2010-2011 Annual Report to The Community

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

A Tradition Of Caring

uring the past year, Norfolk General Hospital continued its commitment to improving the quality of care provided to our patients. Efforts to enhance patient care included the following: The scope of practice of our Registered Practical Nurses was expanded. These professionals now start intravenous therapy and administer intramuscular injections. These increased responsibilities promote collaboration with Registered Nurses when caring for more complex patients. The Hospital invested in Order Sets. Using these care plans enables physicians and staff to always use the most current evidence-based best practices when caring for patients. Clinical staff received education on the prevention of pressure ulcers, and wound care techniques. In addition, a wound assessment tool was implemented. These initiatives were priorities since these wounds mostly affect the more elderly, and patients over the age of 75 account for 54% of total patient days in the Hospital. Renovations and upgrades were made to three rooms on the 4th floor to establish palliative care rooms. Improvements included new lighting, resurfaced carpentry, painting and a family lounge area. The surgical safety checklist in the Operating Room was implemented. The checklist covers common tasks/procedures completed in the Operating Suite including the review of test results and post surgery recovery plans. The first public report on compliance with the use of this checklist occured on July 31, 2010. Establishment of a part-time volunteer chaplain to provide spiritual care for patients, residents and families. Significant progress was made this past year in electronically connecting our hospital to other hospitals. Norfolk General Hospital joined the Diagnostic Imaging Repository located in London. This is the largest diagnostic imaging repository in Ontario. All images that are taken at 29 hospitals within our Local Health Integration Network (LHIN), and adjacent LHINs, are stored in one place, enabling these images to be shared.

Our patients benefit since specialists located in other hospitals can view images online, assisting our physicians in providing the best possible care. Patients may also avoid unnecessary transfers to other hospitals. Norfolk General Hospital, and the other hospitals in our LHIN and the Waterloo-Wellington LHIN, installed Clinical Connect. This provides health care teams with access to a patients medical information regardless of at what hospital care was received. Patient care benefits include a reduction in repeat diagnostic tests, and improved patient outcomes. During fiscal year 2010/2011, there were several milestones: The Norfolk General Hospital celebrated its 85th Anniversary on June 6, 2010 at the Park Place Banquet Hall, with over 200 persons in attendance. Past and present employees enjoyed sharing their fond memories of our organization. Display boards of old and new technologies were of great interest to all attendees. The Ontario Breast Screening Program celebrated its tenth anniversary on October 26, 2010. In July, 2010, the Hospital was recognized as being a leader among the thirteen sites in our LHIN for having high early detection rates. In December, 2010, Holmes House, the first Co-Ed Detoxification/Rehabilitation Program in Ontario, which opened its doors on September 3, 1988, admitted its 10,000th client.

Staff at Holmes House, Drug Treatment Centre Detoxification & Rehabilitation Service.

2010-2011 Annual Report to the Community

 Rich in Community Spirit, Passionate about Patient Care

n Sunday June 6, 2010, Norfolk General Hospital and The Norfolk Hospital Nursing Home celebrated three momentous milestones; the 85th Anniversary of Norfolk General Hospital, 35th Anniversary of The Norfolk Hospital Nursing Home and a 85-year partnership with the Volunteer Association During the Anniversary Open House held at the Park Place Banquet Hall, in Simcoe, those in attendance enjoyed the music of the Simcoe Composite Stage Band; they shared stories and ventured down memory lane through the various displays and memorabilia.

As the Anniversary program commenced, a bagpiper led the various dignitaries and special guests to the podium including the late Luella Bowyer, Norfolk General Ruth Driedger, OR Nurse poses in front of a 1930s style Hospitals first born baby. What an honour it was to have Luella share in this memorable nursing uniform with J.J. Knott, Director, Plant Opera- day. Guest speakers included Toby Barrett, John Race, Mayor Dennis Travale, Dr. Peter tions and Barry Vermeersch, Director of Laboratory, Rich, Mr. Gord Percival, Chair of NHNH Board of Trustees, Jeff Loncke, Chair of NGH decked out in top hats and tails. Board of Directors and Bill Lewis, President and CEO. Thank you to everyone who helped commemorate this special occasion and celebrate our long tradition of caring for our community. In June, 2010, the LHIN approved an InteDuring the year, the Foundation provided $502,474 to the Hospigrated Program for Complex Care. This plan tal. Funds were used to replace aging equipment, increase patient will see Norfolk General Hospital having 18 and staff safety, and enhance the environment for patients and Complex Care beds, made up of 9 beds for their families. We thank the Foundation for the crucial role that it restorative care, 6 for medically complex plays in providing health care services to our community. patients, and 3 for end of life care. We are particularly pleased that restorative care, which is The Volunteer Association provided $103,000 to the Hospital currently being provided in our slow stream which has been put towards the new digital x-ray unit and the Jeff Loncke, rehabilitation beds, will continue to be availscanning/archiving project. The Volunteers continued to do all 2010-2011 Chair able in our community. of the great work that they have always done. They also added innovative initiatives such as assisting with hand hygiene awareCollaboration with the LHIN and Community Care Access ness, and evenly allocating wheelchairs throughout the hospital. Centre was helpful in reducing the number of alternate level of care days from 11,800 last year to 8,900 this year (for the most All of these services enhance the health care environment and part, these patients were in hospital waiting for a long-term care are greatly appreciated by those who benefit from them. bed). We will continue to work with our partners to ensure that Thank you for your efforts. patients are receiving care in the most appropriate setting. During the year, Dr. Dave Mohomed, Dr. Nathan Luyt, Dr. Sarah At Norfolk General Hospital, 90% of high acuity Emergency Johnston and Dr. Dennis Bowman joined the medical staff of the Department patients spent approximately 8.4 hours or less in Norfolk General Hospital. Welcome to our community. We are the Emergency Department. Low acuity patients had a length of very pleased you have relocated to Norfolk County. stay of 5 hours or less. Although these lengths of stay compare favourably to other hospitals in our LHIN, we must continue to We sincerely appreciate the wisdom and leadership provided improve in order to meet the provincial targets of 8 and 4 hours by the members of the Board of Directors. We would like to respectively. The entire health care team is committed to further express our gratitude for the ongoing contributions of all staff, reducing these wait times. physicians, volunteers and Foundation members. Your faithful work helps us provide quality patient care to the community we The LHIN has indicated that Norfolk General Hospital is the serve. most efficient hospital in the LHIN. At the same time, we are facing financial challenges. The current economic environment has not allowed government funding to keep pace with the infla- Jeff Loncke, Chair of the Board of Directors tionary costs of operating a hospital. Therefore, there are fewer William Lewis, President & Chief Executive Officer dollars available to purchase equipment.

This makes the efforts of the Foundation and Volunteer Association even more important.
2 2010-2011 Annual Report to the Community

Thank You Bill Lewis

n April 1, 2011 we said farewell to Bill Lewis, a humble, well respected man who led our community hospital through a remarkable journey and helped pave the way for continued quality patient care for generations to come. Throughout his 11-year term, our hospital witnessed many changes, endured several challenges and celebrated numerous accomplishments. These included the Emergency Room expansion and redevelopment in 2005, the acquisition of a CT scanner in 2006, a complete renovation of the Intensive Care Unit in 2007, H1N1 and pandemic planning, Digital Mammography, increased demands on our Emergency Room, physician shortages, Medical Device Reprocessing renovations, Pac-Med and the hospital and nursing home milestone anniversaries. Thank you Bill and Happy Retirement, from your NGH/NGH Foundation/NHNH Family. William Lewis, Norfolk General Hospital President and C.E.O., 2000-2011.

New Palliative Rooms Providing a Peaceful Atmosphere

hree beautifully refurbished rooms on the fourth floor are now ready for patient care at NGH with an adjoining family lounge. The palliative rooms, which were moved from the hospitals third floor, provide care for those patients facing advanced illness, death and bereavement. We devote our efforts toward the control and prevention of pain, and supporting emotional, spiritual and cultural needs. Our focus is on care rather than cure, said Bettyann DeRonde, VP Patient Care.

Norfolk General Hospital Statement of Operations

The charts below illustrate sources of revenues and expenses as reported in the Norfolk General Hospitals Audited Financial Statements for the period of April 1, 2010 to March 31, 2011. 2010/2011 Revenues $Dollars % of Total Revenues 80% 10% 1% 6% 3% 100% % of Total Expenses 65% 11% 4% 2% 14% 4% 100%

Ministry of Health and Long-Term Care 35,376,753 OHIP and Patient Services 4,228,196 Differential and Co-Payments 684,394 Recoveries and Other 2,599,031 Amortization of Donations and Grants 1,153,558 Total Revenues Expenses Salaries, Wages and Benefits Medical Staff Remuneration Medical and Surgical Supplies Drugs Other Supplies and Expenses Amortization Total Expenses 44,041,932 $Dollars 28,786,577 4,969,153 1,659,225 947,513 6,318,595 1,545,794 44,226,857

NGH Palliative Care Committee

Deficiency of Revenues over Expenses ($184,925)

2010-2011 Annual Report to the Community

The Norfolk Hospital Nursing Home

he Norfolk Hospital Nursing Home (NHNH) celebrated its 35th Anniversary on June 6, 2010 at Park Place Banquet Hall. It was a great success, with several residents, members of the community and guest speakers attending. The philosophy at NHNH has always been to keep our residents as active as they can be for as long as they are able. Keeping this in mind, some of the notable achievements in fiscal 2010/2011 were as follows: Our residents are becoming more active. The percentage of residents participating in the Restorative Care Program increased from 76% in 2009/2010 to 84% in 2010/2011. New functional fitness classes and walking programs were developed and implemented. The number of Activation Programs per quarter increased from 328 in 2009/2010 to 381 in 2010/2011. These Programs include activities such as knitting, scrap booking and a book club. The new electronic clinical documentation system called RAI-MDS (Resident Assessment Instrument-Minimum Data Set) was implemented. We are now using information from this system to illustrate to residents and their families the progress that our residents are making with respect to treating conditions such as depression and pain. The next phase in this process is point of care documentation. Staff and residents completed the Just Clean Your Hands training program developed by the Ministry of Health and Long Term Care to improve hand hygiene compliance in health care settings. The NHNH staff immunization rate for the influenza vaccine was 97%. Our nursing home won the Big Shot Challenge of the Haldimand Norfolk Health Unit for the highest staff participation rate in the long term care sector. The Family Council continued to meet regularly and received education on a wide variety of topics selected by the members. The Board of Trustees continues to be diligent in monitoring the organizations Balanced Score Card on a quarterly basis. Indicators that measure client satisfaction, financial performance, utilization and quality, and innovation and learning are reviewed to ensure our residents are receiving quality care in a safe and friendly environment. Thank you to the Board members and staff for their ongoing efforts in maximizing our performance. The Volunteer Association is vital to our success. The volunteers contributed over 1,600 hours of service for a variety of activities. It was great to see that about 300 of those hours were contributed by junior volunteers. We were glad to note that a second resident has joined the volunteer program at the main information desk. In addition to the many hours that were contributed this past year, a donation of $21,000 was made to purchase a traverse ceiling lift and vital sign monitoring equipment. We would like to express our appreciation to the Board of Trustees for their dedication and leadership in ensuring that our residents are receiving quality care in a safe environment. Thank you to all of the staff and physicians for creating a friendly environment and enhancing the quality of life of our residents every day. Gordon Percival Chair of Board of Trustees William Lewis President & Chief Executive Officer

The Long Term Care Homes Act was proclaimed into force on July 1, 2010 as part of the strategy of the Provincial Government to improve the quality of resident care, enhance residents rights and increase the accountability of the long term care home sector in Ontario. This Act impacted many policies and procedures at NHNH which have been reviewed and revised by our Resident Care Team. One of the positive outcomes is an improved dinGord Percival passes the gavel on to incoming 2011-12 Board of Trusting experience. An enhanced nutritional assessment is now a ees Chair, Mary Hoover, during the NHNH Annual Meeting. component of the admission process. Ongoing nutrition care plan reviews are performed to promote pleasurable dining for our residents. We wish to acknowledge the efforts of the Resident Care Team in continuing to enhance the environment of our residents.
4 2010-2011 Annual Report to the Community

The Norfolk Hospital Nursing Home is truly my Home.

My Story Margaret Juszku

truly feel at home at The Norfolk Hospital Nursing Home. Moving to a nursing home is a very significant transition in ones life. Not wanting to be a burden on my family who already live very busy lives, I decided that a nursing home would be the best choice for my health and well- being. I have called The Norfolk Hospital Nursing Home, my home for the last thirteen years. It is so important to keep your mind and body active. I participate in many of the activities that the nursing home offers outings in the van, crafts, exercise, bingo and especially the weekly church services. One of my true passions is baking. This is an activity that I have continued to do, even after moving to a nursing home. Ive had the opportunity to work with some amazing staff members and enjoy the friendship of my fellow residents. I enjoy baking goodies, pizza, homemade soup, cabbage rolls, and of course my very famous doughnuts. We have held many coffee breaks for the staff, inviting them to get a coffee and enjoy a homemade doughnut. My husband and I have always been very community minded people and like to contribute to society. I still feel like I am contributing to both the home and my family. One of my fondest memories was hosting a bridal shower here at the nursing home for my granddaughter. I also enjoy the annual Childrens Christmas party that the Residents Council puts on every year for the children and grandchildren of the staff. It is so nice to see their little faces filled with excitement. I really enjoy the children, watching them grow year after year; they are our future. The Annual Bazaar is another fond memory I have. We work very hard throughout the year on crafts, and preparing items. It gives me great satisfaction when I hear how well we have done each year. I am very pleased to call The Norfolk Hospital Nursing Home, my home. Margaret Juszku
The Norfolk Hospital Nursing Home Statement of Operations
The charts below illustrate sources of revenues and expenses as reported in The Norfolk Hospital Nursing Homes Audited Financial Statements for the period of April 1, 2010 to March 31, 2011. 2010/2011 Revenues Ministry of Health and Long-Term Care Resident Co-payment and Other Total Revenues Expenses Nursing and Personal Care Food and Accomodation Program and Support Other Total Expenses Deficiency of Revenues over Expenses $Dollars 3,297,264 1,484,096 4,781,360 $Dollars 2,843,296 1,527,196 244,635 214,175 4,829,302 ($47,942) % of Total Revenues 69% 31% 100% % of Total Expenses 59% 32% 5% 4% 100%

Volunteer Linda McCall helps out during the Annual NHNH Christmas Bazaar. A favourite event amongst residents and staff of the nursing home.

2010-2011 Annual Report to the Community

Norfolk General Hospital Foundation

ogether, with a little help from your friends you are saving lives and providing patient care at Norfolk General Hospital. The support of so many loyal donors, volunteers, board members and staff, raised $964,327 this fiscal year.

During fiscal year 2010/2011, 4608 families, 95 service clubs and 476 organizations/businesses supported the NGH Foundation. The funds paved the way to replace aging equipment such as: IV Pumps Therapeutic Bed Surfaces Ice Machine Stretchers 4th Floor Dining Room Furniture ER Weigh Scale ICU Family Room Furniture OR Surgical Microscope for Ophthalmology Cystoscopes, Colonoscope & Gastroscope Ultrasound Probe Baby Warmer with Oxygen and Suction Infant Photo Therapy Lighting Vital Signs Monitors Portable Patient Lifts

The remainder of the funds raised this year are reserved for the purchase of the new Digital Imaging X-ray System and Suite to be installed this fall. The economic climate has not allowed the provincial government to provide funding increases that cover inflation. Therefore, the contributions of the Foundation have become even more important in enabling NGH to maintain and enhance the level of care provided to the community. The extraordinary efforts of many volunteers led to several successful events this past year. We would like to recognize those volunteers for their dedication to health care and to the residents of Norfolk County. We would like to thank all of the members of the Board of Directors, the Foundation staff and the generosity of so many loyal donors for their commitment to making the Foundation a success today, and for their vision to ensure its success tomorrow. Paul Hosack, Chair of NGH Foundation Board of Directors Helen DeBoer-Daggett, Director of Development
Norfolk General Hospital Foundation Statement of Operations
The Foundation continued to receive the generous support of many donors. In 2010/2011, The Foundation received donations totaling $964,327. Most of these funds will be put towards the purchase of a new Digital X-ray Unit/Suite. The charts below illustrate sources of revenues and expenses as reported in the Foundations Audited Financial Statements for the period of April 1, 2010 to March 31, 2011. 2010/2011 Revenues Donations Investment Income Total Revenues Expenses Purchased Services (salaries, wages and benefits) Appeal and Fundraising Administration Other Total Expenses Excess of Revenues over Expenses
Funds Disbursed For Charitable Purposes

$Dollars 964,327 16,137 980,464 $Dollars 200,865 103,622 24,521 18,288 347,296 $633,168 $502,474

% of Total Revenues 98% 2% 100% % of Total Expenses 58% 30% 7% 5% 100%

It was a beautiful sight! On Tuesday May 3, 2011 area Lions Club members and local donors were welcomed back to NGH for the official ribbon cutting ceremony of the new Operating Room Microscope. Shown with the new equipment is ophthalmologist, Dr. John Thorpe.

2010-2011 Annual Report to the Community

Volunteer Association

An Instrumental Part of our Hospital and Nursing Home Family

n June of 2010 the Volunteer Association celebrated 85 years of serving NGH and 35 years of serving NHNH. Fiscal 2010/2011, like the many years that came before, was a success for our Volunteer Association. This was demonstrated by an ability to maintain, and in many cases, improve the services that are provided for our hospital and nursing home. For the 2010/2011 fiscal year our volunteers donated 36,749 hours of time to NGH & NHNH. Success has also been demonstrated by the outcome of fundraising projects and the profits gained from lottery, craft group, hairdressing services, coffee kiosk and gift shop. For the past year our volunteers donated $127,341 toward projects at NGH & NHNH. These projects included the first payment toward our three-year commitment to purchase a scanning and archiving system for efficient maintenance and utilization of health records. In addition, funds were forwarded to the Foundation in support of their Lend a Hand Campaign, to NHNH for purchase of a traverse ceiling lift and to NGH & NHNH for various other smaller projects. Many awards are presented to our volunteers at various venues throughout the year. Jean Dykstra and Jane Hunter were recipients of Provincial Life Membership Awards which were presented in Toronto in November. Ontario Volunteer Service awards were presented to six of our volunteers in Vittoria in June. These volunteers included Shirley Bishop, Merike Merimets, Charlene Thompson, June Faint, Lyn Poole and Pat Cooke. At our Annual General Meeting in April 2010, several volunteers received Local Life Membership Awards and outstanding service awards. Many others received years or hours of service pins including Edith Kindy who received a 50 year pin and Betty Goode who received a 3000 hour pin which includes hours tallied from April, 2003 when the volunteer department switched to electronic record keeping.

Jim, Len, Jane and Molly at the Information Desk. Imagine the total number of hours Betty would have had if we had tallied since 1979 when she first started! Congratulations to all award winners your gift of time is very much appreciated and you are all very deserving recipients of these awards. We have benefitted from a very healthy influx of new volunteers over the past year. This has allowed us to continue filling the many leadership roles that are a necessary part of running an organization of this magnitude. We have also had great success in keeping our twenty plus services running at full capacity allowing us to continue serving our patients, residents, employees and visitors at NGH & NHNH. The Volunteer Association would like to thank the many community members who continuously support our events and businesses. Your support is what determines our success! Sherri Schira-Ladosz - Director of Volunteers and Clergy

Dear Mr. Bill Lewis, President and CEO,

This past winter, my mother, Helga Nielsen, was a patient at NGH for over 4 months. I have to commend your staff on their exemplary care and rehabilitation. Your staff is very caring and compassionate. I also note the hospital is very clean. And the food is good. I came every day and note that everyone says hello as I pass in the hall - what a friendly atmosphere. In February, Moms medical condition deteriorated and she was admitted to Palliative Care on the fourth floor. Again, the compassion and care received was exceptional. Mom was bathed and kept comfortable every day and she passed with great dignity. For that, we are very thankful. We are fortunate to have a hospital in Simcoe offering so many services and outstanding care. Thank you.
2010-2011 Annual Report to the Community 7

Helga with her granddaughter Kim

Norfolk General Hospital

365 West Street Simcoe, Ont, N3Y 1T7

Questions?
519-426-0130

www.ngh.on.ca
519-426-0130

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

Visit our website www.ngh.on.ca

365 West Street Simcoe, Ontario N3Y 1T7