Manitoulin Health Centre Board Minutes

MHC board learns of investments

The last Manitoulin Health Centre (MHC) meeting began with a presentation from Steve Smith of Beautel Goodman Private Client Group, the company that manages MHC’s investment portfolio.

Mr. Smith explained that he was there to familiarize the new board members with his and Beautel Goodman’s role.

He explained how the hospital’s portfolio has been development and managed, as well as reviewing MHC’s portfolio performance over the last seven years, noting that “Since inception in January of 2006, the MHC portfolio has returned 5.47 percent annually, which is equal to a gain of 51.7 percent.”


Chief Executive Officer report

MHC CEO Derek Graham reviewed his November report with the board, beginning with MHC’s proposals under the Small Hospital Innovation Funding.

“As I reported previously, MHC has submitted proposals under the Small Hospital Innovation Funding,” said Mr. Graham. “Decisions have not yet been forthcoming from the North East Local Health Integration Network (NE LHIN) that relate to funding for the hardware and software that supports the building of the electronic medical records, a joint proposal with Espanola and Blind River for a shared data analyst position, a quality/integration lead for MHC and the Island’s health care services, continuation funding for the non-urgent patient transport service with Espanola through the Manitoulin-Sudbury District Services Board, and a senior’s care lead to help link together the complex needs of the elderly in coordination with the regional geriatric program out of Sudbury. I am told we may get a letter before the end of the week.”

Mr. Graham added that a one percent small hospital base funding from the NE LHIN, which was announced previously in the Ontario budget, is still outstanding, but that he expects that information would come in the same letter later in the week.

“Work continues on the next phase of the Meditech deployment,” said Mr. Graham. “Patient Care Documentation module staff training is underway in ambulatory clinic areas.”

“The recent funding announcement by the ministry (Ministry of Health and Long-Term Care) for the Mindemoya site FHT (Family Health Team) construction enable the project to move immediately to detailed architectural design and the creation of the tender documents,” explained Mr. Graham.

Next, Mr. Graham informed the board that that the information gathering from each department with respect to alignment of department level plans that corresponds to MHC’s Strategic Plan is underway.

“MHC’s article on local health alignment efforts was recently featured in an OHA publication, ‘Enhancing Access Through Integration: How small, rural and Northern hospitals are innovating partnerships’,” he was pleased to note. “Also, the deputy minister of health, Saad Rafi, announced his intention to step down from his position early next year and this will have big impacts as his replacement hasn’t been named yet.”

Finally, Mr. Graham concluded his report by explaining that the government of Ontario has initiated a review of the Local Health Integration Act. “A review committee has been struck and is charged with responsibility for this review,” he said. “A report must be returned to the house within the year.”


Chief Nursing Officer report

MHC Chief Nursing Officer Mary Lynn Wright began her November report by discussing efficiency and risk.

“Additional funding has been received to support the chemotherapy volume provided and recertification of one of the chemo nurses has been completed,” explained Ms. Wright.

Regarding patients, Ms. Wright noted that two nurses had attended an acute care trauma symposium in Sudbury.

“Ongoing efforts are occurring with community partners to promote and maintain IV therapy in the home,” added Ms. Wright. “A discharge planning meeting was held this week, with seniors’ services and palliative care being discussed.”

Ms. Wright explained that she and one of the MHC’s employees attended the OHA convention.

“It was very worthwhile and informative,” continued Ms. Wright. “There were several excellent speakers discussing team work, communication, motivation and integration. A double lung transplant recipient talked about the importance of being an organ donor, stressing that one donor could save eight lives. Several speakers talked about safety and quality in health care, promoting system standardization, which ties to the ministry’s quality based procedures project. A futurist talked about potentials in health care with stem cell work, neuro implants and medications for cancer and aging prevention.”


Financial report

MHC Chief Financial Officer Lynn Foster presented a financial highlights report for October.

In her overview of operations she stated, “After seven months of operation in our 2013-2014 fiscal year, MHC ends with a $315,000 surplus.”

“The $316,000 positive variance in revenues together with the $215,000 positive variance in expenses leaves MHC with an overall positive variance of $441,000,” she added.

Ms. Foster next discussed the investment performance, stating that MHC’s investment portfolio has been managed by Beautel Goodman since January 2006 and thanking Mr. Smith for his presentation.

“MHC’s assets under management at book value are equal to $4,307,504 with a fair market value of $4,843,168,” said Ms. Foster. “The asset mix is currently 45 percent fixed income and 56 percent equity, per board policy. The average annualized return since joining the fund (January 2006) is 6.64 percent, with the 12-month rolling average return at 17.69 percent.”

For capital asset purchases, Ms. Foster explained, “to date, MHC has spent approximately $311,000 on capital assets; $140,000 on radiology equipment funded by campaign donations, $82,000 on portable x-ray units (partly funded), $82,000 on various other items and $7,000 on Health Infrastructure Renewable Fund (HIRF) projects.”


Chief of Staff report

MHC Chief of Staff Dr. Stephen Cooper had two reports to review with the board. In the first report, Dr. Cooper explained that Health Regulatory Colleges of Ontario (FHRCO) has a new place on their website that helps health care organizations structure the work sharing of the different professionals in their organization.

“There was also a presentation from the College of Pharmacists and Nurse Practitioners on recent changes in regulations for their colleges and how they will affect their work in hospitals,” added Dr. Cooper. “There seems to be a desire to move away from medical directives, which are unwieldy in large institutions, to regulated changes for professionals to better recognize the level of care they are able to provide.”

On another note, Dr. Cooper explained “the small number of data points collected for measurements in small hospitals creates large confidence intervals.”

“Large confidence levels means that interpreting and comparing the data is inaccurate,” he further explained. “General consensus is that smaller hospitals should measure processes not results. Despite the issues with inaccuracy, small hospitals should measure results and make them public.”

In his second report, Dr. Cooper gave a brief description of his November.

“I had the opportunity to attend Health Achieve 2013,” Dr. Cooper said. “Innovation and quality care continue to be the key issues. Also I met with Dr. Bonin for the Transfusion Committee. Dr. Snider has been invited to start doing endoscopy at MHC in the spring of 2014. Dr. Bhagavatula has replaced Dr. Shivakumar as the visiting psychiatrist for Northeast Mental Health Clinic.”

“I am hopeful that invitations for the NE LHIN Physician Leadership Conference will go out later this week,” continued Dr. Cooper. “OHA and OMA have created a multi-stake holder ad hoc committee to further explore rural health hubs to which I have been invited.”


Auxiliary notes

Ted Musgrove of the Little Current MHC Auxiliary presented the board with the minutes from the auxiliary’s November meeting.

Highlights from the minutes include a $250 donation to the Manitoulin Student Aid Fund and that the auxiliary is at a membership of 45 individuals.

The Mindemoya auxiliary added that they were donating $500 towards the Manitoulin Student Aid Fund and that they had received a $5,000 donation from the Mindemoya BMO.