Hanover and District Hospital

Hanover and District Hospital

Goal 1:

To continue to enhance the acute care program and services of Hanover and

District Hospital, and to remain a highly respected organization that is a role

model, resource, and key partner in the circle of health care.

Goal 2:

To implement the comprehensive human resource strategic plan that will enhance

and lead Hanover & District Hospital to have a highly skilled and engaged health

care work force, volunteers and Board Directors.

Goals 3:

To continue to improve and develop safety initiatives that supports a culture of

safety.

Goal 4:

To continue to enhance and maintain a culture that strives towards green health

care and healthy lifestyles.

Goal 5:

To promote and enhance a culture of fiscal responsibility throughout the

organization.

Hospital Goals

Back row left to right: Dr. Randy Montag, Robert Graham, Bradley Holman, Dr. Neal Stretch

Middle row left to right: Alan Heimbecker, Gerald Rogers, Barbara Hicks, Alan Fisher, David Inglis, Barbara Lansink, Brenda Booth

Front row left to right: Georgia Kreager, Helen Aldersley, Katrina Wilson

Missing from photo: Dr. Bob Basilij, David Mollison

Hanover & District Hospital

Annual Report 2009—2010

Board of Directors

 Alan Fisher, Chair

 Barbara Lansink, Vice Chair

 Robert Graham, Past Chair

 Brenda Booth, Treasurer

 Dr. Bob Basilij, Chief of Staff

 Helen Aldersley, Elected

 Alan Heimbecker, Elected

 Barbara Hicks, Elected

 Bradley Holman, Elected

 David Inglis, Appointed by Municipality of

Brockton

 Georgia Kreager, Appointed by Hospital

Auxiliary

 David Mollison, Appointed as West Grey

Representative

 Dr. Randy Montag, President of the Medical

Staff

 Dr. Gerald Rogers, Appointed by Town of

Hanover

 Dr. Neal Stretch, Vice President of the

Medical Staff

 Katrina Wilson, Hospital President and Chief

Executive Officer

Hanover and District Hospital

90-7th Avenue

Hanover, ON N4N 1N1

Phone 519-364-2340

Fax 519-364-6602

www.hanoverhospital.on.ca

Board of Directors

Hanover and District Hospital 2

At Hanover and District Hospital (HDH), the foundation behind every

patient’s treatment, their care, and even research projects stem from the

power of collaboration and partnerships. Here at HDH we have many

partnerships amongst physicians, nurses, medical staff, and neighboring

healthcare partners. We strive to be transparent and provide

communications between caregivers, patients, and the community. In

addition, we share how we are working with and through the Ministry of

Health and Long Term Care (MOHLTC), Local Health Integration Network

(LHIN), and affiliated partners and research organizations.

Today’s Board Directors, Senior Administration and Management Staff

continue to be challenged with difficult decisions. Hospital-acquired

infection rates are making headlines. A growing number of new

regulations, and legislated reporting requirements are being implemented.

Healthcare costs continue to rise with an aging population and new

technologies, and the difficulty to recruit scarce human resource specialist

is ongoing.

Despite all the changes and pressures, patients come to us in need. They

place their trust, health, and often their lives, in our hands. It’s our

commitment to ensure they receive the highest quality care that a rural

community hospital can provide for them. Safety is the foundation of

quality care, and the entire hospital community at Hanover and District

Hospital is committed to continuously improving safety and quality for

every patient who entrusts us with their care. This is in part thanks to

the generosity of many people from across the catchment area who share

our commitment to bringing the best that healthcare has to offer to the

communities we serve. The Foundation and Auxiliary donations enable our

Hospital to sustain a level of clinical excellence, patient safety, and an all

round satisfaction that has made us a model for rural hospitals. Through

the support of the staff, physicians, community, the Foundation and the

Auxiliary, we have been able to attract the finest physicians and

healthcare professionals, while keeping pace with the technological

advancements necessary to bring the latest treatment protocols to our

rural patients.

That said, we as a Board cannot stress enough that healthcare is rapidly

changing as LHINs make it clear that funding to hospitals will be reduced

in order to divert funds to community-based, primary care, with the

purpose of focusing on less expensive healthcare paths and to redirect

attention toward disease prevention, health promotion, and wellness. In

turn, hospital deficits are unacceptable and Boards are accountable to

ensure budgets are balanced. The Board of Directors and Senior Staff of

Hanover and District Hospital are committed to embracing the challenges

ahead and ensuring that we remain able to serve our community with

care, skill and compassion. Over many years our staff have taken a

microscope to the entire organization to identify efficiencies that help

move people through the system safely, quickly, and address issues that

bottleneck or slow operations down. Changes have been made and

efficiencies accomplished. However, with the ongoing underfunding

and increased costs of supplies, drugs and union wage increases, it

will be increasingly difficult to balance the budget without thinking

strategically where Hanover and District Hospital needs to be in the

future.

To help the community understand where we are as a facility, the

Board Chair and President have been providing Power Point

presentations of Hanover and District Hospital’s Programs and

Services, its strengths and weaknesses to community groups: Hanover

and District Hospital Foundation’s Annual Meeting, Auxiliary’s General

Meeting ,Missionary Church, Rotary Club to name a few.

The Board is under increasing pressure, both legally and ethically, to

carry out its affairs with increasing awareness and regard for the

general public while also being acutely mindful of the budget. In

order to accomplish this we have chosen to move entirely to a

“skills based board” with skill sets that are necessary to move the

organization forward. A mixture of skills and strengths such as

healthcare, quality improvement, financial management, human

resources, strategic planning and communication need to be

represented on the Board, that will allow the Board to focus on

governance, leadership and accountability.

In July of 2009, the Hanover and District Hospital was designated as

a new training facility for the Rural Family Medicine Training

Program by the Department of Family Medicine, Schulich School of

Medicine and Dentistry, the University of Western Ontario.

The Board Directors and staff need to continue to strategically plan

integration for HDH, as a strong acute care component in

partnership within the continuum of care. The decisions should be

from a population-based, geographical approach, to plan health and

health care services, incorporating integration and co-ordination

among the different organizations that surround HDH in the Grey

Bruce and Huron Perth areas. The outcome should be stronger

clinical linkages and levels of care that permit flexibility of

harmonizing services that will allow patients to move easily along

the continuum of care. Thinking and planning with our healthcare

partners will allow streamlining through re-organizing patient entry

and exit, as well as improve recruitment and retention initiatives of

human resources for physicians, nurses and allied healthcare staff.

Katrina Wilson, President/CEO

Alan Fisher, Chair of the Board

Dr. Bob Basilij, Chief of Staff

Message from the President/Chief Executive Officer, Chair of the Board, and Chief of Staff

Tel: 519 364 3790

Fax: 519 364 5334

www.bdo.ca

BDO Canada LLP

485 10th Street

Hanover ON N4N 1R2 Canada

Auditors’ Report on Summarized Financial Statements

To the members of Hanover and District Hospital

The accompanying summarized balance sheet and statement of operations are derived from the complete financial

statements of Hanover and District Hospital as at March 31, 2010 and for the year then ended on which we expressed

an opinion without reservation in our report dated May 6, 2010. The fair summarization of the complete financial

statements is the responsibility of management. Our responsibility, in accordance with the applicable Assurance

Guidelines of the Canadian Institute of Chartered Accountants, is to report on the summarized financial statements.

In our opinion, the accompanying financial statements fairly summarize, in all material respects, the related complete

financial statements in accordance with the criteria described in the Guideline referred to above.

These summarized financial statements do not contain all the disclosures required by Canadian generally accepted

accounting principles. Readers are cautioned that these statements may not be appropriate for their purposes. For

more information on the entity’s financial position, results of operations and cash flows, reference should be made to

the related complete financial statements.

Hanover, Ontario “BDO CANADA LLP”

May 6, 2010 Chartered Accountants, Licensed Public Accountants

Summarized Balance Sheet

March 31 2010 2009

Assets

Current assets $ 2,164,036 $ 2,625,229

Investments held for capital purposes 4,489,956 3,604,710

Property and equipment 6,469,998 6,707,069

$13,123,990 $ 12,937,008

Liabilities and Net Assets

Payables and accruals $ 1,798,623 $ 1,525,745

Deferred contributions 1,513,757 1,624,135

Employee future benefits liability 349,200 304,900

Net assets 9,462,410 9,482,228

$ 13,123,990 $ 12,937,008

Summarized Statement of Operations

For the year ended March 31 2010 2009

Revenue

Ministry of Health and Long Term Care $ 14,729,623 $ 14,169,814

Other 2,254,598 2,462,110

16,984,221 16,631,924

Expenses

Compensation and benefits 10,276,126 9,737,859

Medical staff remuneration 2,015,893 2,033,948

Supplies and other 4,712,022 4,636,299

17,004,041 16,408,106

Excess (deficiency) of

revenue over expenses for the year $ (19,820) $ 223,818

Emergency Visits

2009/2010 20,676

2008/2009 20,662

2007/2008 19,786

Admissions—Medical Surgical

2009/2010 928

2008/2009 929

2007/2008 885

Admissions—Newborn

2009/2010 67

2008/2009 96

2007/2008 86

Patient Care Statistics

Day Surgery Cases

2009/2010 1,061

2008/2009 1,147

2007/2008 993

Average Length of Stay

2009/2010 8.7

2008/2009 8.4

2007/2008 8.4

Working at Hanover and District Hospital

2009/2010 2008/09

Physicians/Surgeons (with hospital privileges) 66 48

Nursing 85 73

Clerical 13 16

Service 30 31

Management/Administration 16 15

Paramedical 22 24

Other 3 3

Volunteers 131 130

Medical Students 10 9

Residents 7 8

Nursing Students (RPN) 2 2

Other Students 3 3

2009 OHA Healthy Hospital Innovators Award

Hanover & District Hospital was awarded the 2009 OHA Healthy Hospital Innovators Award, which was presented at

the OHA Convention in Toronto last November. This award was developed in partnership with the National Quality

Institute (NQI) and recognizes organizations for their:

Commitment to a long-term strategic approach for the development and sustainability of a healthy workplace, and to

becoming role models for healthy workplaces in their communities.

Demonstrating willingness to participate in knowledge transfer on healthy workplace initiatives and effective practices

within and outside the health sector.

Some of our accomplishments that they found commendable are:

 The Hospital's strategic directions identify clear priorities towards healthy and safe workplace, recognizing healthy

lifestyle, workplace health, safety, and culture

 There is a joint responsibility demonstrated through participation of Management, Board, Staff, and physicians.

 Demonstrated measurement through key surveys and balanced scorecard indicators, including QWL

 Enhanced focus on prevention and safety. Strong focus on CQI.

 Leading innovation in workplace health through Healthy Choices, Fit Trail, Green initiatives, and e-learning

programs

 Excellent communications plan and commitment to knowledge transfer

 Improved health & safety policies

 Healthy choices menus

 Carpets replaced with hard flooring

 Physical activity incentive policy

 Employee assistance program

 Mobile flu vaccine clinic

 Attendance awareness awards/Staff recognition weeks

 Yearly memorial service

 On-line learning modules

 Spring into Wellness Month

 Hospital decorating contests

One of Hanover and District Hospital’s Strategic Goals is “To Invest in Human Resources”. To accomplish this, we

strive to continually promote safety and wellness within the workplace. A healthy workplace is one that integrates the

well-being of its staff into daily work life. Another benefit to maintaining a healthy working environment is for the

recruitment and retention of skilled and innovative healthcare professionals. This trend setting initiative is born out of

the belief that hospitals as healthcare organizations should be the role models and leaders in health promotion disease

prevention. Here at the Hanover and District Hospital the Management, Board Directors, Staff and Physicians feel they

have an obligation as a healthcare facility to lead by example. The Human Resources Continuous Quality Improvement

Team and the Environmental CQI Team are continuously generating activities and ideas to help promote health and

wellness. Examples of our wellness initiatives include:

The Hanover and District Hospital is strongly committed to protecting and promoting the health, safety and well-being

of its employees.

Hanover and District Hospital 7

Fit-Trail Project

Fit-Trail Official Grand

Opening -

August 27, 2009

"...[I]f the exercise

doesn't take your breath

away the view certainly

will.

- Robyn Garvey, Bayshore

Broadcasting News

Three years of hard work and planning ended in success for the Hanover and District

Hospital Environmental Continuous Quality Improvement Team with the official Grand

Opening of the Fit-Trail held on August 27, 2009. A crowd gathered under sunny skies as

the ribbon was cut by Hanover Mayor Kathi Maskell, Hospital President and CEO Katrina

Wilson, Hospital Board Chair Alan Fisher, Environmental CQI Leader John Broad, and

Director of Environmental Services Wes Reinhardt. Many members of local service clubs

and hospital staff and officials took part in the inaugural lap of the Trail. Over one

thousand trees surround the one point five kilometer long trail, and that number is

expected to grow. There are also ten fitness stations, each costing between $800 and

$1500, that will help develop all exercise requirements and fundamentals.

All gardening and landscaping was completed by volunteers, and a future Fitness Run-

Walk-Roll will be held to help fund maintenance and upkeep of the trail. The trail will have

a significant effect on the environment, as it will reduce lawn

mowing and provide new vegetation to help breathe fresh air back

into the community of Hanover.

The Fit-Trail is now listed with the Ontario Trail Network by Land

Information Ontario (LIO), and will have a widespread use from

Hospital staff and patients to community members and local Fitness

Clubs. It is wheelchair accessible, and will very positively promote

healthy living for all. Come out and try it for yourself

New Nursing Graduate Program

In 2009 Hanover and District Hospital participated in The Nursing Graduate Guarantee initiative. The Ontario Ministry

of Health and Long-Term Care aims to ensure that every new nursing graduate (RN and RPN) who wishes to work

full time in Ontario will have that opportunity. The government provides funding to create bridging positions to support

new graduates in finding full-time employment immediately upon graduation that can help lead to permanent employment.

These bridging positions also include important orientation supports to help new nurses succeed in the

workplace. Hanover and District Hospital took on 3 new graduate nurses in 2009 and they have been successful at

securing permanent part-time positions in our hospital. Carenet Goes Live

April 20, 2009 saw the implementation of paperless patient charts. The goal of Nursing Clinical Documentation

(Carenet) is to utilize technology to access information by the right person, at the right time, eliminate duplication and

the need for paper

Collaborative Initiatives Across the Southwest Local Health Integration

Network (LHIN) and the province of Ontario

Southwest Patient Access Flow Project:

This project got underway May 4 across the 19 hospital corporations in the South West LHIN in an effort to ensure

patients are able to access the right level of acute care services, when they need it. The purpose of the project is to

ensure that patients who are seriously ill and need to be transferred to another hospital to the care they require, are

transferred as quickly and effectively as possible.

Surge Capacity Management Program in Ontario

In March 2009, Ontario’s Critical Care Strategy started working with the Ontario Hospitals to implement the Surge

Capacity Management Program. This program categorizes surge responses into three levels – minor (within the

hospital), moderate (across a Local Health Integration Network – LHIN) and major events (across several LHINs or

the Province. The Program will:

 Ensure patients are transferred from the emergency room or operating room to critical care services as

quickly as possible;

 Mobilize hospital staff, equipment, and technology from other parts of the hospitals to handle the short term

increase in demand in the critical care department;

 Improve the lines of communication between hospitals in each of the regions covered by the province’s 14

LHINs; and

 Ensure quick responses to large critical care surges that require a coordinated response across each LHIN.

Carenet Goes Live

April 20, 2009 saw the implementation of paperless patient charts. The goal of Nursing Clinical Documentation

(Carenet) is to utilize technology to access information by the right person, at the right time, eliminate duplication and

the need for paper.

New Nursing Graduate Program

In 2009 Hanover and District Hospital participated in The Nursing Graduate Guarantee initiative. The Ontario Ministry

of Health and Long-Term Care aims to ensure that every new nursing graduate (RN and RPN) who wishes to work

full time in Ontario will have that opportunity. The government provides funding to create bridging positions to support

new graduates in finding full-time employment immediately upon graduation that can help lead to permanent employment.

These bridging positions also include important orientation supports to help new nurses succeed in the

workplace. Hanover and District Hospital took on 3 new graduate nurses in 2009 and they have been successful at

securing permanent part-time positions in our hospital.

Hanover and District Hospital 9

Heliport and South Parking Lot

In the month of September our heliport and south parking lot were demolished then reconstructed with a new

drainage system, base gravel and resurfaced with asphalt. A new lighting system was also installed on the heliport to

meet Transport Canada standards for heliport lighting.

A new back up generator was delivered on

September 3, 2009. The generator was lifted onto a

new cement pad at the back of the hospital.

Installation was completed during the fall/winter

2009. The new generator replaces the 30 plus year

old unit and is ready to supply emergency back up

power to the hospital during an unforeseen power

interruption.

New Wheelchair Accessible Washroom

During the winter of 2009/2010 two new accessible washrooms were constructed on Unit 1 in room 120 and room

101. Nursing staff were involved in the design and layout of the new washrooms.

New Back Up Generator

Projects and Renovations

Window Replacements

During the summer of 2009 new windows were installed on the 2nd floor of the hospital. Some of the windows on the

first floor were also replaced. The new windows are high efficiency windows and the frames were resealed when they

were installed so this will result in less heat loss from the room and greater comfort for patients and staff.