Sunnybrook Management Commentary and Analysis 2014/15

Management Commentary and Analysis
2014/15

Table of Contents
1. Introduction 2
2. Financial Performance 4
3. Strategic Plan 2015 – 2018 and Occupancy 6
4. Human Resources 8
5. Education 10
6. Research Institute 12
7. Nursing 14
8. Health Professions 16
9. Greening Sunnybrook 18
10. Community Engagement 19
11. Web Communications 22
12. Improving Service for Patients and Families 24
13. Safety 26
14. Digital Technology 28
15. Partnerships and System Improvement 30
16. Fundraising 32
17. Financial Outlook 2015/16 34
1

1. Introduction
Outstanding patient care, research and
lifelong learning made 2014/15
memorable and successful for
Sunnybrook and for the 1.2 million
patients and families the Hospital cared
for when it matters most. A significant
highlight from the last year was the
development of Strategic Plan 2015 –
2018. The plan points Sunnybrook
toward the future by providing a road map
for how the organization will move forward
its mission and vision, while also balancing
the Hospital’s dual role as a teaching and
research hospital with a defined
community to serve.
On many days, demand for care at
Sunnybrook outweighs the Hospital’s
physical capacity. Strategic Plan 2015 -
2018 aims to reduce Sunnybrook’s
inpatient occupancy levels, which often
exceed 100 per cent, to move toward a
more manageable 95 per cent.
Preparation and readiness were two
dominant themes during 2014/15.
Sunnybrook responded quickly to ensure
a team of staff were ready should a
patient present as a suspected Ebola
case. Staff also worked diligently to
Bayview Campus
2075 Bayview Avenue
Toronto, Ontario M4N 3M5
t: 416.480.6100
paedic & Arthritic Centre
43 Wellesley Street East
Toronto, Ontario M4Y 1H1
t: 416.967.8500
St. John’s Rehab
285 Cummer Avenue
oronto, Ontario M2M 2G1
t: 416.226.6780
Strategic Plan
2015 - 2018
www.sunnybrook.ca
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implement and adhere to the Toronto
Academic Health Science Network
Healthcare Worker Influenza Vaccination
policy, requiring staff to be vaccinated or
wear a mask in areas where care was
provided.
Sunnybrook’s role as an academic health
sciences centre continued to form the
foundation for the work of the Hospital
and its teams – from the focus of the
quality care provided for patients, to the
commitment to the students educated,
to the research conducted, and the
innovations that defined the future of
care. The Hospital welcomed thousands
of students who chose to come to
Sunnybrook to learn from its expert staff
and physicians.
At Sunnybrook Research Institute,
some of the best minds in the world
guided discovery to clinical impact via
the medical marketplace. Sunnybrook
Foundation supported the advancement
of the Hospital through active fundraising
in support of research, education and
equipment initiatives. A gift of $20 million
from the Hurvitz Family Foundation
created the Hurvitz Brain Sciences Centre
to accelerate research and slow the
progress of brain disorders.
Throughout 2014/15, the Hospital was
a social media leader among Canada’s
hospitals, sharing good news happening
on the front line, and in education
and research. The corporate website
expanded and improved its functionality.
Online changes were not the only ones
taking place, as the Hospital rolled out
signs for its new street names, including
Lifesaving Drive and Wellness Way. Inside
Sunnybrook’s doors, 22 new beds were
opened in the Palliative Care Unit in
K-wing, expanding the unit admission
criteria to include long-term palliative
patients with a prognosis of less than
one year.
Sunnybrook’s award of ‘Accreditation
with Exemplary Standing’ until November
2017 truly points to the 10,000-person
team who work above and beyond
expectations each day to care for the
Hospital’s patients and their families. The
many successes in 2014/15 would not
have been possible without the staff who
achieve the best possible results for the
organization.
3

2. Financial Performance
Sunnybrook reported Revenue over
Expenses for the fiscal year 2014-15
of $32.8 million. This overall result is
consistent with earnings in the prior year
and represents approximately 3.1% of
Total Revenue, which is marginally above
the 2-3% range recommended by the
Ontario Hospital Association as needed
for reinvestment in capital equipment,
facilities and working capital requirements.
There were several contributory factors to
these financial results including success
in revenue generation initiatives, final
settlement of several prior year accruals,
and ongoing in-year success in attaining
savings through group purchasing and
other initiatives implemented to increase
efficiency.
Integral to Sunnybrook’s strategic plan
is a targeted occupancy rate of, or
approaching, 95%, in order to provide
safe, quality and efficient care. However,
clinical activity / volumes continue to
grow, largely from admissions arising
in the emergency room. The increased
occupancy rate that arises as a result
of higher volumes also puts a financial
burden on the institution. Sunnybrook
continues to identify and make changes
that favourably impact patient flow which
has resulted in significantly fewer cancelled
surgeries and closures to trauma than
was the experience approximately 5
years ago. In FY 2014/15, however,
increased volumes, largely admitted via
the Emergency Department, did have
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negative downstream impacts resulting in
some cancelled surgery and a resulting
loss of revenue. There continues to be
no closure to trauma.
Sunnybrook is also continuing to
experience cost pressures in relation to
its aged infrastructure. In 2014-15 the
Ministry of Health and Long Term Care
(Ministry) has significantly increased
its focus and funding for hospital
infrastructure renewal and Sunnybrook
used these funds to invest in a number
of high risk areas including: emergency
generator plant upgrade, roofing and
building envelope repairs, elevator
renewals and asbestos removal, Despite
this investment, maintenance costs
continue to increase and create additional
cost pressures for the organization.
Sunnybrook continues to advocate for
further increases by the Ministry in the
Hospital Infrastructure Renewal Fund.
Health System Funding Reform (HSFR)
continues to be rolled-out by the Ministry,
and in March 2015 the Ministry provided
Health Based Allocation Methodology
(HBAM) results for the Province. An indepth
review confirms that Sunnybrook
continues to be a best quartile performer
amongst our peer group and that overall
many more organizations are reflecting as
efficient. With respect to Quality Based
Procedures (QBPs), Sunnybrook remains
focused on providing high quality care,
utilizing best clinical practices, in order to
ensure we provide such care in the most
effective and efficient manner.
The chart below reflects how Sunnybrook
has used the resources entrusted to it to
provide patient care and in particular that
the vast majority of funds are used for
direct patient care. Sunnybrook’s overall
efficiency is further evidenced by less than
9% of total expenses being incurred in
Corporate Support.
Fiscal 14/15: What do these expenses buy?
Fiscal 14/15: What do these expenses buy?
Medical Staff
Food & Physical Support
& Clinical Educa8on
10.5%
Corporate Support
8.6%
3.6% Other (Insurance
& Interest)
1.7%
Clinical Services
Lab, Diagnos8c Imaging
& Pharmacy
Food & Physical Support
Corporate Support
Lab, Diagnos8c Imaging
& Pharmacy
14.3%
Direct Care Expenses:
61.3% Clinical Services
14.3% Labs, Diagnos8c and Pharmacy
75.6% Total
Clinical Services
61.3%
Medical Staff & Clinical
Educa8on
Other (Insurance &
Interest)
5

3. Strategic Plan 2015 – 2018 and Occupancy
In addition to laying out the Hospital’s
strategic goals and objectives, Strategic
Plan 2015 - 2018 is aimed at reducing
Sunnybrook’s inpatient occupancy levels.
On many days over the last year, demand
for care at Sunnybrook outweighed the
organization’s physical capacity and the
Hospital was left with the difficult situation
of having patients in hallways and longerthan-expected
wait times for other areas.
Patient care units across the Hospital’s
three sites spent 2014/15 putting forth
extra effort to care for patients who had
waits in the Emergency Department and
hallways, to make certain those who were
in immediate need of care were able to
access it as quickly as possible.
Strategic Plan 2015-18
To manage the high demand for inpatient
care, Strategic Plan 2015-18 began
to focus the organization’s amount of
routine and general hospital care to a
defined catchment area. These services
are fairly common and are available
closer to home for patients outside of
the organization’s catchment. At the
same time, Sunnybrook reaffirmed its
commitment to its strategic priorities,
those select highly specialized areas
in which Sunnybrook is consistently
Sunnybrook’s Strategic Plan • 2015-2018
Public institutions educate and care for people in a community.
Sunnybrook serves as many people as possible within its available resources.
Sunnybrook has dual roles:
As a community
And as a research &
hospital
teaching hospital
Sunnybrook provides routine health care for residents
of the surrounding neighbourhood.
It also provides specialized care not normally found in other
hospitals to a larger community area.
These specialized services include:
Traumatic
High risk
Advanced imaging
Breast,
injuries and
pregnancies
such as MRI
colorectal and
burns
and premature
to treat cardiac
prostate cancer
newborns
disease and stroke
Are you in
Sunnybrook’s
neighbourhood?
It depends on
the type of care
you need.
HOSPITAL
Sunnybrook provides commonly
found services, such as low risk
surgery, to residents of the immediate
neighbourhood bounded by:
St. Clair Avenue and Highway 401,
If you need routine care and
west to Caledonia Road and east
live outside that area, you will
to the Don Valley Parkway.
likely be referred to a hospital
in your community.
- 22 -
acknowledged to be internationally
renowned. Cancer, Heart and Stroke,
High Risk Maternal and Newborn and
Trauma, provide innovative care at critical
times in patients’ lives, differentiating
the Hospital from others in both the
local and global health care landscape.
Sunnybrook will continue to offer care for
patients across the province who need
access to these strategic priorities and
regional programs and services.
Quality
Improve
through
Focus o
in suppo
Centre d
Work wi
build an
of our c
Science
The ach
priority c
Research
Change
creation
knowled
Prioritie
Lead in
of teach
Sustaina
Advance
appropr
Deliver s
health s
Create a
inclusive
achieve
6

Partnering with patients and families: Person-centred care approach
Start with N.O.D.S.
Introduce yourself with:
N – say your Name
O – state your Occupation
D – describe what you will Do
S – Supportively, Sincerely,
and with a Smile
Seek the Voice of the Patient
ASK first:
Today/right now, what’s most
important to you?
• goal, concern, worry,
preference, care need
• What would you like to see
happen? What would help?
Embed the Voice of the Patient
SHARE & ACT:
What’s important to the patient
and work with the interprofessional
team and health care partners
across the continuum of care
Document the patient story
Take action and see it through
1 2 3
Ensuring that patients and families are
prepared for discharge from the hospital
can be a complex task, but an important
one to ensure optimal patient flow and
keep occupancy levels manageable. At
Sunnybrook, discharge planning begins
at admission with an “expected date of
discharge” included on patient charts.
Health care teams partner with patients
and families to ensure their questions
are answered and they are ready to
return home. The acronym N.O.D.S. was
launched at the Hospital as a reminder
to staff to “N – say your name. O – state
your occupation. D – describe what you
will do. S – supportively, sincerely and
with a smile.” Working together as a
team to improve the information shared
with patients, and address any concerns
about returning home, has been shown
to greatly improve the overall patient
experience.
Rapid referral and assessment
Across Sunnybrook, rapid referral and
assessment clinics assist in preventing
unnecessary hospital admission and
reducing wait times. The Heart Failure
and Rapid Cardiology Assessment Clinic
celebrated its first anniversary, seeing
over 800 referrals in the first year, with
546 seen within 24 to 48 hours. The
clinic sees patients with congestive
heart failure, chest pain, and arrhythmia
that do not require urgent admission.
In the same vein, Sunnybrook’s Rapid
Referral Clinic allows physicians in the
Emergency Department to refer patients
to a general internist for urgent outpatient
assessment, with the goal of improving
patient flow.
7

4. Human Resources
Sunnybrook continued to attract new
talent, and retain top employees, as the
organization’s 10,000-member team
worked collaboratively to impact the lives
of over 1.2 million people relying on the
Hospital each year. The institution was
recognized as an exceptional workplace
by being selected, for the sixth year
in a row, as one of Canada’s Top 100
Employers for 2015. Sunnybrook was
also named as one of Greater Toronto’s
Top Employers for its forward-thinking
human resources programs.
Balancing work and family commitments
Sunnybrook was once again named as
one of Canada’s Top Family-Friendly
Employers in 2014/15. The Hospital was
selected for its leadership in supporting
new mothers with maternity and parental
leave top-up payments, as well as support
for in-vitro fertilization. The competition
also made note that Sunnybrook offers
parental top-up for employees who are
new fathers or adoptive parents and
5
operates a convenient onsite daycare
facility for those returning to work.
Maintaining a safe workplace
The Hospital took a leadership role in
recognizing and preventing violence
in the workplace by introducing a new
program to promote a safe working
environment. The program stresses that
everyone is entitled to a safe and healthy
workplace. Workplace incidents and
injuries, as well as occupational disease,
are unacceptable and every reasonable
effort will be made for their prevention.
8

Celebrating clinical leaders
The 13th annual Schulich Awards
for Nursing and Clinical Excellence
recognized and honoured the clinical
work of staff who demonstrate in their
daily work the values of Sunnybrook. In
2014/15, the Schulich Awards recognized
10 employees working in the areas of
diagnostic, therapeutic and direct clinical
patient care. This valuable recognition
award has been made possible by a
generous donation from Dr. Seymour
Schulich.
9

5. Education
Sunnybrook celebrates education with a mantra of “we are all learners”. More than
4,000 learners from over 25 health care disciplines chose the Hospital in 2014/15 to
experience the best teaching and clinical experiences and to work with some of the
most advanced technology in Canada. Exemplary leadership has helped Sunnybrook
continually reaffirm its strong commitment to education. Dr. Ari Zaretsky, Vice President
of Education and Marilyn Reddick, Vice President of Human Resources, received the
Canadian Society of Training and Development 2014 Learning Leaders Award. This
award honours outstanding leaders who are active advocates and ongoing supporters
of learning opportunities in the workplace, and recognizes the value of ongoing learning
for individuals and the organization. In total, 1,400 e-cards were sent as a “thank you”
to those who have been instrumental educators at Sunnybrook over the last year.
10

Technology-enhanced learning
A full-day event focused on technologyenhanced
learning, from simulation
to virtual reality. Designed for the GTA
health care community and partners
in education, the day included a
broad range of world-class speakers,
presentations, posters and interactive
workshops. Awards were given to Drs.
Jeremy Rezmovitz and Ian MacPhee for
“Use of an iPad App as a Teaching Tool
in Family Practice,” and to Dr. Asim Alam,
Hanna Goldberg, Jessica Liu and Chaim
Bell for “The Characteristics of Disciplined
International Medical Graduates by
Professional Colleges in Canada.”
Integration of patient education into care
An interprofessional daily patient care
record for the inpatient units at the
Bayview Campus was developed to
embed multiple best practices, including
patient education. Ensuring that patient
education is central to daily care is
just one more way that Sunnybrook is
encouraging the best health literacy for
patients and families. There is also annual
funding for print materials to support the
delivery of patient and family education
at Sunnybrook and to build capacity in
creating patient and family education
best practices.
Commitment to internationally educated professionals
With the goal of supporting those
clinical and non-clinical professionals
who immigrated to Canada, as well as
Canadians who obtained their degrees
outside of Canada, an Internationally
Educated Professionals Committee
helped to integrate staff both into the
Sunnybrook community and also the
Toronto community. The committee
developed a guide to support leaders in
guiding staff who are highly technically
skilled in understanding of the Canadian
health care system, and providing support
during their time at Sunnybrook.
11

6. Research Institute
Sunnybrook Research Institute (SRI), with more than 295 scientists and clinicianscientists,
leads from discovery to clinical impact via the medical marketplace.
Physicists, engineers, geneticists, molecular and cellular biologists, and health services
researchers, along with business partners, work with practitioners and patients to
solve the most challenging problems in medical science. The second anniversary of
SRI’s Image-Guided Therapeutics Program was celebrated with the Federal Economic
Development Agency for Southern Ontario that invested $6.9 million into the program,
which the private sector matched. SRI continued to support and cultivate student-led
research, including the D+H SRI Summer Student Research Program, a four-month
program allowing undergraduates to learn the fundamentals of scientific inquiry while
being mentored by SRI faculty. With research spanning the three Hospital campuses,
and 500,000 square feet of space, SRI worked through 2014/15 to ensure patients
benefit from breakthroughs faster than ever.
12

The best young minds
The fourth annual Sunnybrook Research
Prize competition was held, highlighting
the work of nine undergraduates from
universities across Canada. At 18 entries,
the event was the most competitive ever.
The competition recognizes excellence
in undergraduate research in physical
sciences and engineering, and promotes
careers in biomedical research. The
two winning projects this year featured
a technology using functional electrical
stimulation to increase trunk muscle
stability in individuals with spinal cord
injuries, and another on the search for
a biomarker to diagnose Alzheimer’s
disease earlier, using magnetic resonance
imaging.
Terry Fox Foundation supports SRI
Sunnybrook researchers were awarded
a new investment of $2 million over three
years from the Terry Fox Foundation
to support research in quantitative
ultrasound and magnetic resonance
imaging to better tailor cancer therapy.
The award is part of a larger research
investment from the Terry Fox Foundation
to support projects nationally to potentially
revolutionize care for patients with hardto-treat
or advanced cancers through
more personalized approaches. Dr.
Gregory Czarnota and Dr. Greg Stanisz,
senior scientists at SRI, in collaboration
with Dr. Michel Kolios at Ryerson
University, are using ultrasound and
MRI for treatment monitoring.
Securing research investment from CIHR
The Canadian Institutes of Health Research
(CIHR) awarded six SRI scientists with
operating grants in its March 2014
competition, for a total of $4.2 million
over the next five years. Dr. Isabelle Aubert,
Dr. Stuart Foster, Dr. Benjamin Goldstein,
Dr. Mario Masellis, Dr. Richard Swartz
and Dr. Hannah Wunsch (together with
co-investigators Dr. Robert Fowler and
Dr. Damon Scales) were successful. The
projects span the Hurvitz Brain Sciences
Program, the Odette Cancer Centre and
the Trauma Program.
13

7. Nursing
More than 2,900 nurses at Sunnybrook are dedicated to excellence in care, research
and education. The Hospital’s nurses have been recognized locally, provincially, and
nationally for their leadership in the development and sharing of new knowledge with
students, team members, patients, families, and communities. Sunnybrook’s nurses
develop and implement innovative roles that further enhance quality care and services for
patients and their families. In addition to direct clinical roles, nurses fulfill leadership roles
such as Advanced Practice Nurses, Educators, Patient Care Managers, Researchers,
Policy Makers, and Senior Executives.
Nursing professorship focuses on research
Sunnybrook welcomed Dr. Louise
Rose as the inaugural holder of the TD
Professorship in Critical Care Nursing
Research at Sunnybrook and the
Bloomberg Faculty of Nursing, University
of Toronto, for a five-year appointment.
This new role is a first for Sunnybrook
nursing and will focus on conducting
research to improve clinical outcomes for
critical care patients. The aim of the TD
Professorship is to create an environment
for excellence in critical care nursing that
embraces interprofessional care.
14

Cardiac surgery nurse practitioner cross-training initiative
An innovative model involving the
cross training of cardiac surgery nurse
practitioners in the care and management
of cardiology patients was introduced in
the Schulich Heart Centre. The benefits
of the new model include an expanded
knowledge base and skill set for cardiac
surgery nurse practitioners, as well
as an opportunity to pursue quality
improvement work and research.
Sunnybrook nurse saluted for exceptional work
Linda Jurincic, an oncology nurse at the
Odette Cancer Centre, was selected
as the first place winner in the annual
Nursing Hero Awards organized by
Hospital News, one of Canada’s leading
health care newspapers. The Nursing
Hero Awards, announced annually in
honour of National Nursing Week, salute
Canadian nursing heroes and highlight
their exceptional work.
15

8. Health Professions
Interprofessional care, defined as the right number and mix of qualified health care
professionals, when and where patients need it, is well recognized as an enabler for
improving patient care and alleviating demands on the health system. Sunnybrook
has a rich mix of interprofessional staff who work collaboratively to deliver the best
quality of care across all three of the Hospital’s sites. This strategy of partnership and
collaboration enhances care outcomes so that Sunnybrook best meets the complex
needs of its patient population. The inaugural Interprofessional Grand Rounds were held
in 2014/15, and will take place quarterly, rotating across the Hospital’s three campuses.
Interprofessional education and care celebrates teamwork
More than 100 Sunnybrook staff members
representing dozens of roles participated
in the 5thAnnual Interprofessional
Education and Interprofessional
Care Showcase. Poster and podium
presentations highlighted the outstanding
work of the Hospital’s teams with respect
to interprofessional education and
care at Sunnybrook and beyond. The
organization’s teams are finding areas
for improvement, implementing new
strategies and studying ways to enhance
how staff work and learn together with
the goal of improving patient care and the
quality of work environments.
16

Kudos for Sunnybrook’s outstanding team
The University of Toronto recognized the
Hospital’s excellence in interprofessional
teaching and contribution to creativity,
innovation, enthusiasm and effectiveness
with the Award for Merit for Excellence in
Interprofessional Education Teaching. In
addition, Lisa Di Prospero was selected
for the Ivy Oandasan Leadership Award
for Outstanding Leadership in Advancing
Interprofessional Education. This award
honours excellence in interprofessional
education and recognizes a leader
whose unique and innovative contribution
has had a significant impact on the
development of education at the
University of Toronto.
Boost for academic appointments
Sunnybrook has significantly increased
the total number of non-physician
professional staff with university
affiliations. These professional groups
are commended on their outstanding
number of academic appointments
achieved in the academic year and for
their contributions to student education.
The Department of Radiation Therapy
has a total of 56 clinicians holding
appointments, an increase of 93 per cent
over the previous year. The Department
of Pharmacy also excelled, increasing by
88 per cent its number of appointments
to a total of 15 clinicians.
National accreditation for spiritual care
The Hospital’s Spiritual and Religious
Care team is an integral part of the
health care team, providing spiritual
care to patients, families, and staff of
all faith backgrounds throughout the
hospital. Following the evaluation of the
function and effectiveness of the spiritual
care education program and learning
environment, Sunnybrook received
accreditation by the Canadian Association
for Spiritual Care. The association is a
national multifaith organization committed
to the professional education, certification
and support of people involved in pastoral
care and pastoral counseling.
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9. Greening Sunnybrook
Sunnybrook’s focus on creating awareness about environmental issues, getting staff
involved in greening initiatives and encouraging sustainable behaviors at work and
at home continued in 2014/15. The Hospital hosted its fifth annual Earth Matters
Showcase in April. Sunnybrook is widely recognized by the health care industry as
an environmental leader and has received significant recognition for environmental
efforts, including being named one of Canada’s Greenest Employers every year since
2009. The Hospital also achieved a bronze rating in the Ontario Power Authority’s
Green Hospital Scorecard.
Electricity savings
The Hospital embarked on a project
to ensure the optimization of its chilled
water systems. The Ontario Power
Authority is supporting the initiative
with roughly 80 per cent of the project
costs covered through its incentive
program. It is anticipated that the net
cost to Sunnybrook will be in the order
of $40,000 and this initiative will lead to
electricity cost savings of $30,000 to
$90,000 per year. Available chilled water
capacity will increase as well.
Long-term sustainability plan
Sunnybrook’s 2014 Five-Year Energy
Management Plan outlines how the
hospital will reduce energy consumption
and its related environmental impact.
The hospital-wide sustainability policy
addresses the hospital’s vision and
goals with respect to energy and water
conservation, waste reduction, pollution
prevention, green purchasing and
transportation.
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10. Community Engagement
Sunnybrook extended its commitment to community engagement by launching an online
patient engagement tool in 2014/15. The new website encourages an online discussion
with patients and the community about Sunnybrook policies and procedures. From
consultations on the Quality Improvement Plan, to the strategic planning process, to
patient and family counsels, Sunnybrook strived to ensure stakeholders were informed
and provided with opportunities for input and discussion. Listening to feedback from
patients, family members and the community has helped Sunnybrook to improve the
overall experience people have with the Hospital and provide the best possible care.
Incorporating the patient and family perspective
The organization’s many patient and
family councils and committees continued
to thrive in 2014/15. The Odette Cancer
Centre began recruiting for Patient and
Family Advisors to ensure the patient’s
point of view during their cancer
experience is heard and integrated into
all service and quality improvements.
Other groups, such as the Neonatal
Intensive Care Unit Parent Council and
the Veterans Family Advisory Council,
continued to help promote high-quality,
person-centered care at Sunnybrook.
19

sunnybrook.ca/engagement launches
A new online patient engagement tool
launched to allow the Hospital to work
with patients and families on a variety
of issues. Featuring an interactive
slideshow, survey questions and a video
component, the engagement topics
included discharge planning and smoking
on campus. In November, telephone calls
from Sunnybrook no longer appeared on
Caller IDs as “Unknown” or “Blocked,” but
rather as “Sunnybrook Hospital” (Bayview
Campus), “Sunnybrook Orthopaedics”
(Holland Centre) and “Sunnybrook
Rehab” (St. John’s Rehab Campus).
The decision was made as the result of
feedback from an online survey indicating
that nearly 90 per cent of respondents
identified with the following statement:
I get a lot of telemarketing calls that I don’t
answer. It would help me connect better
with my health care team if I knew it was
them calling.
Strategic plan community engagement
Online engagement wrapped up for
Strategic Plan 2015 – 2018, following
several months of encouraging feedback
from patients, families, peer organizations
and many more interested stakeholders.
Engagement was open to all members of
the community via the Hospital’s website
through animated slideshows, each
telling a different part of the strategic
planning story.
Navigating the health care system
Sunnybrook’s Personal Health Navigator
blog, written by Patient Navigation
Advisor Paul Taylor, relies heavily on
medical experts at Sunnybrook. Content
is derived almost entirely from questions
from patients and their families about
the hospital and the health care system.
The blog is posted on the Sunnybrook
website, appears in the Your Health
Matters newsletter and is syndicated
on HealthyDebate.ca. Recent entries
include “Why is the wait so long to see
a psychiatrist?” and “What you need to
know about planning to die at home”.
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Sunnybrook Speaker Series
Since 2004, the free community
Sunnybrook Speaker Series events have
educated the community on topical
health care issues. Held from May to
September, the events provide helpful
medical information and an opportunity
for the community to hear from and
ask questions of Sunnybrook’s experts.
During 2014/15, eight events were held
and can be viewed at sunnybrook.ca:
• Better Living: Resources and
Support During the Cancer Journey
• Healthy Mom, Healthy Baby: Mental
Health, Exercise and Diabetes in
Pregnancy
• Forgetfulness: When Should I
Worry?
• Clutter As We Age: When Does
Collecting Become a Problem?
• Your Role in Managing Diabetes
• Caregiver Wellness: Fueling Your
Physical, Emotional and Spiritual
Wellbeing
• Take Heart: Latest Updates in
Cardiac Care
• Depression in the Elderly
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11. Web Communications
The Hospital’s web communications
team continued to be a leader among
Canadian hospitals for their strong
social media strategy. Social media
efforts touched virtually every program
at Sunnybrook, improving the patient
experience, spreading news about the
organization’s research and innovations,
and leveraging health expertise for patient
education. The hospital’s YouTube
channel surpassed 2,000,000 video
views, becoming the most watched
YouTube channel among Canadian
hospitals. A Heart Month campaign was
run on social media, featuring daily photos of Schulich Heart Centre staff and their
heart health tips, and a ‘heart puzzle’ game was shared over social media. During
the Hospital’s involvement assessing potential Ebola patients, the digital team was on
standby to share updates with the community and media.
Huffington Post and Sunnybrook
Huffington Post started to include
Sunnybrook’s patient education materials
and blogs on their site in 2014/15.
The popular site offers news, blogs,
and original content and covers not
only health but also politics, business,
entertainment, environment, technology,
and much more. Sunnybrook’s Personal
Health Navigator blog has been featured
a number of times in Huffington Post,
along with the Hospital’s slideshows and
health tips. This development has greatly
expanded the number of patients viewing
Sunnybrook’s content.
22

Cancer surgery, and a twin birth, in 140 characters
Building on the success of the heart
bypass surgery live-tweet, Sunnybrook
live-tweeted a colon cancer surgery in
November 2014 to raise awareness of
screening and prevention and to highlight
the innovative work of the Odette Cancer
Centre. The live-tweet was a “trending
topic”, one of the most talked about, on
Twitter in Toronto. Before the holidays,
Sunnybrook shared a twin-birth story
on social media, through text, photos,
video and infographics to highlight the
innovative care and research of the
Women and Babies Program.
Operation Raise a Flag
The web team led the digital campaign
for “Operation Raise a Flag,” using social
media, email and other digital assets
to promote the fundraising initiative.
Online buzz was generated by sharing
Veterans’ stories through social media,
including photos, text and also featured
a compelling video shown at the Air
Canada Centre during Raptors and Maple
Leafs games.
Raising awareness, one tweet at a time
The web and digital communications team
leveraged annual awareness campaigns
throughout 2014/15 to spread the word
about healthy behaviours to a number of
key audiences. The dangers of distracted
driving and walking generated significant
social media activity, including ‘shares’
from Sunnybrook’s partners at the Toronto
Police Service and PARTY Program. The
work of the youth psychiatry division was
highlighted during and around National
Child and Youth Mental Health Day, with
social media advertising and new expert
health tips on the Your Health Matters blog.
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12. Improving Service for Patients and Families
Underlying everything that Sunnybrook does is the goal of improving the patient
experience, and being there for patients and families when it matters most. Staff from
clinical, support and administrative areas work every day to achieve this. In 2014/15,
Sunnybrook partnered with Language Services Toronto to provide patient and staff
support with real-time phone interpretation services 24/7 in 170 languages. A grant from
the Canadian Foundation for Healthcare Improvement also allowed the organization
to partner with patients and families on five videos, encouraging a “person-centred
care” approach to achieve the best patient interactions possible. This strategy focuses
on increasing patient engagement and on supporting staff to use approaches to care
that put the patient first.
Tailored patient education
Personalized patient guides for women
undergoing breast cancer surgery were
created at the Odette Cancer Centre. In
the past, patients were typically given
numerous pamphlets and brochures to
explain various aspects of their surgery.
The new strategy produces a single
personalized guide for each patient based
on the type of surgery. The guide will also
be available through MyChart.
24

Family Navigation Project launched
The Hospital launched a first-of-its-kind
navigational service to guide and support
families who have youth struggling
with mental health and addictions.
Sunnybrook’s Family Navigation Project
is a new call-in and email program that
partners “navigators”, or clinically trained
health professionals, with youth who
are experiencing mental health and
addictions struggles, and their families,
helping to guide them through the
complex mental healthcare system. The
project is improving access to treatment
for youth aged 13 to 26, and supporting
the families so they receive the help they
need.
Patient education website launches for the Women & Babies Program
Sunnybrook launched a new patient
education website for women who are
pregnant, planning on getting pregnant
or new parents. CRIB, or the Centre for
Resources and Information (Birth, Babies
and Beyond) is an online resource for a
variety of topics, including staying healthy
in pregnancy, breastfeeding, prenatal
tests and general tips for postnatal care.
Available online at www.sunnybrook.
ca/crib, the site complements the
CRIB resource centre, staffed by
knowledgeable family educators who
help women identify their learning goals
and create an education plan.
Supporting families with a loved one in intensive care
Sunnybrook focused on ways to provide
more support for family members who
have relatives in intensive care units.
Planning began in 2014/15 for the
creation of an interactive web-based tool
to provide information for families during
often stressful hospital stays, which will
ultimately serve as valuable decisionmaking
tool. To complement this work,
ICU-related topics were covered with
greater frequency in the Personal Health
Navigator blog.
Cancer fatigue web tool
The Odette Cancer Centre launched
an evidence-based patient and family
education web tool to help people
with cancer and those who support
them understand, learn and be active
participants in the management of fatigue
across the cancer journey. Cancer-related
fatigue is the most common symptom
people with cancer experience and can
have significant impact on quality of life.
The tool will be embedded in symptom
management response and will be
studied for impact
25

13. Safety
Sunnybrook strived in 2014/15 to raise awareness and facilitate implementation of
best practices to achieve the highest quality care for patients and their families. As
always, the Quality Improvement Plan tracked performance in a number of highpriority
areas, driving the Hospital’s commitment to continuous improvement in patient
safety and quality. International recognition was garnered over the last year, including
the re-verification of the Ross Tilley Burn Centre by the American Burn Association.
Sunnybrook also joined a number of large databases, allowing the Hospital to compare
its performance with local, national and international academic hospitals that provide
care to similar surgical patient populations. These include the American College of
Surgeons, National Surgical Quality Improvement Program, the American College
of Surgeons, Trauma Quality Improvement Program and the University of Toronto’s
Cardiovascular Data Management Centre.
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Sunnybrook’s iLead Quality & Patient Safety Support Program
Sunnybrook’s iLead portal enabled
staff and leaders to view their unit or
program-level performance regarding
key quality indicators, including four
indicators on the Quality Improvement
Plan: hand hygiene, mobility, infection
rates and patient satisfaction scores.
This tool enabled improvement teams
across the organization to gain a greater
appreciation of the impact of their clinical
care and improvement activities on
patient outcomes.
Support for dementia behaviors
The Hospital continued to focus on the
Senior Friendly strategy. In 2014/15, the
strategy included additional interventions
that focus on the effective management
of responsive behaviors due to dementia.
This includes having staff champions
serve as role models and mentors
to provide ongoing awareness and
education. There is a strong focus on
preventing, identifying and implementing
strategies to manage delirium.
Protecting staff in the operating room
The OR and Related Services Department
at the Holland Centre rolled out a new
technology called Tissue Safe. This
initiative uses vacuum packaging for
transportation of bone specimens. The
technology improves occupational health
and safety for staff by minimizing the use
of formalin in the operating room.
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14. Digital Technology
State-of-the-art technologies and innovations continued to enhance patient care at
Sunnybrook during the last year. Digital technologies have improved patient outcomes
by helping the Hospital identify and track infections, medication errors and also alerting
physicians to drug interactions and other problems. SunnyCare’s “one-stop-shop”
electronic medical record system, providing clinicians with access to patient lists, lab
results, radiology reports, and more, earned Sunnybrook national recognition for its
leadership.
MyChart adds new ‘Mood Tracker’ feature
MyChart, which allows patients to set
up, manage and access their own
personal health record online, is now
accessed in over 130 countries around
the world by patients and their families.
With over 72,000 active users, MyChart
receives on average over 2600 new
users each month. In 2014/15, a new
‘Mood Tracker’ feature was added,
allowing patients to record moods and
feelings they experience throughout
the day on their mobile devices and
computers. Information can be used
as part of the patient plan in Psychiatry
and other clinical areas, so that patients
may play a more active part in their
health monitoring outside the walls of
the Hospital. Research suggests that
when patients are empowered to track
their moods and feelings, their outcomes
will be better.
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SunnyCare successes
Sunnybrook received the LEADing
Practice Award from Canada Health
Infoway, in partnership with Accreditation
Canada, for SunnyCare. The award is
part of Infoway’s “Knowing is Better”
clinician education campaign developed
to generate broad awareness of the
benefits of interconnected electronic
health record systems in clinical practice
across Canada. Medication history has
been launched in SunnyCare to enable
documentation of a patient’s home
medications in an electronic database.
Sunnybrook clinicians have centralized
access to this critical information for
medication review and reconciliation
purposes, leading to better quality and
safer care.
Family Practice leadership
Rolling out “Ocean” tablets has allowed
Family Practice patients to update their
demographic information, sign e-mail
consent forms, complete health-related
questionnaires and the annual patient
survey, all prior to their appointments.
Another initiative has allowed Cumulative
Patient Profiles, from the electronic
medical records, to be downloaded to
SunnyCare and MyChart. This enables
other health care professionals in the
organization to access family practice
patients’ current health information,
such as an up-to-date medication list,
when they present to the Emergency
Department or are admitted to hospital.
Streamlined access to patient records
The Sovera service went live at the
Bayview campus in 2014/15, delivering
scanned images of patient charts within
SunnyCare and the electronic patient
reocrd. The initiative allows clinicians
to view the paper chart online. This
initiative bring numerous benefits,
including 24/7 access to patient charts
from any computer connected to the
Sunnybrook network and the ability for
multiple users to view a single chart at
the same time. As a result, the Hospital’s
health care providers are spending more
time meeting patients’ needs and less
time going through bulky folders and
documents that comprise the typical
medical record.
29

15. Partnerships and System Improvement
Sunnybrook’s commitment to high levels of collaboration with its many health system
partners continued in 2014/15, resulting in continuous improvements in how quality
care is delivered. With the emergence of Ebola in West Africa, critical care physicians
led the way internationally in assisting with treatment and the development of disease
management planning. Sunnybrook’s ambulatory care strategy had a strong focus on
reducing Emergency Department visits and the Hospital is one of the top performers
in Toronto for reducing readmissions within 30 days, due in part to strong partnerships
including the Toronto Central Community Care Assess Centre. In 2014/15, there were
also new relationships to connect primary care providers with patients particularly
following hospital discharge. A survey indicated that 80/100 family physicians received
eDischarge reports promptly following patient discharge from Sunnybrook.
Emergency preparedness and risk management
The Hospital’s emergency preparedness
and risk management teams supported
extensive preparation for the care of
potential Ebola patients, including
development of protocols, simulations
for personal protective equipment
procedures, and mock case scenarios.
Several physicians led in the effort, both
on the frontline of disease management in
West Africa, and at home at Sunnybrook.
Dr. Neill Adhikari, with the Department of
Critical Care Medicine, helped with Ebola-
30

elated clinical training organized by the
World Health Organization for clinicians
and Ministry of Health personnel from
10 at-risk sub-Saharan Africa countries.
Dr. Rob Fowler served as a Consultant
to the World Health Organization during
the ongoing West Africa disease outbreak
and helped to develop Public Health
Agency of Canada guidelines on the care
of patients with Ebola.
Mackenzie Health and Sunnybrook optimize quality care
The Hospital expanded and formalized
its relationship with Mackenzie Health
to improve access to high quality health
care services for patients in York Region
and beyond. The partnership is reducing
duplication and improving health system
capacity by using the program strengths
of each organization. The collaboration
has created a corridor of care for referral
and repatriation for highly specialized
tertiary and quaternary services needed
by the residents of York Region, at
the same time exploring opportunities
for enhanced research and teaching
activities between the organizations.
Automated physician notifications improved communication
A new system was launched focused
on accurate physician information in the
Patient Care System (PCS), considered
critical for timely information sharing. The
initiative focuses on improving physician
contact information and reducing errors
when manually entering information
into PCS. The solution uses a patient
self check-in approach with pre-coded
registration cards containing physician
and patient registration information to
automatically populate PCS. The new
approach is convenient for patients and
easy to navigate.
Ensuring a seamless and timely transfer of patients
Extracorporeal life support is a type of
cardiopulmonary bypass that supports
the lungs, heart, or both in patients
in intensive care with reversible lifethreatening
respiratory or cardiac
disease. In 2014/15, Sunnybrook
launched a collaboration with University
Health Network to provide access to
extracorporeal life support and ventricular
assist device programs for the Hospital’s
patients. A ventricular assist device is
a mechanical heart pump that can
be implemented inside or outside the
chest to provide support for the heart
as it recovers from injury or until heart
transplant. Patients requiring care will be
transferred to Toronto General Hospital,
a hospital site that has developed
considerable expertise in managing these
patients.
31

16. Fundraising
Sunnybrook Foundation exists to support the Hospital to achieve the vision of inventing
the future of health care by securing philanthropic support from the community. The
Foundation has been awarded the highest possible rating of four stars by Charity
Intelligence Canada for efficient use of donor funds, transparency and accountability.
Cycling event raises funds for prostate cancer care
Dozens of cyclists pedalled from Muskoka
to Sunnybrook in August as part of the
2014 Tour de Bleu, raising funds for
the purchase of an advanced 3T MRI
machine to aid prostate cancer patients.
The equipment is indispensable to the
Odette Cancer Centre’s establishment
of a prostate centre that will support
groundbreaking research, improve and
create new diagnostic methods, and
deliver precise, image-guided treatments
that maximize effectiveness while
minimizing harm. The MRI scanner will
provide superior imaging of soft tissues
and tumours, enabling medical staff to
detect prostate cancer at the earliest
stages and in some cases find tumours
missed by standard imaging.
32

RBC Run for the Kids celebrates its second year
The RBC Run for the Kids celebrated
its second year, raising $1.9 million for
Sunnybrook’s Family Navigation Project.
The proceeds helped young people
affected by mental illness and addictions
– and their families – to get the help they
so urgently need. The run drew more than
7,100 participants, making it the fourth
largest running event in Toronto.
Landmark donation for brain sciences
A $20-million donation, earmarked for the
Hurvitz Brain Sciences Centre, will allow
Sunnybrook to link experts in each field
of brain sciences in an effort to accelerate
research and slow the progress of brain
disorders. Along with the naming of the
Centre, Sunnybrook’s brain sciences
program was renamed the Hurvitz Brain
Sciences Program. The Centre will
combine a renovation of Sunnybrook’s
existing F-wing with a new building of
the same size alongside it.
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17. Financial Outlook 2015/16
Sunnybrook has submitted a balanced
budget for fiscal 2015/16 and entered
into a new Hospital Service Accountability
Agreement (H-SAA) with the LHIN.
However, the budget includes various
assumptions for both HBAM and QBP.
Neither funding has as yet been confirmed
by the LHIN but Sunnybrook anticipates
receiving its funding allocation in June
2015. Following receipt, Sunnybrook will
evaluate its budget in order to determine
if changes are required so as to meet the
H-SAA balanced budget criteria.
The Government of Ontario is facing longterm
financial constraints and an aging
population demographic. Consistent
with the past three years, ongoing
fiscal restraint policies point to relatively
small and targeted funding increases
i.e. tied to specific new deliverables,
and not for inflationary costs. This will
impact all hospitals and is approaching
near unsustainable levels in light of the
ongoing cost pressures, largely wage
related. Sunnybrook will continue to
seek innovative solutions to achieve
further improvements in efficiency and
to increase non-Ministry funding as well
as actively participating in the Toronto
Central LHIN on its Health Links strategy
as the lead role for the North East Toronto
Health Link.
34

Notes
35

Notes
36

Management Commentary and Analysis
2015