With good fiscal management and despite ever-increasing financial pressures, CPDMH continued to make the best possible use of the funding provided by the Champlain Local Health Integration Networks (LHIN) and ended the year with a surplus.

For the most part, patient activity within the various departments of CPDMH remained constant from the previous year. The exception to this was the Ambulatory Care Department which experienced a 10.39% decrease in visits from the previous year. This decrease occurred likey because of a temporary change in service with the Hospital’s orthopaedic program.

Service	2009/10	2008/09	% Change
Emergency Visits	22,093	21,641	2.09 %
Ambulatory Care Visits	9,720	10,847	-10.39 %
Diagnostic Imaging Exams	18,227	17,394	4.79 %
Surgery Cases	1,373	1,363	0.73 %
Hospital Admissions	616	631	-2.38 %
Inpatient Days	5,773	5,900	-2.08 %
ALC Days (Patients waiting Placement)	1,426	1,373	3.86 %

With an infection control rate of 1.1% for 2009/10, the Hospital has once again showed a strong compliance with sterilization and other infection control protocols. Key improvements in infection control also resulted in the Hospital leading the way in best practices for Cleaning, Disinfection and Sterilization in its Central Processing and Sterilization Area (CSR).

Best Practices recommends that written policies and procedures for all aspects of reprocessing are based on current standards and reviewed annually. At CPDMH, this annual review and the opportunities for improvement are reported to the patient care team, Medical Advisory committee and the Board of Trustees quality committee. To avoid in-house bias and complacency with the same system of review, the CPDMH approached the local chapter of the Central Service Association of Ontario (CSAO) and proposed a peer review with a hospital that has similar operations and equipment.

The Perth and Smiths Falls District Hospital agreed to this shared learning exercise and audits were performed at the two facilities, Carleton Place and Perth, in April and August 2009. The peer audit resulted in improvements in three key areas:

The resulting improvements not only supported the adoption of Best Practices but many of the implemented changes also proved to be cost effective for both organizations. For their efforts, the Hospitals were awarded the Best New Abstract Award at the National Community and Hospital Infection Control Association-Canada conference. In the next little while, the Hospitals will also share their experience and findings at the next meeting of the Gamma Chapter of the CSAO.

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.

In October 2009, the Hospital was informed that the LHIN was undergoing a review of the Clinical Services in the region and a decision on the business case would be delayed until the study was complete. Following the completion of the review, the Hospital will have to revisit the current plan for the new facility, possibly consider a redesign of the current business case and resubmit the proposal for approval in order to move to Functional Program planning.

In the meantime, a municipal committee has been formed to focus on the Health Village component of the Hospital Redevelopment Project. The Health Village would accommodate other healthcare partners in a separate building near the new site of the hospital. The partners building would be privately built and is considered separate from the hospital’s submission.

The vision for the Hospital Redevelopment and Health Village concept closely aligns with a regional system of care. The focus of the Model is ‘a constellation of health and social services to integrate care and address population needs’. The potential Health Village would create a seamless experience for the user; an improved match between single service and multiple needs of clients; effective and efficient use of system resources and capacity; and better health outcomes.

In a constant quest to improve clinical workflow and patient safety, CPDMH has taken a significant step to move forward to a fully electronic patient record and the Hospital has partnered with Queensway – Carleton Hospital (QCH) and Meditech to implement a fully integrated hospital information system.

The current partnership with QCH will see CPDMH migrate to Meditech 6.0. This new version of software facilitates a new streamlined user interface with workflow oriented screens, full secure access over the internet, highly available patient information, improved data integrity and quality management. This adoption positions the Hospital to move forward to advance clinical applications and towards a full electronic record.

In February, CPDMH along with QCH and the Kemptville District Hospital (KDH) became the first hospitals in the Champlain Local Health Integration Network (LHIN) to start sending patient information to the Northern and Eastern Diagnostic Imaging Network (NEODIN).

NEODIN is a diagnostic imaging repository that will link together the medical imaging records from hospitals throughout Northern and Eastern Ontario. NEODIN has adopted a hub and spoke model for service delivery which pairs small facilities to larger one. CPDMH and KDH were connected to the network as spokes to QCH, the hub hospital.

When completed in 2011, 59 hospitals from the North West, North East and Champlain LHINs, servicing almost two million people across 840,000 square kilometres from the Manitoba border in the West to Cornwall and Hawkesbury in the East, will be able to seamlessly share patient images and reports.

In June 2009, CPDMH participated in Accreditation Canada’s peer review program to evaluate the Hospital’s performance against national standards of excellence. These standards examine all aspects of health care, from patient safety and ethics, to staff training and partnering with the community.

Following the review, the Hospital was awarded the highest level achievable, Full Accreditation Status, and it was noted that CPDMH was compliant with all required organizational practices for safety. In 2009, less than 20% of small hospitals received this award following a survey by Accreditation Canada.

In September, CPDMH’s lab also participated in a peer review from Ontario Laboratory Accreditation (OLA). The OLA program is mandatory for all licensed Ontario medical laboratories and relies on laboratory physicians, managers and scientists to serve as assessors for the accreditation program.

The lab accreditation process includes the assessment of such standards as requirements for Quality and Competence, Safety and Point-of-Care Testing. As part of the assessment the OLA Team also visited the patient care areas of the hospital to ensure policies and procedures are followed and compliant with lab requirements.

The review showed that the CPDMH Laboratory had achieved compliance rate of 99%, with 469 standards met out of 474 and as a result, received a full four year Accreditation from OLA.

CPDMH has made a few more steps forward in its quest to improve the community’s access to healthcare services by adding the following outpatient clinics to its service delivery:

On June 11, 2009, The World Health Organization issued a level 6 Pandemic Alert and the world prepared for a very different flu season. At CDMH, preparations for a pandemic began in 2005 and following The World Health Organization announcement, the Hospital activated its Emergency Response Plan.

As part of the Emergency Response Plan, the Hospital participated in daily and weekly teleconferences with other hospitals and community agencies, critical care networks and Public Health officials to ensure care was provided in a consistent manner. The majority of H1N1 cases did not require hospitalization but during October and November of 2009, CPDMH saw patient volumes increase by 40% for the emergency department. Hospital staff also rallied to provide immunization support and vaccinated over 1300 residents within the community.

The health of patients, staff and physicians remained a priority throughout this emergency as in-house emergency stockpiles were allocated to the safety of everyone. Staff, physicians and volunteers are to be commended for their ongoing dedication and commitment to patient care during this time period.

CPDMH is pleased to report that its patient satisfaction ratings continue to be very good and better than both the average for the Champlain LHIN and the Province. The average of overall impressions in the Emergency Department was 82% compared to provincial average of 74% for small hospitals. In addition, the patient length of stay CPDMH’s Emergency Department is 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 for 9 out of 10 Patients during October 2009 (Length of stay is reported in hours)

· I was in tough shape upon arrival and before transfer, I feel I received tremendous medical treatment in ER. I was quickly treated, my pain relieved and then bundled off to the Heart Institute. Let me say thank you from the bottom of my new heart

· Having come from a large city where an average wait in the ER is well over several hours, I am very impressed with the service at CP. The care and consideration shown by the nursing staff is outstanding. You feel they really care about you as an individual.