Royal Victoria Regional Health Centre (RVH) is a progressive, growing organization located in Barrie, Ontario, with a proud history and dynamic future.
For 115 years RVH has been delivering safe, high quality healthcare to residents throughout the booming region of Simcoe Muskoka; an hour north of Toronto. As the largest community health centre in the region, RVH provides a full range of acute services, including specialty services not found elsewhere in the area, such as interventional radiology, comprehensive cancer care and advanced stroke care.
The health centre logs over 350,000 patient visits each year, including 73,000 Emergency Department visits. RVH's team of 300 physicians, over 2,300 employees and 1,000 volunteers is committed to delivering Inspiring care ... always.
In the spring of 2012 RVH opened an impressive $450 million expansion, which doubled the size of the heath centre, significantly increased capacity to 400 beds, allowing RVH to offer expanded and enhanced services, including the Simcoe Muskoka Regional Cancer Centre and the region's only cardiac and respiratory units. The expansion tripled the size of the Emergency Department and doubled the Imaging Department. The health centre's laboratory expanded significantly and became one of Canada's first fully-automated labs. With an expanded annual budget of over $250 million, 400,000 square feet of new space, 700 additional employees and many new processes and practices, RVH has been transformed in the past year. As good news as the expansion is for the community, RVH understood that this kind of explosive growth has the potential to change its culture dramatically.
In 2010, RVH, with full support from its Board of Directors, embarked on a journey called 'be excellent!'. By aligning the entire organization – from strategic directions to goals and objectives – RVH was determined to create a clear focus on what matters most: improving quality, safety, and the patient experience.
RVH's 'be excellent!' journey
Royal Victoria Regional Health Centre's journey began with its leadership team. By hardwiring best practices in the behaviours of its managers, directors and senior leaders, excellence through prescriptive tactics would become part of everyday operations.
RVH kicked-off the journey with an investment that allowed its entire leadership team, including the organization's "Firestarters" to attend the Studer Group's Taking You and Your Organization to the Next Level conference in nearby Toronto. With that solid foundation of understanding, the organization was able to implement practices focused on employee engagement, leader development and accountability -- including rounding for outcomes, Stoplight Reports, frequent and consistent recognition, implementation of the Leader Evaluation Manager® – all aligned under RVH's five pillars of Quality, Service, People, Finance and Capital Redevelopment.
In September 2012 RVH completed its eighth "Leadership Excellence Institute" with approximately 100 health centre leaders in attendance.
In just two years, RVH has already seen tremendous success from this measured, conscious commitment to excellence.
RVH's focus on quality and safety has been recognized by Accreditation Canada as being "accredited with Exemplary Standing". This is the top ranking possible from Accreditation Canada and achieved by only 20 per cent of Canadian healthcare institutions.
- Hand hygiene compliance rates have increased from 60 to 89 per cent, a 50 per cent increase in the number of people who follow this important safety protocol.
- RVH has realized a 90 per cent reduction in conservable days and continues to trend in the right direction, from one of the poorest performers in the province, to the top 50 per cent and continuing to climb.
- RVH continues to roll-out clinical excellence tactics, beginning with daily leader rounding with patients and families in all inpatient units, post care calls, SBARD and hardwiring AIDET® throughout our organization.
RVH's goal is to transform its culture to a singular focus on the patient and their family. To put patients first, and to not only meet, but exceed their expectations.
- Hip surgery wait times have decreased from nearly 250 days to 74 days, while other hospitals in Ontario have increased from 150 – 200.
- Reduced knee surgery wait times from nearly 250 days to 93 days.
- Reduced Left without Being Seen (LWBS) rates in the Emergency Department from 6.6 to 3.3 per cent; the equivalent of over 2,200 patients remaining at RVH to receive care they were seeking.
- RVH's Emergency Department implemented a "split flow" model, a "flow coordinator" and supply/demand schedule to better manage flow.
- Physician Initial Assessment in the Emergency Department has been reduced by approximately 100 minutes, from the 90th percentile to the 60th (compared to peer hospitals) and continues to improve.
- AIDET®, the standardized introduction model, is now a core requirement for all current and new employees.
- Daily leader rounding with all inpatients and their families was implemented on all inpatient units.
RVH's people are the cornerstone of "inspiring care" and the organization is committed to making the health centre the best facility to work, practice, volunteer and train.
- Workplace injuries have decreased significantly, resulting in a drop in lost days (represented as FTEs) from a high of 27.3 FTEs per quarter to basically non existent (< 1.0).
- First year turnover has decreased from 27 per cent to 15 per cent.
- Paid sick time was cut from a high of 5.2 per cent to 3.2 per cent, meaning less overtime, better quality of care and higher patient and staff satisfaction. The most recent results place RVH amongst the top 10 per cent of performers within its peer group.
- Following the last employee and physician experience survey, RVH implemented over 250 action items created by staff and physicians to make the health centre a better place to work and practice. This collaborative spirit will help determine new ways to improve quality, work environment and patient care.
- RVH's journey to 'be excellent!' has also meant improving communication with its people. In addition to an extremely robust internal communication plan which includes monthly Town Halls, a bi-weekly newsletter, monthly 'Take a Break with the CEO' sessions and the introduction of numerous innovative communications strategies. RVH has trained 900 employees and physicians in enhanced communication techniques.
- Implementation of over 60 standardized "Communication Boards" in every department of the health centre has allowed RVH to engage its people in quality and service improvement initiatives and highlight recognition and successes. Staff can interact with these boards through informal manager-led huddles, while reviewing the completed items on Stoplight Reports and completing the "What can we do" sections of quarterly results graphs.
- Senior leader visibility has increased through implementation of twice-monthly Senior Leader Rounding.
- Comprehensive "Evidence-Based LeadershipSM Tactics" were introduced for all new leaders.
- Regular meetings of various 'be excellent!' service excellence committees encourages leaders and front line staff from throughout the organization to work together and implement best practices to improve the patient and provider experience at RVH.
With leaders fully-accountable for annual budgets, RVH ensures it is able to make the best, most efficient use of valuable public funds.
- Despite tremendous growth and unprecedented demand for service, RVH achieved a balanced budget for the past two years and established a $2 million ongoing clinical reinvestment strategy.
- Focused efficiency measures increased weighted cases per bed day from 67 to 78 (16 per cent increase).
Royal Victoria Regional Health Centre's expansion is one of the largest capital projects in Simcoe Muskoka history.
- The $450 million redevelopment was completed under budget.
- A carefully planned, phased opening of the new space was one of the safest and smoothest transitions of its size and complexity in Ontario.
- The expansion included over $70 million in the very latest medical equipment, including two Interventional Radiology suites for minimally invasive surgeries; RIVA – Canada's first robotic arm for the safe preparation of chemotherapy medications; one of the country's first fully-automated laboratories; the latest and most advanced MRI technology; state-of-the-art equipment in the 12-bassinet Neonatal Intensive Care Unit (NICU).
- RVH purpose-built space to accommodate its highly-successful Family Medicine Teaching Unit where family physicians train during their final two years of residency. This official partnership with the prestigious University of Toronto Department of Family and Community Medicine is just one of RVH's many academic affiliations.
Royal Victoria Regional Health Centre believes that providing its employees, physicians and volunteers with purpose, worthwhile work, and an opportunity to make a difference, will help the organization always exceed the expectations of its patients and deliver even safer, higher quality care.