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A MESSAGE FROM OUR LEADERSHIP

The COVID-19 pandemic brought some of the most demanding, complex and difficult situations that many of us have ever faced. The third wave, with the arrival of variants of concern, challenged hospitals and healthcare workers like never before. While this has been a year unlike any other, our teams at Halton Healthcare have responded in the way they always do: with compassion, accountability and respect.

Our first positive case of COVID-19 was identified in March 2020. Since then, we have played a major role in the health system response. Our three testing centres and vaccination clinic are providing vital services to our communities. We are also supporting other hospitals through the GTA Hospital Incident Management System (IMS).

Beyond COVID-19 we focused on our three strategic priorities of Innovate, Collaborate and Empower.

We have continued to work collaboratively with our health system partners as part of the Connected Care Halton Ontario Health Team (CCHOHT). OHTs are a driving force in transforming health systems across our province. The collaborations and partnerships built through the OHTs ensure that we are active participants in this process.

The pandemic has underscored the urgent need to redevelop our hospitals to ensure we are equipped to respond to infectious diseases, increased patient numbers and other unforeseen issues. Over the past year, Halton Healthcare has been recognized as a leader for effective capital planning. We are continuing the much-needed redevelopment for Georgetown Hospital, applying our lens of long-term space planning to this critical project.

We are continuing to work to improve patient, visitor and staff experiences, through our innovation grant program. Thanks to this funding, OTMH implemented an innovative wayfinding system for people with sight loss. Read about how Blindsquare is reducing barriers and enhancing inclusion in this report.

In July, our Board of Directors initiated a planning process to review and refresh Halton Healthcare’s strategic plan. This fall we will be introducing Inspiring Care, our updated, ambitious and inspirational strategic plan.

The past year has been characterized by a constantly changing environment, extreme demands, and unprecedented challenges. It has also been characterized by an unprecedented level of care across our teams at Halton Healthcare. Looking back and looking ahead, we are dedicated to delivering on our vision of exemplary patient experiences, always.

  • Richard Nunn
    Chair, Board of Directors
  • Denise Hardenne
    President & CEO
  • Dr. David McConachie
    Chief of Staf

GETTING THE SHOT: ADMINISTERING HALTON’S FIRST COVID-19 VACCINE

Halton Healthcare was the first to administer Pfizer-BioNTech COVID-19 vaccinations in Halton Region.

“We feel very privileged and proud to have been selected to set-up the first COVID-19 vaccination centre in Halton region and to provide this important inoculation to eligible individuals. Everyone has been working so hard in the fight against COVID-19, to actually be administering the first doses of this vaccine in the Halton Region was truly remarkable,” said Denise Hardenne, President & CEO, Halton Healthcare.

The first vaccination was received by Vanessa Jones, who works with vulnerable seniors at Northridge Long-Term Care Home in Oakville.

The vaccine was administered by Sandra Nocent, a registered nurse at Oakville Trafalgar Memorial Hospital (OTMH).

When asked why she was getting the vaccine, Vanessa said “I’m doing it for the seniors and all the people I love.”

Since December, the Vaccination Centre has continued to provide vaccinations to eligible individuals in our communities in partnership with Halton Region Public Health. Just five months after the first vaccine, staff and physicians in the Vaccination Centre celebrated the 100,000th dose administered marking a milestone in our fight against COVID-19.

 

COVID CARE AT HOME PROGRAM

In response to the third wave of the COVID-19 pandemic, Halton Healthcare successfully launched its COVID Care at Home Program at all three of its hospitals in April 2021. This Program allows the hospital to discharge COVID patients home safely where they are closely monitored and provided with care and support services customized to their needs in their recovery. The early discharge of these patients helps maintain community access to emergency services.

The COVID Care at Home Program team at Halton Healthcare checks in regularly to monitor each patient remotely. They work in tandem with the Rapid Response Nurse from Mississauga-Halton Home and Community Care Services. As a team, they can adjust treatment and medications and arrange for support services, as needed, during the patient’s recovery. Patients are also provided with a 24/7 Support Care Line should their condition worsen or if they have any concerns.

“COVID positive patients are often scared and traumatized by their illness. Our goal is to ensure they are on the appropriate medical therapies and then guide their recovery until they are safe enough to go home. Some patients, while excited about going home, may also be very anxious, especially if they still experience breathing difficulties or remain on oxygen,” explained Dr. Stephen Chin, Chief of Hospital Medicine, Oakville Trafalgar Memorial Hospital. “And that is where this COVID Care at Home Program really shines – by wrapping care around patients to help them transition home seamlessly.”

“My experience at home with all the constant care and monitoring has been excellent,” said Ishan, a patient who was discharged home with the COVID Care at Home Program after spending eight days in hospital. “The hospital team especially from the respirology department is still constantly checking up on me and my case manager (from Mississauga-Halton Home and Community Care Services) has been incredibly thorough. I am actually blown away by all the care and support. With their attention to detail, I feel supported at each stage of my rehabilitation.”

In the first seven weeks of the program (to June 7, 2021), COVID Care at Home served 286 patients. By June, more than 128 patients had been discharged from the program.

This COVID Care at Home Program is the result of a collaboration between Mississauga-Halton Home & Community Care Services, Halton and Peel Community Paramedics, C.AIR Home Oxygen Program, Canadian Home Healthcare and healthcare teams throughout Halton Healthcare. It is unique in that it reaches beyond the traditional catchment areas of our Halton Healthcare hospitals, extending the boundaries of our care to our neighbouring communities.

PALLIATIVE CARE COMMUNITY SUPPORT

“Studies show that most people – about 80% of Canadians want to die at home. Yet over 55% die in hospital due to barriers to care. Many end-of-life patients come to the Emergency Department or are repeatedly admitted to the hospital because they did not have the care and support they needed at home,” said Dr. Nathan Wong, Hospitalist at Milton District Hospital. “These patients often end up dying in the hospital, sometimes alone. There had to be a more compassionate alternative. We were determined to find a way to care for these patients at home and keep them out of the hospital.”

This was the impetus for the creation of the Milton Community Palliative Care Physicians (Milton CPCP) launched in January 2020 to provide in-home physician support for patients requiring end-of-life care.

Three years in the making, this coordinated approach was a joint venture between Halton Healthcare, the Mississauga Halton Local Health Integration Network (LHIN) and a dedicated group of Milton physicians, led by Dr. Nathan Wong and Dr. Deborah Marshall. Both physicians are Hospitalists at MDH and members of the Connected Care Halton Ontario Health Team (CCHOHT) Palliative Care Work Stream.

Their successful efforts in establishing the Milton CPCP were used by the CCHOHT as the blueprint to replicate the program elsewhere. The CCHOHT represents a partnership of health care providers in the Halton Hills, Milton and Oakville communities committed to better ‘population health,’ better patient experiences, reduced costs and a better care team experience.

Building on the success achieved in Milton, the CCHOHT Palliative Care Work Stream has been establishing the Community Palliative Care Program in Halton Hills and integrating the current Oakville Community Palliative Care Physician Program within Halton Healthcare.

“The goals of this CCHOHT initiative are to decrease the number of ED visits in the last 30 days of life and to decrease palliative patient deaths in hospital when patient’s wishes are more aligned with dying at home,” explained Dr. Tarek Kazem, Palliative Medicine Physician Lead, Halton Healthcare and co-lead for the Connected Care Halton Ontario Health Team’s (CCHOHT) Palliative Care Work Stream. “These programs will ensure that these patients and families get the right care and support at this critical time in their life.”

The Palliative Care Work Stream has also implemented a 24/7 HELP line to provide a single point of access for palliative patients, families and primary care providers and offer clinical services through Palliative Care Nurse Practitioners who are on call. This includes confidential counselling and emotional support by phone or video conference, providing and sharing information, and facilitating conversations about the goals and care plan for end of life.

PLAYING A KEY ROLE IN ONTARIO’S PANDEMIC RESPONSE

Throughout the COVID-19 pandemic Halton Healthcare has worked with the provincial government and its regional partners in supporting the local health system response. The province initiated a GTA Hospital Incident Management System (IMS) to monitor hospital capacity needs, and Halton accepted many patients from overcapacity hospitals in the GTA.

During Wave 1 of the pandemic, in anticipation of increased demand on hospital resources, Halton Healthcare built two internal field hospitals. The 12-bed internal field hospital at Milton District Hospital has been in use since June 2020 and in early December 2020 Halton Healthcare opened the 40-bed internal field hospital at Oakville Trafalgar Memorial Hospital to further increase bed capacity.

Both internal field hospitals were created using existing shelled-in space built to accommodate future expansion. Making use of existing space inside the hospitals provides better access to infrastructure and support services such as clinical staff, diagnostics, pharmacy, lab and food services.

This additional space has been a significant resource to respond to increasing patient volumes and Halton Healthcare is proud to be able to respond to local capacity needs and support its hospital partners.

As part of its response, Halton Healthcare established and has operated three COVID-19 Priority Testing and Assessment Centres since March 2020, initiated COVID-19 in-house lab testing, supported the provincial congregate setting strategy, and in December 2020, opened a Vaccination Centre at Oakville Trafalgar Memorial Hospital for priority healthcare workers in Halton Region.

HALTON HEALTHCARE BY THE NUMBERS
APRIL 1, 2020 TO MARCH 31, 2021
 

1,526
VOLUNTEERS

675,759
PATIENT
MEALS SERVED

17,344
ONCOLOGY
VISITS

126,357
EMERGENCY
DEPARTMENT VISITS

5,089
STAFF

38,739
SURGERIES

37,171
DIALYSIS
VISITS

4,277
BABIES
BORN

2,706,572
LABORATORY
TESTS

869
MEDICAL + PROFESSIONAL STAFF (PHYSICIANS, DENTISTS & MIDWIVES)
 

250,235
DIAGNOSTIC
IMAGING EXAMS

89,823
ADDICTIONS +
MENTAL HEALTH
VISITS

29,547
FRACTURE
CLINIC VISITS

COVID-19 ACTIVITY
MARCH 1, 2020 TO JUNE 13, 2021
 

13,638
VIRTUAL
VISITS

1,289
COVID-19
PATIENTS

478
IMS
TRANSFERS

128,525
VACCINE DOSES
ADMINISTERED

225,159
TESTING CENTRE
VISITS

IMPLEMENTING A TEAM BASED MODEL OF CARE

When hospitals began to be overwhelmed during the third wave of the pandemic, Halton Healthcare looked at how more patients could be cared for, safely. One strategy was to implement a team-based model of care where groups of healthcare professionals and support staff came together to care for patients.

Nurses with expertise in acute patient care lead the team and act as Subject Matter Experts. The other team members include a Clinical Extern and a Mobile Pandemic Support Lead who assist with non-clinical tasks. Any additional support may be brought on as required.

Carole Moore, Chief Operating Officer, Oakville Trafalgar Memorial Hospital, said that during the pandemic, the pressures in Intensive Care Units (ICUs) required that staff be redeployed into the Team Based Model of Care. “Team Based Model of Care actually requires more staff but allows expanded capacity of limited, highly skilled critical care nurses,” she explained.

“A comprehensive roll-out plan which included on-site leadership support, a fulsome communication plan and clear roles and responsibilities allowed this Model to successfully be implemented. This Model of Care has allowed patients in our community to be cared for locally, rather than requiring an admission to hospitals outside of their hometown,” explained Letitia McDougall, RN and interim Program Director, Georgetown Hospital Family Practice Program.

The Team Based Model of Care was successfully implemented at all three hospitals during the pandemic.

ACCESSIBLE WAYFINDING TECHNOLOGY

In partnership with the Canadian National Institute for the Blind (CNIB), Halton Healthcare is piloting BlindSquare, an innovative wayfinding system for people with sight loss. This accessible indoor navigation system uses physical beacons and GPS data to deliver audio instructions to smartphones, communicating detailed points of interest and providing directions for safe, reliable travel in both indoor and outdoor environments. It is a free app available on the Apple App Store.

BlindSquare beacons were installed throughout Oakville Trafalgar Memorial Hospital (OTMH). These beacons provide users with customized audio messaging as they travel to their destination. Messages include where to find the nearest entrance and how to navigate to specific areas such as the emergency department or food court.

“Technology is a powerful tool in the hands of Canadians with disabilities and we are so thrilled to see this project take off at OTMH,” said Shane Silver, Vice President of Social Enterprises for CNIB. “BlindSquare’s technology will help patients, visitors and staff navigate the hospital safely and independently – something many of us take for granted. We are delighted that OTMH is the first hospital in the world to implement BlindSquare’s innovative technology.”

This new initiative was funded by Halton Healthcare’s Innovation Grant Program that enables staff-driven projects aimed at improving patient, visitor and staff experience. This project also enhances Halton Healthcare’s Diversity, Equity and Inclusion Strategy by reducing barriers to inclusion and enhancing independent experiences for people with sight loss. It elevates the organization’s accessibility practices beyond the compliance required by the Accessibility for Ontarians with Disabilities Act.

HOME DIALYSIS PROGRAM TOP FIVE IN ONTARIO

The Ontario Renal Network’s March 2021 Quarterly Report placed Halton Healthcare in the top five in the province for the number of patients on home dialysis. While this success can be attributed to a progressive Nephrology Program that empowers patients to dialyze independently, it also reflects a recent innovative collaboration between the Nephrology and the Surgery Programs to protect an already compromised patient population during the COVID-19 pandemic.

“Home dialysis offers patients the most flexibility and allows them to live a life that is not defined by their kidney disease. Whether they choose hemodialysis or peritoneal dialysis, patients are provided with a ‘menu of choices’ as to when, where and how often they can dialyze,” explained Dr. Sanjay Pandeya, Nephrologist and Medical Director of Home Dialysis at Halton Healthcare.

“One type of home dialysis, Peritoneal Dialysis (PD), requires a specialized surgical procedure that was not offered at Halton Healthcare up until recently,” continued Dr. Pandeya.

“We made this home dialysis insertion surgery a priority to protect this vulnerable patient population. With the support of our hospital leadership, and both the Surgical and Anesthesiology team, we now have regular dedicated operating room time for this procedure,” explained Dr. Duncan Rozario, Chief, Surgery Program, OTMH.

“Both Dr. Choy and Dr. Pampaloni are now an integral part of our Nephrology Program. They run their surgical consults right out of our Clinic so dialysis patients don’t have to leave the Nephrology unit. The focus is on the patient experience,” explained Dr. Pandeya. “We also have a dedicated Coordinator who supports the patient throughout their journey and liaises between the Surgical and Nephrology programs to ensure a seamless process.”

“Our program focuses on supporting patients no matter where they are on their dialysis journey. We provide a comprehensive, hands-on training program for those pursuing home dialysis which continues to follow patients even after their transition home. Our physicians and clinical teams are committed to supporting our patients so they can achieve their best life possible,” added Gail Burns, Director of the Renal Dialysis Program at Halton Healthcare.

THANK YOU!

Our hospitals are fortunate to be supported by the efforts of three Volunteer Associations and three Foundations.

During the pandemic the volunteer program was suspended to limit the number of people in our buildings. Staff, physicians, patients and families have missed the smiling faces and helpful hands that our volunteers offer and we look forward to welcoming them back as valuable members of our healthcare team.

The support we received from our communities was overwhelming and much appreciated. From encouraging messages, to donations of food and supplies, to financial contributions made through our three Foundations, people continue to show support for their community hospital.

Thank you to our volunteers and Foundations for their continued commitment and dedication to our communities during these challenging times.

WITH RENEWED PURPOSE: A NEW STRATEGIC PLAN THAT IS INSPIRING CARE

To Care.

Every day, people come to work at Halton Healthcare to do just that: care.

“To Care” is the purpose statement that is at the heart of Halton Healthcare’s new strategic plan.

Called “Inspiring Care,” the plan was developed over the last year as an update of Pathway 2020. Board members, representatives from across the organization and advisors Optimus SBR worked together on the project. Through surveys, town halls and interviews, more than 1,700 people had input to the plan.

While the plan is new, in many ways it is a refresh to Pathway 2020 rather than a whole scale change. The mission, vision and values have remained the same or been tweaked slightly. The purpose statement is the new addition.

“Purpose-driven organizations succeed because people’s personal values and their personal purpose are aligned with the corporate purpose,” explains Board Chair Richard Nunn. “It gives enough flexibility where people can be unique and deliver their value to the organization within that frame of purpose. If everyone does that we’ll keep moving in the right direction.”

Care is a thread that winds throughout the plan. All of the strategic priorities are aligned under the care label in one of four categories: connect, advance, respond and engage.

The initiatives that have been identified allow Halton to advance in a number of areas and build on learnings from the pandemic.

“The world of healthcare is changing fast,” says Nunn. “The trends that we were talking about a year or so ago have just accelerated.”

Some of those trends include digital delivery of healthcare, developing partnerships, our role in health system transformation, caring for the whole patient including their family, and effective capital planning.

Inspiring Care will begin implementation in fall 2021. Along with initiatives that span the whole organization, departments, clinical programs and services will use the key tenets of the plan to align their activities and develop their own initiatives.

The middle of a global pandemic is perhaps not the moment most healthcare organizations would choose to undertake a major strategic planning exercise. However, as the organization prepares to operationalize Inspiring Care, the timing feels right.

For Denise Hardenne, President & CEO, the plan is a gateway to restoration, recovery and new directions. “People need to have some downtime, and then when they come back they’re refreshed and we already know what we need to be doing next,” she explains. “My job, in partnership with the board, is keeping that forward looking perspective for the organization while we do what we need to do on a day-to-day basis. This plan tells people what we’re all about and what our future aspirations are.”

FINANCIALS

Statement of Operations (expressed in thousands)

Year ended March 31
 
20212020
REVENUES
Ministry of Health and Long-Term Care               $479,918$414,923
Interest income1,0282,892
Other operational income57,96074,117
Deferred grant amortization17,50619,571
 556,412511,503
EXPENSES  
Salaries, wages and benefits                      391,983347,250
Supplies and other expenses90,90683,524
Medical and surgical supplies28,37325,491
Drugs18,35416,586
Equipment amortization21,96024,546
 551,576497,397
Excess of revenues over expenses
before building interest and amortization
Building interest and amortization, net
4,836   (1,855)14,106  (1,362)
Excess of revenues over expenses$2,981$12,744

Halton Healthcare’s 2020/21 fiscal year ended with a $2.981M surplus.

The increase in Ministry revenues reflects the one-time investment to offset unexpected COVID-19 expenses and restore lost revenue related to the pandemic.

As a result of the support provided by the Ontario government, Halton Healthcare was able to achieve the planned and approved balanced plan of a $3M surplus.

Audited financial statements for the year-ended March 31, 2021 are available at www.haltonhealthcare.com.

BOARD OF DIRECTORS 2020/2021

Officers

  • Richard Nunn, Chair
    Sharon Barkley, Vice Chair
    Wendy Millar, Treasurer
    Denise Hardenne, Secretary

Directors

  • Pankaj Arora
    Dr. Dalal Aziz
    Charlotte Burke
    Mayor Rob Burton
    Councillor Zeeshan Hamid
    Samantha Horn
    Councillor Jon Hurst
    Dr. Hanif Jamal

    Judy Linton
    Dr. David McConachie
    Ken McDermot
    John W. Nyholt
    Laurent Thibault

    Jennifer Tindale

    Riccardo Trecroce
    Dr. Michael Zettler 

SENIOR LEADERSHIP TEAM

  • Denise Hardenne, President & CEO
    Dr. David McConachie, Chief of Staff
    Bill Bailey, Senior Vice President, Redevelopment, Facilities & Retail Operations
    Judy Linton, Senior Vice President, Patient Experience & Chief Nursing Executive
    Hilary Rodrigues, Senior Vice President, Corporate Services, Performance & Chief Financial Officer
    Dr. Daniel Edgcumbe, Vice President, Medical Affairs
    Cindy McDonell, Chief Operating Officer & Program Director, Georgetown Hospital
    Carole Moore, Chief Operating Officer, Oakville Trafalgar Memorial Hospital
    Sharon Norris, Vice President, Human Resources Planning & Organizational Development
    Janet Skupsky, Chief Operating Officer & Program Director, Milton District Hospital