As another year fiscal comes to a close, the Carleton Place & District Memorial Hospital (CPDMH) would like to take an opportunity to highlight its accomplishments over the past year. The Hospital would also like to express our appreciation to all the staff, physicians, volunteers and Board Members for their commitment to our organization, and of course, the community for its continued support.

FINANCIAL INDICATORS

CPDMH’s management team and staff continue to be aware of the financial pressures faced by the Hospital and throughout the year, worked diligently to make the best use of the funding provided by the Champlain Local Health Integration Networks (LHIN). As a result, the Hospital continued its trend of finishing the year in a positive financial position with a small operating surplus of $3,272.

As per other years, CPDMH saw the greatest volume of patient activity in the Emergency Room, Ambulatory Care Clinics, and in the Diagnostic Imaging Department and for the most part, patient activity within the various departments remained constant from the previous year. The exception to this was the Ambulatory Care Department and the Inpatient Unit; both had increases in its Utilization Stats. The increase in the number of visits to the Ambulatory Care Department is attributed to the addition of 2 new clinics to the Hospital’s list of services in 2009/10.

Despite Hospital Admissions being virtually the same from the previous year, the Inpatient Unit had noticeable increases in the number of Inpatient Days (8.2%) and ALC days (25.9%). The numbers of inpatient days increased because the acuity of the patients admitted to the hospital was higher and as a result, the patients required more intense care.

While the increase in ALC Days looks significant, the reason for the increase is because the ALC definition was changed by the Ministry of Health and Long Term Care. The definition previously included 3 subcategories of patients waiting for another level of care - Rehab, Palliative Care and Patients awaiting placement to long term care. However in July 2010, the definition for ALC patients was expanded to include 10 additional patient subcategories. Some of the new categories include patients waiting for home care through CCAC (Community Care Access Centre), patients requiring convalescent care and patients awaiting placement in a retirement facility.

Service	2010/11	2009/10	% Change
Emergency Visits	21,492	22,093	-2.7 %
Ambulatory Care Visits	11,292	9,720	16.2 %
Diagnostic Imaging Exams	17,781	18,227	-2.4 %
Surgery Cases	1,436	1,373	4.6 %
Hospital Admissions	619	616	0.5 %
Inpatient Days	6,248	5,777	8.2 %
ALC Days	1,796	1,426	25.9 %

In the past year, CPDMH took a significant step forward in maintaining it’s compliance with sterilization and other infection control protocols by renovating its Central Processing and Sterilization Room (CSR). The project, which occurred from July – October, was initiated because of recommendations from its peer review with Accreditation Canada during the fall of 2009.

The CSR is responsible for the cleaning, preparation, processing, sterilization and delivery of equipment, sterile instruments and trays to patient care areas including the Operating Room. The goal of the project was to improve work flow, enhance storage areas, and secure a protected area for sterile storage of medical equipment, devices and supplies.

The project finished on time, under budget and more importantly, with very little disruption to patient services. In fact, despite the slight interruption in service delivery within the CSR, CPDMH’s surgical program saw a slight increase in the number of procedures in the year.

Hand Hygiene is an important practice for health care providers and has a significant impact on reducing the spread of infections in hospitals. During the past year, CPDMH decided to focus its efforts on proper Hand Hygiene before patient contact during Canadian Patient Safety Week. To be clear, health care providers are washing their hands, however CPDMH believes that continued education on proper hand hygiene can only improve the heath and safety of our patients and of course, our health care team.

Table 3: Comparison of Hand Hygiene Compliance Before & After Initial Patient Contact

In April 2008, CPDMH submitted a proposal to the Ministry of Health and Long Term Care to build a new and enlarged hospital at the intersection of Maple Lane and Lake Avenue East. When approved, the new hospital is estimated to cost $86 million, with the Ministry investing $69 million in the new facility and the community being required to raise the remaining $17 million.

Over the past year the Hospital has continued to do its best to move the redevelopment project forward. During the year, the Hospital met with candidates of both the municipal and federal election to provide information on the project, provide a tour of our current facilities and appeal for support of this important endeavour. With the upcoming provincial election, the Hospital will continue to present its case to candidates in the hopes of receiving an approval announcement soon after the Members of the Provincial Parliament have been determined.

In January 2011, CPDMH and The Mills Community Support Corporation partnered to launch the North Lanark Assisted Living Program. The program is funded by the Champlain Local Health Integration Network (LHIN) under the Provincial Aging at Home Strategy.

The North Lanark Assisted Living Program is an important step forward in supporting the development of an ‘age friendly community’. The services provided are available to individuals aged 65 years of age or older; suffering from chronic conditions; and living in their own private home or within a residential setting such as an apartment building. When fully operational, the program will support 75 people.

CPDMH continues to move forward in its quest to develop a fully electronic patient record and spent a significant portion for the year adding a Scanning and Archiving application to its current information system, Medical Information Technology, Inc.

The new application enables CPDMH to quickly scan documents and images, associate the documents with patient records and securely archive all health care information electronically. The complete digital record is then immediately accessible to healthcare providers.

The application is being developed and implemented in partnership with the Queensway- Carleton Hospital (QCH) and Arnprior & District Memorial Hospital (ADMH). The Meditech system and applications are hosted at QCH and maintained and supported by the QCH Information Systems/Information Technology department.

CPDMH has made a few more steps forward in its quest to improve the community’s access to healthcare services and is using Telemedicine to add to its service offering a thrombosis program as well as a Cardiac Telehome Monitoring program

The regional thrombosis program has been launched to assist in the management of anti-coagulant (blood clot) therapy and is offered in co-operation with The Ottawa Hospital. The Cardiac Telehome Monitoring program is offered in partnership with the University of Ottawa Heart Institute and is targeted to patients suffering from Congestive Heart Failure. The goal of the program is to create a partnership between the patients and their multidisciplinary care teams so that the patient is able to actively manage their condition at home.

Over the past year the Hospital has also made a few changes to the way care is provided to specific patients within our community. The first standardization of care is made possible through a partnership with the University of Ottawa Heart Institute to treat Congestive Heart Failure. The program provides a clinical care pathway for nursing staff, prepared orders for clinicians to follow and an information booklet for patients and their families. This initiative has been implemented with all the hospitals in the Champlain LHIN and ensures that patients will receive the same standard of care throughout our region.

The hospital has also developed a clinical pathway to better monitor our patients with diabetes. This pathway will allow our health care team to assist our diabetic patients in regulating their blood glucose levels and reduce the potential risk of developing diabetes complications.

Throughout 2010/11, our Hospital expanded the scope of practice for our RPNs (Registered Practical Nurses) to include IV insertion and fluid electrolyte administration. Implementing this change will allow the Hospital to improve the continuity of care to our patients and increase our ability to respond to our patient needs in a timely manner. We also believe that expanding this scope of practice will lead to improved job satisfaction with our RPNs, all of who are vitally important to the quality of care we provide to the community.

CPDMH is pleased to report that its patient satisfaction ratings continue to be slightly better than both the average for the Champlain LHIN and the Province. Our Emergency Department received an 87.6% rating in the overall quality of care provided compared to the Provincial score of 84.6%.

CPDMH is also pleased to report that its patient length of stay in the Emergency Department continues to be one of the lowest of all the Champlain LHIN hospitals that choose to participate in the Emergency Department Reporting System.

Table 4: Average Length of Stay for Visits to the Emergency Department during April 2011 (Length of stay is reported in hours)