters FallsRiver Hills
Shelley
Seven
PinawaMilner Ridge
Great Falls
St-Georges
Bird
Pointe du
River
FallsOtter Nutimik Lake
Betula Lake
Juno
Culver
Hoctor
Darwin
Medika
Prawda
McMunn
Vassar
JunctionSouth
SpragueMiddlebro
West Hawk Lake
GlennEastBraintree
Falcon
Lake
Decimal
Brereton Lake
Rennie
Indigo
Bois
Telford
Ophir
CrossLake
Moose Lake
Roseau River
Aubigny
Ste. Elizabeth
Crystal City
Pilot Mound
MacGregor
Treherne
Somerset
Manitou
St. Claude
CouleePlum
Teulon
Dunnottar
St-Pierre-Jolys
Ste Anne
Garson
Powerview
Lac du Bonnet
Carlowrie
Southport
St. Leon
Notre Dame de Lourdes
Randolph
Gretna
Gladstone
Carman
MORDEN
WINKLER
Stonewall
Morris
Altona
Emerson
Gimli
BeachWinnipeg
SELKIRK
Niverville
STEINBACH
Beausejour
Siglavik
SwanLake
LA PRAIRIEPORTAGE
WINNIPEG
Dam
Dam
Dam
Dam
Dam
Dam
Dam
IslandElk
BuffaloPoint
Bay
Buffalo
Cypress
Pine
River
Ck
Boyne
River
River
Pembina
Riviere
River
La Salle
River
Rosea
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Seine
River
Rat
River
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,
Southern Health-Santé Sud covers an expanse of 27,0252 kilometers of southernmost Manitoba. An important gateway to the province from the U.S. interna onal border, Southern Health-Santé Sud stretches from the 49th parallel up to the Trans-Canada Highway from the Ontario border to Winnipeg, and then follows the southwest edge of Lake Manitoba down to the Pembina escarpment in the west.
Southern Health-Santé Sud lies in the prehistoric bed of Glacial Lake Agassiz. While the topography in the east is primarily that of Canadian Shield lakes and forest, the west is predominantly prairie grassland and rolling pastures. At its heart is the Red River Valley, a natural fl oodplain, which has been fl ooded repeatedly through the centuries, impac ng the lives
of the people in the surrounding land. Other major watercourses include the Assiniboine and Whiteshell Rivers. Major fl ood-control programs such as the Red River Floodway and diversion on the Assiniboine River and protec on by dikes have been undertaken.
Situated at the centre of the con nent, this region experiences signifi cant temperature changes: very cold winters and warm, humid summers with exposure to numerous weather systems throughout the year. Thecon nental climate can bring blizzards, extreme cold, and severe wind chills. On the other hand, summer me can bring strong thunderstorms and tornadoes from warm moist air masses such as the F5 tornado that hit Elie, rated the strongest in Canadian history. Nevertheless, the area has o en been called
3Southern Health-Santé Sud ANNUAL REPORT 2014-2015
1 Friesen, J. 1963-64. Expansion of Se lement in Manitoba, 1870-1900. MHS Transac ons, Series 3, 1963-64 season2 Amalgamated municipali es as of January 1, 2015
the important part of the ‘bread basket’ of Canada and the world because its fer le soils are conducive to producing rich and abundant agricultural crops. There is also a noteworthy market gardening industry and livestock sector.
As shown in petroglyphs at Bannock Point, and in archeological digs in Sandilands Forest Reserve, Na ve presence in the province can be traced over thousands of years. Ancient Mound-Builders also le their burial and ceremonial mounds throughout the area to mark their passage. Long before the fi rst explorers came to the region, nomadic Aboriginal tribes roamed the area. They enjoyed the natural bounty of plen ful fi shing and hun ng grounds. As European se lers arrived in the area, the Ojibway and Chippewa relied on the strength of their cultural iden ty to adapt to new condi ons. Today, in Southern Health-Santé Sud we have seven First Na ons communi es:• Long Plain First Na on• Dakota Plains Wahpeton Na on• Swan Lake First Na on• Roseau River Anishinabe First Na on• Sandy Bay Ojibway First Na on• Dakota Tipi First Na on• Buff alo Point First Na on
In those very early years of se lement in southern Manitoba, hun ng and trapping cons tuted the fi rst “commercial industry” sustaining Aboriginal people, the Mé s and voyageurs. Prior to 1870, the Mé s and French se led along the Red and Assiniboine Rivers, and, in the Portage la Prairie area, an important trading post was established. This was followed by English colonists from Ontario and French-speaking se lers from Quebec. With Manitoba’s federa on with Canada in 1870, and the comple on of land surveys along the river, other lands were made accessible for homesteading. In the mid 1870s, blocks of land were set in reserve for group se lers. “The fi rst Mennonites came to Manitoba in 1874 and se led in the “East Reserve” (Steinbach) located north and east of the Rat River. A second reserve (Rhineland and Stanley) was established west of the Red River, along the border towards the Pembina Mountains, in 1876.1”
Today, just over 190,000 people live in Southern
Health-Santé Sud tracing their ancestries to one or more ethnic groups including Aboriginal, Bri sh, Dutch, French, German (including Mennonites, Hu erites and Kanadiers from Mexico and South America), Polish, Ukrainian and many others. As a thriving cultural region and the most populated of the rural Regional Health Authori es, Southern Health-Santé Sud ranks as one of the fastest-growing areas in the province. Over the past decade, it has grown by 20%, a growth rate double the provincial average; this means that more than 30,000 new people live in this region. Two factors have played major roles in this impressive popula on growth: the region’s above average birth rate, and immigra on movement from overseas and elsewhere in Canada.
There are 4 ci es, 4 towns, 1 village, 7 municipali es2, 20 rural municipali es, 1 unorganized territory, 56 Hu erite colonies, Mé s and Francophone communi es, a growing large Mennonite popula on as well as many other cultures.
4
Programs & Services
▪ Elderly Persons’ Housing ▪ Emergency Medical Services (Ambulance) ▪ Home Care Services
▪ Adult Day Programs ▪ Meals on Wheels ▪ Personal Care at Home ▪ Respite Care ▪ Treatment Clinics
▪ Medical Clinics ▪ Medical Officer of Health ▪ Mental Health
▪ Adult Counselling Services ▪ Adult Inpatient Psychiatric Treatment (Eden Mental Health
Centre) ▪ Child & Adolescent Services ▪ Crisis Response Services ▪ Crisis Stabilization Unit ▪ Employment Support Services ▪ Housing Support Services ▪ Intensive Case Management Services ▪ Psychiatry Services ▪ Safehouse ▪ Seniors Health Services
▪ Midwifery ▪ Nutrition Services ▪ Palliative Care ▪ Pharmacy ▪ Primary Health Care
▪ Chronic Disease Education ▪ Family Doctor Finder ▪ Medical Clinics ▪ Mobile Clinic ▪ My Health Teams ▪ Nurse Practitioners ▪ Primary Health Care Centres ▪ QuickCare Clinic ▪ Teen Clinic
▪ Public Health-Healthy Living ▪ Families First ▪ Healthy Baby ▪ Healthy Living Services
▪ Get Better Together ▪ Healthy Communities Conference ▪ Healthy Living Grants ▪ Local Health Promotion ▪ TeleCARE Manitoba
▪ Public Health Nursing Services ▪ Communicable Disease Prevention & Control ▪ Immunizations/Child Health Clinic ▪ Postpartum & Breastfeeding Support ▪ Prenatal Education ▪ Reproductive Health ▪ School Health ▪ Travel Health
▪ URIS- Unified Referral Intake System
▪ Rehabilitation ▪ Audiology ▪ Occupational Therapy ▪ Physiotherapy ▪ Speech Language Therapy
▪ Services to Seniors/Congregate Meal Program ▪ Supports for Seniors in Group Living
Other Services ▪ Aboriginal Program ▪ Corporate Communications/Media Relations ▪ Disaster Management ▪ Finance ▪ French Language Services ▪ Human Resources ▪ Information and Communication Technology (ICT) ▪ Quality of Care & Patient Safety ▪ Spiritual Health Care ▪ Support Services ▪ Telehealth
Facility-Based Services ▪ Acute Care
▪ CancerCare ▪ Emergency Care ▪ Extended Treatment/Rehabilitation ▪ Hemodialysis ▪ Medical Care ▪ Obstetrical Care ▪ Outpatient Services ▪ Respiratory Services ▪ Special Care Unit ▪ Surgery/Surgical Care
▪ Affiliate Health Corporations ▪ Community Owned Not for Profit ▪ Lab & Imaging Services
▪ Cardiac stress testing ▪ Computed Tomography (CT Scans) ▪ Electrocardiogram (ECG) ▪ Laboratory ▪ Magnetic resonance imaging (MRI) ▪ Mammography ▪ Ultrasound ▪ X-ray
▪ Personal Care Homes ▪ Transitional Care
In collabora on with the community and partners, Southern Health-Santé Sud endeavours to provide access to appropriate services in the appropriate se ng as demonstrated by the many programs and services delivered in the region. We strive to deliver a seamless con nuum of care that supports our clients at every stage of their lives.
5Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Guy LévesqueChair, Ste. Anne
Bronwen BugdenMorden (June 2014)
Paul CeneriniNotre Dame de Lourdes
Roy EnnsSteinbach
Guy GagnonSte. Agathe
Susan Hart-KulbabaBuff alo Point
Debbie IversonCarman (January 2015)
Don Kuhl, Vice Chair (2014-15) Winkler
Line LeclercLa Broquerie
Daren Van Den BusschePortage la Prairie
Leo Van Den BusscheSt. Adolphe
Jean BalcaenRicher (to March 2015)
Armande LeClairLetellier (to March 2015)
Board of Directors
Cheryl McKitrick, Vice-Chair (2015-16) Crystal City
Ron Tardiff Lore e (to November 2014)
6
Sacred MomentsBy all accounts, 2014-15 has been a year of enriching moments that have touched and transformed Southern Health-Santé Sud in many ways. Refl ec ng on the events of the past year, the Board of Directors acknowledges some of the ‘big’ moments: establishment of the Pa ent Experience Group, the Accredita on Survey, the Community Health Assessment, Strategic Planning, Community Engagement ac vi es, the Mobile Clinic, Aboriginal High School and Adult Health Internship Program and many others. But underlying all of these, are the meless moments where genuine commitment to
people-centredness and to living our core values is witnessed in our organiza on’s culture.
Members of the Board of Directors of Southern Health-Santé Sud pause for a ‘sacred moment’ prior to the start of their mee ngs. A sacred moment, which each Board member takes turns to prepare, might begin with a quote, or a short insigh ul video, or a personal story. But the purpose is for each person in the room to pause, clear their mind, and refl ect on “the why” they are there: the pa ents.
The sacred moment helps the board to connect to the people of the region, and to make them the centre of focus in all that we do. “The sacred moment helps me park all my other responsibili es and pressures,” says Board Member, Susan Hart-Kulbaba, “and truly focus on the clients and the pa ents that I am there to serve.” Board Chair, Guy Lévesque, also feels the sacred moment has helped the board in its work. “Board members refl ect deeper before asking ques ons. Because we are put in the right frame of mind from the start, I believe it’s easier for us to make be er decisions.”
It’s also brought the Board members closer together, adds Hart-Kulbaba. “We are learning what’s going on inside the person, and the reasons that brings them to the Board table,” she says. “Those things have helped us get to know each other in a deeper way.” Refl ec ons of sacred moments are now being embraced across the organiza on as a whole.
Governance MattersIn accordance with provisions of The Regional Health Authori es Act, Southern Health-Santé Sud is responsible for the administra on and delivery of health services to meet the health needs in the region. The Board of Directors is required to ensure that the organiza on complies with applicable legisla on, regula ons, provincial policies and ministerial direc ves.
Governing a complex regional health organiza on with a delineated budget, directors need to be able to understand the con nuum of the health system and recognize its inherent fi scal, human resource, and quality challenges. While represen ng the region as a whole, and bringing diverse perspec ves to the table, Board members must establish a strong principle-based culture that permeates throughout the en re organiza on.
The Minister of Health appoints 15 directors with varied experiences and skills to the Board of Directors, who are responsible for the mandate, resources and long-term, sustainable performance of the health authority. In 2014-15, a vacancy was created with the departure of Chairperson Denise Harder. Eff ec ve September 2014, Guy Lévesque who had assumed the role of Ac ng Chair, was offi cially appointed Chair of Southern Health-Santé Sud and Don Khul was elected Vice-Chair. Addi onally, Jean Balcaen and Armande LeClair completed their terms March 31, 2015. Debbie Iverson was appointed in January 2015 to complete the term vacated by outgoing Board member Ron Tardiff .
Guiding MomentsWith strong leadership
7Southern Health-Santé Sud ANNUAL REPORT 2014-2015
The best chance we have of connecting with the sacred is in our interaction with the weakest, the sickest, the most vulnerable.
Paul Cenerini,Board Member, Southern Health-Santé Sud
“”
Members of the public are eligible to apply for appointment to the Board of Directors. Informa on regarding qualifi ca ons, general responsibili es of Board members, and nomina on forms are available at the Southern Health-Santé Sud Regional Offi ces or on the Manitoba government website: h p://www.gov.mb.ca/health/rha/nomina on.html
Regular Board mee ngs are convened on a monthly basis, ten mes yearly to enable directors to discharge their mandated du es and responsibili es. Special mee ngs may be held as the need arises. In stewarding the organiza on forward, the Board also provides oversight through its membership on formally cons tuted commi ees: ▪ *Execu ve Commi ee ▪ *Audit Commi ee ▪ Policy Review Commi ee ▪ Community Engagement Planning Commi ee ▪ *Quality and Pa ent Safety Commi ee ▪ *Finance Commi ee
* Mandatory commi ees as per Bylaw #1
Unless expressly authorized, commi ees do not take ac on or make decisions on behalf of the Board.
The Board’s mee ngs are structured to provide a framework for members to do their oversight roles. Controls are performed and progressively reviewed by the Board during the year to monitor performance for compliance to its policies, for fi nancial repor ng as well as by an external audit process with oversight by the Audit Commi ee of the Board.
As part of its oversight role, the Board regularly reviews its governance policies and processes. In taking responsibility for the eff ec veness of its governance prac ces, an important priority of the Board is to have processes for con nuous improvement. The Board has ins tuted an internal ra ng system consis ng of evalua ng the performance of the Board as a whole on an annual basis, as well as a CEO appraisal. Addi onally, each Board mee ng is evaluated as to its eff ec veness and the performance of the Board against its own policies.
Specifi c me is also devoted to community engagement (see page 21), strategic thinking and having insigh ul discussions. With ul mate responsibility for Southern Health-Santé Sud’s strategic outlook, the Board led several workshops in the past year to address the organiza on’s direc on and focus in the next fi ve years. Progress on plans is measured and supported through regular dashboard reviews.
Strategic Health PlanThe new Strategic Health Plan for Southern Health-Santé Sud is a document that resonates because it illustrates the voices of staff and pa ents.
“The format of this Strategic Health Plan is very diff erent from previous ones because we have included feedback from pa ents and staff in their own words about their expecta ons and roles,” says Southern Health-Santé Sud CEO Kathy McPhail.
Pa ent input is a top priority for the Governing Board, says Board Chair, Guy Lévesque. “Listening to the pa ent and making sure the pa ent is part of the decision-making process is important to the Board and is something we have been emphasizing for a while.” Pa ent input was gathered in a number of ways. A Pa ent Experience Local Health Involvement Group met several mes to share their health care experiences and off er their views on health care. As well, some pa ents completed surveys to provide input about their health care expecta ons.
Staff members were also surveyed about their thoughts on their role in achieving the plan’s strategic direc ons. Almost 800 staff responded. The strategic direc ons that we have in this Strategic Health Plan speak to all staff and it’s empowering and exci ng for them to feel that they can be a part of the work and contribute to providing be er health care for people in the region.
The Board assumes responsibility in the develop-ment of the Strategic Health Plan, working with staff to iden fy the most pressing and challenging issues and determining objec ves for each. “We haven’t reinvented the wheel – we have had a Strategic Health Plan before, but we have updated it, and made some changes, making it stronger by adding pa ent input,” says Lévesque.
8
Capacity Building Health System Innovation Health System Sustainability Improved Access to Care Improved Service Delivery Improving Health Status & Reducing Health
Disparities Amongst Manitobans
Healthy Manitobans through an appropriate balance of prevention and care.
Manitoba Health, Healthy Living & Seniors
Priori es & Goals
Objec ves Cancer Patient Journey Continuing Care Strategy Family Doc for All Wait Times/Access
Together leading the way for a healthier tomorrow.Our Vision
Our Mission
Board ENDs Healthy People and Healthy Environment Accessible Health Services Safe, People-centred, Quality Health Care Sustainable, Accountable and Responsive Health
Organization
To support people and communities in achieving optimal health by providing innovative, sustainable and quality health services.
Our Core Values Integrity | Compassion | Excellence | Respect
A Solid Framework... moves us forward
9Southern Health-Santé Sud ANNUAL REPORT 2014-2015
New Strategic Directions2016-2021
Acknowledge that we all share the accountability for our own health as well as that of our community and that we can all contribute in some way to achieve be er health outcomes.
Op mize community engagement partnership opportuni es through purposeful alignment with our vision1
Embrace our community’s diversity and strive to ensure health gains are shared by everyone in our region.
Strengthen and focus our commitment on health equity and health promo on2
Provide the right care at the right me in the right place by the right provider throughout the pa ent journey.
Design programs and services for be er access and op mal service delivery3
Through our dedica on to people-centredness and inspira on from our pa ents and families.
Transform and improve the pa ent experience4
Focus on quality and inspira on from our pa ents and families.
Achieve excellence in pa ent safety5
Recognize the need for organiza on-wide fi scal responsibility and stewardship within the context of a rapidly expanding popula on and increasing demand for services.
Pursue sustainability through a diligent focus on con nuous program and service review and evalua on
6
Engage with our employees, volunteers and physicians to provide for a progressive, respec ul and safe work environment.
A ract and retain a skilled and engaged workforce7
10
Kathy McPhail, CEO
Every day.Every moment.
We are there for you. Each year, thousands of individuals trust us with their care. Because in health care every moment is an opportunity for what ma ers most, the caring men and women of Southern Health-Santé Sud aspire to make meaningful connec ons every day, transla ng our core values into ac on.
In this pursuit, we agree that fi scal year ending in 2015 was, in many ways a “momentous” one, brimming with examples of hard work, accomplishments, success and wonderful stories, many of them untold … Our annual report showcases but a few.
Health care is a profoundly human discipline. At Southern Health-Santé Sud, we talk about “Humanizing the Health Care Experience”. As demonstrated in the stories in this report, we want our culture to embody our core values where people make decisions based on what we stand for, living and connec ng with integrity, compassion, excellence and respect every day.
At its ‘People-centred Workshop’ in 2014, the Board of Directors of Southern Health-Santé Sud decided to purposefully take a special moment to pause and refl ect on the people they serve throughout the region at the beginning of each regular board mee ng. Seeking to humanize the work of the Board, this prac ce now also sets the founda on for ethical discussions and choices in the way the Board conducts itself in its subsequent governance work.
Con nuously inspired by the strength and resilience that pa ents and families demonstrate, we are following a deliberate course focused on transforming the pa ent experience.
In partnership with pa ents and families, a Pa ent Experience Group was set up in 2014. Seeing the health care experience through their lens and unique perspec ves provides for greater understanding and opportuni es for improvements. We are incredibly grateful for their spirit of generosity in represen ng the pa ent voice and in sharing their stories with the goal of making it be er for others.
It has been suggested that a strategic focus on effi ciency as well as empathy provides the founda on towards improvements in humanizing our work places and our pa ent/resident/client care. In the last couple of years, we have made great strides in helping staff fi nd effi ciencies through LEAN approaches to our work with par cular a en on to quality improvement, pa ent and work fl ow, and pa ent safety. The LEAN and Releasing Time to Care (RTC) ini a ves have had tremendous outcomes whether it be reorganized work spaces or saving and redirec ng me to pa ent care. Equally exci ng has been the implementa on of LEAN ideas and principles across the region.
Regional teams have also been doing signifi cant “behind the scenes” work related to developing improvement priori es for programs and services. Focused on quality, risk, pa ent safety, work life and culture, these priori es are aligned with Accredita on Canada standards. In March 2015, Accredita on
2014-2015
A message from the Chair of the Board of Directors and the
Chief Executive Offi cer
Guy Lévesque, Chair
11Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Canada visited over 46 sites and conducted a rigorous assessment process of Southern Health-Santé Sud. Surveyors acknowledged the wonderful work that is being done in our organiza on and iden fi ed some key strengths in our organiza on including our commitment to quality, our posi ve rela onships and partnerships, innova ve primary health care, and our dedica on to cultural diversity.
Every Day, Every Moment – our work never stops, 24 hours a day, 7 days a week … We do indeed have commi ed staff , physicians, and volunteers who are passionate about making a diff erence and strive to share the best of themselves. Our success is and will always be a direct result of their contribu ons, perseverance and teamwork. Whether in the forefront or behind the scenes, they pull through and go the extra mile. For example, in the face of the Ebola public health global crisis and in collabora on with provincial and na onal eff orts, our staff responded professionally and diligently, doing prac ce exercises to test protocols and equipment in readiness for this challenge – adding to their already full days.
Without ever compromising pa ent safety or the quality of care we provide, strong fi scal performance con nues to be an important commitment of our accountability to the community. Through prudent and ethical budget prac ces, combined with effi cient and eff ec ve management of resources, once again Southern Health-Santé Sud opera ons fi nished the year in a balanced posi on – an investment in the future sustainability of this organiza on.
Eff ec ve governance has been an important founda on for Southern Health-Santé Sud’s strong performance. With valuable insight and though ul stewardship, Board members provide leadership that responds to the health care needs of our communi es. They model an organiza on that embodies integrity, compassion, excellence and respect.
Connec ng and engaging with the community is at the cornerstone of how we make decisions and choices in important moments. Besides the many other
community engagement ac vi es in Southern Health-Santé Sud, Local Health Involvement Groups (LHIGs) are evolving. A core group of applicants has been established and are working on a regional approach for mee ng.
In addi on to our Community Engagement ac vi es in 2014, we directed our a en on on the Community Health Assessment (CHA) and published a comprehensive document detailing the health status of the region’s popula on. We observe that, on average, Southern Health-Santé Sud has a rela vely healthy popula on. Key indicators of well-being show that, in recent years, through the combined eff orts of many, in terms of health status, good things are happening in Southern Health-Santé Sud. However, while overall regional rates appear average or be er, we also observe some signifi cant dispari es in health status and access to services. With integrity, compassion, excellence and respect, we are compelled to work towards ensuring health equity for all in our Region.
We value our partnerships with Manitoba Health, Healthy Living and Seniors, affi liate organiza ons and community-owned not for profi ts. Together we can engage in system-wide improvements that provide for the most eff ec ve use of our resources that impact on the health of communi es. We are also thankful for our community partners and their ongoing support, generosity, and coopera on.
Even as we celebrate our accomplishments, it’s essen al that we plan for the years ahead. In 2014-15, we embarked on an ambi ous strategic planning journey to ar culate our future direc ons embracing a compelling vision for the future. We will con nue to inspire a transforma on with an ac ve commitment to living our core values.
It is said that great achievements happen because of a collec on of small, pivotal moments along the way. And, in Southern Health-Santé Sud, every day, every moment is a story to be told. We invite you to read but a sample of these in this year’s annual report.
Chief Execu ve Offi cerBoard Chair
12
In 2014-15, except for a few minor changes, Southern Health-Santé Sud’s Senior Leadership Team remained basically the same as the previous year.
• VP-Human Resources Jim Hunter announced his re rement. René Ouelle e has been recruited as his replacement.
• VP-Clinical Services & Chief Nursing Offi cer posi on became vacant. Responsibili es have been re-assigned to the Execu ve Directors on a temporary basis.
Board of Directors
Chief Executive Officer
Executive Director - Communications & French
Language Services Medical Officer of Health
Executive Assistant
VP - Clinical Standards & Chief Nursing Officer
VP - Planning, Innovation,Quality, Safety & Risk
VP - Human Resources VP - Medical Services
VP - Corporate Services VP - Finance & Capital
Area Executive Directors
Medical Officer of Health
Claudette Lahaie
Jane Saunders
Dr. Shelley Buchan
Vacant
Vacant Jane Curtis
René Ouellette Dr. Denis Fortier
Martin Montanti Ken Klassen
Greg Reid (East)Cheryl Harrison (Mid)
Marianne Woods (North)Paulette Goossen (West)
Kathy McPhail
Organizational Structure
March 2015
13Southern Health-Santé Sud ANNUAL REPORT 2014-2015
A strong team of people are working hard every day to make sure people in Southern Health-Santé Sud receive high-quality medical care. Dr. Denis For er, VP-Medical Services leads the medical services team and oversees medical programs for the region.
The backbone to medical services is the network of staff including Chiefs of Staff , Medical Program Leads, Directors of Health Services and support staff who ensure everything runs smoothly at each health centre – this to ensure pa ents receive high-quality health care every day.
Chiefs of StaffsMost health centres have a designated Chief of Staff who is the local, onsite medical leader, working closely with the site’s Director of Health Services to ensure medical services run smoothly at the facility. The Chief of Staff ensures good rela onships and manages complaints related to physician ma ers and also shares responsibility for all clinical services at the facility. So for example, if there’s Emergency Room medical care where physicians’ input is required to improve the program, the Chief of Staff is also involved.
All Chiefs of Staff for the region meet regularly as part of a Regional Medical Advisory Council to address the medical services por olio across the region.
Medical LeadsMedical Program Leads are doctors responsible for medical programs off ered across the region.
Medical Leads in the Obstetrics, Medicine, Cri cal Care and Surgery programs at each of three regional centres (Bethesda Regional Health Centre, Boundary Trails Health Centre and Portage District General Hospital), help manage the actual programs. As well, they contribute to and address broader, regional ma ers related to these programs.
In addi on to the Leads in regional centres, there are also Medical Leads for programs that are delivered across many sites and communi es in the region, such as Pallia ve Care, Mental Health or Seniors Health.
Behind the Scenes“There is a lot of work to do to ensure high-quality, responsive and safe care in our health centres and in our regional programs,” says For er. “I am very grateful for the strong team of dedicated staff who help support the various facets of Medical Services.”
Demand for clinical services across Southern Health-Santé Sud con nues, keeping the region’s hospitals busy as the following numbers refl ect:
► 2014-15 admissions to hospitals in the region was 12,387.
► Number of ER visits in 2014-15 was 108,396.
Clinical Services Kept Busy
Medical Services... a strong team
Southern Health-Santé Sud Chiefs of staff (rt-lt): Dr. Paul deMoissac (Hôpital Ste-Anne Hospital); Dr. Ockie Persson (Boundary Trails Health Centre); Dr. David Kinnear (Portage District General Hospital); Dr. Christo Minnaar (Bethesda Regional Health Centre); Dr. Gisèle Viens (Centre de santé St. Claude Health Centre); Dr. Robert Manness (Morris General Hospital); Dr. Denis For er (interim COS - Carman Memorial Hospital); and Dr. Dieter Bueddefeld (Altona Community Memorial Health Centre). Missing from photo: Dr. Riviraj Warnakulasooriya (Centre médico-social De Salaberry District Health Centre) and Dr. Gerard Desmond (Lorne Memorial Hospital).
14
Healthy People and
Healthy Environment
15Southern Health-Santé Sud ANNUAL REPORT 2014-2015
With 190,841 residents as at 2014, Southern Health-Santé Sud had the fastest growing popula on over the past decade. The region contributed almost a quarter (24%) of Manitoba’s overall popula on growth in that me period. While the region has a slightly younger popula on compared to Manitoba, overall growth has occurred in all age groups with the fastest growing age categories being in the 55-64 years (47% growth) and 64-74 years (41% growth). Popula on projec ons for Manitoba are expec ng that Southern Health-Santé Sud will have the highest growth rate in the province achieving a popula on of 220,000 by 2022.
Just under 1 in 8 residents in the region (11.9%) iden fi es themselves as Aboriginal. Of the Aboriginal popula on in the region, the majority reported Mé s iden ty (56%) followed by First Na ons (42.2%). The remainder of this popula on iden fi ed as Inuit, mul ple iden es or other (1.6%).
Thirteen per cent of the popula on has immigrated from another country with about a third arriving between 2006 and 2011. Immigrants are primarily from Europe (53.6%) and Asia (26.7%). The top 5 source countries in the region are from Germany, Russia, Philippines, United Kingdom, and India.
Health StatusAs reported in the 2014 Community Health Assessment, (see h p://www.southernhealth.ca/cha.php) in terms of overall health status, we observe that Southern Health-Santé Sud is comparable in many ways to the rest of Manitoba with overall rates generally appearing average or be er than the province.
Indeed, life expectancy in Southern Health-Santé Sud is the highest in the province with a signifi cant increase in the region between 2002-2006 and 2007-2011. Female life expectancy increased from 83 to 83.7 years and male life expectancy increased from 77.7 to 79.2 years.
As well, Premature Mortality Rate which is the number of deaths occurring before the age of 75 and considered to be the best single health status indicator, decreased signifi cantly over me and was signifi cantly be er than the provincial average. The top causes of premature death were similar to Manitoba: cancer (40.0%), circulatory diseases (20.7%), injury and poisoning (12.3%), endocrine and metabolic disorders (5.7%) and diges ve diseases (3.7%). Cancer and circulatory diseases claim almost 60% of all premature deaths.
The PEOPLE ofSouthern Health-Santé Sud
Healthy People and Healthy Environment
“There are so many things that aff ect people’s health – including social, economic, and environmental factors. A big part of helping people to be healthy is engaging with
them, and listening to their needs, their strengths, and their vision of how they want to ensure health equity for everyone in their communi es. It’s gra fying to be able to
support people and to connect them to the resources they need – informa on, funding, or other community partners – so they can realize their healthy living goals.”
Leigh Finney, Healthy Living Facilitator, Steinbach
16
Overall in the region, we have seen decreasing rates for Poten al Years of Life Lost (number of years of life “lost” when a person dies “prematurely” – before the age of 75).
Nevertheless, in terms of Poten al Years of Life Lost, it is noted that uninten onal injuries are the most preventable causes of death and yet the leading cause of death among young Canadians.
Southern Health-Santé Sud rates were slightly higher than the province. From 2000-2012, uninten onal injuries were responsible for 781 deaths among regional residents (approximately 65 deaths per year) and the Poten al Years of Life rate for uninten onal injuries in 2012 was 36.4 years per 1,000 (under 75 years).
In terms of total mortality rate, it declined from 7.54 deaths per 1,000 to 6.83 which is the lowest among Manitoba RHAs and sta s cally below the Manitoba average. Several districts had rates sta s cally below the Manitoba average.
Given the results on key indicators of well-being, we can speculate that through the combined eff orts of individuals, the community and the Regional Health Authority in recent years, there are many good things happening in Southern Health-Santé Sud. There is much to celebrate! However, as we recognize the possibili es, we also acknowledge the challenges. While overall regional rates appear average or be er, we also observe some important dispari es.
Socioeconomic Factor Index (SEFI) is an index-based on Canadian Census (2001 and 2006) data that looks at average household income, propor on of lone-parent households, unemployment rate for residents aged 15 and older, and propor on of the popula on (age 15+) without high school gradua on.
Community Health Assessment Paints a Picture of Health“The Community Health Assessment (CHA) provides a picture of the overall health of people in the region. With this CHA, we have tried to look at the indicators that have proven over me to be really good for measuring popula on health,” says Ales Morga who coordinated the development of the CHA.
One thing that has emerged through this process is the health dispari es in the region – so not just looking at popula ons as a whole, but drilling it down so we can understand what the data means and it refl ects on the health of diff erent popula on groups. The data provides a star ng point for conversa ons about health equity in our region.
For the fi rst me, informa on from the Youth Health Survey of grade 7 to 12 students across the en re region has been included in the CHA. “We learned a lot of useful things about the lifestyle choices of our young people,” says Morga. “For example, only 28% of our youth reported ge ng 9 or more hours of sleep on school nights. Informa on like that is very helpful to health care providers when they connect with families and residents.”
17Southern Health-Santé Sud ANNUAL REPORT 2014-2015
► Cardiovascular disease prevalence1 and heart a ack rates showing slight increases while ischemic heart disease prevalence and stroke rates experiencing signifi cant decreases over me.
► Cancer incidence2 rates overall in the region were signifi cantly lower than the Manitoba average. The region was also below the provincial average for each of the major cancers of lung, breast, prostate and colorectal cancer. Cancer survival rates were signifi cantly higher in Southern Health-Santé Sud compared to the Manitoba average.
► With respect to mental illness, the region generally had a lower prevalence rate for mental health-related condi ons such as mood and anxiety disorders, demen a and substance abuse in comparison to other Manitoba RHAs.
► Diabetes incidence rates and the lower limb amputa on rates both declined signifi cantly. As well, diabetes prevalence has increased signifi cantly which implies that people with diabetes are living longer. Increases in prevalence also suggests earlier detec on, and improvements in people taking be er care of their chronic disease.
► Incidence and prevalence for respiratory condi ons, such as asthma, were found to be declining in the region and well below the Manitoba average.
► Other chronic condi ons such as arthri s and osteoporosis recorded regional declines in prevalence which were sta s cally signifi cant.
CHRONIC DISEASE BURDEN
In general, popula on growth in Southern Health-Santé Sud has also meant that more people are living with chronic diseases. Even though prevalence rates may not have changed, the diseases have impacted more people within the region.
In terms of the burden of illness, there is a mixed picture in the region:
1 Prevalence: the percentage of residents living with the
disease over a given me period. This rate indicates how widespread the disease is in a popula on.
2 Incidence: the average number of newly diagnosed cases of the disease over a given me period. This rate conveys informa on about the risk of contrac ng the disease in a popula on.
18
Fairness with Equity“We are s ll trying to achieve fairness for all but, with equity, you’re recognizing that not everyone is star ng from the same place, and need the same things,” says Ales Morga. “That’s a very diff erent way of thinking.”
When people look at health care through an equity lens (vs. ‘equality’), it prompts conversa ons about the factors which put some at a disadvantage, or create barriers preven ng them from being as healthy as possible. These can be anything from race, ethnicity, religion, gender, age, income or educa onal levels. There are many such conversa ons taking place across Southern Health-Santé Sud at every level of the organiza on.
Equity Lens Changes the Picture... a defi ning moment
Getting the Conversation Going“We’re having conversa ons with staff and the Board of Directors about health dispari es within our region and what do they mean when we’re providing services,” says Stephanie Verhoeven, Regional Director - Public Health-Healthy Living. “We’re asking ourselves whether we’re addressing inequi es when we make decisions about the delivery of health programs and services to clients and communi es in the region, and what are the consequences of the ac ons that we take.”
“We can’t have a one-size-fi ts-all health system,” says Verhoeven, who adds a health equity assessment tool is in development for care providers and decision makers. “It’s a tool which can help iden fy people who are not star ng at the same place, and
consider what things systema cally disempower or exclude them. Once we understand these things, we can think about what needs to happen to make the provision of health care services and programs more equitable for everyone. It helps if we recognize that we cannot only rely on individuals taking responsibility for their health, but also consider how communi es take collec ve responsibility for the health of all their members.”
Building health equity is an ongoing journey, adds Verhoeven. “Health equity isn’t something that we’ll just arrive at. We’re not going to reach a goal of health equity for all in two years or fi ve years,” she says. “Moving forward ... It’s going to be a new and constant reality.”
Photographers know that when you change a lens, you change the picture. Using this same analogy, health equity is a new and important lens for health.
The recently completed Community Health Assessment (CHA) showed that although Southern Health-Santé Sud has one of the healthiest popula ons in the province, health disparity s ll exists in diff erent regions and among diff erent popula on groups, says Ales Morga, Manager - Planning and Evalua on in Southern Health-Santé Sud. “We have some districts that are very healthy and others that are less healthy, but within all of them there is a lot of varia on,” she says. “The CHA has really helped to put a lens to help people understand what health equity means. It’s a diff erent way of looking at informa on and trying to address some of the issues that cause inequity. Indeed this was a defi ning moment.”
Equality doesn’t always mean EquityEquality = SamenessGiving Everyone the same thing → it only works if everyone starts from the same place.
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Equity = FairnessOpportunities → we must first ensure equity before we can enjoy equality.
19Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Healthy Living Grantsbuild health equity
In 2014, there were 28 projects approved for Healthy Living Together grants across Southern Health-Santé Sud. Grants through Public Health-Healthy Living provide funding from $2,000 to $10,000 for projects that help improve the health and wellness of the local community.
Ac vi es funded through the grant must address fi ve areas, which evidence has shown are important modifi able risk factors for chronic disease. The risk areas are healthy ea ng, tobacco reduc on/staying tobacco free, ac ve lifestyles, mental well-being, and injury preven on. Fi y per cent of the grant must also focus on senior’s wellness or include intergenera onal ini a ves and programs. The inten on is that these grants serve as ‘seed money’. Communi es and working groups are challenged to fi nd other funding sources for ‘spin off ’ or ‘ongoing’ projects based on the success of their ini a ves.
A healthy living facilitator works directly with a community group to discuss local health data and to help them iden fy projects that would be health-enhancing or suppor ve of health in their communi es. The healthy living facilitator also assists the group with its grant applica on and off ers ongoing support for project development.
... Every Moment has a story ...Healthy Living Grant Helps Improve Food Security in Ste. Anne
About a year ago, school social worker, Joanne Vielfaure-Romaniuk realized that there was a growing need in the local communi es where she works for a food bank. More and more children were par cipa ng in the breakfast programs off ered by local schools, and between 15 and 30 children were provided with lunches every day because they’d come to school without one.
“I see poverty and the impact of it every day and I really wanted to come up with a solu on,” says Vielfaure-Romaniuk. “My goal was not to just give out food, but to build rela onships and tools to give to families and individuals who may need a li le bit of support.”
Community members in Ste. Anne and Richer immediately got behind the plan to develop a food bank and formed a commi ee, which decided not only to establish the food bank, but also to build a community garden to help address the wider issues of food insecurity within these communi es.
Healthy Living Facilitator, Leigh Finney, helped the commi ee secure a $6,800 Healthy Living Together grant which helped cover the costs for Ste. Anne/
Richer to develop a plan and educate themselves on how to create a food bank in their community. It also included development costs for the garden, which is located at Richer School, and the group hopes to build another garden in Ste. Anne as well.
The local Knights of Columbus stepped up to help by providing the group with 450 sq. . of space in its garage for the Accueil Kateri Centre, which will house the food bank and eventually become a Healthy Living Centre. “Our mission is not to be just a food distribu on centre, we want to help people
The response from the community with regards to se ng up a food bank in Ste. Anne was phenomenal with approximately 90 people taking part. There were signifi cant dona ons received that evening and a few barrels full of food were also donated – this totally unsolicited.
20
Some of the Healthy Living grants available through Public Health-Healthy Living are designed to build community capacity, says Jennifer Baker, Regional Manager - Public Health-Healthy Living for Southern Health-Santé Sud.
An example is the “School Travel Plan/Caught Using Your Head” project which provided funding for four communi es - Carman, Morden, Headingley and Portage la Prairie, who iden fi ed they were ready to focus on injury preven on and encouraging safe travel to and from school on bike or foot.
Portage la Prairie’s Fort la Reine Elementary School worked with its local healthy living facilitator, Dianna Meseyton-Neufeld and the RCMP to encourage kids to wear bike helmets, and off ered incen ves such as water bo les, kick stands and bike locks for kids who were “caught” wearing a helmet. The school also held a bike rodeo to educate the kids on how to fi t a bike helmet correctly and to apply safe and proper riding techniques. Because many students at the school have to cross busy crosswalks and walk on streets with no sidewalks to get to and from school, the school implemented a ‘walking school bus’ program to help improve safety. The Healthy Living grant helped pay for an adult to walk to and from school with the kids every day.
The project provided added benefi ts such as students ge ng to school on me, rapport building with students, be er school-parent rela onships, decreases in absences and academic improvements because of regular a endance.
“We know that if children develop healthy, safe, ac ve travel strategies they are more likely to con nue safely walking and cycling the rest of their lives,” says Baker. “The Healthy Living grant provided seed money for the school to come up with an ac ve transporta on plan. The plan has been so successful that it will con nue next year with new funding sources.”
Healthy Living Grants Build Community Capacity
help themselves,” says Jean Balcaen, Vice-Chair of the Ste. Anne Food Bank Commi ee. “Part of that is the community garden which will provide fruits and vegetables, but we also want to have sessions for people such as cooking demonstra ons, or other educa onal ac vi es to help improve food security in the community.”
Finney says it was the passion and dedica on of the community that impressed her the most. “The food bank was their vision and it was a great fi t with the Healthy Living Together grant, so I am happy we were able to be part of it and to provide resources to help them make the project happen.”
21Southern Health-Santé Sud ANNUAL REPORT 2014-2015
In 2012, the Province of Manitoba mandated that each of the province’s 5 health regions would create Local Health Involvement Groups (LHIGs) made up of residents to provide advice to the regional boards on issues that aff ect local health services.
The original model for Southern Health-Santé Sud was to create four LHIGs in 4 diff erent geographical areas of the region, as well as a separate Pa ent Experience LHIG, which is already underway, and a French-speaking LHIG in partnership with Santé en français.
Residents of the region were invited to apply to serve on the proposed LHIGs. A core group of applicants has been established for the geographical LHIG, which recently met to discuss strategies for how to proceed. “They are very engaged and commi ed and want to be a part of the process,” says Trish Braun, Community Engagement Facilitator for Southern Health-Santé Sud. “I am looking forward to working with the group because I know they’re going to be advocates to get the Local Health Involvement Groups going.”
“We now have a core group of people who care about health in our region, and their recommenda on is that we grow our LHIGs over me from this strong core,” says Southern Health-Santé Sud CEO, Kathy McPhail, who adds the Governing Board’s next task is to set topics for which it wants to seek input. “The Board is keen to have input from the LHIGs as an addi onal advisory mechanism to provide a public view about certain current and emerging issues and topics.”
As they evolve, LHIGs will be another way to connect with residents of the region in addi on to the many other community engagement ac vi es in which Southern Health-Santé Sud is already involved. These include an annual public mee ng, public newsle ers, community stakeholder mee ngs, and health preven on and promo on groups. “The Board and staff strongly feel that, as a people-centred organiza on, we need to have a health care system in which the public has a personal sense of ownership. As well, a LHIG represen ng the French-speaking community will also form part of the engagement process. A pa ent experience LHIG has been ac ve since 2014 (see p. 33).
For more than a decade, the Carman Community Stakeholder Group has been bringing together local Southern Health-Santé Sud staff and people from many diff erent groups and organiza ons who all share an interest in the health of their community.
It’s an ac ve and dynamic group that has made a diff erence to the health and well-being of the community. “There have been a lot of valuable partnerships and programs that have come about as a result of people si ng around the table with like interests,” says the Carman area’s Economic Development Offi cer, Tyler King, and stakeholders group member. “As an example, the Carman Community Health Centre Board is also involved in the group and it has developed many of its informa onal seminars with input from the stakeholders group about what topics the community is interested in.”
Stakeholder members have also developed programs together such as a Biology Health Experience for high school students who spend a day at the Community Clinic and health care facili es. The program provides an educa onal opportunity for the students to gain some fi rst-hand knowledge about human health and creates awareness of the many op ons for health-related careers.
A discussion several years ago among the Carman Stakeholder Group about the lack of seniors housing led to more seniors housing being developed in the community, adds Mary Heard, Director of Health Services - Carman and Area. “These are wonderful examples of where we have been able to have a discussion about the needs in our community and to come up with some crea ve ideas to help address them,” she says.
Stakeholder Groups Continue to Make a Difference Across the Region
Local Health Involvement Groups... being in the Moment with the community involvement
22
Gaining Momentum in the Community ... progress through partnership ... making the most impact with every Moment
The aptly named Momentum Project in Portage la Prairie has defi nitely provided momentum for con nuing work in the community aimed at reducing the barriers to economic security for women.
The project has been led by Portage la Prairie Community Revitaliza on Corpora on (PCRC), which has collaborated with other community partners, including Southern Health-Santé Sud.
Funded by the Status of Women Canada, the Momentum Project focused on the areas of child care, transporta on and collabora on. These three factors were iden fi ed as key barriers to economic security in the Portage la Prairie and area by women who took part in the early research stages of the 3-year project. Recommenda ons coming out of the project include the development of a child care hub, where other services – such as the Public Health-Healthy Living Offi ce or family resource programs are located along with daycare spaces. “The idea is that parents who are already bringing their children to daycare can access other programs under one roof,” says Elicia Funk, Execu ve Director of PCRC.
An electronic database of community resources is also being developed to connect clients and service providers to the resources they need, says Tracy Ediger, a public health nurse who sits on the collabora on commi ee.
Another ongoing ini a ve is bringing more events – such as a board game evening and ‘how to grow a herb garden’ event - to community neighbourhoods. “People told us that lack of transporta on can keep them from par cipa ng in events, so they wanted more family ac vi es in their own neighbourhoods,” says Funk, who adds, another goal is to build safety. “If people in neighbourhoods know one another and have social support networks, their feeling of safety will increase.”
It’s really important for health care providers to be involved in ini a ves like the Momentum Project, says Funk, because the things that help determine a person’s health are the same things that can aff ect community and social development.
Sharing informa on is an important part of the partnership, adds Healthy Living Facilitator, Dianna Mesyeton-Neufeld. “The ini a ves and ideas that come out of this project are local, Manitoba-grown ideas that can probably work well in some other communi es. Because they have a regional and community focus, healthy living facilitators can help share some of these ideas.”
Owen Vanstone of Vanstone Nurseries demonstrates how to grow and take care of a herb garden.
23Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Let’s Get Better Together... being the best you can be ... making every Moment count
It takes so li le to feel be er about yourself, says Denise Payment, a leader for the Get Be er Together program. “We can all learn things about how to take be er care of ourselves, and there is strength in being part of a group because we meet new friends and get new ideas,” she says.
Get Be er Together is a self-management program that brings together a group of people dealing with a chronic health issue – such as diabetes, anxiety or depression – to encourage and support each other as they learn what they can do to self-manage their chronic disease. It’s about being the best you can be so that every moment counts.
“We go through what’s called a self-management toolbox,” says Brenda McConnell, who a ended the program in Portage la Prairie last fall, a er being diagnosed with diabetes a year-and-a-half ago. “The leaders pick a diff erent subject every week. So it might be about managing emo onal changes, or healthy ea ng, or the importance of staying physically ac ve.”
Par cipants and their leaders set goals for themselves each week. “The goal can be something small such as ‘I want to eat more veggies this week’,” says Payment, who has led three Get Be er Together groups over the last four years. “By sharing the goal with the
group, they make a commitment, which gives them the mo va on to try and achieve it. When they report back the next week, everyone is always encouraging and suppor ve and, even if they didn’t achieve their goal, we problem-solve together. It gives them skills that they can also use outside of the group.”
It’s great to make new friends and share experiences with others who are coping with the same things as you are, says McConnell. “It’s a safe place to talk about things with each other, while looking to improve your own health,” she says. “We each have a phone buddy we keep in touch with during the week to fi nd out how they are doing.”
Get Be er Together is off ered in diff erent communi es in the Southern Health-Santé Sud region each year. Even though she has led the course three mes, Payment says it’s always an energizing experience for her. “Every group is diff erent and it’s enriching for me to work with diff erent people. I came out of the program with my own goals and it was a posi ve experience for me too.”
“I would encourage anyone who is at a stage where they are comfortable talking about their chronic illness to go and par cipate in the Get Be er Together program,” says McConnell. “It’s free, and even if you pick up one or two pieces of informa on you didn’t have before, it’s really worthwhile.”
The Portage la Prairie Get Be er Together group is a self-management program that brings together a group of people dealing with chronic health issues, encouraging and suppor ng each other as they learn what they can do to self-manage their chronic disease. Pictured is the Portage la Prairie Get Be er Together group: (back row lt.-rt.) Byron Buchanan; Brenda McConnell; Roseanne Harder; leader Denise Payment; (front row lt.-rt.) Moyra McBurney and Elsie Stockman.
24
Healthy Babies Strong families create beautiful Moments Lara Wieler is new to Morden so the Healthy Baby program helps her to meet other mothers in the community and to fi nd out about family services and programs. The program provides useful informa on, she adds. “We recently had a car seat talk and, while at that session, a public health nurse also taught us about cks and how to iden fy them which is really handy to
know,” says Wieler, who a ends the program with her second baby and her daughter. “If I need a fi ve minute break, there is someone who can hold my li le one, and there’s daycare for my daughter. It’s a safe place to go and, if I’ve had a tough week, it’s a great place to de-stress.”
The social support that the Healthy Baby program gives to expectant and new moms is a really important part of the program, says Terry Schmidt, a Healthy Baby Coordinator who is based out of Steinbach. “We are a support and educa onal program that’s delivered in the communi es where they live,” she says. “We create a suppor ve, welcoming, and non-judgemental environment, and encourage strong parent-infant rela onships.”
The Healthy Baby program also provides a monthly nutri onal supplement for those who qualify during their second and third trimester.
The Healthy Baby program is available to prenatal women up un l their child is one year old. “We come to each community once a month, and we have 12 priority topics that we cover with them,” says Schmidt. “We always promote breas eeding, and discuss infant development and issues such as baby blues or postpartum depression. We talk a lot about a achment and have parent-infant ac vi es that moms can do with their babies.”
Although based around specifi c topics, the program is fl exible enough to discuss topics that the group raises, adds Anita Hiebert, Healthy Baby Coordinator for the Morden area. “Because we are family-focused, the conversa ons go where the group wants to go,” she says. “We try to be aware of what’s going on in their lives and what they’re hearing and seeing and make sure the informa on they’re ge ng is coming from reliable sources.”
“The biggest benefi t is just mee ng new mothers who are in the same boat as me,” says Wieler. “And also ge ng the informa on, because some mes you get lots of advice but it’s much be er if the people are right there with you.”
Lara Wieler and her children (lt. Chloe; rt. Mikael). Lara joined the Healthy Baby program and found social support that the Healthy Baby program gives to expectant and new moms.
ren (lt. ined
m and the
ves to s.
25Southern Health-Santé Sud ANNUAL REPORT 2014-2015
“Have you smoked in the last seven days?” ... making a lifelong decision in the Moment ...This is a ques on which health care staff asks when they are admi ng pa ents to the Portage District General Hospital. It’s a ques on being asked following a recent pilot project that aims to help smokers not smoke during their me as inpa ents at the hospital. The 6-month Tobacco Cessa on Project fi rst iden fi ed pa ents who were smokers upon admission, and a nurse then went through a smoking assessment with them.
The 5 As
Health care staff now off er pa ents Nico ne Replacement Therapy (NRT) or Champix for their comfort and safety while in the hospital. Pa ents are also referred to the Smoker’s Helpline upon discharge.
“The project allows us to accurately track the number of pa ents that are smokers at the hospital,” says Chantal Chevalier, Healthy Living Facilitator with Southern Health-Santé Sud. “This standard ques on is now on the front page of our admission form and it’s used throughout the en re facility so that we can con nue to accurately track the number of smokers that are admi ed.”
During the pilot phase, pa ents fi lled out an evalua on form on discharge, and staff measured the project’s success by collec ng data including the number of pa ents who were smokers, how many used NRT while in the hospital, and how many were referred to the Smoker’s Helpline when they were discharged.
The pilot project was a great success, says Chevalier, and adds that the process it created is now embedded in the system at the Portage District General Hospital. “We are tracking smoking rates, and have added NRTs and Champix to the regional formulary – a list of medicines available to pa ents while they are in the hospital,” she concludes. “Health care providers take the me to discuss op ons for qui ng smoking as part of their rou ne interac on with clients and pa ents who are smokers.”
The fi ve steps are:• Ask every pa ent if they
smoke.• Advise the smoking pa ent
to quit.• Assess the pa ent’s
willingness to quit.• Assist the pa ent in qui ng.• Arrange for follow-up.
Moments of Mental Health Well-being... another Out of the Blue success story!Out of the Blue is a program coordinated by the Southeastern Suicide Preven on Commi ee part of Southern Health-Santé Sud which includes representa on from youth, and a wide variety of community stakeholders.
The 5th annual “Out of the Blue” campaign was launched in January 2015 at the Shevchenko School in Vita. This year’s launch involved students from Grades 7 to 12, community members and service providers – this to help raise a New Voice for Mental Health.
Building on last’s year’s success, this year’s campaign targeted high school students, businesses, individuals and many community organiza ons – all with a common goal to ensure the New Voice is being heard through various ini a ves of mental health awareness, suicide preven on and s gma reduc on presenta ons. Although suicide interven on and preven on remain the primary focus, there has been an expanded shi to include discussion around mental health and mental illness and what it means to the youth. This year’s presenta ons were delivered at 5 schools, in 5 school divisions: Shevchenko School in Vita, École St. Joachim in La Broquerie, Ste. Anne Collegiate in Ste. Anne, Ins tut Collégial St. Pierre in St. Pierre Jolys, Roseau Valley School-Morris School and Steinbach Regional Secondary School did their own presenta ons this year.
Creatively Blue Gala The Blue Carpet gala was held in Spring 2015 at the St. Pierre Recrea onal Centre. It was a ended by 218 guests dressed in crea vely blue a re. The theme for the event was ‘Hope’. Awards were handed out to groups and individuals who have helped raise a New Voice for mental health in Southern Health-Santé Sud. Businesses, individuals and community groups were also acknowledged for their Blue Awareness ac vi es, Blue Expressions and others.
Southern Health-Santé Sud is very proud to have joined all of our Gala guests, sponsors and honored guests in delivering such extraordinary support for the “Out of the Blue” campaign for the fi h year in a row. This event plays a role in awareness raising, decreasing s gma related to mental illness while also focusing on mental health promo on. We con nue on this journey in hope.
The 5A’s are a framework that health care providers use to try and help people stop smoking.
26
Accessible Health
Services
27Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Morden/Winkler My Health Team LaunchesIn collabora on between Agassiz Medical Clinic in Morden, the C.W. Wiebe Medical Centre in Winkler, community partner, South Central Immigrant Services, Southern Health-Santé Sud and Manitoba Health, a second My Health Team in Southern Health-Santé Sud was launched for the Morden/Winkler area.
Imagine a one-stop-shop for all your primary health care needs – where you can see your doctor, or nurse prac oner, or die an, or mental health worker all under one roof, and not have to repeat your medical history to each one. My Health Teams come close to this, off ering a team of inter-connected health care providers that work together to provide a broad range of quality health care services.
A gap analysis as part of the planning process for the Morden/Winkler My Health Team iden fi ed areas of need that required further resources. As a result, My Health Team will add a number of health care providers including a mental health clinician, chronic disease nurses, and a respiratory technician/educator. These new providers will provide their services to both of the medical clinics.
“We know that there are s ll a number of people who don’t have regular access to a physician,” says Jim Neufeld, Administrator at C.W. Wiebe Medical Clinic. “These new care providers have the skills to help us deliver some primary care services and to reduce the workload of our physicians so they can take on extra pa ents. By being a ached to our clinics, it makes it easier for our pa ents to access these services because they don’t need to be referred to a provider in another loca on.”
All My Health Team providers have access to the same electronic medical record for a pa ent, which makes it easier for everyone to stay up to date on what the pa ent’s care needs are.
The fi rst My Health Team was launched at Steinbach last year, and Dr. Mark Duerksen says it has improved the quality of care that pa ents receive. “The integra on of new providers within a shared electronic medical record system has allowed for be er pa ent scheduling,” he says. “And it’s improved communica on between physicians and providers.”
A third My Heath Team for the Portage/Gladstone area is also ge ng closer to launch. The gap analysis has been completed, and areas of focus have been iden fi ed, and it’s an cipated that new staff will be hired and My Health Team will soon be opera onal, says Dr. Mike Omichinski, a physician at the Portage Clinic.
Neufeld says the two medical clinics have a long history of working together and My Health Team is the next step in their collabora on. “It isn’t new for our clinics and physicians to work with each other and other care providers to give good quality care to our pa ents,” he says. “What’s new is that we are sharing the care providers between the clinics, and My Health Team is taking on a li le broader geographical footprint that encompasses both clinics’ prac ces.”
My Health Teams are interconnected, working to provide a broad range of quality health care services.
“”
“Essen ally we want to off er quality care to our pa ents when they need it. That’s our ul mate goal. This can be done in many ways on a day-to-day basis ranging
from keeping working areas clean ... to ensuring someone gets the right service, in the right place, at the right me. From my perspec ve, I like to accommodate our pa ents’
schedules as much as possible and to ensure that all is in place so that appointments run as smoothly and effi ciently as possible.”
Lauren Gauthier, Clinic Coordinator, Clinique Notre-Dame Clinic
Accessible Health Services
28
You’d be er not be late for an appointment at the QuickCare Clinic, says Brian Brunelle, who recently visited the clinic in Steinbach because of a nagging ear infec on.
“When they tell you your appointment is at nine o’clock: you’re walking into the room,” he says. “There’s no wai ng.”
That doesn’t mean that the care isn’t excellent, he adds. “I was very impressed with the care. The health care provider did a thorough exam, checked my blood pressure, and asked a lot of ques ons,” says Brunelle. “When she checked my ears, she was able to see there was fl uid behind them. They gave me an bio cs which fi nally worked, giving me a lot of relief because I’d been in pain for a while.”
QuickCare clinics are staff ed by registered nurses and nurse prac oners and are located in places within the community that are easy to access – in Steinbach, for example, the clinic is at the Clearspring Centre. QuickCare clinics are open evenings and weekends, when regular health care providers may not be available, and off er care for minor ailments that don’t require a trip to the emergency room.
“What impressed me the most is that if one person wasn’t sure about something, they asked a colleague about it – and someone on the team had the answer,” says Brunelle.
Brunelle says his whole family have now been to the QuickCare clinic a few mes and have been totally sa sfi ed with the care they receive. He urges anyone with a minor ailment not to hesitate going to the QuickCare clinic. “I didn’t need to see a doctor,” he says. “I had a minor ailment that could be a ended to by another health care provider. Instead of tying up the doctor’s me, I think more people should be using the QuickCare clinic because they provide another op on to access a health care provider vs. having to visit a physician or a hospital emergency room, allowing them more me to deal with people that have serious health issues and need their help.”
Don’t be Late... QuickCare clinic awaits!
Is there a Doctor in the House?
When the doctor that Ron Funk had been seeing for many years re red, he didn’t really know where to start looking for a new doctor and was too busy to phone around and ask which doctors were accep ng pa ents.
Funk’s wife had heard about a new provincial service – the Family Doctor Finder – which matches people who don’t have a family doctor to a primary health care provider close to home. She sent an email to register her husband for the program and within two weeks he received a call off ering to connect him with a nurse prac oner who was accep ng pa ents in Morden, where he lives.
Since the program began in 2013, it has connected around 24,000 people – including about 1,000 in Southern Health-Santé Sud – to a doctor or nurse prac oner. The program is part of a provincial ini a ve to make sure that every Manitoban who wants a primary care provider has access to one by the end of 2015. “The Family Doctor Finder supports these eff orts by providing a customer-focused and ac ve service to connect people with a primary care provider,” says Monica Goertzen, Primary Care Connector with the program.
“I have only gone to see him once so far, but I’m happy,” says Funk, who admits without the program he probably wouldn’t have made much eff ort to try and fi nd a new doctor. “This made it very simple and smooth for me and they quickly found someone who was available. I’m not sure how long it would have taken me to do that. I think we’re very lucky to have a program like this.”
Ron Funk, has been connected with a health care provider in his home town, with the help of the Family Doctor Finder program.
Ron Funk, has been connected with a health careprovider in hishome town, with the help of the Family Doctor Finder program.
29Southern Health-Santé Sud ANNUAL REPORT 2014-2015
When Donna Huyber sustained a back injury, the thought of having to sit in a car and drive 45 minutes to the closest walk-in clinic where she would then have to sit awai ng an appointment was excrucia ng.
Thankfully, Huyber avoided all that pain and inconvenience by going to the mobile clinic that visits her community every Tuesday. “I went to the mobile clinic every two weeks for two months,” says Huyber, who lives in Langruth. “It was so convenient because it was a fi ve minute walk from my home, so I didn’t have to deal with bad roads and I could do this at the end of my work day, so I didn’t even have to take me off work. If you make an appointment, they always run on me. Even as a walk-in, you might have to wait 15 minutes at the most.”
Huyber is also extremely impressed with the care she received. “It was so awesome that I wanted to switch and have the nurse prac oner be my primary health care provider,” says Huyber. “She is very thorough. One thing I really appreciated was that she gave me immediate treatment for relief of the pain un l I could get my prescrip on fi lled, and also off ered to fax a prescrip on to my pharmacist in Gladstone.”
Mobile clinics currently provide health care services to four communi es in Southern Health-Santé Sud - Plumas, Langruth, Woodbridge, and Dominion City and coming soon to St. Ambroise. They have two exam rooms where a nurse prac oner and registered nurse off er treatment for minor health ailments, and also provide informa on and help for pa ents managing chronic diseases. At this point, the bus is travelling over 1,000 km per week between all our sites.
Community residents can access the same services as they would in a regular clinic, such as prescrip on renewals, regular check-ups, referrals, immuniza ons, and lab services, and will soon be off ering blood tests. “We already do urine screening, and throat swabs for strep as well as pregnancy tests. We are just wai ng for the equipment to arrive so we can also do blood work in the mobile clinic,” says Nurse Prac oner, Cindy Fehr. The volume of pa ents coming to the mobile clinic is defi nitely increasing, says Fehr, and it’s quickly become not only a great resource for its clients, but also for the community.
Mobile Clinic... health care rolls in closer to home
Kyla Kempert, visi ng the Mobile Clinic in Woodridge.
With so few resources in a small community, the mobile clinic is just one more thing that people don’t have to drive for, says Huyber, which is why she encourages everyone she can to use it. “I think this is a valuable resource and people need to get out and use the mobile clinic so that it’s worthwhile for it to con nue to come here,” she says. “It’s convenient, easy to access and eff ec ve.”
30
Getting Better at Home... evolving Moments of innovationLore a Mayor would have had great diffi culty a ending an outpa ent physiotherapy clinic for treatment a er having a knee replacement last October. Instead, thanks to the Community-based Rehabilita on Program, the physiotherapist visited her at her home in Gladstone.
“Because of my decreased mobility, it was not possible for me to make it to an outpa ent clinic“ says Mayor. “The physiotherapist working with me in my home, made sure I was doing my exercises right and it was just terrifi c.”
The Community-based Rehabilita on Program provides occupa onal therapy and/or physiotherapy services in clients’ homes. The program is aimed at people who might otherwise not be able to access outpa ent rehabilita on services, says Jackie Derksen, Regional Director - Rehabilita on Services for Southern Heath-Santé Sud. “We’re trying to off er the service to people who may be at risk of their health, mobility or independence deteriora ng, or where their situa on might mean they could be hospitalized.”
Gladstone resident, Grace Anderson, was also grateful to receive the Community-based Rehabilita on Program a er she broke her hip in January and returned home a er a week in the hospital. She says it was valuable to have the physiotherapist and occupa onal therapist come and give her advice about what to do in her own home se ng. “She looked at my home and told me if I needed to change something,” says Anderson.
Health care providers, such as family physicians, physician assistants, nurse prac oners or home care case coordinators can refer clients they feel would be appropriate for the program. Community-based Rehabilita on is intended to op mize the client’s func onal health and improve their quality of life and independence at home, adds Derksen.
The Community-based Rehabilita on Program is off ered throughout the region and is based out of the region’s three regional centres: Bethesda Regional Health Centre in Steinbach, Boundary Trails Health Centre in Morden/Winkler, and Portage District General Hospital.
Southern Health-Santé Sud Shortens Colonoscopy Wait Times with a new central referral process for gastrointestinal endoscopyWait mes for colonoscopy appointments have been drama cally reduced across Southern Health-Santé Sud, thanks to a new Colonoscopy Central Referral process.
Colonoscopy is a vital part of screening for colon and rectal cancer. Pa ents are now off ered the next available appointment for a colonoscopy at fi ve health centres in the region and are given priority based upon urgency of the referral from their doctor. In 2014-15 there were 4,235 endoscopies performed in the region.
The Central Referral process matches pa ents needing a colonoscopy with the site which has the shortest wait me. The aim is for the pa ent to receive the test within 13 days for urgent and 27 days for semi-urgent cases. Pa ents who have a higher suspicion of cancer can also be connected to nurse navigators who assist pa ents and their families through the cancer journey as quickly and easily as possible. A pa ent may also choose not to accept the fi rst available appointment if he or she prefers to go to a specifi c site.
The project is part of the provincial “In Sixty” Cancer ini a ve which aims to reduce wait mes from when cancer is fi rst suspected to the fi rst treatment to 60 days or less. “If we can treat cancer earlier, outcomes can be be er, but certainly the anxiety provoked by long wait periods is also greatly reduced,” says Dr. Denis For er, VP - Medical Services for Southern Health-Santé Sud. A standardized form fi lled out at the pa ent’s fi rst consulta on is also a part of the improvements made to the referral process. Addi onal informa on is collected so that the pa ent doesn’t need to be seen again for a pre-op consulta on. Not only does this speed up the me for diagnosis and treatment, it also helps to free up appointments in the region for other pa ents needing primary care.
The colonoscopy project developed further to a review of the region’s previous system using ‘LEAN’ principles to reduce wasteful wait mes and improve effi ciency. “LEAN allows us to monitor and evaluate our health systems in a consistent way, so we can con nue to make improvements and off er a safer, more responsive health system to the people we serve,” says Dr. For er.
31Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Irene Wiebe is celebra ng 3 years cancer free, but it might have been a diff erent story if she hadn’t started having regular mammograms through the BreastCheck Program.
“At age 50, I started doing biannual mammograms and when they discovered my tumour, it was so small that no doctor was ever able to fi nd it,” says Wiebe. “If I had waited un l I could feel the tumour, I don’t know what the outcome would have been.”
Wiebe had no risk factors or family history of cancer which she says demonstrates why it’s important to take advantage of the free BreastCheck Program. Wiebe had her diagnosis within a month of the screening and surgery 3 months later.
“I am a great believer in taking advantage of what’s available, especially something that could save your life,” says Wiebe. “It’s readily available, so why not do it?”
The BreastCheck mobile program off ers mammograms in 90 communi es around the province as well as at 4 permanent sites in Winnipeg, Brandon, Thompson and the Boundary Trails Health Centre. “People do not have to wait for the next mobile to come to them,” says Brandy Pantel of CancerCare Manitoba. “Anyone can make an appointment at the permanent sites at any me.”
BreastCheck is available free to all women from the age of 50. BreastCheck mails an invita on le er to a end the program when a woman turns 50 and a reminder le er when she is due to return. “80% of breast cancers occur in women over the age of 50,
It Could Save Your Life... valuing every Moment
Brenda Sarrasin had her fi rst mammogram 13 years ago in Winnipeg. Two years later, she received a reminder in the mail advising that the mobile BreastCheck comes to Île des Chênes, where she lives. Since then, she has been going for regular mammograms at the mobile site and says the service is fantas c. “The mobile BreastCheck is two minutes from my house, and it only takes fi ve minutes. It’s so convenient and the service is equally good as if you went to one of the major centres,” says Sarrasin. “The mobile isn’t in such a ‘clinical se ng’. In fact, it feels like you are amongst a group of friends; the technicians are fantas c. They put you at ease and it’s as if you’re there for a visit. It’s worth the fi ve minutes out of your day to get a mammogram done.”
which is one of the reasons we recommend that most women begin screening at that age,” says Pantel. “But if someone has a family history of breast cancer, they should talk to their doctor about the best plan for them.”
“We want to save lives,” says Pantel. “Mammography is the only test for breast cancer that has been proven to do that.”
Since the go live dateJan. 2013 to April 30, 2015
238 referrals
Boundary Trails Health Centre Hub
Bethesda Regional Health Centre Hub
Since the go live date Sept. 2014 to April 30, 2015
888 referrals
32
Safe,People-
centred, Quality Health
Care
Every Day,Every Moment.
33Southern Health-Santé Sud ANNUAL REPORT 2014-2015
A Moment of Truth Hearing the Patient VoiceA er Donna Penner experienced a cri cal incident a few years ago, she realized how important it is for pa ents to have a voice in health care. As a result, Penner jumped at the chance to serve on the Pa ent Experience Local Health Involvement Group which brings together health care staff , board representa on, and pa ents from Southern Health-Santé Sud.
“The Pa ent Experience Group creates an avenue for pa ents to share their health care experiences, and their views on topics that ma er to them,” she says. “It also allows pa ents to see the inner workings of health care. It creates a more balanced rela onship between the pa ents who use our system, and the people responsible for making it work.”
CEO Kathy McPhail shares that ‘pa ents’ is meant in the broadest term, meaning inpa ents, outpa ents, users of community health care and personal care home services, as well as rela ves and caregivers. “Because we’re here to serve all the residents of our region, it’s important to be able to look at what we provide through their eyes. We strive to seek input on pa ent experience through a variety of ways. For example, hospital pa ents are welcome to fi ll a survey following their discharge and this meaningful informa on helps us to develop strategies to enhance the pa ent experience moving forward.”
Commi ee member, Marie Ferguson, believes the Pa ent Experience Group can play an important role in be ering the health care system. “Feedback from our own personal experiences can provide our physicians and caregivers with the tools they need to improve the care they provide to their clients,” says Ferguson, whose daughter was a pa ent aff ected by a cri cal incident a year and a half ago.
Penner was involved in the planning process and, like the other members of the planning group, decided to stay on and serve on the formal commi ee. “The planning process was just the start for them,” says
Trish Braun, Community Engagement Facilitator with Southern Health-Santé Sud. “They wanted to be the doers too.”
Penner says she’s learned that there are many dedicated people within the region working hard to make health care safer for all future pa ents. “Our system is always striving to provide person-centred, dignifi ed care, and to ensure all cultures are included,” she says. “It’s very serious about including the pa ent voice.”
Addi onal pa ents or family members some mes share their stories with the group. “Some of the stories aren’t easy to hear and there have been tears around the table,” says Braun. “But the passion that comes from those stories is what inspires us. It’s a very special group and has truly become a valuable partnership.”
“I believe that the future of health care can be be er than the present and that, by working together, we have the power to make it so,” says Ferguson.
“O en it’s the li le things that ma er the most in my daily work, such as giving a friendly, warm gree ng, or just being there to listen to a pa ent and help support his
or her family. I’ve no ced that eff ec ve communica on amongst the many health care professionals involved in the pa ent’s care is key to providing quality, safe, and focused care
for pa ents and their families.”Allison Stone, Chemotherapy Nurse, Boundary Trails Health Centre
Safe, People-centred, Quality
Health Care
Pictured (lt.-rt.): Marie Ferguson, Robert Rintoul and Donna Penner, members of the Pa ent Experience Group taking me to debrief a er a mee ng.
34
Accredita on Canada is a not-for-profi t organiza on which partners with health care regions in the accredita on process. The ongoing Accredita on cycle assesses an organiza on’s programs and services against standards that are focused on pa ent safety and improving the quality of health care. As part of this process, a team of surveyors visits the health region every four years. Southern Health-Santé Sud received its visit this past March.
“The surveyors are trained to review an organiza on’s processes against our standards of excellence, which are based on best prac ce,” says Madeleine Drew, Accredita on Specialist with Accredita on Canada. “They have experience working in diff erent health care fi elds, such as acute care, long term care, or primary care.”
Surveyors trace either an administra ve process or the path of a client through the health care system. “It’s not just looking at documents or having mee ngs,” says Drew. “Accredita on is also about understanding how the client journeys through the health care system, and how the organiza on meets the recommended standards as clients go through every stage of that journey.”
Providing safe, quality health care involves a complex, inter-connected system behind the scenes that is necessary to support the work of providing care. “The Accredita on process doesn’t just look at the rela onship between health care providers and clients, but also looks at all the structures and processes that contribute to the work that’s done at the point of care,” says Darlene Anderson, Regional Coordinator - Quality & Accredita on for Southern Health-Santé Sud.
Accredita on is a process that involves all members of the health care team, including pa ents, and clients, and extends out to health care services in the community as well.
Accreditation ... celebrating Moments of excellence
Moment of Excellence shared through Patient ExperienceAn accredita on surveyor spoke with Steinbach resident Anne Kehler about the care that she receives through the home care program. “He (accredita on surveyor) wanted to know how home care was working out for us, and if it is fulfi lling our needs. I told him that we’re very happy with it and the people are excellent,” says Kehler, who says the interview le her feeling reassured about the region’s health care system. “It made me feel that they care,” she adds.
“Accredita on is a learning and growth opportunity,” says Darlene Anderson. “A lot of the things set out in the standards are things we’re doing already, but we all have things we can improve upon. Accredita on Canada helps us stay current with best prac ces in care delivery so we can con nue in our eff orts to off er excellent health care services.”
Following the Accredita on Site visit in March 2015, the
Accredita on Decision Commi ee advised that Southern Health-Santé Sud is Accredited under the Qmentum accredita on program. “This is a milestone
to be celebrated, and we congratulate you and your team
for your commitment to providing safe, high-quality health services,” shares Christopher Dean, Chair of the Accredita on Decision Commi ee. Please visit www.southernhealth.ca for access to the complete Accredita on Report.
FollowSit
A
tcon
Accreditation• 46 loca ons were assessed by the Surveyor Teams• 22 sets of standards were used in the assessments.
Accredita on Canada uses 8 dimensions that all play a part in providing safe high-quality health care
35Southern Health-Santé Sud ANNUAL REPORT 2014-2015
The following chart shows the percentage of criteria that the organiza on met for each quality dimension.
Representa ves from Accredita on Canada, Southern Health-Santé Sud staff as well as Affi liate and Community Owned Not for Profi t sites gathered at the conclusion of the Accredita on Survey debriefi ng on March 20, 2015.
Overall we met an average of 89.3% of the quality dimensions. There are opportuni es for improvement that require follow up with Accredita on Canada such as enhancing our fall and wound preven on strategies in some programs and using two client iden fi ers prior to providing service. Accredita on status will con nue un l March 2019 provided that repor ng requirements are met.
Quality Dimensions: percentage of criteria met
Accessibility
Appropriateness
Client-centred Services
Con nuity of Services
Effi ciency
Popula on Focus
Safety
Worklife
97
84
95
99
93
90
88
93
0 10 20 30 40 50 60 70 80 90 100
A Team Committed to ... the quality improvement journey
36
Back to Basics for Births
Natural Births in HospitalsFor those who choose the hospital se ng, the trend is also towards a more natural experience. Some facili es have a pool or Jacuzzi tub to allow women to labour in water as well as various natural pain control methods such as massage and back rubs in place of medica ons. “Instead of hooking them up to machines, we encourage women to move around, have a shower or use a birthing ball,” says Lorraine Cassan, Regional Obstetrical Educa on Facilitator for Southern Health-Santé Sud. “Studies have shown that when women are ac vely involved in making decisions about their own care, the risk of post-partum depression goes down signifi cantly.”
Through prenatal classes, public health nurses are also part of the team working to help ensure the best quality care for moms and babies in the region, encouraging breast feeding, and helping mother and baby make the transi on from hospital back to their home.
“We’re all working together as a team to con nue to off er the very best family-centred, safe care for moms and babies throughout the region,” says Cassan.
“We do have some fi rst me moms reques ng home births, but we also have many women who’ve had hospital births who are looking for something diff erent,” says midwife, Veronica Reimer, one of 15 part- me/full- me midwives in the region. “For some women, home birth makes them feel more in control. When they’re holding their baby in their arms, they feel incredibly powerful because of what they’ve accomplished.”
Women also like the fact that midwives support them through the pregnancy, the delivery, and for 6 weeks a er the birth, says midwife, Lisa Harcus. “When you have the same person giving con nuous support, it decreases interven ons and the need for medica ons which really helps support the natural birthing process,” she says.
Home Birth: a beautiful MomentThe choice of a birthing op on is a very personal decision. Julia Thiessen and her husband gave this a lot of thought and decided that she would give birth to her second child, Frederic, in the basement of her Altona home.
“Part of the reason I chose a home birth is that I like to labour at home for as long as possible,” says Thiessen, “A er doing some research, speaking with midwives and based on my previous birth experience, my spouse and I decided on a home birth.”
As more and more women seek a natural birth experience, midwives, nurses, public health staff and physicians across the region are working together to provide as many birthing op ons as close to home as possible. For a number of reasons including priority popula on, high-risk pregnancies, staffi ng levels and geographic loca on, not everyone can be accommodated.
“Birth has always been a natural, not a medical event, and we con nue to off er op ons that allow women
to have the birth experience they want, while s ll ensuring that we off er safe care to both mothers and babies,” says Dr. Denis For er, VP - Medical Services for Southern Health-Santé Sud.
Medical op ons will always be available for women who want them, or when they are necessary, but overall the number of women in the region who had epidurals or caesarean sec ons last year were well below the provincial average.
37Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Growing Moments... EMS extends the emergency roomEmergency Medical Services (EMS) extends the Emergency Room (ER) out onto the sports fi eld, the home, the side of the road, or wherever a person needs emergency or primary care.
“Many of the things that paramedics provide at the scene are treatments that people would historically only have received in an ER,” says Sco Noble, Regional Director - EMS for Southern Health-Santé Sud.”
All EMS staff employed by the region have completed a na onally accredited, Basic Primary Care Paramedic program and, a er a period of me, can apply to access advanced training to the Intermediate Care Paramedic level. They also receive ongoing training from the region’s Clinical Educa on team. “The intermediate paramedic receives addi onal training to off er an advanced level of care at the scene such as administering the same medica ons for a cardiac arrest as would be given in the ER,” says Noble. “Educa on is expanding the capabili es of our paramedics at both the basic and intermediate levels to be er support and manage pa ents prior
EMS at a Glance
• 20 EMS stations located across the region.• 31 ambulances.• 146 full time and 60 casual paramedics• the region responded to a total of 18,193 EMS
calls in 2014-15• total amount of kilometres travelled by EMS units
in 2014-15 = 1,777,149
Thiessen’s fi rst son, Leo, was born in the hospital. “With my second son, I felt the home birth was much more peaceful, relaxing and calming, and it allowed me the comfort and privacy I was looking for,” shares Thiessen.
The birth also seemed to be a part of the family’s natural daily rou ne, says Thiessen. “We just carried on seamlessly with life a er the delivery,” she says. “Our older son was asleep in his room during the labour and, when he woke up, I remember hearing his footsteps upstairs as the midwife greeted him before he went off to school with his grandmother. The care truly was very family-centred.”
Thiessen says she defi nitely felt she had more choices with a home birth. “I could choose who would be there for the birth, where I wanted and felt most comfortable to labour, and could decide on the ligh ng, the temperature and even what food I wanted.”
Thiessen says one of her worries about having a home birth was that she would be overwhelmed with prepara ons, but says the midwives made it simple. “The midwives provide most of the needed supplies. They also reviewed the list of things I needed to have on hand so I could be organized well ahead of me,” she says. “It was benefi cial to feel prepared because even when the baby decided to come 9 days early, there was no sense of urgency. The midwives have a very unobtrusive way of coming into your home, and they follow your cues. It was a beau ful, in mate experience for our family.”
to hospital. With this training, we are be er able to transport pa ents longer distances if they don’t have a receiving facility that is close by.”
“What people expected EMS personnel to do 10 years ago is nowhere near the level of care that they can provide today,” says Noble. “We are very lucky to have a dedicated team of people that is the glue that keeps the EMS program moving forward and providing a high level of quality care to people throughout the region wherever they need it.”
Pictured with her family, Julia Thiessen was very grateful for the opportunity to experience home birth.
38
A Day in the Life of a Paramedic... never a dull Moment
There isn’t a day that Tom Helliwell doesn’t want to go to work. “I love my job,” says Helliwell, who has been a paramedic for 31 years. “I like helping people and enjoy giving the best care I can. I enjoy working as a team with other health care professionals such as physicians, nurses, and lab & imaging staff and fellow medics. I also have an excellent management team which is available whenever needed for advice or assistance.”
Helliwell and his colleague begin early at 6 a.m. The day fi nishes when they leave the Emergency Medical Services sta on at 6 p.m., remaining on call un l 6 a.m. the following morning. Shi s rota ons are usually 3 on and 2 days off .
No day is ever quite the same as the last. There are rou nes – paperwork, emails, and daily equipment inspec ons – just like any job. Regular training through the Paramedics Associa on of Manitoba, regional training offi cers, and independent study helps staff keep up with what’s new and prac ce call out scenarios. Paramedics also have to re-cer fy every year.
Never know what to expectBut when the pager goes off , Helliwell can fi nd himself responding to anything from a motor vehicle accident to a cardiac arrest or a li assist, where a client has slipped out of a chair in their home and needs assistance to get up. Some days are tougher than others.
“We hold somebody’s hand and comfort them when they are in the middle of trying to bring a new life into this world ... we also hold their hand when they are dying in the back of our unit,” says Helliwell. “We have to be good listeners in our profession, and treat everybody with dignity, care and respect. Everyone is treated the same – with our heart and our care in mind fi rst.”
It’s important to stay calm and focused, says Helliwell. “Some mes your heart starts bea ng faster, and the adrenalin is fl owing, but you need to pull back and see the whole picture,” he says. “When the pager goes off , we respond to our radio, head to the ambulance, and connect with the Manitoba Transporta on Coordina on Centre in Brandon for more informa on about the call, and to establish its priority, which determines if we need lights and sirens or not. If the person relaying informa on from the scene isn’t very
clear, we can some mes get a bit of a surprise when we get to the call.” Paramedics need to be ready for the ‘unexpected’ at all mes.
Incredibly rewardingHelliwell has never had a baby delivered in the back of his ambulance yet, but admits he’s come close. “It’s an incredibly rewarding moment when you get the mother to the hospital safely and as comfortably as possible and know that the delivery is imminent,” he says. “There is nothing more heartwarming than responding to a call when you detect a heart a ack and get the person quickly to the higher level of care they need, only to have them shake your hand and thank you on the street the next week.”
Tom Helliwell, paramedic for Southern Health-Santé Sud.
39Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Wash Your Hands and Stay WellFour Moments of Hand Hygiene
The message is ge ng out that good hand hygiene helps prevent infec on and that it’s important in so many environments – which is why hand rub sta ons are popping up in community centres, arenas, libraries, schools, daycares, grocery stores and restaurants.
“If there is one, fundamental thing that people can do to limit the transmission of organisms that can make us sick, it’s clean their hands,” says Dr. Shelley Buchan, Medical Offi cer of Health for Southern Health-Santé Sud.
Hospitals and doctors’ clinics are full of sick people, and people are coming and going all the me – pa ents, visitors, staff , contractors, couriers – who can all poten ally bring infec on in with them or take it out into the community. That’s why all staff across the region are encouraged to prac ce the “Four Moments for Hand Hygiene.”
“When health care workers go into a room to care for a client, they clean their hands and, before they leave the room, they clean them again,” explains Judi Linden, Regional Coordinator - Infec on Preven on & Control for Southern Health-Santé Sud. Staff also clean their hands while in the room each me they touch anything, such as a bedrail or IV, change a dressing, or when in contact with blood or body fl uids. “We also provide Point of Care hand rub in our facili es, so that a person always has hand rub available within arm’s reach of the pa ent being cared for.”
Reach for the Hand RubHand rub contains alcohol, which is an excellent disinfectant. It has become the preferred technique for cleaning hands in health care and public se ngs because it’s quick, easy, less harsh on the skin than constant hand washing. Hand rub is readily available in most loca ons.
Personal care homes and seniors buildings are other se ngs where infec ons can cause a lot of problems for aging residents. Boyne Lodge Personal Care Home in Carman recently ini ated a program to educate staff , visitors, volunteers, and all residents about proper hand hygiene. “We have really promoted the posi ve impact that hand hygiene has on everyone’s health,” says Recrea on Manager, Shirley McCutcheon. “It has just become a part of everyone’s rou ne, and our staff and visitors are also carrying that message and prac ce out into the community.”
Although outbreaks of diseases like fl u s ll happen, McCutcheon says they are shorter lived as a result of improved hand hygiene and other procedures staff have put in place to prevent the spread of infec on.
“It’s very basic,” says Linden. “Clean your hands, and keep your environment clean. Really, that’s the bo om line.”
Hand washing is the number one method of preventing the spread of infections.
Shelley Buchan, Medical Offi cer of Health
“ ”Southern Health-Santé Sud’s hand hygiene policy calls for all health care providers to perform hand hygiene before and after contact with a client or the client’s environment, after body fl uid exposurerisk and before aseptic procedure, based on the ‘4 Moments of Hand Hygiene’. Hand hygiene is audited in Southern Health-Santé Sud using an audit tool adapted from the Canadian Patient Safety Institute. Health care providers were observed by trained auditors to determine compliance with hand hygiene performance for each of the 4 Essential Moments for Hand Hygiene.
40
Sustainable, Accountable
and Responsive
Health Organization
41Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Regional Orientation... a learning Moment regarding our core valuesAll new employees of Southern Health-Santé Sud a end Regional Orienta on, usually within their fi rst 3 months of employment. Regional Orienta on sessions are held once a month at each of the 3 regional centres - Bethesda Regional Health Centre in Steinbach, Boundary Trails Health Centre in Morden/Winkler, Portage District General Hospital - and generally around 20 new staff a end each session. The day-long orienta on combines presenta ons, videos and quizzes. It usually begins with a welcome and introduc on to the region by a member of the Senior Leadership Team. That’s followed by a video message from CEO, Kathy McPhail that explains the organiza on’s mission, vision and core values of integrity, compassion, excellence and respect.
A ending the Regional Orienta on, Danielle Klassen shares that a video about empathy struck a strong chord with her. “You don’t always realize what everybody’s day has been like. The video helped me understand how important it is to be compassionate and to consider other people’s a tudes and emo ons,” said Klassen, who began her job with Southern Health-Santé Sud a week earlier. “Being given all the informa on I need to be able to do my job is important and I think this orienta on contributes to that.”
“Regional Orienta on allows us to provide all of our new staff with the same informa on at the same me right from the outset, so they understand values which shape how we perform our work and how we conduct ourselves,” says Kim Dyck, Regional Director - Staff Development, Infec on Preven on & Control. “It’s very reassuring for people in the region to know that our core values are embedded every day in everything we do.”
New staff learn the ropesAt a recent Regional Orienta on session, new staff member Kris na Ple said she was surprised to learn how diverse the region’s popula on is. “I didn’t know before today that there are 69 diff erent languages spoken by people in Southern Heath-Santé Sud,” she said. “The orienta on gives a good overview of the whole region, not just the facility where I work.”
“The Regional Orienta on is a chance to share key messages with new staff , such as the importance of our core values,” says Dyck. “There are topics that we are required by legisla on to provide for our new employees, such as the Personal Health Informa on Act and Workplace Safety and Health training, which we can off er in a consistent manner through the regional orienta on.”
Integrity | Compassion | Excellence | RespectWe adhere to a moral, ethical and professional code of conduct that can be trusted and relied upon.
We have empathy for those we provide service to and for those we work with.
We all take responsibility and leadership in the pursuit of the highest levels of quality, competence and effectiveness.
We are meeting people where they are at in this moment and respecting that where they are is related to a lot of other things.
Sustainable, Accountable and Responsive Health
Organization
“With recruitment challenges, some mes we have to re-assess the way we do things to ensure sustainability. Our goal to best use our resources may involve
many diff erent things; such as realigning staff hours to match mes of peak demand, adding more recrea onal ac vi es to be er engage the residents, and include pa ents
awai ng personal care home placement. We know that a resourceful plan responds and is accountable to the needs of our facility, our staff , our pa ents, our residents, and our
community.”Janet Chobotar, Director of Health Services - Vita & Area
42
Discovering the Gift of Healing
When Holly Leost talks to young Aboriginal people about why they are interested in a career in health care, almost everyone tells her it’s because they want to help their people and their communi es.
“Our people are natural caregivers and we are helping them to fi nd that gi within themselves,” says Leost, Regional Director - Aboriginal Employment for Southern Heath-Santé Sud.
One of the ways the region is doing that is through its highly successful Aboriginal Health High School Internship Program (AHHSIP), which helps young Aboriginal people learn about, and explore health care careers.
“We share with youth that a lot of our current health care workers will be re ring soon and we need to replace them. We tell them they could be the ones to do these jobs,” says Leost. “When we started this program, more than 50% of our Aboriginal youth weren’t gradua ng from high school. We wanted to encourage them through this program to understand that they need a good educa on. We say educa on is our new buff alo. Since the program started, we have higher gradua on rates.”
Since 2009, the award winning AHHSIP has introduced Aboriginal high school students to many diff erent health care careers. A er an orienta on session, the students spend a full day every two weeks from February to June, job shadowing health care staff in many diff erent roles. A er comple ng 55 volunteer hours, students receive a half school credit, and are off ered a 6-week summer job placement in a health care facility in the region.
Demand for the AHHSIP is growing as more young people learn from their peers how great the program is, says Leost. At Sandy Bay Ojibway First Na on this year, 20 applicants were interviewed for 8 spots. “I was surprised how many of these young people have set a health career goal for themselves,” she says. “They wanted to be nurse prac oners, cardiologists, den sts, and midwives. That’s the quality of the students the program is a rac ng.”
As a result of the success of the AHHSIP, a new internship program is being piloted for young adults aged 18 to 30. The Aboriginal Adult Internship Program aims to off er similar opportuni es for young adults to learn about health care careers. Working with a large
number of community partners, the program provides pre-employment and life skills training, a week of job shadowing with health care aides, licensed prac cal nurses and registered nurses, and several weeks of work experience in a health care facility in the region.Many students who par cipate in the AHHSIP go on to pursue careers in health care and become role models for other Aboriginal young people, says Leost. “It’s wonderful to see the pride they have in the work they’re doing, and to watch their confi dence grow,” she says.
Aboriginal Health High School Program - a success story• As of 2014, 100 students have par cipated in
the program.• 85 students completed both phase one (55
volunteer hours) and phase 2 (summer work placement)
• 90% of students have expressed interest in the Bachelor of Nursing program.
• Over 70% of students a ending the program are s ll in school or have graduated from Grade 12.
• Southern Health-Santé Sud has hired 7 of the students since 2009.
• More than 10 students are already enrolled in various post-secondary training programs to pursue health care careers.
43Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Aboriginal Internship Program - an Inspirational MomentWhen Cli on Race e’s school principal fi rst told him about the Aboriginal Health High School Internship Program in Grade 9, he was keen to sign up because he was already interested in a career in health care.
But Race e, who is a student at Isaac Beaulieu Memorial School at Sandy Bay Ojibway First Na on, never thought he would actually be working right alongside health care providers. “I didn’t expect we’d be working right in the workplace with them,” says Race e, who job shadowed nurses, health care aides and other health care workers. “It gave me a lot of experience. It was awesome.”
Race e liked the program so much he went back the following year, and also did a 6-week summer work experience at the Gladstone Health Centre in 2013 and at a personal care home in Portage la Prairie in 2014. “I really liked it,” says Race e. “I didn’t even want to quit working at the end of the summer.”
Race e says the internship program and his work experience taught him responsibility and gave him a lot of confi dence. “I would recommend the program to other students because it would give them some opportuni es to consider and lots of experience working with other people,” says Race e.
Race e, who is now in Grade 11, has decided that, when he graduates next year, he wants to go to the Assiniboine Community College to train to become a licensed prac cal nurse. “If I hadn’t done the internship program, I probably wouldn’t have ever thought about being a licensed prac cal nurse,” he says. “I had no idea what it was they did but when I started job shadowing, I liked it and decided that’s what I want to do.”
Cli on Race e, Grade 11 student, in his internship program, working in the maintenance department at the Gladstone Health Centre.
A Chance to Give BackWhen Whitney Soldier took the 5-month health care aide cer fi ca on course at Red River College in Winnipeg, she had a li le bit of an advantage. Soldier had par cipated in the Aboriginal Health High School Internship Program where she’d job shadowed nurses and health care aides and had picked up quite a bit of medical terminology. “Some of the stuff they were teaching me was like a review because I already knew it,” she says.
The internship program not only helped her in college, it also helped prepare her to enter the workplace. Soldier, now 21, has been working with Southern Health-Santé Sud for 2 years. She started out doing home care and then worked at the Pembina Manitou Health Centre for a year before moving to her current posi on as a health care aide at Lorne Memorial Hospital in Swan Lake. “I am happy where I am because I love the people I work with and it’s great to work in a community where you grew up knowing the people,” she says. “The ability to be able to give back by working at the hospital is a great feeling.”
Soldier also got valuable hands-on experience through a summer job placement where she spent 3 weeks at Pembina Manitou Health Centre and 3 weeks at the hospital where she now works.
Soldier is following in the footsteps of her grandma and mother as the third genera on of cer fi ed health care aides in the family. Although this defi nitely infl uenced her decision, she says the internship program helped prepare her for her career. “The program gave me the opportunity to see what it was like to work in health care,” she says. “It matured me a lot, and gave me more confi dence in myself entering school and also the workforce.”
Whitney Soldier, Health Care Aide at Lorne Memorial Hospital in Swan Lake.
44
Rural Bus Tour Highlights Opportunities for Bilingual Nurses ... recruitment ‘à la mode’Six nursing students chose to take their fi nal prac cum in bilingual, rural health care facili es – this a er having taken a bus tour in Fall 2014.
The tour invited future graduate students of the 2 nursing programs at the Université de Saint-Boniface to visit 3 bilingual health care facili es in the communi es of Ste. Anne, St. Pierre and St. Claude.
Julie Arnaud, Recruitment & Reten on Offi cer for Southern Health-Santé Sud is thrilled with the outcome of the pilot project, which aimed to encourage students to take their prac cum, and eventually work in the region. “We struggle to fi ll bilingual vacancies, so we wanted to invite nursing students to come out and see the facili es and the services we off er,” says Arnaud.
Natalie Ayo e was one of the 20 students on the bus tour, and says she was impressed by the region’s facili es. “At school, they only promote the big city hospitals, so I really had no idea what was out there,” she says. “The facili es we visited were beau ful and I was glad that I got a chance to visit the region.”
Ayo e decided to take her prac cum outside the city at the Bethesda Regional Health Centre in Steinbach, but says she’d like to eventually work in one of the bilingual facili es she visited on the tour.
Another key aspect of the tour was to give the students tools to prepare them to provide bilingual services. “On the bus, we had a lot of games and
ac vi es designed to help them understand how important their ability to speak both offi cial languages is,” says Lise Voyer, Recruitment and Careers Promo on Manager with Santé en français. “Being able to provide an ‘ac ve off er’ of French language services ensures that pa ents and clients in bilingual facili es can receive care in the language of their choice.”
Delivery of Ac ve Off er is the most eff ec ve manner to ensure that a pa ent or client feels welcome to communicate in either French or English.
Community members were also anxious to be involved in welcoming the students. Council members and other residents came out to speak and answer ques ons about their communi es, says Arnaud. “It was good to learn a li le bit about the communi es too,” says Ayo e. “Some of us are thinking about going into community health nursing or public health so, if we know the community, we can off er be er care to pa ents because we understand their background a li le be er.”
“Without the bus tour, I would never have known what was out there, and I would probably have chosen somewhere in the city for my prac cum,” adds Ayo e. “I think it’s a great idea to make students aware of the many great opportuni es outside the city.” Results from the bus tour were posi ve in that a few nursing students chose to do their prac cum in the region which led to successful hires of grad nurses (licensed prac cal nurse and registered nurses) who par cipated in the 2014 bus tour.
In collabora on with Santé en français, a francophone recruitment regional bus tour was organized to take the fourth-year nursing students (18 registered nurses and 2 licensed prac cal nurses from the Université de Saint-Boniface) to 3 designated bilingual sites in Southern Health-Santé Sud. Pictured is the group stopping for a rest at Cabane à sucre (maple sugar camp) in St. Pierre, while on their francophone recruitment regional bus tour.
45Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Ebola Update ... preparing for every MomentThe risks of an Ebola virus outbreak in Canada remain extremely small and, to date, although there have not been any confi rmed cases of the disease in Manitoba, health care providers have been busy prac cing and preparing for an Ebola outbreak on a precau onary basis throughout 2014-15.
All acute care and emergency room staff as well as ambulance a endants in Southern Health-Santé Sud have developed processes and have run through various scenarios of how to deal with a pa ent suspected of having Ebola. That includes how to correctly don and remove personal protec ve equipment, such as suits, gloves, and masks. All emergency departments and ambulances have an Ebola personal protec ve equipment kit.
“We have done everything necessary behind the scenes to protect the public and to protect our health care providers,” says Kim Dyck, Regional Director - Staff Development and Infec on Preven on and Control with Southern Health-Santé Sud. “We have the protec ve equipment available, and every site has a plan for how they would handle a client that was suspected of having Ebola. The Senior Leadership Team was extremely suppor ve and made sure it was a priority that everyone was trained.”
“Sierra Leone and Guinea s ll have Ebola outbreaks but the number of new cases has declined over the last few months”, says Dr. Shelley Buchan, Medical Offi cer of Health for Southern Health-Santé Sud. Liberia has not had a case of Ebola since the end of March 2015 showing that the preven on eff orts have been successful. A person with symptoms suspicious of Ebola would be transported to the Health Sciences Centre in Winnipeg, which is the province’s designated Ebola inves ga on and treatment site. The Winnipeg Regional Health Authority is one of the partners that has helped coordinate training across the province.
Infec ous disease control training takes place regularly in the region. “We do ongoing training and make sure that we all use rou ne prac ces – such as hand washing - and addi onal precau ons at all mes when we are dealing with all of our clients,” says Dyck.
“Our health care staff now has a good handle on how to triage a possible case of Ebola,” says Buchan. “We have systems in place to iden fy it early so that we can provide protec on for staff and treatment for anybody who is sick.”
More Learning Moments
Southern Health-Santé Sud par cipated a Poverty Simula on workshop hosted by the United Way as part of a project coordinated by Portage Community Revitaliza on Corpora on – this with a focus on barriers to the economic security of women.
The workshop was designed to make par cipants understand what it’s like to live that reality every day. “It was a real eye-opener,” says Guy Lévesque, Southern Health-Santé Sud Board Chair. “Everyone was broken into family units, and each one had a diff erent set of circumstances. In my family’s scenario, the father has been laid off and the mother was working for minimum wage. For the 4 weeks we were supposed to live through, our budget was already short $600 when we began.”
Around the room were diff erent community services and programs – such as social services, medical services, police, food bank etc. Each family was given a certain number of transporta on slips to get to these places. “One thing that I realized is that although all these services are there, some people don’t know about them and, for many, they can’t get to them,” said Lévesque.
Lévesque shares that the value of workshops like this brings home the challenges that exist and the need to be responsive to the needs iden fi ed. “It helps the Board think about how to deal with the issues that are crea ng barriers for people to access the services they need. We have to con nue to encourage diff erent agencies and groups to work together and to fi nd ways to make people aware of and be able to easily connect to the vital services they need.”
Together leading the way for a healthier tomorrow.
46
Solving Ethical Questions... one Moment at a time
What is an ethical dilemma?Common ethical issues include situa ons where family, client or pa ent goals confl ict with the goals of the health care team, for example, when a client or family member requests a certain food that the health team doesn’t recommend for that person. The ac ons or beliefs of co-workers can also cause confl ict, and there are even ethical implica ons around the alloca on of fi nancial or other resources. Ethical dilemmas can as easily pop up in the laundry room as in the emergency room. “Ethics is a part of our everyday business and it’s not always those big decisions in the clinical areas, it’s also about everyday situa ons,” says Hannah.
The framework is one of the tools adopted by the Regional Ethics Commi ee, which has a mandate to build internal capacity within the region says Hannah. “Southern Health-Santé Sud’s Regional Ethics Commi ee’s mandate is to look at some of the challenging situa ons that arise in people’s daily work, and make sure they have the tools and resources to guide their decision making in an ethical way.”
Because ethical issues can arise at any level or at any me, everyone in
the organiza on, including the Governing Board has been educated about how to use the Ethical Decision- Making Framework. “The Framework is one of the ways in which the Regional Ethics Commi ee is trying to build capacity within the region,” says Hannah, who also chairs the commi ee. “We are trying to give people the tools and resources to guide their own ethical decision-making.”
If you’ve ever had a feeling in the pit of your stomach that something isn’t quite right, or found yourself asking “Should I do this?”, you have probably experienced an ethical dilemma.
Southern Health-Santé Sud staff deal with ethical dilemmas in the course of their work every day and now they have a new tool to help guide them through the process of making a decision that is ethically sound.
Finding a feasible solutionThe Ethical Decision-Making Framework walks staff , either individually or as a group, through a 4-step process to recognize and deal with an ethical dilemma (see sidebar).
“We have already had various workshops and provided staff and the leadership team with theory and knowledge on general ethical principles and values,” says Kris ne Hannah, Chair of the Regional Ethics Commi ee and Regional Director - Quality, Pa ent Safety and Risk with Southern Health-Santé Sud. “We are now star ng to roll out the new Ethical Decision-Making Framework and worksheets to give them more tools to help them apply that knowledge in a prac cal way.”
The framework allows staff to pause and consider what ethical principles are embedded in the issue they’re dealing with, says Hannah, “Those principles refl ect our organiza on’s core values of integrity, compassion, excellence, and respect. The worksheet helps guide their thought process, and encourages them to ask ques ons to arrive at a feasible decision from an ethical standpoint.”
Ethical Decision Making Framework I D E A
What is an ethical dilemma? Am I trying to determine the right
course of action? Am I asking a “should” question? Are values and beliefs involved?
Am I feeling uncomfortable?
If you answered yes to any of these questions, you may
be encountering an ethical dilemma
1. Identify. Ethical dilemma Relevant facts Patient preferences Evidence Contextual features
Ask: What is the ethical dilemma?
2. Determine. Stakeholders (all relationships) Relevant ethical principles Additional factors/dilemmas
Ask: Have perspectives of relevant individuals been sought?
4. Act. Implement chosen option Document and communicate
decision to relevant parties Evaluate decision/plan
Ask: Are we (am I) comfortable with this decision?
3. Explore. Options (at least 3 options) Strengths and limitations Mission, vision, values, and policies Make a choice
Ask: What is the most ethically justifiable option?
47Southern Health-Santé Sud ANNUAL REPORT 2014-2015
A Glean on LEAN
Staff in Southern Health-Santé Sud are becoming more and more excited about LEAN. “When staff complete a LEAN project, they see the improved care for pa ents and the fact that they’re the ones that have made that happen is very mo va ng for them,” says Jane Cur s, VP-Planning, Innova on, Quality, Safety & Risk for the region.
It’s the reason why the numbers of LEAN green and black belts – who are trained to lead LEAN projects and then train others – is growing. “LEAN encourages staff at all levels to think diff erently, to be innova ve, to be crea ve, and to know that they o en already have the ideas for improvement,” says Cur s. “It sends a message that everyone has a role in quality improvement and is supported in that role.”
LEAN is a quality improvement tool that is used to assess work fl ow and eliminate ineffi ciencies in processes and procedures to make them more streamlined and eff ec ve. The program focuses heavily on measurement and analysis of exis ng processes to iden fy areas where they can be improved.
LEAN projects have defi nitely brought cost savings in some areas and, in others, it has served to streamline processes thus saving me. But the biggest goal being achieved by LEAN is improved quality and effi ciency, says Cur s.
Better Use of ResourcesAn example is the LEAN project at Rest Haven Nursing Home in Steinbach, which set out to discover why the respite bed in the facility was only being used 30 to 40% of the me.
The LEAN team realized the problem wasn’t that the respite bed wasn’t needed, but that people in the community weren’t aware that it existed. “We had not done enough to communicate to the community that we had a respite bed,” says Tannis Nickel, Director of Nursing at Rest Haven. “We made up a brochure and passed it out to seniors housing in Steinbach. We also worked more closely with the home care program, sending them a monthly email to remind them to book respite care for their clients and/or let them know if there are some weeks available for clients in need of the bed.”
As a result of the LEAN project, the respite bed is now used 100%.
“What’s exci ng is that more and more staff are coming up with their own projects from their own areas because they’ve seen where there’s an opportunity to make improvements,” says Cur s. “LEAN just seems to gain momentum all the me.”
Members of the LEAN Team focusing Respite Beds at Rest Haven Nursing Home in Steinbach are (lt to rt): Don Fast, Gine e Morgan, Heidi Wiebe, Lorraine Friesen, Brige e Banman and Tannis Nickel.
48
LEAN Project Profi les
LEAN: We Communicate Best ProjectO en a LEAN project ends up taking a diff erent turn than originally intended. “When you take LEAN training, you understand that you shouldn’t take the problem at face value,” says Lee Basse , Manager of Health Informa on Services for Southern Health-Santé Sud. Her LEAN project resulted in improved billing processes and reduced cycle mes to invoice and reconcile payments from the Workers Compensa on Board (WCB) for work-related injuries.
“Our project took a complete 3600 turn because, when I began, I was worried about the number of rejected claims we were ge ng from WCB. LEAN training gave me the ability to pick apart the process and analyze the data, I realized the problem was not what I thought it to be,” says Basse . “The problem was actually that we weren’t always capturing work-related injuries and collec ng the correct informa on for claims. That had a domino eff ect all the way along the line reaching the fi nance department, which invoices WCB and then has to reconcile the payments.”
A er streamlining the process, the cycle mes were dras cally reduced. “It used to take our fi nance clerk an average of eight hours to reconcile a WCB cheque and now it takes her under an hour.” How much money has been saved because of the project won’t be known for several months, but Basse an cipates it will be substan al.
LEAN: Bits $ Buys Project
Purchasing Informa on and Computer Technology (ICT) products and parts used to be frustra ngly slow and complex for many of the staff in Southern Health-Santé Sud. A recent LEAN project has changed that by harmonizing the process to make it easier and more effi cient.
“We discovered that ‘the ini al customer contact to the me we created a purchase order for an item’ was taking around 4.5 days. We were also seeing defect rates for approximately 46% of the requests – such as non standard products being requested or missing informa on,” says Shaun Twist, Regional Director - ICT for the region, who led the LEAN project.
A list of approved products was created which solved the problem of customers not knowing what products they needed, and reduced ordering errors. The responsibili es of purchasers were be er defi ned and a ‘hot swap’ inventory of commonly used products and replacement parts was established. As well, the system of tracking orders was improved and ICT teams met more frequently to iden fy any issues.
“As a result of all the changes, the average me it takes to contact to the actual purchase went down to 0.5 of a day, and defect rates dropped to 7%,” says Twist. “LEAN gave us a good, defi ned process to follow and a number of tools to use to work through the improvements. It’s also created a catalyst to help us to develop our teams and to gather a group of people together that are focused on a common goal for a certain meframe.”
Members of the LEAN Team focusing on Improved Billing Processes and Reducing Cyle Time are (Back Row - lt to rt): Lonnie Rietze, Kaitlin Macpherson, Linda Reimer, Sherri Goffl ot, Donna Samborski and Brenda Hiebert as well as (Front Row - lt to rt) Denise Grant, Lee Basse , Cheryl Reimer and Pa Barclay.
49Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Engaged Communities and Partners• The Tables de concerta on régionales du Centre
and Sud-Est offi cially represent the region’s French-speaking communi es. Southern Health-Santé Sud par cipated in all mee ngs of the Tables in 2014-15. We presented the Human Resources Guide, ongoing updates on Ac ve Off er and recruitment and reten on eff orts, as well as strategies of consulta on related to Local Health Involvement Groups and the French community.
• Southern Health-Santé Sud also a ended all mee ngs of the commi ee overseeing the Centres de bien-être communautaire in La Broquerie and Ste. Agathe.
• Under the leadership of provincial partner Santé en français (Manitoba), Southern Health-Santé Sud is ac vely par cipa ng on 2 ad hoc provincial commi ees, one to study op ons on how to best measure client experience rela ve to FLS and the other, to develop a provincial human resources policy to ensure sound and consistent prac ces and procedures are followed on a provincial scale – this with regard to staffi ng designated bilingual posi ons or posi ons with a bilingual/French requirement.
• In addi on to airing on seven Goldenwest Radio sta ons within Southern Health-Santé Sud, monthly promo/preven on radio spots aired on French radio sta on Envol 91.
BonjourHello
French Language Services
Strong FLS Policy and Administrative Framework• Comprised of staff from various programs/services/
sites across the region, the Southern Health-Santé Sud FLS Advisory Commi ee meets regularly to provide advice and guidance on ma ers pertaining to policies, programs and prac ces involving the use of French Language Services.
• Implementa on rollout of Southern Health-Santé Sud FLS policies occurred in 2014-15. A new common framework for the designa on of bilingual posi ons was implemented, including a regional approach to measure bilingual capacity rela ve to designa on of posi ons. Some of the ini a ves related to this accomplishment include:
The FLS Strategic Plan serves as a solid roadmap presen ng an integrated approach in providing access to bilingual health services. A er only two years into the 2013-16 FLS Strategic Plan, Southern Health-Santé Sud con nues to stride out with signifi cant ini a ves and accomplishments in French Language Services (FLS). As important as the plan itself, the process leading to the plan was equally valuable, including extensive community consulta on and input/valida on from Santé en français (Managerial Table and Board of Directors), la Table de concerta on du Centre, la Table de concerta on Sud-Est as well as the Southern Health-Santé Sud Board of Directors.
The focus this year was to develop numerous components and tools and to provide support to the region in the implementa on of new processes in a very short meline. The following are highlights of achievements and ini a ves as they relate to the four FLS Strategic Direc ons.
Active Offer in Action• In 2014-15, the FLS Unit coordinated 130 requests
(over 100,000 words) for Southern Health-Santé Sud sites, programs and services for transla on services.
• “Ac ve Off er ... à la mode” is an upbeat interac ve workshop developed to help par cipants to be er understand the concept of Ac ve Off er. Sessions were held in Ste. Anne, St. Pierre, Notre Dame de Lourdes and St. Claude with a total of 84 employees par cipa ng. The evalua ons refl ected very posi ve feedback and brilliant learning moments.
• In addi on to providing an FLS component to the Regional Orienta on for all staff whereat useful informa on regarding Ac ve Off er is shared, more in-depth orienta on opportuni es are provided to incoming staff that have key responsibili es and require advanced understanding regarding FLS.
50
○ A Human Resources (HR) Guide and suppor ng management tools to guide managers in the recruitment and selec on process was developed/rolled-out across the region; the Guide incorporates specifi ci es and FLS tools to support the process in recrui ng and selec ng candidates for designated bilingual posi ons.
○ An extensive designa on exercise was carried out with various sites/programs/services to determine bilingual designa on of posi ons.
Success in FLS Recruitment and Retention• Collabora vely with the Université de St-Boniface
(USB) and Santé en français, Southern Health-Santé Sud par cipated in a recruitment bus tour, organized to transport students (18 registered nurses, 2 LPNs) from the USB to some of the designated bilingual sites in our region. The results were very tangible with subsequent student requests for internship placement to bilingual rural se ngs. Given the overwhelming feedback, this will be repeated in Fall 2015.
• Southern Health-Santé Sud a ended 6 out-of-province career fairs where there is a high concentra on of French-speaking popula on – this with a focus on bilingual recruitment. We have been successful in recrui ng 6 individuals.
• Coordinated through the Southern Health-Santé Sud FLS Unit, Santé en français visited 7 schools in our region to help promote careers in health care.
• The Université de Saint-Boniface has an agreement to off er the Division scolaire franco-manitobaine clientele secondary-level credits to Grade 11 and 12 students for the completed technical
ChallengesWhile our ul mate goal is to fi ll all designated bilingual posi ons with bilingual incumbents, the most signifi cant challenges in regards to FLS con nue to be:
• bilingual staffi ng shortages• geographic distances among the French-speaking popula on• recruitment to highly-specialized designated bilingual posi ons• access to data on French-speaking popula ons, acknowledging there has been progress on these eff orts in the
past few years• awareness/understanding of Ac ve Off er by the public and the staff (ongoing turnover)• assessing/evalua ng client experience regarding FLS.
As we acknowledge the major challenges in terms of the cri cal lack of bilingual human resources, the vision that emerges is one of collabora ve eff orts with the community.
and professional Aide en soins de santé (Health Care Aide) course. These credits can then be transferable to the corresponding programs at the Université de Saint-Boniface for up to 5 years a er high school gradua on. Students of the Division scolaire franco-manitobaine who have successfully completed the program according to the university criteria and who have obtained a high school diploma will receive the Cer fi cat d’aide en soins de santé (Health Care Aide Cer fi cate) from the Université de Saint-Boniface.
• 2014-15 French Language Services Learning Opportuni es:
○ 39 employees took French language services training (Français en milieu de santé)
○ 1 staff member par cipated in the Élan immersion program (immersed/intense for one week)
○ 7 employees took part in a home-based online French Language Training pilot project. Evalua on of the pilot project is underway.
○ French health learning sessions off ered by the University of O awa through to the Université de Saint-Boniface are now available via Telehealth.
○ Informa on is entered in the payroll system to generate reports. The repor ng and monitoring capacity for designated bilingual posi ons integrated into the region’s payroll system is considered a best prac ce. Currently, the ini a ve can provide the number of designated bilinguals posi ons (approximately 600) and inform what percentage of these posi ons are fi lled by bilingual incumbents.
51Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Designated Bilingual Positions (as at May 2015)
578 designated bilingual positions343 designated bilingual positions filled by bilingual incumbents219 designated bilingual positions not filled by bilingual incumbents16 designated bilingual positions - vacant
Geneviève Lefebvre had just moved to Portage la Prairie and her family was s ll wai ng to move into its new house when her 13-month old son started to have convulsions one night.
They called 911 and when the ambulance came, Geneviève, who is Francophone, felt helpless and at a loss as she struggled to fi nd the right words in English to tell the Emergency Medical Services (EMS) personnel what was happening. When they switched to French, the relief was incredible. “Suddenly, I felt safe,” she says. “It was comfor ng for me and calmed me down at once because I could tell them what I needed to. I was so thankful that they could speak French and that they did without me even asking them to.”
What the EMS staff did is called Ac ve Off er – this means informing a client at the fi rst point of contact that bilingual services are available so they can speak the language of their choice. The goal of Ac ve Off er is to make sure that a client feels welcome to communicate in either French or English.
Merci ... a display of compassion in a Moment when it mattered most
At the Portage District General Hospital, Geneviève was equally surprised to fi nd that the nurse on the ward was also bilingual. “Once my son was stable, she was able to clearly tell me what had happened in my own language,” she says. “I was so red and confused, and my husband was also in an emergency room at that point for other ma ers that surfaced during the ordeal. So it was a blessing to be able to speak my own language to someone.”
Her son ended up being fi ne and Geneviève, who now has 3 children, is grateful that there are so many bilingual services available in Southern Health-Santé Sud. She sincerely appreciates the eff orts that people make in so many health care roles. “Even if they only have a few words – if only to say ‘Bonjour’, ‘Salut’ or ‘Merci’ - it is very welcoming when someone tries to communicate in French,” she says. “In mes when it ma ers - at mes of pain, or joy, or illness - there was someone present to talk to me in my own language. This has meant a lot to me and my family.”
52
Bethesda Regional Health CentreIn September 2014, the Emergency Room redevelopment project at Bethesda Regional Health Centre was completed including the addi on of observa on beds and a special care unit. The complete ER redevelopment project totalled $18 million.
Marking Milestone Moments ... building for the future
In September, 2014, the Bethesda Regional Health Centre Emergency Department Access relocated to Henry Street. Pictured is the recep on/triage area and wai ng room.
There have been a number of signifi cant developments and progress towards infrastructure transforma on and development during 2014-15.
“Capital projects could include replacing old infrastructure or a new building that’s required because of popula on growth or an increase in demand of some kind,” says Ken Klassen, VP-Finance and Capital for the region. Community Involvement ImportantCommuni es are heavily involved in iden fying a need for capital projects. “Once we iden fy a need for a major capital project, and it’s approved, the provincial policy on health facility construc on requires the community to make a signifi cant contribu on to the project,” says Klassen. “For new infrastructures, the community is required to raise 10% of the total project value before we can sign the contracts with the contractors to build the building. So our partnership with communi es is a vital star ng point for any capital project.”
Because Southern Health-Santé Sud has the fastest growing popula on of any health region in Manitoba, it’s almost always a factor in any new capital project for the region. “We’re op mis c that we’ll get more capital projects approved in the near future to con nue to address the needs of our growing popula on,” says Klassen.
53Southern Health-Santé Sud ANNUAL REPORT 2014-2015
The new Emergency Medical Services (EMS) Sta on in Île des Chênes offi cially opened on March 17, 2015. The $800,000 EMS Sta on building has two bays for ambulances plus crew offi ces, work areas, washrooms and showers. The total size of the building is approximately 2,100 sq. . This new EMS sta on will help the region in our sustained eff orts to meet our mandate of enhanced pa ent safety and improve client services in the region.
Pictured at the offi cial sod turning event held in March 2015: (lt.-rt.): Greg Reid, Execu ve Director - East; Wayne Wiklund, Paramedic; Jackie Hunt, Mayor - Île des Chênes; Minister Ron Lemieux, Minister of Tourism, Culture, Heritage, Sport and Consumer Protec on; Guy Lévesque, Board Chair; Kathy McPhail, Chief Execu ve Offi cer; Ernie Dumaine, Councillor - RM of Ritchot; Lindsay Reimer, Paramedic; and Sco Noble, Regional Director - EMS. Also present were paramedics: Steve Ginter; Evan Friesen and Mitch Tetreault.
Approximately 150 people par cipated in the Tabor Home sod turning event held in spring 2015. Par cipa ng in the celebratory moment were (lt-rt): Ken Klassen, VP-Finance & Capital; Sherry Hildebrand, CEO Tabor Home; Kathy McPhail, CEO; Irvin Wiebe, Deputy Mayor and Tabor Board Vice-Chair; Sharon Blady, Minister of Health; Ken Wiebe, Mayor of Morden; Guy Lévesque, Board Chair; Paule e Goossen, Execu ve Director - West; and Wilf Warken n, Tabor Home Board Chair.
Tabor HomeOn January 23, 2015, the Manitoba Government announced release of a public tender for the construc on of a 100-bed personal care home in the Morden-Winkler area. The building will be 77,319 sq. ., more than twice the size of the current facility. It will include 100 units, of which 20 could be u lized for suppor ve housing.
New EMS Station Opens in Île des Chênes
54
Notre Dame Health CentreOn January 26, 2015, the Manitoba Government announced awarding of a contract for the construc on of a new health centre in Notre Dame de Lourdes. The new 22,601 sq. . facility will be located next to the current personal care home and primary health care centre, elimina ng the need to transfer personal care home residents to the hospital for diagnos c tests. Services at the 10-bed health centre will include an emergency department, imaging and laboratory diagnos c services, an obstetrical/birth unit, inpa ent and outpa ent services and bilingual medical educa on. In addi on, the new health centre’s kitchen will be constructed to serve both pa ents and residents. A laundry facility will also be built to support the current regional services.
Approximately 300 people par cipated in the Notre Dame Health Centre Sod Turning Event held in spring 2015. Par cipa ng in the celebratory moment were (lt-rt): Mona Spencer, Director of Health Services - St. Claude, Notre Dame & Area; René Comte, Community Representa ve/Construc on Commi ee; Dr. Denis For er, VP-Medical Services; Honourable Greg Selinger, Premier; Honourable Sharon Blady, Minister of Health; Kathy McPhail, CEO and Cheryl Harrison, Execu ve Director - Mid.
Future Directions• In partnership with Manitoba Health, Healthy Living and Seniors (MHHLS), Southern Health-Santé
Sud awarded the contract for Prime Consultant Design Services for the main entrance project at the Bethesda Regional Health Centre to 3 Architecture Landscape Interior Design. Under the terms of the contract, the Prime Consultant will engage a universal access specialist and will provide a comprehensive review and a design solu on to address universal accessibility of the Bethesda Regional Health Centre main entrance in Steinbach.
• Construc on is underway on a new 100-bed, long-term care facility in Morden. The new Tabor Home in Morden represents a $38-million investment by the province and the community. It will be located on the east side of Morden, adjacent to PTH 3, and will replace the exis ng facility that was built in 1968 and expanded in 1984. Construc on of the new Tabor Home is expected to be completed in the spring of 2017.
• Construc on is underway on a new 10-bed health centre next to the personal care home and the primary health care centre in Notre Dame de Lourdes. The new, $20.8-million centre will ensure families in the area have access to bilingual emergency and urgent care services, inpa ent care diagnos c services (imaging and laboratory) and outpa ent services. In addi on, the new health centre’s kitchen will serve the personal care home. Construc on is expected to be complete in the spring of 2016.
55Southern Health-Santé Sud ANNUAL REPORT 2014-2015
There is no denying that very complex issues underlie the current health care environment. On the one hand we are challenged to constantly improve quality and to renew and modernize the system. On the other hand there is a signifi cant emphasis on constraining costs. Against a background of increasing demand for programs and services, human resource challenges also have an important impact on sustainability of the system. In addi on, the 2014 Community Health Assessment illustrates some ongoing, key themes that will form the founda on for the planning and delivery of health care programs and services over the next fi ve years.
A Growing, Diverse Popula onSouthern Health-Santé Sud has a diverse popula on, which is growing at a rate of around 2% a year, faster than any other health region in Manitoba, increasing demand for health care services.
Variable Access to Health CareThe Community Health Assessment (CHA) showed that there are increasing wait mes for some community services, and, with over 69 diff erent languages spoken by residents of the region, language can some mes be an access barrier. Many residents also have to go outside the region to see specialists and other s ll do not have a family doctor.
Health Dispari es Exist within the RegionEven though Southern Health-Santé Sud has one of the healthiest popula ons in the province, dispari es s ll exist in diff erent geographical areas and across diff erent popula on groups. The CHA data explores some of the factors aff ec ng this inequity, such as educa on levels that are lower than the provincial averages and income gaps between people living close to large centres and those in rural areas.
More People Living with Chronic DiseaseAs popula on con nues to grow, this means the crude rate of people living with chronic diseases is also expected to increase. Even though prevalence rates have not changed over me, the diseases have impacted more people as popula on aging gathers momentum.
Healthier Lifestyle ChoicesCHA data has shown that there’s a need for improved healthy lifestyle choices, such as increasing physical ac vity, qui ng smoking, ea ng healthier foods, or reducing binge drinking.
Appropriate Care and Be er Pa ent ExperienceThe region con nues to face challenges with appropriate care environments for aging popula ons.
Critical Success FactorsTransforma onal leadershipGoing forward a er 3 years since fi rst becoming a new en ty, Southern Health-Santé Sud con nues to reinforce its core values, vision and mission. A key success factor is learning to embrace and adapt to change. This has been both a challenge and an opportunity. It is acknowledged that a posi ve culture of responsibility and accountability is cri cal at all levels of the organiza on. In order to drive this forward Southern Health-Santé Sud is focusing on:1. People-centred, purposeful and values-based
leadership – Integrity, Compassion, Respect and Excellence
2. A healthy workplace to grow and perform3. Achieving excellence with a posi ve spirit through
teamwork4. Innova ons and quality improvement through
employee crea vity and evidence-informed criteria5. Partnerships with pa ents, clients and residents in care.
The Pa ent Experience Improving the pa ent experience remains the priority for Southern Health-Santé Sud. We are developing other ways – such as Pa ent Experience Local Health involvement Groups and pa ent surveys – to reach out to pa ents and families to explore and understand their experience in health care. We are commi ed to working in partnership with them to inform our decision-making prac ces concerning ma ers that impact on their experience.
Partnerships and Community EngagementSouthern Health-Santé Sud con nues its commitment to create opportuni es to explore and discussa variety of health topics and to provide local input and insight to the region. Partnerships are the key to building capacity in the system.
We are living in exponen al mes and now is the moment to set the stage and think strategically about the next 5 years. The new strategic direc ons will be our touchstone through to 2021 guiding our eff orts in the next 5 years (see p. 9).
Creating new Moments
56
Numbers at a
glance
2014-15OUTPATIENTS
Outpatient visits (emergency and ambulatory care clinic) =
SURGERIESInpatient and day surgeries in the operating room =Cataracts (performed at Portage District General Hospital) =Hip replacements (includes partial) =Knee replacements (includes Oxford) =
BIRTHSNewborn admissions =October (14-15) May (13-14) had the highest number of births in the region =February (14-15) October (13-14)had the lowest number of births in the region =
MISCELLANEOUSTotal inpatient discharges =Number of acute care beds (incl. transitional care beds) =Number of long term care beds =Call volumes for EMS (20 stations) (primary transport) =Call volumes for EMS (inter-facility transport) =Dietary meal days prepared =Kilograms of laundry processed in-house =
115,455
10,067
209210194
1,605
149
121
10,624485
1,1899,8456,824
10,537
207237208
1,820
169
126
10,870490
1,18910,246
6,558
2013-14
118,681
628,522 626,4182,355,5482,446,920
57Southern Health-Santé Sud ANNUAL REPORT 2014-2015
There are approximately 1,166 employees employed by Affi liate Health Corpora ons and a Community Owned Not for Profi t site in Southern Health-Santé Sud region.
Affi liate Health Corpora ons:
Eden Mental Health Centre Menno Home for the Aged Prairie View Lodge Rest Haven Nursing Home Rock Lake Health District Hospital Rock Lake Health District Personal Care Home Salem Home Inc. Tabor Home Inc. Villa Youville Inc.
Community Owned Not for Profi t:
Heritage Life Personal Care Home
Workforce Demographics
(May 2015)
43%Facility
26%Nursing
18%Home Care/Community
Services
12.5%Professional Technical
0.5%Other
Non Union/Management/Salaried Physicians
1,166Employees
(employed by Affi liate Health Corporations/Community Owned
Not for Profi t)
Southern Health-Santé Sud
58
Type of Administra ve Cost
% of Total Opera ng Expense
2014-15Southern Health-
Santé Sud
2013-14Southern Health-
Santé Sud
Pa ent Care-related 0.3% 0.2%
Human Resources & Recruitment 1.0% 0.9%
Corporate Opera ons 3.6% 3.5%
Total Administra ve Cost 4.9% 4.6%
We take pride in managing what is entrusted to us and make great effort to apply available resources in the most effective and effi cient manner possible.
The administra ve cost percentage indicator (administra ve costs as a percentage of total opera ng costs) adheres to Canadian Ins tute for Health Informa on (CIHI) defi ni ons. Administra ve costs and percentages for Southern Health-Santé Sud (including hospitals, non-proprietary personal care homes and community health agencies).
The CIHI defi nes a standard set of guidelines for the classifi ca on and coding of fi nancial and sta s cal informa on for use by all Canadian health service organiza ons. Southern Health-Santé Sud adheres to these coding guidelines.
At the request of the Manitoba Health, Healthy Living and Seniors, the presenta on of administra ve costs has been modifi ed to include new categoriza ons in order to increase transparency in fi nancial repor ng. These categories and their inclusions are as follows:
Pa ent care-related func ons: infec on control, pa ent rela ons, quality assurance, accredita on, cancer standards and guidelines and bed u liza on management.
Recruitment and Human Resources-related func ons: recruitment and reten on, labour rela ons, personnel records, employee benefi ts, payroll, health and assistance programs and occupa onal health and safety.
Corporate Opera ons: general administra on (execu ve offi ces, board of directors, medical directors, administrator of acute, long term and community care, public rela ons, planning and development, community health assessment, risk management, internal audit), fi nance (general accoun ng, accounts receivable, accounts payable and budget control) and communica ons (telecommunica ons, visitor informa on and mail service).
The administrative costs as a percentage of total operating costs adhere to CIHI defi nitions:
Administrative Cost Reporting
59Southern Health-Santé Sud ANNUAL REPORT 2014-2015
September, 2015
Honourable Sharon BladyMinister of Health
Dear Minister:
On behalf of the Board of Directors of the Southern Health-Santé Sud, we respec ully submit our 2014-2015 Annual Report.
The document was prepared under the Board of Directors’ direc on and in accordance with the Regional Health Authority Act and direc ons provided by the Minister of Health. In compliance with appropriate legisla ve authority and government requirements, all material, economic and fi scal implica ons known as of September 30, 2015 have been considered in preparing this Annual Report. The Board of Directors has approved this report.
Sincerely,
Guy LévesqueBoard ChairSouthern Health-Santé Sud
Letter of Transmittal
60
Auditor’s ReportDeloitte LLP 360 Main Street Suite 2300 Winnipeg MB R3C 3Z3 Canada
Tel: (204) 944-3637 Fax: (204) 947-9390 www.deloitte.ca
Report of the Independent Auditor on the Condensed Financial Statements
To the Board of Directors of Southern Health-Santé Sud
The accompanying condensed financial statements, which comprise the non-consolidated statement of financial position as at March 31, 2015 and the non-consolidated statement of operations for the year then ended, is derived from the audited non-consolidated financial statements of Southern Health-Santé Sud for the year ended March 31, 2015. We expressed an unmodified audit opinion on those financial statements in our report dated June 24, 2015. Those financial statements, and the condensed financial statements, do not reflect the effects of events that occurred subsequent to the date of our report on those financial statements.
The condensed financial statements do not contain all the statements and disclosures required by Canadian public sector accounting standards. Reading the condensed financial statements, therefore, is not a substitute for reading the audited non-consolidated financial statements of Southern Health-Santé Sud.
Management’s Responsibility for the Condensed Financial Statements Management is responsible for the preparation of a summary of the audited financial statements in accordance with Note 1.
Auditor’s Responsibility Our responsibility is to express an opinion on the condensed financial statements based on our procedures, which were conducted in accordance with Canadian Audit Standard 810, ‘Engagements to Report on Summary Financial Statements’.
OpinionIn our opinion, the condensed financial statements derived from the audited non-consolidated financial statements of Southern Health-Santé Sud for the year ended March 31, 2015 are a fair summary of the financial statements, in accordance with Note 1.
Chartered Accountants
July 29, 2015 Winnipeg, Manitoba
61Southern Health-Santé Sud ANNUAL REPORT 2014-2015
March 31, 2015 March 31, 2014
ASSETSCURRENT
Cash and short term investments $ 32,342,029 $ 39,467,152Accounts receivable, net 3,039,663 2,930,260Accounts receivable - Manitoba Health 13,606,759 2,394,267Accounts receivable - contract sites - 218,693Accounts receivable - Founda ons 558,787 670,014Inventories 1,339,173 1,604,239Prepaid expenses 2,622,373 951,365Due from Manitoba Health - vaca on en tlements 8,839,967 8,839,967
$ 62,408,751 $ 57,075,956
NON-CURRENT
Due from Manitoba Health - re rement en tlements 11,463,152 11,463,152Capital Assets 153,694,108 147,802,260
$ 227,566,011 $ 216,341,368
LIABILITIES, DEFERRED CONTRIBUTIONS AND NET ASSETSCURRENT
Accounts payable and accrued liabili es 19,844,855 18,969,385Accounts payable - Diagnos c Services Manitoba 473,979 798,801Accounts payable - contract sites 64,393 -Accrued vaca on benefi t en tlements 16,960,045 16,797,087Current por on of long term debt 213,785 228,679
$ 37,557,057 $ 36,793,952NON-CURRENT
Accrued re rement benefi t en tlements 18,656,000 17,457,000Due to contract sites - re rement en tlements 2,901,000 2,744,000Due to DSM - benefi t en tlements 1,385,910 1,282,985Accrued sick leave benefi t en tlements 6,539,353 6,788,420Long term debt 845,075 1,063,685
$ 30,327,338 $ 29,336,090DEFERRED CONTRIBUTIONS
Expenses of future periods 10,795,745 7,308,141Capital assets 145,447,208 139,454,477
$ 156,242,953 $ 146,762,618
NET ASSETSInvested in capital assets 7,188,040 7,055,419Internally restricted 1,633,301 905,611Unrestricted (5,382,678) (3,697,322)
3,438,663 1,958,425$ 227,566,011 $ 216,341,368
Non-Consolidated Statement of Financial Posi onSouthern Health-Santé Sud
Audited Condensed Financial Statements
62
March 31, 2015 March 31, 2014
REVENUEManitoba Health $ 324,726,789 $ 311,510,986Other government departments 684,675 355,432Non-global pa ent and resident income 12,910,917 12,215,063Other income 10,254,678 9,218,588Amor za on of deferred contribu ons - expenses of future periods 4,164,269 3,969,860Amor za on of deferred contribu ons - capital and founda ons 7,308,480 6,653,760Interest and dona ons 947,399 978,455Ancillary opera ons 2,351,429 2,402,515
$ 363,348,636 $ 347,304,660EXPENSES
Acute care services 109,195,279 105,624,040Long term care services 48,807,969 47,128,039Medical remunera on 27,319,377 23,775,898Community-based therapy services 5,738,055 5,206,594Community-based mental health services 9,073,145 9,185,571Community-based home care services 38,417,641 37,509,711Community-based health services 17,256,972 15,398,830Emergency medical services 14,552,965 13,920,148Diagnos c services 17,329,985 16,309,280Regional Health Authority undistributed 21,320,455 21,420,861Contract sites 41,589,491 40,065,311Interest on long term debt 424,022 143,061Pre-re rement leave 2,857,375 1,114,855Sick leave (249,067) (167,668)Amor za on of capital assets 7,570,073 6,905,920Major repairs 95,713 141,067Ancillary opera ons 2,036,271 2,133,057
363,335,721 345,814,573
EXCESS (DEFICIENCY) OF REVENUES OVER EXPENSES $ 12,915 $ 1,490,087
In compliance with The Public Sector Compensa on Disclosure Act of Manitoba, interested par es may obtain copies of the Southern Health-Santé Sud public sector compensa on disclosure (which has been prepared for the purpose and cer fi ed by its auditor to be correct) and contains the amount of compensa on it pays or provides in the corresponding fi scal year for each of its offi cers and employees whose compensa on is $50,000 or more. A complete set of fi nancial statements and the auditor’s reports are also available by contac ng: Chief Execu ve Offi cer, Southern Health-Santé Sud, 180 Centennaire Dr, Southport MB R0H 1N1 or Toll free: 1-800-742-6509 or online through our website at: h p://www.southernhealth.ca/publica ons.php?cat=1
Non-Consolidated Statement of Opera ons
Southern Health-Santé Sud
Audited Condensed Financial Statements
Note 1Management is responsible for the prepara on of the fi nancial statements. The statements presented include only the non-consolidated-statement of opera ons and the non-consolidated statement of fi nancial posi on. They do not include the non-consolidated statement of changes in net assets, the non-consolidated statement of cash fl ows, and the notes to the non-consolidated fi nancial statements.
63Southern Health-Santé Sud ANNUAL REPORT 2014-2015
Public Interest Disclosure - Bill 34 — The Public Interest Disclosure - Bill 34 (Whistleblower Protec on Act) gives employees and others a clear process for disclosing concerns about signifi cant and serious wrongdoing in the Manitoba public service, and provides protec on from reprisal. The act (Bill 34) is not intended to deal with rou ne opera onal or human resource ma ers. Employees who have concerns about such ma ers should follow exis ng procedures to deal with these issues. The law applies to employees and offi cers at all levels of provincial departments, Offi ces of the Legisla ve Assembly and government bodies including Regional Health Authori es.
As per subsec on 18 of the Act, and in terms of repor ng procedures, the following is the Whistleblower Protec on Report.
Whistleblower Repor ng Offi cer: René Ouelle e
Repor ng Period: April 2014 – March 2015
Disclosures received: Subsec on 18(2a) 1 ReceivedAlthough a Whistleblower inquiry was received it did not meet the defi ni on under the Whistleblower Act.
Inves ga ons commenced: Subsec on 18(2b) 0 CommencedThere were no inves ga ons commenced as a result of a disclosure.
Finding of wrongdoing/recommenda ons/correc ve ac ons taken: Subsec on 19(2b) 0 Findings of Wrongdoing
0 Recommenda ons0 Correc ve Ac ons Taken
There were no fi ndings of wrongdoing/recom-menda ons or correc ve ac ons taken as a result of a disclosure or Whistleblower inquiry.
Whistleblower Protection Accountability ProvisionsRecent amendments to The Regional Health Authori es Act include provisions related to improved accountability and transparency and to improved fi scal responsibility and community involvement.
Amendments include: As per Sec ons 22 and 51, the establishment by the Minister of terms and condi ons of employment (compensa on, etc.) to be included in the employment contract of the chief execu ve offi cer and designated senior offi cers of a regional health authority.
Employment contracts have been established for the CEO and all Senior Leaders of the organiza on. These contracts contain all terms and condi ons of employment as set out by the Minister.
As per Sec on 23 (2c), the prepara on, implementa on, pos ng on the website and upda ng of the regional health authority’s strategic health plan.
Southern Health-Santé Sud’s Strategic Health Plan 2016-21 was completed in June 2015 and is posted on the website.
As per Sec ons 23.1 and 54, the establishment by the Minister of requirements rela ng to accredita on of a regional health authority and the accredita on/par cipa on in RHA accredita on of health corpora ons and certain health care organiza ons and publishing of the results.
Southern Health-Santé Sud has completed all requirements achieving Accredita on Status following a survey in March 2015.
As per Sec ons 51.4 and 51.5, the establishment of restric ons on regional health authori es rehiring of the chief execu ve offi cer and designated senior offi cers within one year of termina on of employment without prior Ministerial approval, and, in the of case of health corpora ons, the chief execu ve offi cer or equivalent (execu ve director, COO, etc.) without RHA approval.
The Board of Directors of Southern Health-Santé Sud has reviewed it’s policy regarding the Chief Execu ve Offi cer job profi le. There were no senior offi cers that were hired within one year of termina on of employment. A policy is currently under development.
Public Interest Disclosurereporting
64
ContactUs
Regional Offi ce – La BroquerieBox 470, 94 Principale St
La Broquerie MB R0A 0W0
T 204-424-5880 | F 204-424-5888
Regional Offi ce – Morden3 30 Stephen StMorden MB R6M 2G3
T 204-822-2650 | F 204-822-2649
Regional Offi ce – Notre Dame Box 190, 40 Rogers StNotre Dame de Lourdes MB R0G 1M0
T 204-248-7250 | F 204-248-7255
Regional Offi ce – Southport180 Centennaire DrSouthport MB R0H 1N1
T 204-428-2720 | F 204-428-2779
Careers – Human ResourcesBox 470, 94 Principale StLa Broquerie MB R0A 0W0
T 204-424-6045/204-428-2735
Careers – Physician RecruitmentBox 190, 40 Rogers StNotre Dame de Lourdes MB R0G 1M0
Media EnquiriesBox 470, 94 Principale St
La Broquerie MB R0A 0W0
For more informa on on our health services, visit:
southernhealth.ca
or email:[email protected]
or Toll Free:1-800-742-6509
