A simple, eloquent letter sent in 2008 by a patient's husband to the Senior Management Team at The Ottawa Hospital (TOH) changed the course of our history. The issue was not the quality of health care, but rather the lack of compassion shown to the patient. That letter began our Journey to Excellence. Guided by our vision to provide each patient with the world-class care, exceptional service and compassion we would want for our loved ones, we've been making great progress. We are honoured to have been named the International Healthcare Organization of the Quarter by Studer Group.
As the only adult acute tertiary care hospital in eastern Ontario, TOH is the sole provider of complex care for patients with trauma, cancer, cardiac disease, vascular, thoracic and neurosurgical illnesses.
TOH was formed in 1998 after merging and consolidating the services of the three hospitals, although our roots go back to 1845 when a simple building sheltered 14 patients, 10 of them free of charge, during its first year. Now, we are one of the largest teaching hospitals in Canada; last year we treated 47,712 admitted patients and 143,939 emergency patients. Our three main bustling campuses are important community resources for the population of 1.2 million people whom we serve in English and French. We boast specialty centres in cancer, heart, kidney and vision care, as well as rehabilitation services.
The Ottawa Hospital
8.8 Days (average length of stay)
186 Clinical Fellows
8 Research Fellows
218 Elective Residents
631 Medical Students
1,734 Nursing Placements
38 Paramedics Student Placements
47,712 Patient Admissions
34,506 Surgical Cases
14,834 Eye Care Surgical Cases
143,939 Emergency Visits
1,066,979 Ambulatory Care Visits
6,631 Babies delivered
14,437,780 Laboratory Procedures
*Note: Numbers are based on The Ottawa Hospital's Annual Report 2011-2012
In Canada, hospitals are funded by government and do not charge patients for service. Despite today's economic and budgetary challenges, we remain committed to providing excellent patient care; we do not see budget cuts as an excuse for less-than-excellent care.
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Journey to Excellence: Compassionate care for every patient, every time
In 2008, a full ten years after the merger of three hospitals into TOH, we had made great strides in becoming recognized nationally as an academic health science centre. The hospital was financially efficient, providing good patient care and considered a good place to work.
Good, but not great.
The Board of Governors and the Senior Management Team were dissatisfied with progress in quality and patient safety indicators as well as anecdotal evidence of inconsistencies in the patient experience across the organization. Change was needed, and it began with that letter. (For the full story, please see our Every Patient, Every Time 2012-2015 Strategic Directions report.
We knew it was time to make a profound and lasting change at TOH. By 2010, TOH had a new vision and a new goal – to become a top 10 per cent performer in North America in quality and patient safety. TOH began its journey with a focus on three important themes: patient experience, performance management and physician engagement. We adopted five strategic focus pillars to guide all hospital activities: Quality, People, Academics, Partners and Finance.
After partnering with the Studer Group, TOH implemented Evidence-Based Leadership℠ tools and processes that have accelerated and sustained performance improvement across the board, and especially operational, clinical and service excellence.
Among our many improvements, these stand out:
- Hand Hygiene Compliance: After our fiscal year 2011-2012 target of 80 per cent was exceeded, we set our fiscal year 2012-2013 target at 85 per cent. We continue to see excellent results and year to date we have achieved 90 per cent.
- Inpatient Overall Rating of Care: We started at 35.5 per cent excellent in January 2010 and as of September 2012, we were at 50.6 percent, with a YTD result of 47.9 per cent excellent. Our fiscal year 2012-2013 target was 46 per cent excellent; we have surpassed this target and are seeing evidence of sustained performance.
Other improvements and successes include:
- Our engagement score has increased by 5 per cent for employees and by 8 per cent for our physicians.
- We are 14 months into our "You're in my care" campaign.
- We have created a Physician Engagement Agreement and are working on a model of professionalism for our physicians.
- In our outpatient areas, the percent for Overall Rating of Care of Excellent ranges from 61.5 per cent to 93.8 per cent, for September 2012 YTD.
- In fiscal year 2011-2012, our Patient Advocacy Department received 127 patient compliments from April to November; this current fiscal year, we have already received 174 compliments in the same timeframe.
Awards and distinctions
In November 2012,Mobile Enterprise Magazine named TOH the winner of the 2012 Mobilizer Award in the Enterprise-Wide Mobility Deployment category. Our Information Services team moved our electronic medical records onto the iPad for all physicians, pharmacists, liaison nurses and medical students, saving them time and improving communications with patients. It is now routine to share x-ray images and other results directly with the patient or his or her family, while at the bedside.
In October 2012 at What's Right in Health Care®, TOH received a 2012 Studer Group Excellence in Patient Care Award in the academic/teaching category. The award recognized TOH's achievement, improvement and overall outstanding performance in patient care.
The Canadian Forces Medallion for Distinguished Service was presented to TOH for outstanding service by a hospital outside of the military community. TOH has a longstanding relationship with the Canadian Forces. We expanded our support to deliver high-quality trauma care, surgical services and rehabilitation to wounded soldiers returning from Afghanistan.
The Inter-professional Model of Patient Care that we developed in 2006 appears to be the first of its kind. This model – a guide to organize the delivery of patient care among health professionals from different disciplines – helps provide seamless care for patients and families. Our Model of Nursing Clinical Practice, the first in Canada, is being implemented in other acute, transitional and long-term care facilities.