2011-2012 Annual Report to The Community

Norfolk General Hospital - Norfolk General Hospital Foundation - The Norfolk Hospital Nursing Home - Volunteer Association

A Tradition Of Caring

e are what we repeatedly do. Excellence, then, is not an act, but a habit. Aristotle
Change is a constant in todays world, and nowhere more so than the health care sector. Over the past year, hospitals have experienced new legislation, new public reporting responsibilities, and continued change and challenges driven by constrained funding, scarce human resources, and scarcity of critical supplies like medications. Through it all though, the people who work and volunteer at Norfolk General Hospital (NGH) have never wavered in their commitment to excellence in all that they do. Our staff and medical team make continuous improvements in patient safety, working hard to prevent infections, reduce medication errors, and minimize the risk of falls for our patients. Staff members in every department understand and are committed to their role in ensuring excellence in patient care.

Our surgical program attracted Dr. Anas Al Kassem who brings a wealth of surgical experience. Dr. Nancy Gabel is relocating in July and will be rounding out the complement of anesthetists; she will also be doing other work in the obstetrical program. The Emergency Department has also recruited Dr. Hany Demian as a full time ED physician. One of our areas Bettyann DeRonde, VP Patient Care and Kelly Isfan, of focus has been CEO, welcome new surgeon Dr. Anas Al Kassem on revitalizing our Operating Room equipment. Our patients deserve the best and most up to date surgical equipment. The Foundation has taken up the challenge of raising funds for an operating room table, a bronchoscope, colonoscopes, patient monitors, and a bassinet warmer. All of this is costly equipment totaling over $500,000.

Kelly Isfan, President and CEO NGH-NHNH

A Renewed Vision

n September, 2011, Kelly Isfan joined the Norfolk General Hospital to become the fifth President and Chief Executive Officer since 1925, replacing William Lewis who retired in April 2011.

Isfan, who grew up in Dysart, Saskatchewan has a university degree in commerce and a masters degree in health care administration. She has worked in numerous small hospitals and health care organizations across the country. Prior to making the decision to move to Norfolk County and lead NGH, Isfan was the CEO at The hospitals commitment Campellford Memorial Hospital for to excellence has helped us eight years. attract and retain the best and Norfolk General Hospital has a well deserved, fantastic reputation and I am honoured to be a part of it. I have thoroughly enjoyed getting to know staff, working with our respective boards and settling into my new community. Thank you to everyone for the warm welcome. I feel very at home at NGH and in Norfolk County.

Operating Room Revitalization The final stage in the Lend a Hand campaign.

brightest to our community. Over the past year NGH has hired 40 nurses, 10 allied health professionals, 21 support staff and five new managers, including the President & CEO. We are very pleased to be welcoming three new physicians to our community.

However, we must keep in mind that our team performs over 2500 surgeries every year, and the new equipment will serve us well for several years to come. During 2011-12, the NGH Foundation provided $905,907 for capital equipment. The majority of these funds were used to purchase a new digital x-ray unit. The commitment to purchase ceiling lifts, which are improving patient and staff safety was completed. Funds were also used to upgrade several patient rooms, providing an enhanced environment for palliative patients and their families. Without the commitment to fundraising by the foundation and the generosity of our local community, NGH would not exist as a vital community hospital.

2011-2012 Annual Report to the Community

The Volunteer Association provided $115,710 to NGH. They were successful in completing a three year pledge in two years for the hospitals scanning and archiving equipment. Other funds provided a glidescope and a patient monitor, as well as other smaller projects. We extend our heartfelt gratitude to the Volunteer Association; not only for your fundraising ability, but for the presence you bring to our hospital every day.

Over the next year, NGH faces a significant financial challenge. The current economic climate has not allowed government funding to keep pace with inflationary operating costs. While NGH has been recognized as being one of the most efficient hospitals in our LHIN, if not among our peer group across Ontario, we will be facing a $1.3 million deficit, and we will be required to take measures to balance our budget. As we make difficult decisions, our commitment to quality patient care will be the touchstone against which we measure our choices. The hospital will be refreshing our strategic plan over the next year. The current plan was written seven years ago and in our fast changing world is recognized as out of date. We will be excited to engage staff, volunteers and physicians, as well as patient, families and external partners in our strategic planning process, which will begin in September. Our staff members and medical team are to be congratulated and thanked for their commitment to maintaining high quality patient care while living within our constrained resources. We would also like to express our gratitude for the wisdom and leadership provided by the Board of Directors. Together, all of us in the NGH family work together to ensure that our hospital is able to help improve the health of our community. Peter Hellyer, Chair of the Board of Directors Kelly Isfan, President & Chief Executive Officer

Accreditation: Staff welcome an Accreditation surveyor into surgical

daycare.

NGH had a very successful Accreditation Canada report in 2012. We participate in Accreditation Canadas survey program as part of our ongoing commitment to quality improvement. A three day on-site survey was conducted in March. NGH successfully met 96% of the 1600 criteria included in our survey. The surveyors noted that many quality and safety initiatives are underway in clinical service areas. There are notable successes that have been undertaken with energy and enthusiasm, often by clinical program teams with staff, physicians, and leadership representation.

Norfolk General Hospital Statement of Operations

The charts below illustrate sources of revenues and expenses as reported in the Norfolk General Hospitals Audited Financial Statements for the period of April 1, 2011 to March 31, 2012. 2011/2012 Revenues $Dollars % of Total Revenues 79% 10% 1% 7% 3% 100% % of Total Expenses 65% 12% 4% 2% 14% 4% 100%

Ministry of Health and Long-Term Care 35,770,956 OHIP and Patient Services 4,474,510 Differential and Co-Payments 585,303 Recoveries and Other 3,088,095 Amortization of Donations and Grants 1,189,059 Total Revenues Expenses Salaries, Wages and Benefits Medical Staff Remuneration Medical and Surgical Supplies Drugs Other Supplies and Expenses Amortization Total Expenses 45,107,923 $Dollars 29,474,168 5,390,563 1,652,464 909,493 6,371,733 1,631,317 45,429,738

Peter Hellyer, Chair of the Board of Directors

Deficiency of Revenues over Expenses ($321,815)

2011-2012 Annual Report to the Community

Quick Facts
Hospital In-patients Admissions: 3,578 Adult, 289 Newborn Patient Days 34,206 Adult, 567 Newborn ER Visits 28,463 Deliveries (Newborn) 292 Surgical procedures Operation Room: 2,416 (inpatient and day surgery) Endoscopy procedures 2,940 Distribution of beds Medical -51, Surgical -16, Peds-2, ICU-6, Obstetrics-5, Complex Care-26 = Total Adult 106 and 5 Bassinets

New Members of Our Leadership Team

Hand Hygiene Compliance Rates: Before initial patient/patient environmental contact 82% After patient/patient environmental contact 88%
Tara Willemsen
Operating Room Director

NGH Infection Control team partnered with health unit promoting hand hygiene and flu vaccination

Rae Jerome

Director of Finance

Mark Jefferson

Infection Control Director

www.ngh.on.ca
Dr. Graham
2011-2012 Annual Report to the Community 3

The Norfolk Hospital Nursing Home

The team uses research and evidence of best practice to develop and improve the care in the nursing home on an ongoing basis. Some of the areas we have focused on this past year include medication management and safety, pleasurable dining, the best practice pneumonia pathway, the urinary tract infection best practice pathway, and falls reduction. The quarterly medications checks have played a pivotal role in decreasing the number of medications that the residents receive. One of the goals for the resident care team was to decrease the number of falls by 50%. The team was successful in reaching this goal by taking a multidisciplinary approach to falls prevention. Residents Council Report
Vicky Florio, Director of Care, NHNH and Mary Hoover, Chair of Board of Trustees

iscal year 2011 2012 was a busy and productive year for the Board of Trustees, management and staff at The Norfolk Hospital Nursing Home (NHNH). The Board of Trustees has an important role to monitor and evaluate the quality of resident care on an ongoing basis and receives a quarterly Balanced Score Card which enables them to closely monitor trends in resident care. We would like to express appreciation to The Board of Trustees for their dedication and commitment to NHNH. The efforts of staff, physicians and volunteers in providing quality services to our residents are acknowledged and sincerely appreciated. NHNH is currently preparing for the Accreditation process which is scheduled for October 2012. By participating in this voluntary process, our organization demonstrates its commitment to providing quality care and service. Resident Care Team The Resident Care Team meets every two weeks with residents and their families to provide an opportunity to speak with each other face to face and share input into individualized care plans. With the use of The RAI MDS tool (a specialized resident assessment tool), the team can provide residents and families with scores that show whether an intervention has been successful or if there are other alternatives or methods of improvement. The RAI MDS tool provides staff with data that can be compared from year to year. The team is responsible to continually plan and design services to meet the needs of the residents in the nursing home while maintaining excellence in care.
4

The Residents Council led by Margaret Juszku has a very active voice within the Nursing Home and community. This past year the residents council sponsored the childrens Christmas party for children and grandchildren of staff. This is an event everyone looks forward to and is appreciated by all. Our Christmas Bazaar celebrated another successful year, raising $3067.50. Thank you to the hard work and dedication of Margaret Juszku for advocating the best quality of life for all residents who live at NHNH, your hard work is acknowledged and appreciated. Volunteer Association Our volunteers truly add so much to our programs and enrich the lives of our residents. This year a $5,000 donation was provided to the NHNH from the Volunteer Association. These generous funds were used towards the purchase of a new shower and bath tub chairs. Palliative Care The staff at NHNH are truly passionate about the care they provide to our residents. There have been advancements and modifications made to our palliative care service. Several staff members have enrolled and completed further training in this area. It can be a difficult task knowing that at some point we will be providing end of life care to our residents.

Caring for residents at end of life is a privilege; we often see families at their most sorrowful moments and most emotional times of their lives as they come to terms with the end of the life and loss of a loved one. We see it as a great honour to be entrusted to provide this care to our residents and families at such a difficult time.

2011-2012 Annual Report to the Community

Never too old to enjoy the Fair

Point of Care Implementation

ecording resident care at NHNH has become much more efficient with the full implementation of Point of Care (POC) electronic documentation. Prior to POC implementation, staff members were completing documentation on a number of paper flow sheets. Now staff has an electronic POC system that allows easy documentation entry with a touch of a finger and ensures that all resident information is used to create a specific plan of care. POC also contributes to an accurate submission to the Canadian Institute for Health Information (CIHI). The team has been working very hard to implement this new standard of care with the assistance of Deborah Moore, RAI Coordinator.

Fern Gatten, a resident of the Norfolk Hospital Nursing Home took part on an outing to the Norfolk County Fair. Fern who was 101 years old at the time enjoyed a ride, and the view from the ferris wheel. The philosophy at NHNH is to keep our residents as active as possible as long as possible. The physio department, activity department and nursing staff, all work together to provide opportunities for the residents to remain active. The number and types of programs have increased with a real focus on restorative care. Residents participate in exercise classes, wheel chair mobility, walking classes and strengthening programs which in turn allows the resident to participate in their own care and daily activities as much as possible.

Exemplary Employees
Sherri Myke, NHNH Employee of 2011 with Kelly Isfan, CEO, John Race, grateful supporter & Sherri Schira-Ladosz, 2011 Dr. George Marshall recipient.

The Norfolk Hospital Nursing Home Statement of Operations

The charts below illustrate sources of revenues and expenses as reported in The Norfolk Hospital Nursing Homes Audited Financial Statements for the period of April 1, 2011 to March 31, 2012. 2011/2012 Revenues Ministry of Health and Long-Term Care Resident Co-payment and Other Total Revenues Expenses Nursing and Personal Care Food and Accomodation Program and Support Other Total Expenses Deficiency of Revenues over Expenses $Dollars 3,430,806 1,483,675 4,914,481 $Dollars 2,946,939 1,542,510 249,062 231,298 4,969,809 ($55,328) % of Total Revenues 70% 30% 100% % of Total Expenses 59% 31% 5% 5% 100%

2011-2012 Annual Report to the Community

Norfolk General Hospital Foundation

T
he incredible support of the community has enabled the Norfolk General Hospital Foundation to fund the purchase of many capital items for the hospital over the past 25 years. This support saves lives and helps the hospital provide the very best health care to our community.

With the support of so many loyal donors, volunteers, board members and staff, $811, 387.00 was raised this 2011/2012 fiscal year. The funds were used to purchase a brand-new digital X-ray suite which boasts up-to-the-minute digital technology. Low dose radiation means that this X-ray technology is much safer for our patients. Additionally, the new equipment is much easier for staff to operate and simply more efficient all around. As we look ahead to our next fiscal year, our fundraising plan is focusing on revitalizing our Operating Rooms with some very vital equipment. While the government plays a critical role in hospital funding, it does not provide any dollars for capital equipment. It is largely thanks to the continuing generosity of our donors that Norfolk General Hospital can offer the level of quality care that it does. The Foundation is very fortunate to have the support of so many incredible volunteers who led many successful events this past year. Thank you for your support! We would also like to thank all the members of the Board of Directors, the Foundation staff and the generosity of so many loyal donors for their commitment to the Foundation. We value your continued support knowing every dollar you give helps to provide the best possible care for all our patients. Paul Hosack, Chair of NGH Foundation Board of Directors Julie Powell, Director of Development, NGH Foundation

The diagnostic imaging team in the new X-ray suite at NGH thanks to the generosity of the community.

Thank You!

In 2011-12 You helped us purchase...

Telescope for ophthalmology microscope Palliative room renovations - 4B Holmes House - Roller shades Two Anesthesia carts Patient ceiling lifts Digital X-ray and suite

Norfolk General Hospital Foundation Statement of Operations

The Foundation continued to receive the generous support of many donors. In 2011/2012, The Foundation received donations totaling $811,387. Most of these funds were put towards the purchase of a new Digital X-ray Unit/Suite. The charts below illustrate sources of revenues and expenses as reported in the Foundations Audited Financial Statements for the period of April 1, 2011 to March 31, 2012. 2011/2012 Revenues Donations Investment Income Total Revenues Expenses Purchased Services (salaries, wages and benefits) Appeal and Fundraising Administration Other Total Expenses Excess of Revenues over Expenses
Funds Disbursed For Charitable Purposes

$Dollars 811,387 19,122 830,509 $Dollars 127,119 97,028 23,739 24,339 272,225 $558,284 $905,907

% of Total Revenues 98% 2% 100% % of Total Expenses 47% 36% 9% 9% 100%

Thanks to your support, the Foundation was able to purchase much needed equipment for our hospital. Im very excited and looking forward to working with the community to support NGH.

Julie Powell
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Volunteer Association

N
E

o one is more cherished in this world than someone who lightens the burden of another (unknown author)
xceptional People with Extraordinary Hearts is a very good descrip-

Glidescope and monitor purchase for OR

Left to right: Brian Miller (lottery treasurer), Sheila Driedger (OR nurse), Jean Dykstra (lottery convenor), Elaine

tion of the volunteers that assist Thorpe (OR nurse), Claudia King (Annual draw coordinator). daily at NGH & NHNH. This was the theme for this years National Volunteer Appreciation Week which is celebrated each April. For those who donate their time to NGH & NHNH, this special week comes along just as they are closing off their books at the end of their fiscal year. For our Volunteer Association, 2011-12 was a very successful year, which allowed the many fundraisers, businesses and events to thrive resulting in the completion of a three year pledge in just two years. This pledge was for the purchase of scanning and archiving equipment for NGH. Additional funds were given for other projects at both NGH & NHNH resulting in a grand total of $115,710 being donated for 2011-12. In addition to raising much-needed funds, volunteers have continued to serve in many departments throughout our hospital and nursing home. We have continued to experience a healthy influx of new volunteers over the past year keeping our total number well over 400 including men, women and junior volunteers. This has allowed us to continue filling the many leadership roles that are a necessary part of running an organization of this magnitude. This has helped keep our 20 plus services running at full capacity allowing us to continue achieving our goal of serving our patients, residents, employees and visitors. Many awards are presented to our volunteers at various venues throughout the year. Charlene Thompson, Maria Heinrich and Joan Kent were recipients of Provincial Life membership awards which were presented in Toronto in November. Ontario Volunteer Service awards were presented to six of our volunteers in Vittoria in June. These volunteers included Pat Lowry, Linda Misener, Angela Moyaert, Eva Vickery, Beth Drennan and also Luella Bowyer whose daughter received this award on behalf of her mother who passed away earlier in 2011. Luella, who volunteered with us for many years, was also the first baby born at NGH. Other awards were also presented at our Annual General Meeting including local life memberships awards, outstanding service awards, years and hours of service pins. Included were two 50 year pins that were presented to Elva Broker and Ellen Johnson!

The Volunteer Association would like to thank the many community members who continuously support our events and businesses. Your support is what determines our success!
Mary Peever - President Volunteer Association Sherri Schira-Ladosz - Director of Volunteers and Clergy

Upcoming Fundraising Events

NGH Foundation Online Auction, June 30-July 17 www.ngh.on.ca 23rd Annual NGH Foundation Golf Tournament - July 17 & July 18 Delhi Volunteer Branch Golf Tournament - August 15 NGH Foundation Radiothon - October 17
2011-2012 Annual Report to the Community 7

Norfolk General Hospital

365 West Street Simcoe, Ont, N3Y 1T7 www.ngh.on.ca 519-426-0130

Questions?

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THIS REPORT IS PUBLISHED BECAUSE as a publicly funded health care institution, Norfolk General Hospital is accountable to the province and the communities we serve including the Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN). THIS REPORT is part of our efforts to improve information-sharing. Our Board of Directors is committed to practicing good governance, improving the transparency around how Norfolk General Hospitals Board and leaders are addressing our significant challenges, and demonstrating our accountability to you, the public we serve. WE INVITE your feedback on the Annual Report. For questions or comments, contact Jason Harnett, Communications Development Officer at 519-426-0130 Ext.6977.

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365 West Street Simcoe, Ontario N3Y 1T7