Hospital board AGM reveals many challenges met, surpassed

by Nancy McDermid

LITTLE CURRENT—A challenging year for the Manitoulin Health Centre Corporation (MHC) has resulted in a positive outcome due to the work of dedicated board members, staff and volunteers at the Little Current and Mindemoya sites, according to reports given on June 23 during the annual general meeting.

Michael Shain, chairperson for the Board of Directors, began the meeting by acknowledging the skill and dedication of former chairperson Karen King who passed away this winter. He told the board “it has been my honour and privilege to have served for the last six months as Chair of the Board for MHC. I assumed this position mid-way through Karen King’s tenure, and following her passing, I discovered just how large the shoes she wore were in her capacity as chair, and in what high regard she had been held.”

The chairperson spoke of Ms. King’s dedication to the well being of the MHC and said that “it is fitting that I take this opportunity to again state how fortunate we all were to have been the beneficiaries of her strong character and her many talents.” He credited Ms. King with helping to make the MHC a highly regarded health care facility along with “the talent and dedication of everyone who plays a part in the day to day activities of the MHC, from our maintenance staff to our physicians to everyone in between.”

Mr. Shain continued by saying, “No matter where you go in either facility, one finds competent and caring staff. Certainly this was one of the many positive observations made by the recent visit of the accreditation team, and complementing all of this is our highly skilled management team led by Derek Graham.”

Focusing on Mr. Graham and his management team, Mr. Shain said, “I think it fair to observe that never has there been a year in which there have been so many complex legislative initiatives affecting health care. Our management team was not only able to implement the sometimes very onerous changes arising from the new legislation, but at the same time they were working hard to bring Meditech on stream and assisting with getting the family health team project in Mindemoya off the ground. Throughout the year Derek has been front and center in our fundraising campaign, and while all of this was occurring, he an his team were also achieving the not insignificant task of running a two-site health care facility in a very effective manner, and with a balanced budget. Derek, you and your team are second to none.”

The chairperson acknowledged the support the MHC has received from communities throughout the Island. “Nowhere is this more noticeable than with our Auxiliaries, who work very hard behind the scenes to raise funds for the direct benefit of patients. They spend thousands of volunteer hours each year in all sorts of activities supporting the MHC, and on behalf of the board, I want to thank both Auxiliaries for their tremendous efforts.”

Recognizing the board for its contributions as well, Mr. Shain said, “Our strength as board members is our dedication to our mission and vision statement: To contribute to the health and well being of all who come to us in need, and ‘dedicated to excellence in all we do.’ We come from all walks of life and all parts of the Island and we do our very best to make decisions that are respectful of our diverse opinions and in the best interests of the MHC.”

Naming committees such as the executive, fundraising, quality assurance, resource, strategic planning and the nominating committee, he thanked the board members who chair the committees and those who serve on them. “You make it possible for the board to work efficiently and effectively.”

Referring to board member Dave Hill who has served for six years, he said, “I want to thank Dave for his significant contribution as board member and for his involvement on the resource, strategic planning and fundraising committees.

A certificate of gratitude was then presented to Mr. Hill.

Chief Executive Officer Derek Graham spoke next, noting that the year was an unprecedented year for the MHC as there were significant challenges and key milestones met by the organization. “There has been a common thread running through our efforts as we work to fulfill our mission,” he said. “That thread is a keen focus on efficiency, effectiveness and safety.”

Mr. Graham also spoke about the passing of Ms. King as a “tremendous loss to our organization.” He expressed that her “values and inspirational guidance continue to be reflected through the organization.”

Reviewing the past year, he stated that “the pace of healthcare legislative change has been unequaled. The Ontario government continues to utilize its legislative powers to reform healthcare, and hospitals have certainly been at the focal point of these efforts,” he said.

“As a result, the requirements concerning process alignment with regulations, data collection and posting of publicly accessible reports has consumed many hour of senior management time at MHC.”

Listing patient safety, quality improvement activities, procurement practices that demonstrate value for dollar, compensation restraints on executives, non-union staff wage freezes as events all occurring within the year, Mr. Graham said that they were implemented in a way that “has demonstrated corporate compliance with the regulations, but in a manner that is least intrusive to our small hospital resources and operations.”

He noted that the current fiscal situation brought about because of a shrunken tax revenue base for Ontario, continues to perpetuate a serious provincial deficit.

“Hospital revenues are shrinking, resulting in a widening gap between the cost of our operations, which are largely dependent upon centrally negotiated union settlements, and the monies being provided to pay for them through our global budget,” Mr. Graham said.

“MHC has been fortunate to date in maintaining the breadth of services which we offer to our Island community at the two hospital sites, however it is likely that if the current trend of revenue-to-cost growth remains as projected, we may find ourselves in an unsustainable situation,” he added.

“We must work together in carving a path forward, locally, regionally and provincially in determining how best to meet this challenge,” he said.

He added that the issues are compounded by the political uncertainty of an impending provincial election.

“Yet, in spite of uncertainty, MHC has much to be proud off!” he exclaimed. “We are moving forward and achieving important strategic goals, even in the midst of this difficult external environment.”

The chief executive officer listed some of the many successes the MHC has had in the past year including the completion of Phase 1 and 2 of the Meditech implementation (the joining of a consortium of 20 hospitals to share information,) and achieving accreditation status with over 94 percent of Accreditation Canada’s safety and effectiveness standards realized and met.

The expansion of a standardized electronic database for policies and procedures, continued renovations at the Mindemoya site and the completion of renovations at the Little Current site allowing for a separate small procedures area, away from the emergency department, that once housed it were on the list.

A construction feasibility study was submitted to the Ministry in regards to office space for the Central Manitoulin Family Health Team and building security infrastructure and heating/ventilation/cooling was enhanced at both sites.

In regards to the fundraising campaign, over half of the required gifts and pledges were secured.

The MHC, according to Mr. Graham, is continuing to build on a ‘Safe Culture’ campaign and have created a traditional programs brochure, written in both Ojibwe and English.

“We have increased advocacy for Northern rural healthcare issues, with a seat on the Board of Directors for the OHA, and we have successfully advocated with the NE LIHN for e-health for the physician’s office information integration project,” he said.

“We have been leading the signing of an agreement within our region to extend the voice dictation automation platform for radiology reporting to all network hospitals and helping to secure Health Infrastructure Renewal Funding for Ontario’s hospitals.”

Mr. Graham described the list as “tremendous” and said that “it is somewhat staggering and definitely humbling to look back and reflect upon these achievements. The board, physicians, senior leaders, management and especially the front-line staff of our hospital should be immensely proud of these accomplishments. It is no wonder that I’m very thankful to be leading this organization—you are remarkable.”

Dr. Stephen Cooper, chief of staff at the Little Current site, reported next, complimenting his “great medical staff who are very easy to work with.”

“The hospital has been very fortunate to have a relatively stable and competent medical staff during my tenure as Chief of staff,” he said. He noted that the Little Current group will be welcoming Dr. Ben Quackenbush, a chartered graduate of the Northern Ontario School of Medicine, as a replacement for Dr. Arianna who left one-and-a-half years ago. Other changes at the MHC include a return to his nursing home/home visit practice for Dr. Jeffery, who has been caring for Dr. Arianna’s patients, and a move from the Mindemoya group to Manitowaning for Dr. Bedard, though he will continue to provide service at the Mindemoya site. “Dr. Davis, who was the resident physician of Manitowaning, is moving on to do more Third World medicine,” Dr. Cooper explained. “She was an active participant of the Withdrawal Management Committee and did many shifts at the Little Current site, so she will be missed.”

The Chief of Staff spoke about his staff, saying, “Once again, I am fortunate to work with a group of physicians who are supportive of the running of the hospital. All the committees that required a physician had active participation from the medical staff. The recent approval of asthma guidelines and order sets for insulin and treatment of Non STEMI patients (heart attack) are great examples of the clinical committees working hard to improve patient treatment and safety. I am especially pleased about the asthma guidelines since I committed to moving forward on those guidelines at last year’s annual meeting.”

Reporting on the hospital accreditation he said he understood that it went well and noted that both accreditors appeared to be impressed with the physicians’ rounds, where the doctors meet regularly to discuss management of inpatients and any new medical information.

In his report, the doctor wrote that “it is reasonable to expect that the next five to 10 years are going to be financially more difficult. It will be important that the medical staff become more integrated with regional health providers. I have been an active participant on the Trauma Advisory Committee, an instigator of LHIN Chief of Staff meetings and recently, the Emergency Department Network Initiative. I have also volunteered to be the chair of the Ontario Medical Association Rural Section. Use of regional policies and guidelines are expected to not only improve the efficiency by which we provide health care, but also to improve patient care.”

In his final paragraph, he wrote, “Finally, there has been a move toward measuring the quality of health care delivered through Ontario’s hospitals. Though there have been problems with what and how indicators are being measured the concept is an excellent one. The recent MRP collaboration initiative is a good example of the Ministry (of Health and Long Term Care) putting their goals into actions. The medical staff of MHC are in the process of adjusting the medical staff indicators that we have been measuring to meet MoHLTC standards.”

The two MHC Auxiliary reports were read next by Little Current Auxiliary member Ted Musgrove.

Reporting on the Little Current Site Auxiliary, he listed care bags, tuck cart goodies, blankets for ALC patients, and free LCD television as some of the services they have provided. The auxiliary are also fund-raising for new radiology equipment.

“These services and goals can only be achieved by a dedicated group of volunteers,” wrote President Leila Kiviaho in her report. “We have a group of 14 to 16 active members who attend monthly meetings and give of their time in diverse capacities. Team work is essential to maintain or accomplish our goals.”

Mr. Musgrove read that, “Constant fundraising is necessary for our auxiliary and we held 11 events this year. In addition there are five on going fundraisers.” The president noted that there was an increase in donations to the In Memorium Fund this year.

The group hosted the Regional Spring Conference in April and received positive feedback for their efforts.

Making a substantial donation for the purchase of new radiology equipment of in October, the group is getting ready to make another.

“The year has been busy and productive, but coloured by sadness as we mourned the passing of our top ticket seller and two associate members, however, we continue to do our best for the Manitoulin Health Centre in Little Current,” Ms. Kiviaho wrote.

The Mindemoya Auxiliary annual report, written by President Leila Thureson, stated that “Last year we were requested to channel our efforts toward the replacement of radiology equipment. We were able to donate $25,000 both spring and fall towards this goal. We are aiming at another donation this fall.”

Ms. Thureson continued to write that, “since the inception of the chemo room, several of the donations to the auxiliary have been specified for it and as such, have been held for that purpose. We are now donating $15,000 of those funds towards the purchase of the biological safety hood for the chemo room.”

The auditors report prepared by chartered accountants Freelandt Caldwell Reilly LLP, detailed the financial position of the MHC as of March 31, 2011. For a third year in a row, the MHC has finished with a surplus. This year it is approximately $58,000.

The overall investment portfolio for the MHC has recovered from a financial dip that occurred a few years ago. The conclusion was that the MHC had a successful year and has a solid financial basis with which to go into the new year.

The nominating committee report followed with the nomination and election of Don McGraw and Greg Bond to the board for the next three years.

In a separate nomination and election, the position of chairperson was filled by Georgie Hari, vice-chairperson by Suzanne Norris and secretary-treasurer by Derek Graham.