Our Future, Our Plan, Tgether: Strategic Plan fr The Scarbrugh Hspital 2009-2014
A Message frm Dr. Jhn Wright, President & CEO It s been nearly tw years since I was first appinted, then hired, as President and CEO f The Scarbrugh Hspital. Since that time we have made changes bth big and small t ensure that ur hspital prvides the best care t ur cmmunity. I am delighted t present ur Strategic Plan fr 2009 2014 as it represents a significant undertaking fr ur rganizatin and ur radmap t an inspired future. Our revised Missin, Visin and Values are at the heart f ur Strategic Plan, breathing life int ur daily activities and acting as a beacn t bth patients and staff alike. Our fur Strategic Directins have been designed t intentinally fcus ur activities and effrts ver the next five years. Fiscal restraint is the harsh reality f healthcare in this era, and we are well aware that we need t be purpseful in ur investments allcating resurces t thse activities that will yield the greatest return and take us ne step clser t being recgnized as Canada s leader in prviding the best healthcare fr ur glbal cmmunity. This plan reflects the input frm nearly 1,300 persns frm passinate cmmunity members t frntline staff t physicians and clinicians and members f ur Bard. I am grateful during the many mnths f deliberatin t have had the supprt f a dedicated Senir Leadership Team as well as supprtive Bard Chair and Vice Chair. This brad base allwed us t clsely examine urselves acknwledge ur strengths, address ur weaknesses and identify pprtunities fr a bld, new future. I lk frward t taking this jurney with yu. 2
A Prud Histry A New Day In the ver half-century since The Scarbrugh General Hspital pened its drs bth the hspital and the Scarbrugh cmmunity have seen many changes. Funded in 1956 by the Sisters f Misericrde and surrunded by farmland, the hspital s birth was a respnse t the needs f the residents f this grwing bedrm cmmunity. S, t, was the inceptin f the Salvatin Army Grace Hspital. The hspital s fficial pening in 1985 was the result f many years f planning and deliberatin all fcused n ensuring that the healthcare needs f a rapidly grwing cmmunity were met thrugh the creatin f a mdern purpse-built facility n Birchmunt Rad. While the Scarbrugh landscape has changed dramatically ver the years, the cre purpse f these tw institutins -- t serve the cmmunity -- has been unwavering. Frm their inceptin t nw, bth hspitals have been recgnized fr numerus achievements while striving t mdernize their facilities t keep pace with patient demands. The Scarbrugh Hspital (TSH) was created ten years ag thrugh the vluntary merger f the Scarbrugh Grace Hspital and the Scarbrugh General Hspital. Currently, TSH is TSH s Patient Care Areas: Canada s largest urban cmmunity hspital and Cardi-Respiratry & Critical Care Medicine & Specialized Geriatrics Emergency & Urgent Care Family & Cmmunity Medicine Maternal Newbrn & Child Care Mental Health Services Nephrlgy Surgery, Orthpedics & Rehabilitatin serves ne f the wrld s mst ethnically diverse ppulatins. With apprximately 576 beds acrss tw hspital sites and an annual perating budget f mre than $320M (2008/09) The Scarbrugh Hspitals 3,400+ emplyees, 700+ medical staff and 720 vlunteers successfully manage ver 450,000 patient encunters every year. The ten years since the merger have been met with bth challenge and pprtunity -- including the devastating impact f SARS and many changes in leadership. Hwever, these events nly served t strengthen the hspital s reslve. Many lng-serving staff prudly share their stries f trial and triumph -- and their belief that it is the strength f The Scarbrugh Hspital family that cmpels a dedicatin t the Scarbrugh cmmunity. The appintment f Supervisr Rb Devitt in 2007 ushered in an era f renewal fr TSH. The Bard f Directrs at that time was relieved f its duties, and a new skills-based grup f Gvernrs was selected t act as stewards f a new and thriving TSH. Dr. Jhn Wright was hired as 3
President and Chief Executive Officer in 2008, in turn putting tgether a strng senir leadership team required t inspire and implement a revitalized future fr the hspital. Key Statistics, 2009/10 General Site Birchmunt Site Ttal Beds 351 239 590 ED Visits 54,882 41,186 96,068 Admissins 19,347 14,028 33,375 O/R Outpatient Cases 5338 10,063 15,451 Clinic Visits 137,379 75,156 212,535 Ttal Outpatient Visits 352,884 146,282 499,166 Births 2824 2493 5317 Hip Replacements 193 62 255 Knee Replacements 735 275 1,010 Cataracts 5,931 5,931 MRI Scans 7,926 7,926 Cancer Surgeries 1073 1073 Vlunteer Hurs 28,606 28,099 56,705 The Business TSH is in and Where the Hspital Wants t be in 10 Years Shrtly after the cnfirmatin f Dr. Wright as CEO, the new Bard and Senir Team initiated a prcess that wuld ultimately yield a new Missin, Visin and verarching Strategic Plan fr the rganizatin. Emphasis was placed n the imprtance f refreshing the hspital s Missin (the business the hspital is in, and whm it serves), Visin (what wuld be true abut TSH in 10 years) and Values, as well as the imprtance f implementing the plan. The First Steps Twards Our Plan Tgether The first step, Strategic Planning, was undertaken between Octber 2008 and July 2009 and yielded the develpment f renewed Missin, Visin and Values, Strategic Directins and Strategic Objectives. Aptly named: Our Future, Our Plan, Tgether, the Strategic Plan served as the catalyst fr many initiatives including Strategy Deplyment a prcess t develp f a series f Screcards fr prgrams, departments and individual managers and directrs. Building n the bjectives created during the planning prcess, these screcards identified specific measures and targets 4
t mnitr and measure perfrmance acrss all areas f the hspital. The Strategic Deplyment phase was cmpleted in Nvember f 2009 and the hspital has nw begun t mnitr and aggressively manage its strategy. Strategic Planning: many phases, many faces TSH s Strategic Planning prcess unflded ver six phases, with each phase intentinally designed t achieve specific utcmes. The prject benefitted frm the advice and stewardship f a Steering Cmmittee, cmprised f members f the Senir Leadership Team and selected members f the Bard f Directrs, including the Chair and Vice Chair. The Steering Cmmittee met mnthly t review results (such as key messages emerging frm staff fcus grups) and t prvide guidance n the steps t be undertaken, including the design f bth staff and Bard retreats. T supprt the mre tactical activities a Wrking Grup was struck and met weekly t discuss and review activities, address prject risks and t prvide feedback n prject activities such as Staff Fcus Grups. 5
A significant amunt f time and energy was devted t the Stakehlder and Staff Cnsultatins held in Phase 3 f the Planning prcess. Recgnizing the need t bth hnur and learn frm the past while shaping an inspired future, TSH was deliberate in its engagement f staff, physicians, bard and external stakehlders including cmmunity grups, peer rganizatins and the Central East Lcal Health Over 1300 persns were cnsulted as part f the planning prcess: Integratin Netwrk. The hspital benefitted frm the advice and wisdm frm ver 1,300 individuals -- frm members f the cmmunity, frmer patients up t the Chairman f the Bard. The results f the cnsultatins prvided the backbne fr discussins at bth retreats held with staff, members f the Senir Leadership Team and Bard f Directrs. Bard and Senir Leadership Team interviews 11 interviews with external stakehlders 7 fcus grups with cmmunity service prviders 3 twn hall style fcus grups with members f the general public/ cmmunity 1 Survey administered t cmmunity stakehlders 13 fcus grups with staff 7 fcus grups with physicians 1 Survey administered t staff, physicians 6
Key Messages: Where Opprtunities Meet Strength At the end f these cnsultatins, TSH had received very clear messages abut what its rle shuld be and where a cmmitment f time and energy was required fr the hspital t evlve. Fr the purpses f clarity and discussin, these messages were categrized int a Strengths, Weaknesses, Opprtunities and Threats Matrix (cmmnly referred t as a SWOT analysis) highlighted in the Table n the next page. Nt surprisingly, the mst ntable f TSH s strengths was a cmmitted and caring staff members wh were ready fr change. Similarly, TSH s cmmunity members were keenly interested in being active participants in the hspital s new future. These persns recgnized that, althugh the current relatinship was largely develpmental, great strides had been made t reach ut t the cmmunity in recent mnths with gd reviews. Internal challenges such as a rivalry between sites (nt uncmmn within multi-site hspitals) added new cmplexity t the capital redevelpment currently underway and required fr TSH t keep pace with bth patient vlume and need. Thrugh a series f meetings and presentatins, the Bard and staff reviewed this infrmatin, using it as springbard fr the successful develpment f the Strategic Plan. Strengths Cmmitted Staff Critical Mass Readiness fr Change Balanced Budget Apprach t Diversity &Health Equity Gd Patient Care in Specific Areas Multidisciplinary Apprach Crprate Perseverance Recgnitin f the Need t Cmmunicate Opprtunities Leverage partnerships t supprt cntinuity f care Leverage SARS t becme leaders in infectin cntrl Underserviced mental health cmmunity Align t LHIN planning Current gvernment investments in ehealth & IT Health prmtin fr diverse ppulatins Weaknesses Internal rivalry between sites Relatinship with cmmunity (althugh in develpment stage) Relatinship with LHIN Leadership turnver Aging physical facility in need f facelift Wait times & cntinuity f care Staff & Physician satisfactin Lack f resurces Threats Grwing, increasingly chrnic ppulatin Increasing number f uninsured persns in Scarbrugh Ecnmic dwnturn Aging wrkfrce Recent media attentin Lack f system integratin CE LHIN Clinical Services Plan In additin t the SWOT analysis utputs, TSH reviewed feedback related t where it shuld fcus its time, energy and resurces in rder fr the hspital t realize its ultimate visin f being recgnized as Canada s leader in prviding the best healthcare fr a glbal cmmunity. While these themes, identified thrugh the cnsultatin prcess, were brad in nature, they represented the catalyst fr TSH as it began t develp its renewed Missin, Visin, Values and Strategic Directins. Thrugh 7
discussin amngst the Senir Team and Bard Members, and ver the curse f three retreats, the hspital was able t evlve these themes int intended utcmes, described n the next page. Key Theme Intended Outcmes Unified Multi-Site Cmmunity Hspital Defined rle fr each site Vibrant cmmunicatin strategy Crprate culture that supprts implementatin & fllw thrugh Renwned fr culturally cmpetent care Patient & Family-driven Care Culturally cmpetent care Strng Chrnic Disease Management, Health Prmtin & Disease Preventin Adptin f patient & family driven care philsphy (e.g. physical facilities are designed with patients in mind; signage & wayfinding adequately supprts the needs f a diverse patient ppulatin) Capital Renewal Fcus n capital renewal Funding fr new equipment & adequate resurces fr facility maintenance Emplyer f Chice Supprt fr educatin and prfessinal/leadership develpment Staffing plans that supprt effective wrklad management Strategic recruitment & retentin Centre(s) f Excellence In specific prgrams In infectin cntrl In patient & family-driven care fr diverse ppulatins Purpseful Cmmunity Engagement True partner in the LHIN system Strategic health-cmmunity cllabratins Disciplined Quality & Perfrmance Strng digital backbne Measurement Transparent, evidence-based decisinmaking Defining the Elements f TSH s Strategic Plan With cnsultatin cmpleted, TSH mved t define the key elements f its Strategic Plan. Starting with Missin, Visin and Values, the rganizatin sught t define its Missin: Why TSH exists ; Visin: What the hspital wants t be true abut itself and Values: The beliefs and behaviurs that are demnstrated by all staff. With these fundatinal elements in place, the hspital wrked t create its Strategic Directins thse critical areas f fcus fr the rganizatin fr the next five years. These directins and their assciated bjectives represented nt nly where the hspital wuld spend its time and energy, but als hw the hspital wuld ultimately define its success. Fr this reasn, TSH wrked t define specific measures and targets thrugh the develpment f a balanced screcard, cmpleted as part f TSH s Strategy Deplyment. 8
Twards an Inspired Future fr TSH After many mnths f cnsultatin, the hspital s new Missin, Visin and Values were develped. These sentinel aspects f TSH s revitalized future represented the deliberatins f bth staff and Bard Members. Retreats were held during April and May f 2009 t develp these tenets, with refinements made by the Senir Leadership Team between meetings. Final apprval happened in July, 2009. TSH s Missin and Visin are ambitius s the hspital wrked t identify fur key areas f fcus -- Strategic Directins -- t better enable the rganizatin t maximize bth individual and cllective effrts. These pririties -- the 4 P s -- represent chices fr investment f time, energy and resurces ver the next five years. Each f the directins is described n the next page. 9
Our Patients Patient and family-driven care is an apprach grunded in mutually-beneficial partnerships amng health care prviders, patients, their families and ther cmmunity caregivers, and invlves patients and their families nt nly as partners in their wn care, but as essential allies in helping t redefine the way healthcare is cnceived, planned and evaluated. The gal f this Directin is t create an envirnment f patient safety that exceeds ur patients highest expectatins and delivers care that is patient and family-driven. Our Peple TSH wants t be n Canada s Tp 100 Emplyers list in five years. This means that the hspital wuld have leading practices in eight key areas: Physical Wrkplace Wrk Atmsphere & Scial Health, Financial & Family Benefits Vacatin & Time Off Emplyee Cmmunicatins Perfrmance Management Training & Skills Develpment Cmmunity Invlvement The gal f this Directin is t be the emplyer f first chice where ur peple are recgnized as the best talent and inspired t deliver excellent patient and family-centred care. Our Prgrams, Plans & Partners United, TSH has a key leadership rle t play in an integrated healthcare system. With the needs f a diverse cmmunity as a key driver, TSH will wrk with cmmunity partners and the CE LHIN t ensure that the needs f the cmmunity are identified and addressed. The gal f this Directin is fr TSH, as a unified rganizatin, t lead the develpment f a crdinated plan fr the prvisin f care fr all f Scarbrugh. Our Perfrmance TSH is cmmitted and accuntable t ur cmmunity t prvide the safest and highest quality care fr ur patients. The hspital will measure and reprt ur perfrmance and cntinually strive t imprve everything it des. The gal f this Directin is t create an accuntable, high-perfrming rganizatin that delivers measurable results. Defining Success: TSH s Objectives Upn cmpletin f its Missin, Visin and Values, TSH embarked n the last phase f strategic planning: defining Strategic Objectives. Succinctly stated, Strategic Objectives are the utcmes TSH wants t achieve; they are the measures f the hspital s success. Fr each Strategic Directin, a number f Supprting Objectives were cnfirmed. Described belw, these 10
bjectives frmed the basis fr the ver-arching strategy map - the path t be taken by the hspital t realize its intended gals. TSH Strategic Directins Our Patients - Create an envirnment f patient safety that exceeds ur patients highest expectatins and delivers care that is patient and familydriven. Our Peple - Be the emplyer f first chice where ur peple are recgnized as the best talent and inspired t deliver excellent patient and family-centred care. Our Prgrams, Plans and Partners - As a unified rganizatin, lead the develpment f a crdinated plan fr the prvisin f care fr all f Scarbrugh. Our Perfrmance - Create an accuntable, high perfrming rganizatin that delivers measurable results. Supprting Objectives Be recgnized as a leader in the delivery f care t a diverse cmmunity Deliver care cnsistent with the patient and family-driven care mdel by staff, physicians and vlunteers Demnstrate a culture f patient safety Imprve patient utcmes Be recgnized as a tp emplyer Imprve staff and physician satisfactin Ensure staff are highly cmpetent and achieving best practices in all areas Supprt training and educatinal pprtunities fr staff and physicians Build leadership capacity within ur staff and physician grups Becme a unified, integrated healthcare prvider acrss multiple sites Identify and supprt prgrams, services and partnerships that psitin TSH fr leadership in the regin and meet the needs f ur unique cmmunity Demnstrate cmmitment t strategic directins and clinical pririties by targeting infrastructure investments (facilities, systems and equipment) Imprve the timeliness, efficiency and accuracy f infrmatin available fr decisin-making Imprve accuntability and transparency fr prgram and service perfrmance Enhance the utilizatin f evidencebased best practices and prcess imprvement methdlgies 11
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Measuring Prgress: Hlding the Gains In rder t ensure that this plan cmes t life, TSH cmmitted t ensuring that utcmes are rutinely measured and managed. As such, TSH develped balanced screcards fr every prtfli, prgram and service in the rganizatin. At the apex f this effrt was the develpment f a Balanced Screcard fr the rganizatin. The Screcard will be presented t the Bard f TSH n a quarterly basis t ensure that prgress n the new strategic plan is measured and managed regularly. Making the Mst f a New Day Nw that the Scarbrugh Hspital has defined and deplyed its strategic plan, the challenge fr the rganizatin will be t hld the gains t cntinuusly and vigrusly mnitr and measure perfrmance. The use f the Balanced Screcard will n dubt prve invaluable in this endeavr but it will be the peple f the Scarbrugh Hspital that will make the hspitals new day a reality truly: their future, their plan, tgether. 13