York Central Hospital: Joanne Marr, Acting President & CEO

by HCE Exchange on August 19, 2010

Over the past 47 years, York Central Hospital has transformed itself from a 100-bed hospital serving 25,000 people to become a major regional health centre serving a population of about a half million residents. Located in Richmond Hill, Ontario the hospital serves one of Canada’s fastest growing and most culturally diverse communities. The current growth rate for the area is 3.8% – a rate that is approximately twice that of the provincial average. To keep pace with the needs of its community, the hospital continues to steadily expand its facilities while planning for future expansion on both its existing site in Richmond Hill and a future hospital site in Vaughan.

“The focus of these efforts is around building a strategically focused organization, refreshing our clinical vision and strategy so that we can continue to translate our actions into best practice,” says Joanne Marr, Acting President and CEO. “Part of that will  involve an exercise in clarifying our actual vision, to define [what it means to be] a large community hospital in Canada.”

A Capacity Building Journey

Last year York Central Hospital celebrated the grand opening of phase one of its redevelopment project.  The $93.2 million expansion of its main hospital site that added 148,000 square feet of space to the hospital has helped to shorten wait times and increase the community’s access to care. Already seeing the benefits, York Central was one of only two hospitals in the province to meet targeted wait times in the Emergency Department. The hospital was also named as a Best Practice Spotlight Organization by the Registered Nurses Association of Ontario.

The construction effort tripled the size of the emergency department and created new medical imaging suites. The hospital now has a new and significantly expanded chronic kidney disease unit, a brand new intensive care unit, new and expanded staff and conferencing facilities, two new surgical inpatient units, a new inpatient/outpatient mental health facility, including psychiatric intensive care, and a new and expanded Family Birthing Centre. There are ongoing plans in place for the continued refurbishment of the existing campus and facilities.

Beyond physical capacity, the hospital has also developed a multi-pronged focus that includes improved patient and employee satisfaction. Recent surveys indicate steadily increasing rates of patient satisfaction.  Staff satisfaction surveys indicate higher than average ratings by the perception of hospital staff that the environment is favorable to diverse cultures. “We need to create a culture and a workplace where respect and inclusion is fundamental to the way we approach care, the way we do business, and the way we work with one another, as well as our public,” says Marr.

In the last year York Central has shown a significant decrease in staff turnover, as well as an 85% reduction in the use of agency staff. Given the highly competitive nature of the Ontario health care market, the increased retention of staff and reduced dependency on agency are solid indications that the focus on patient and staff satisfaction is paying off.

Future Development Focuses

Many of the awards and recognitions York Central Hospital has received come with funds for further development. A recent recognition for their capacity building efforts, for instance, comes from IPAC, the Institute for the Public Administration of Canada.

“The IPAC grant recognizes us for demonstrating leading practices in the area of management and leadership,” says Marr. “The funds have helped us to develop an office of strategy management, as well as develop an approach called dynamic evaluation and storytelling which says the way you tell stories can have a powerful impact in changing practice. This is something the clinicians are in the process of learning. Part of the award supports the publishing and presenting of our experiences in developing our report card and pay-for-performance system at health care conferences. So not only does that money help us to take our journey to the next level, it also involves sharing our learnings with others in the industry.”

York Central Hospital has now completed the pilot phase of a patient flow process improvement project sponsored by the Ministry of Health. With an initial focus on the interactions and communications between the emergency department and an inpatient general medicine unit,where hospital bottlenecks were most often found, the project learnings are now being used to improve the timeliness and quality of patient care throughout the hospital

The hospital has also done significant work in the area of mentorship in the last couple of years. “We’ve been very successful as an organization in bringing new graduates from a variety of disciplines into the organization and offering them further development opportunities under the guidance of experienced staff, to help create a workplace of choice,” says Marr.

An Aging at Home project illustrates York’s collaborative approach with other healthcare organizations and a willingness to look outside of their own system for answers. “We have successfully initiated new services targeted to allow older adults to be cared for and to stay at home longer, to receive a more significant amount of service at the community level,” says Marr. “We have also collaborated with another area hospital to develop a nurse led outreach team to long term care (LTC) facilities. This allows nurse practitioners to provide onsite care to residents, and education for staff, to improve the quality of care in the LTC facility, while reducing unnecessary visits to the emergency department.”

Just One Part of the Community

“We are part of a broader system,” says Marr. “I think that’s an important paradigm.  We need to think outside the walls of our organization and we need to seek out partnerships and alliances in a strategic way because we can’t be all things to all people. There are certainly things that hospitals are particularly suited to do, and I think as hospitals we need to provide a leadership role from that perspective and connect the dots for patients and their families.”

“We don’t need to do everything, but as part of a broader system, and in partnership with other healthcare providers and other agencies, even outside of our sector, we can create an actual healthcare system.”

-by T.M. Simmons

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