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Prairie Mountain HealthPrairie Mountain HealthPrairie Mountain Health

Santé Prairie MountainSanté Prairie MountainSanté Prairie Mountain

Annual Report Annual Report Annual Report 201220122012---201320132013

Health and Wellness For AllHealth and Wellness For AllHealth and Wellness For All

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Table of contents Letter of Transmittal and Accountability………………. Page 2 CEO message………………………………………………………. .Page 3 Our Board……………………………………………………………. Page 4 Board Governance………………………………………………...Page 5/6 Organizational and Advisory Structure…………………..Page 7 Our results: Capacity Building……………………………….Page 8 Health System Innovation………………...Page 9 Health System Sustainability…………….Page 10 Improved Access……………………………...Page 11 Improved Service Delivery………………..Page 12 Improved Health Status and Reduced Health Disparities……………………………..Page 13 Audited Financial Statements………………………………..Page 14/15 Expenditure Breakdown………………………………………..Page 16 Auditor’s Report…………………………………………………...Page 16 Administrative Costs……………………………………………..Page 17 Accountability Provisions……………………………………...Page 18 RHA Map……………………………………………………………….Page 19 Public Interest Disclosure……………………………………...Page 20 French Language Services……………………………………...Page 20

*Front cover photo courtesy of Barb Froman, Therapies Department-Dauphin Community Health Services Office- Prairie Mountain Health.

Letter of Transmittal and Accountability We are pleased to present the annual report for Prairie Mountain Health for the fiscal year

ended March 31, 2013 as approved by the Board of Directors at their regular meeting held

September 25, 2013.

The annual report was prepared under the Board's direction in accordance with The Regional Health Authorities Act and directions provided by the Minister of Health. All material, economic and fiscal implications known as of March 31, 2013 have been considered in preparing this annual report. This report reviews the actions and initiatives of Prairie Mountain Health from April 1, 2012 to March 31, 2013. As with all health care organizations, the years ahead will continue to present many challenges however with the assistance of our staff, our community partners and of course, Manitoba Health, we will continue to strive to meet the Vision and Mission we have articulated. The amalgamation of three regions into one, while challenging and a significant amount of work, has allowed us to use the strengths of the three previous regions to build capacity and ultimately improve the quality of service in many areas. We need to acknowledge the staff from across the three previous regions and now Prairie Mountain Health who have embraced the opportunities that amalgamation has afforded. Through a collective effort with our partners, employees and physicians, much progress has been made toward ensuring that the highest quality care is accessible to our residents. We would like once again to acknowledge the Board of Directors and the Executive Management Team for their shared leadership over the past year. To all staff, thank you for your contribution each and every day to making sure the best possible care and service is delivered. To our community stakeholders we express gratitude for working with us, challenging us and keeping us motivated to do the best job possible. Respectfully submitted,

Marg McDonald, Board Chair Penny Gilson Board of Directors Chief Executive Officer

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CEO messageCEO messageCEO message ...2012/2013 year in review...2012/2013 year in review...2012/2013 year in review

As we look back on the fiscal

year 2012/2013, one could

certainly say it was indeed a

„milestone year.‟ In April

2012, as part of the provincial

budget, the Manitoba

government announced plans to

reduce the number of RHAs

from 11 to five. A new health

region, temporarily named

Western RHA, would consist of

the former Assiniboine,

Brandon and Parkland RHAs.

All of the former RHA Boards

approved of this merger which

was announced April 24, 2012.

Moving forward

From the outset, the goal was to move the new

organization forward as quickly as possible. However,

we were steadfast in our commitment and assurance that

front-line care would not be impacted in any way by the

amalgamation.

In the early days of transitioning to a new, larger region,

it became clear that we could build upon all three former

Region‟s experiences, best practices and lessons learned.

We adopted an early slogan of “the strengths of three,

the success of one.”

We quickly formed six transition teams including:

-Steering, -Planning, -Finance, -Human Resources,

-Information Technology and -Communications.

These teams worked diligently and tirelessly to ensure

day to day operations continued while we planned for

new processes and policies associated with the

transition to the new region.

Board named

On June 27, 2012, the Minister of Health, Hon. Theresa

Oswald, named the chairs of the five new RHA Boards,

and identified the new members of the Board of

Directors. For our health region, the new Board was

comprised of 15 Board of Directors, five from each of the

former RHA boundaries.

Our first meeting of the new Board occurred by

teleconference July 4, 2012. The next few months were

spent learning about our new region through a revamped

health profile document, detailed financial picture and

programs and services inventory. We also asked Board

members to consider the corporate name of our new

organization.

Program highlights In November 2012, in conjunction with the Manitoba

Institute of Patient Safety, we were very pleased to host a

significant patient safety forum in Brandon. The forum

featured several high-profile speakers at an open public

event, including keynote speaker Donna Davis, an advocate

for patient and family-centered care.

We also hosted an exclusive „health

care professional development

session‟ geared towards key

learnings and opportunities for

improvement in client-centered care.

Another very important health

improvement project involves the

province‟s Cancer Patient Journey Initiative.

Our Region, in conjunction with Manitoba Health and

CancerCare Manitoba, has been very active over the past

year in planning strategies aimed at shortening the entire

cancer patient journey. We remain committed to completing

seven health deliverables associated with the initiative by

2016.

Being recognized

Prior to amalgamation, Brandon RHA was scheduled to

participate in the national accreditation process.

Accreditation Canada surveyors conducted on-site surveys of

Brandon RHA operations in June 2012, and we were pleased

to report that 94 % of quality measures were achieved.

Throughout the year, we continued our commitment to

quality improvement processes, through the Releasing Time

to Care (RTC) Program and Pursuing Excellence-based on

LEAN thinking-to make our work environments more

efficient, more effective and offer enhanced quality of

service. We were very pleased that Neepawa Health

Centre‟s RTC project was featured in Canadian Nurse

magazine in 2012. We are proud that 28 green belts and

seven (7) black belts have been trained through the

Learning To See Six Sigma project. This highly

innovative approach trains individuals to lead

improvement projects in our Region.

New identity

In December 2012, after receiving approval from

Manitoba Health, we officially changed our placeholder

name from Western RHA to “Prairie Mountain Health”.

With that, came a new logo and detailed visual identity

package which helped solidify our organization.

Prairie Mountain Health was chosen because it fits our

new geographic features perfectly, with the sprawling

prairies all around us, and some „mountain –type‟ features,

like Riding Mountain, Turtle Mountain, and Duck

Mountain, that majestically rise and fall within our

boundaries

Our thanks

In closing, on behalf of our Board and Regional

Leadership Team, I thank all for their patience and

guidance as we worked our way through the amalgamation

process. I thank all of our staff, physicians, volunteers and

Board members for the dedication and commitment you

bring to your work. Together, we can continue to

embrace opportunities for improvement that will best

serve the patients, residents

and clients within this new

region we proudly call

“Prairie Mountain Health.”

Penny Gilson,

Chief Executive Officer

Prairie Mountain Health

Thank you to all of our

staff, physicians,

volunteers and Board

members for the

dedication and

commitment you bring

to your work.

Prairie Mountain Health

hosted a significant

patient safety forum in

Brandon in 2012.

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Health and Health and Health and Wellness for AllWellness for AllWellness for All

Our MissionOur MissionOur Mission

Together, we deliver Together, we deliver Together, we deliver quality health services quality health services quality health services that meet the needs of that meet the needs of that meet the needs of

the population.the population.the population.

Our BoardOur BoardOur Board First Row- From left to

right, Marg MacDonald,

Chairperson, Brandon,

Harry Showdra, Vice-

Chairperson, Swan River,

Sharon Basaraba,

Gilbert Plains,

Rita Blaikie, Brandon,

and Reg Buss, Sandy

Lake.

Second row-(L to R)

Dean Dietrich, Neepawa,

Barry French, Stockton,

Alex Grimaldi, Dauphin,

Diane Ironstand,

Tootinaowaziibeeng,

and Terry Johnson,

Virden.

Third row- (L to R)

Gwynn Ketel, Pine River,

Alison McNeill-Hordern,

Brandon, Jonathan

Murray, Brandon,

Catheryn Pedersen,

Holland, and Perry

Roque, Brandon.

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Board GovernanceBoard GovernanceBoard Governance

Prairie Mountain Health operates under the direction of a 15-member Board, which is responsible to the Minister of Health. When the three former Regions (Assiniboine, Brandon, Parkland)

officially amalgamated May 28, 2012, the Minister of Health appointed five (5) representatives from each former region to the new Board of Directors.

The Board‟s mandate and responsibilities arise from the “Regional Health Authorities Act”. It has the legislated responsibility and authority to plan, manage, deliver, monitor and evaluate

health services within the region. The Board does this in a variety of ways, including providing sufficient oversight measures, ensuring the organization‟s accountability by monitoring and

evaluating its performance, and interacting and communicating with its stakeholders and partners, which includes the general public. Although Board members reside in various communities

throughout the Health Region, they represent the entire Region at the Board table.

Vision: “Health and Wellness for All.”

Mission: Together, we deliver quality health services that meet the needs of the population.

Values: Our values define what we believe in; what we stand for. They provide us with a common understanding of what is important and provide us with a framework to guide our work,

our actions and our decisions. Prairie Mountain Health has four values: Integrity, Respect, Responsiveness, and Engagement.

Integrity

Being accountable for our actions

Putting words into action

Demonstrating ethical behaviour

Being inclusive and fair

Respect

Earning the trust of our patients and coworkers

Treating others with compassion and dignity

Appreciating each other

Demonstrating genuine caring in all we do

Communicating honestly and openly

Responsiveness

Being receptive and open-minded

Responding to the needs of our patients, families and staff

Supporting our patients and each other

Promoting innovation and continuous improvement

Improving safety and effectiveness of our services

Engagement

Involving community, clients and staff

Listening to and considering ideas and concerns in decision-making

Using a team approach in the work we do

Showing leadership

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Board GovernanceBoard GovernanceBoard Governance

The Prairie Mountain Health Board meets monthly (except for July and August) and meetings vary from in-person, through the Telehealth Network and by teleconference. The Board is

responsible for establishing the Regional Strategic Priorities, contained within its Strategic Plan. Strategic priorities remain constant over a five-year period, however, associated indicators,

performance measures and major initiatives are monitored and revised annually by the Board. As amalgamation occurred in the middle of the last five-year strategic planning cycle, our

region developed a strategic plan which covers a three-year period (2013-2016).

The Board has four standing committees to assist it in carrying out its legislative responsibilities. They are:

Executive Committee- Acts on behalf of the Board in urgent situations, when it is not feasible or practical to convene a meeting of the entire Board. The Committee must report any actions

taken at the next meeting of the Board and it does not have the authority to change Board bylaws or policies.

Finance Committee- Reviews options and implications for the Board‟s consideration regarding finance and capital planning issues. It advises the Board on annual budget, monthly financial

statements, and various financial policies and procedures.

Audit Committee-Reviews the audit plan and results of external audits. Also reviews statutory and regulatory obligations and monitors policies related to

financial reporting and controls.

Quality and Patient Safety Committee- Advises and makes recommendations on standards and practices aimed at improving quality, patient safety and

innovation. It reviews performance related to quality, patient safety, patient and community input and feedback and compliance with accreditation

standards.

Stakeholder/Health Partner Consultation

Prairie Mountain Health continued its focus on partnerships, visibility, linkage and communication within our Region.

The Region has developed a PMH Stakeholder newsletter that is distributed, on behalf of the Board, to an extensive list of health partners.

The Region has an active Acute Care Patient Advisory Council in Brandon as well as a Regional Medical Advisory Council. There are area Medical Leadership Committees which link back

to the Executive Management Team, with regular updates provided to the PMH Board.

Executive Management Team members, along with some Board members, attended the Region‟s initial Summer Stakeholder Tour through three weeks in June/July 2012. There were 12 key

community stakeholder meetings, 52 general staff meetings and over 60 tours of sites and programs across the Region.

In 2012, there were 12 key

community stakeholder

meetings, 52 general staff

meetings and over 60 tours of

sites and programs across the

region.

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Organizational StructureOrganizational StructureOrganizational Structure

Advisory StructureAdvisory StructureAdvisory Structure

The Manitoba government reduced the number of regional health authorities (RHAs) from 11 to five

as part of a plan to streamline administration and protect front-line health care. As part of this process,

new Local Health Involvement Groups will be created to help ensure RHAs are responsive to local

community needs.

During November and December 2012, 23 public meetings were held throughout Manitoba to hear

ideas for creating the new Local Health Involvement Groups. Manitobans were also invited to offer

suggestions through an on-line survey. Over 700 people took the time to share their views and

Manitoba Health and the RHAs wish to thank those who participated.

The Minister of Health is reviewing all suggestions and comments. Already, several common themes

are emerging. It‟s clear Manitobans value a transparent process with meaningful, two-way

communication between individuals and the RHAs. It was also clear Manitobans are looking for a

variety of ways to engage with the RHAs, to ensure people of all ages, from all parts of the province,

have an opportunity to be heard.

Manitoba Health and the regional health authorities would like to thank everyone who provided

valuable insight at the public meetings. Manitoba Health, along with RHAs, will continue to review

the input as we develop a model for the Local Health Involvement Groups in 2013/2014.

Board of Directors

Chief Executive Officer

Penny Gilson

Director of Communications

and Corporate Operations

Lara Bossert

VP Finance (CFO),

Capital Support Services/

COO Brandon Regional

Health Centre

Brian Schoonbaert

Senior Advisor Acute

Care & Nursing

Pat Cockburn

VP Community & Long

Term Care/Senior Allied

Health

Jayne Troop

VP Corporate Services

Janet Wilcox-McKay

VP Planning Quality/

Chief Patient Safety Officer

Maggie Campbell

VP Medical Services/

Diagnostic Services/CMO

Dr. Shaun Gauthier

Executive Management Team- From left to right: Maggie Campbell, Pat Cockburn,

Janet-Wilcox-McKay, Penny Gilson, Dr. Shaun Gauthier, Lara Bossert, Jayne Troop,

Brian Schoonbaert.

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Capacity BuildingCapacity BuildingCapacity Building

---Create a positive, safe work environment that attracts and retains qualified Create a positive, safe work environment that attracts and retains qualified Create a positive, safe work environment that attracts and retains qualified staff who are proud to work for Prairie Mountain Health;staff who are proud to work for Prairie Mountain Health;staff who are proud to work for Prairie Mountain Health; ---Develop capacity within Prairie Mountain Health to further advance Develop capacity within Prairie Mountain Health to further advance Develop capacity within Prairie Mountain Health to further advance health system priorities;health system priorities;health system priorities; ---Develop a highly skilled, diverse workforce.Develop a highly skilled, diverse workforce.Develop a highly skilled, diverse workforce.

Prairie Mountain Health (PMH) continues with a

number of regional recruitment and retention

initiatives. Some of them that are underway

include:

Workplace Violence Prevention Strategy;

Aboriginal Workforce Initiative;

Medical Manpower Plan; and

Staff development and training.

In February 2012, 48 first and second year medical

students enrolled in the University of Manitoba‟s

Faculty of Medicine, participated in a two-day

workshop in Brandon. The Manitoba Medical

Student Rural Interest Working Group selected

Brandon to once again host the workshop which is

aimed at highlighting the positive benefits of

practicing medicine in rural communities.

Prairie Mountain Health continues to partner with

the Red River College to host the Licensed Practical

Nursing (LPN) to Bachelor of Nursing (BN) Program.

Dauphin is one of four rural locations hosting the two-year program,

which commenced in August 2011. Neepawa will be a rural location for the program in 2013.

Specific initiatives will be aimed at recruiting therapists, such as occupational therapists,

physiotherapists and speech language therapists; recruiting newly graduated nurses; and obtaining

funding for summer positions for students of pharmacy, nursing and medicine.

Staff safety remains a priority within Prairie Mountain Health. Workplace Violence Prevention

pilot projects are being implemented in the Minnedosa and Swan Valley Health Centre

(Swan River) Emergency Departments. The results of these trials will be used to develop strategies

for ensuring staff safety and security.

There have been many team-building initiatives this year including developing a regional long

service and retirement recognition program, introducing staff appreciation cards and a regional

spirit week. Future plans for building capacity in the region include continued efforts to recruit and

retain staff and physicians in Prairie Mountain Health.

8,3358,3358,335 Approximate number of Approximate number of Approximate number of

employees working for employees working for employees working for Prairie Mountain Health.Prairie Mountain Health.Prairie Mountain Health.

164,000164,000164,000 Population of residents Population of residents Population of residents

within Health Region.within Health Region.within Health Region.

67,000 67,000 67,000 Distance in square Distance in square Distance in square

kilometres of PMH kilometres of PMH kilometres of PMH health region.health region.health region.

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Health System Innovation Health System Innovation Health System Innovation

---Develop innovative, evidence informed improvements that promote effective, efficient use Develop innovative, evidence informed improvements that promote effective, efficient use Develop innovative, evidence informed improvements that promote effective, efficient use of resources and technology;of resources and technology;of resources and technology; ---Deploy a continuous improvement system.Deploy a continuous improvement system.Deploy a continuous improvement system.

In order to create excellence in the health care system, staff have been trained to lead quality improvement

projects using Lean Six Sigma methodology. Two separate but complimentary programs have been initiated.

Lean Six Sigma uses a defined process of data collection, analysis and problem solving to determine the

challenges within a process, make changes and ensure the changes are positive and sustained. As the skills of

the trained staff increases they work their way through a series of belt levels (white, yellow, green, black) and

increasingly challenging projects/improvements. Some of the projects include:

Transportation systems;

Incident reporting process;

Mental Health Intake;

Job Posting Process.

The Releasing Time to Care Initiative is a process improvement program developed by the NHS (National Health Service UK) based on Lean

methodology for use in acute care facilities. The goal for RTC is to organize the unit and their processes to allow for the most efficient use of

time and space freeing up time for staff to spend caring for the patients. Staff, with the support of management and improvement facilitators

work through a series of 11 modules to improve the way work is performed on the unit. Staff teams from the units involved receive several

days of training prior to beginning work.

PMH has two trained instructors and will be training two additional instructors this fall.

To date, 10 facilities/units in Prairie Mountain Health have adopted this process with three more to implement RTC initiatives in the fall

of 2013.

One facility, Neepawa Health Centre, has completed the program and continues to realize improvements through continuous quality

improvement initiatives. Improvements include, but are not limited to, workload balance, increased time to spend in direct patient contact,

savings in supplies/ medications and their distribution, increased staff and client satisfaction.

Since 2011, Neepawa staff have reported significant improvements in their ability to care for patients and in the work environment as a

result of the RTC process. Patients also appear to be extremely satisfied with the care they receive. In the latest satisfaction survey, 100%

of patients either agreed or strongly agreed in all but one question that they were satisfied with the information, care and respect they

received. In January of 2013, 93% of Neepawa staff either agreed or strongly agreed that they were satisfied with the amount of contact

time they spent with patients.

What is Lean? Lean thinking is the belief that there is a

simpler, better, easier way to complete our

work. It is about eliminating waste,

inefficiencies and errors. It is about

making our work environments efficient

and effective. Lean improves safety,

quality costs, efficiencies and service

delivery.

What is Six Sigma?

Six Sigma is a set of statistical tools and

techniques for process improvement.

Six Sigma projects follow a defined

sequence of steps, DMAIC.

(Define, Measure, Analyze, Improve,

Control).

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Health System SustainabilityHealth System SustainabilityHealth System Sustainability

FEATURE: MBTelehealthFEATURE: MBTelehealthFEATURE: MBTelehealth Telehealth is a high speed, secure, video link that connects

clients to health care providers through a TV screen. Many

specialists in Manitoba offer clinic appointments by

Telehealth. The benefit is that patients can have access to

specialists without the burden of driving to Brandon or

Winnipeg.

Last year, Prairie Mountain Health (PMH) was the largest

provincial user of Telehealth outside of Winnipeg. There are

currently 17 communities in the region that can be used for

clinical appointments, education, Televisitation,

support groups and administrative purposes.

Rural PMH sites include: Baldur, Dauphin, Deloraine, Grandview, Hamiota, Killarney, McCreary,

Neepawa, Rivers, Roblin, Russell, Shoal Lake, Ste. Rose, Swan River, Virden, and Winnipegosis.

There are six locations in Brandon: Regional Health Centre, Regional Admin (Town Centre, former

Brandon), Mental Health (Town Centre, former ARHA), Home Care (Town Centre, former Brandon),

Western Manitoba Cancer Centre, and Child & Adolescent Treatment Centre. Work is progressing in

2013/14 to add two more sites: Souris and Carberry.

Telehealth utilization continues to rise each year in Manitoba. MBTelehealth usage for Prairie Mountain

Health has increased from the 2011/2012 fiscal year by 4.6%. Five Prairie Mountain Health sites are in the

MBTelehealth top ten most utilized rural sites: Dauphin Regional Health Centre, Swan Valley Health

Centre, Brandon Regional Health Centre, Ste. Rose General Hospital, and Roblin District Health Centre.

In Manitoba, and in Prairie Mountain Health, Oncology is the most used specialty service, followed by

Psychiatry.

---Establish integrated delivery of core health services;Establish integrated delivery of core health services;Establish integrated delivery of core health services; ---Introduce and utilize technologies and information systems that Introduce and utilize technologies and information systems that Introduce and utilize technologies and information systems that support sustainability.support sustainability.support sustainability. ---Manage and maintain PMH infrastructure to meet future needs;Manage and maintain PMH infrastructure to meet future needs;Manage and maintain PMH infrastructure to meet future needs; ---Strategically invest in futureStrategically invest in futureStrategically invest in future---oriented capital projects that meet needs oriented capital projects that meet needs oriented capital projects that meet needs and supports health system sustainability.and supports health system sustainability.and supports health system sustainability.

272727 Sites that went live with EChart Sites that went live with EChart Sites that went live with EChart

Manitoba in 2012/2013.Manitoba in 2012/2013.Manitoba in 2012/2013.

171717 Current number of communitiesCurrent number of communitiesCurrent number of communities

within Prairie Mountain Health within Prairie Mountain Health within Prairie Mountain Health offering Telehealth program.offering Telehealth program.offering Telehealth program.

Teams continue to review their activities and create better integration across the

new region. Much of the year was spent reviewing existing programs and

services while considering the most effective, efficient ways to integrate care and

service delivery. With the considerable number of facilities within Prairie

Mountain Health, a comprehensive Capital Plan is under development.

The Region, in collaboration with Manitoba Health, continues to move forward

on a number of capital projects that are at various stages of development.

Some key projects include:

Ste. Rose Primary Health Care Centre proposal;

Swan River Primary Care Clinic development;

Dauphin Regional Health Centre ER/SCU redevelopment;

Brandon Regional Health Centre redevelopment; and

Murray House completion (Brandon).

EChart Manitoba, the provincial electronic health record system, continued to

roll-out within Prairie Mountain Health. In 2012/2013, 27 sites went live with

the EChart system within the health region. EChart Manitoba is a secure

electronic system that allows authorized health care providers to access patient

information when needed.

Utilization Data: (Source: Utilization Statistics April 1, 2012 – March 31, 2013 –

MB Telehealth Management Report, Quality Analyst.)

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Improved AccessImproved AccessImproved Access

Prairie Mountain Health continues to work toward addressing diagnostic imaging wait times for MRIs,

Ultrasounds and CT scans across the region with the goal of attaining provincial targets for these services.

For median (average) wait times for hip and knee surgeries, the Region saw a 43 per cent decrease (44 weeks to

25) from March 2012 to March 2013. In relation to cataract surgery median wait times, the region saw a 54 per

cent decrease (13 weeks to 6) during the same time period. For more information on provincial wait times, log on

to www.gov.mb.ca/health/waittime.

A new Cataract Surgery Program, at Swan Valley Health Centre in Swan River, commenced April 16, 2012.

A surgeon from Winnipeg, along with anesthetists from Dauphin, help fill the cataract surgery slate. It was

anticipated that up to 200 surgeries were to be completed annually. The RHA thanked Swan Valley Lions Clubs,

and the Swan Valley Health Facilities Foundation, for their contributions to the new program.

The Southern Air Ambulance Inter-facility Transfer (IFT) Program resumed operations in November 2012.

In the PMH region, the communities that this air ambulance can respond to include: Dauphin, Deloraine,

Erickson, Killarney, Melita, Neepawa, Roblin, Russell, Shoal Lake, Souris, Swan River and Virden.

According to the Canadian Community Health Survey (CCHS) 2009, the following percentages of residents

in the former tri-region areas reported they have a regular family doctor:

Assiniboine RHA 82.4%

Brandon RHA 86%

Parkland RHA 89.4%

(Note: The CCHS does not include residents of First Nation communities.)

FEATURE: Doctor for AllFEATURE: Doctor for AllFEATURE: Doctor for All The „Doctor for All‟ initiative is a provincial strategy that aims to increase access to quality primary care in

Manitoba. Manitoba Health has committed to ensuring that all Manitobans who would like access to a family

physician and a primary health care team, will have that access by 2015. A Steering Committee for the Doctor

for All initiative in PMH has been established.

Prairie Mountain Health has a combined total of 170 family physicians and there are currently 12 nurse

practitioners who provide service within the region.

Through the provincial Doctor for All initiative, we are working toward connecting people with a primary health

care provider. Because access to primary care is a priority in Prairie Mountain Health, a Mobile Primary Care

initiative is underway to bring primary care to residents of remote communities. Planning in partnership with

communities, the “Primary Care Bus” will offer a variety of health care services mainly in the northern half of

Prairie Mountain Health.

121212 PMH communities served by PMH communities served by PMH communities served by

Southern Air Ambulance Southern Air Ambulance Southern Air Ambulance InterInterInter---facility Transfer program.facility Transfer program.facility Transfer program.

170 170 170 Approximate number of family Approximate number of family Approximate number of family

physicians working in PMHphysicians working in PMHphysicians working in PMH

12 12 12 Nurse Practitioners providing Nurse Practitioners providing Nurse Practitioners providing

service within PMH in 2012/2013.service within PMH in 2012/2013.service within PMH in 2012/2013.

---Improve access to services by reducing barriers;Improve access to services by reducing barriers;Improve access to services by reducing barriers; ---Provide right care, in the right place, at the right time by the right provider;Provide right care, in the right place, at the right time by the right provider;Provide right care, in the right place, at the right time by the right provider; ---Engage clients and communities so they experience improved access to appropriate services.Engage clients and communities so they experience improved access to appropriate services.Engage clients and communities so they experience improved access to appropriate services.

12

Improved Service DeliveryImproved Service DeliveryImproved Service Delivery

Staff of Prairie Mountain Health are working with groups to improve services for Aboriginal people. The members of a Health

Services Integration Fund project, including the West Region Tribal Council, have developed plans that will contribute to better care

for residents of these communities.

During the last year, staff from Prairie Mountain Health have been involved in activities such as the Annual Diabetes Gathering

and offering Diabetes and Heart Health program services in several First Nation communities. Efforts have been made to improve

discharge planning to assist First Nation residents with the transition from hospital to community.

Future plans include expanding cultural awareness training for staff, continued development of the Aboriginal Workforce

initiative and enhancing partnerships with communities.

Prairie Mountain Health participated in a series of consultations with community stakeholders to obtain direction about the formation of Local

Health Involvement Groups (LHIGs). Community members were invited to attend these meetings to provide their thoughts about the best ways

for health authorities to connect with the public about their programs and services.

Regional staff are working on developing a Client Relations Program that will receive suggestions and compliments and work with clients

to address their concerns.

A regional Patient Safety Education Program (PSEP) is under development to train staff to implement quality improvement and

patient safety initiatives in their own practice environments. These initiatives will help staff to provide safer, more effective care.

A strategy to deliver PSEP training to staff will be implemented in the coming year.

FEATURE: Cancer Patient Journey FEATURE: Cancer Patient Journey FEATURE: Cancer Patient Journey The Cancer Patient Journey strategy has been working towards earlier cancer detection, as well as swift diagnosis and treatment.

The Surgical Program in Brandon is participating in the Cancer Patient Journey Initiative. The first cancer grouping in the Cancer Patient

Journey Initiative is breast cancer. In Brandon, the improvement project looked at the wait time from when the patient agreed to surgery to the

date that the patient had their surgery. On average, this wait time (from consent to surgery) was taking 23 days. With improvements in this pro-

cess, the Brandon team was able to reduce this wait time by four days.

In Prairie Mountain Health, there are three patient navigators, whose role it is to help patients navigate the Cancer system and ensure they receive the appropriate care in a timely

manner. Based in Swan River, Deloraine and Brandon, the patient navigators were hired on a part time basis, but all positions have become full time since December of 2012. They have

been working closely with CancerCare Manitoba and the Cancer Patient Journey Initiative to develop resources and tools that will help to standardize practice across the province and

increase awareness of their services for the public and health care providers. In partnership with CancerCare Manitoba and other navigators, they are examining navigation services for the

province of Manitoba.

All of this work is being done to achieve the Cancer Patient Journey Initiative‟s goal of reducing the time from suspicion of cancer until starting the first treatment to 60 days.

Ultimately, this will lead to increased access and more timely access to services.

666 Number of initial Local Health Number of initial Local Health Number of initial Local Health

Involvement Group consultation Involvement Group consultation Involvement Group consultation meetings held within Prairie meetings held within Prairie meetings held within Prairie Mountain Health.Mountain Health.Mountain Health.

333 Cancer Care Patient Navigators Cancer Care Patient Navigators Cancer Care Patient Navigators

within the health region.within the health region.within the health region.

---Establish partnerships to improve health service delivery to First Nation and Metis Manitobans;Establish partnerships to improve health service delivery to First Nation and Metis Manitobans;Establish partnerships to improve health service delivery to First Nation and Metis Manitobans; ---Continuously improve health care safety;Continuously improve health care safety;Continuously improve health care safety; ---Create a culture of clientCreate a culture of clientCreate a culture of client---focused care and service delivery.focused care and service delivery.focused care and service delivery.

13

Improved Health Status & Improved Health Status & Improved Health Status &

Reduced Health DisparitiesReduced Health DisparitiesReduced Health Disparities

Many teams are working on implementing provincial strategies to improve health. Although there are disparities in health

status across Prairie Mountain Health, teams will identify the best approaches to reach those who are at highest risk.

The provincial Continuing Care Strategy focuses on building capacity to support individuals to remain living in the

community through a broad range of community based services and innovative approaches to promote health. It will also

focus on ensuring there are enough long term care beds (e.g. Personal Care Homes, Supportive Housing) to meet the needs

of Manitobans and to improve health outcomes for residents of personal care homes.

Strategies being considered may include enhancements to the Home Care program, further implementation of technology in both Home Care and Personal Care Homes, exploring

community-based housing as alternatives to personal care homes, strengthening and promoting co-operation among health care partners to keep people at home, and developing new and

innovative ways of delivering service that will promote positive health outcomes. To date, a provincial Implementation Advisory Committee led by Manitoba Health has been established

with representation from each region to begin the work of further developing the implementation plan associated with this strategy. Some planning and activities already underway that

relate to this initiative include the planning for technology in Personal Care Homes and Home Care; and, the quick Response Home Care Service in Brandon that will help support after

hours access to Home Care.

Brandon Friendship Centre, and several other key stakeholders including Prairie Mountain Health, partnered to host an Aboriginal Mental Health and Wellness National Conference in

Brandon in October 2012. The “Creating a New Legacy” conference promoted awareness and knowledge of healing initiatives that aim to mitigate the emotional impact, and mental

health problems, that are associated with the legacy of the residential school system.

The RHA‟s Emergency Medical Services Program was actively involved over the past year in several Injury Prevention presentations. Some of those included:

Use of the ERIK program (Emergency Response Information Kit);

Hidden Hugs;

Car Seat Inspections;

The PARTY (Preventing Alcohol Related Trauma in Youth Program; and

Farm Safety Day camps.

FEATURE: Continuing Care StrategyFEATURE: Continuing Care StrategyFEATURE: Continuing Care Strategy––– Innovative RehabilitationInnovative RehabilitationInnovative Rehabilitation One initiative that will promote independence and work toward preventing premature admission to a personal care home is the Innovative

Rehabilitation Pilot Project in Prairie Mountain Health. The overall goals of the pilot program are to promote client strength, well-being, and safety

in the home environment by providing a rehabilitation or exercise plan of care. By providing these services in the home environment with trained

therapy staff, the program is designed to help people go home from hospital sooner, prevent readmission to hospital, and help people to remain in

their homes longer. The Innovative Rehabilitation Projects are to be conducted in Brandon Dauphin, Virden, Melita, Ste. Rose, McCreary and

Grandview.

---Improve population health through health promotion, disease prevention, Improve population health through health promotion, disease prevention, Improve population health through health promotion, disease prevention, health protection and a focus on the role of the determinants of health.health protection and a focus on the role of the determinants of health.health protection and a focus on the role of the determinants of health.

7 7 7 Number of Innovative Number of Innovative Number of Innovative

Rehabilitation Pilot Projects Rehabilitation Pilot Projects Rehabilitation Pilot Projects

that will be conducted in that will be conducted in that will be conducted in

PMH.PMH.PMH.

44 44 44 Personal Care Homes Personal Care Homes Personal Care Homes

within PMH.within PMH.within PMH.

14

Consolidated Statement of Financial PositionConsolidated Statement of Financial PositionConsolidated Statement of Financial Position

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27,6

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4,4

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301,7

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***Presented in landscape format for an easier read and to allow totals to be more Presented in landscape format for an easier read and to allow totals to be more Presented in landscape format for an easier read and to allow totals to be more easily reflected.easily reflected.easily reflected.

15

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21

Consolidated Statement of OperationsConsolidated Statement of OperationsConsolidated Statement of Operations

*Presented in landscape format for an easier read and to allow totals to be more *Presented in landscape format for an easier read and to allow totals to be more *Presented in landscape format for an easier read and to allow totals to be more easily reflected.easily reflected.easily reflected.

16

A complete set of financial statements, the auditor’s report and the statement of public sector

disclosure (related to Section 2 of the Public Sector Compensation Disclosure Act) is available

by contacting Prairie Mountain Health at (204) 483-5000 or 1-888-682-2253.

To the Members of Prairie Mountain Health:

The accompanying summary financial statements of Prairie Mountain Health,

which comprise the summary consolidated statement of financial position as at

March 31, 2013 and the summary consolidated statement of operations, changes in

net assets, cash flows and remeasurement of gains and losses for the year then

ended are derived from the audited consolidated financial statements of Prairie

Mountain Health for the year ending March 31, 2013. We expressed an

unmodified audit opinion on those financial statements in our report dated

June 19, 2013.

The summary consolidated financial statements do not contain all the disclosures

required by Canadian public sector accounting standards. Reading the summary

consolidated financial statements, therefore, is not a substitute for reading the

audited consolidated financial statements of Prairie Mountain Health.

Management’s Responsibility for the Summary Consolidated

Financial Statements

Management is responsible for the preparation and fair presentation of these

summary consolidated financial statements in accordance with Canadian public

sector accounting standards.

Auditors’ Responsibility

Our responsibility is to express an opinion on these summary consolidated

financial statements based on our procedures, which were conducted in accordance

with Canadian Auditing Standard (CAS) 810, “Engagements to Report on

Summary Financial Statements.” Opinion

In our opinion, these summary consolidated financial statements derived from the

audited consolidated financial statements of Prairie Mountain Health for the year

ended March 31, 2013 are a fair summary of those consolidated financial

statements.

M N P, LLP

Chartered Accountants

Brandon, Manitoba

June 19, 2013

1401 Princess Avenue, Brandon, Manitoba, R7A 7L7,

Phone: (204) 727-0661, 1-800-446-0890

42.7%

23.5%

0.5%

6.3%

3.9%

0.2%

6.3%

0.8% 4.2%

0.30%2.7% 3.9%

3.7%

0.002%1.0%

Acute Care

Personal care home service

Therapy Services

Medical remuneration

Community-based mental health services

Sick Leave benefits

Community-based home care services

Ancillary expenses

Community-based health services

Community-based services administration

Emergency Medical Services

Regional undistributed costs

Amortization of capital assets

Interest on long-term debt

Pre-retirement benefits

Expenditure by Program/Service 2012/2013

Auditor’s Report Expenditure

Breakdown

17

Prairie Mountain Health adheres to standardized coding guidelines (MIS) as defined by the

Canadian Institute of Health Information (CIHI).

Administrative costs include corporate operations (including hospitals, non-proprietary

personal care homes and community health agencies), as well as patient care-related functions

such as infection control and patient relations and recruitment of health professionals.

The figures presented are based on data as at 2012/13. The most current definition of

administrative costs determined by CIHI includes:

Administrative CostsAdministrative CostsAdministrative Costs

Category of Administrative Expense All primary cost centres include costs related to salaries,

benefits, travel, telecommunications, insurance, audit &

other fees, office supplies and other supplies and expenses.

Percentage

of Total

2012/13

Expenses

Percentage

of Total

2011/12

Expenses

Corporate: Includes the primary cost centres of General

Administration, Executive, Board of Directors, Public

Relations, Planning, Risk Management, Advisory Councils,

Community Health Assessment, Finance and

Communications.

3.16 3.35

Patient Care Related: Includes the primary cost centres of Quality Assurance

and Accreditation.

.27 .27

Human Resources and Recruitment: Includes the primary cost centres of Human Resources,

Recruitment & Retention, Labor Relations, Employee

Benefits, Health & Assistance Programs and Occupational

Health & Safety Prevention.

1.08 1.07

Total 4.51 4.69

Guideline: Administrative Cost Definitions

Corporate operations: General administration (executive offices, board of directions, medical directors, administrators of acute, long-term and community care, public relations, planning and development, community health assessment, risk management, internal audit), finance (general accounting, accounts receivable, accounts payable and budget control) and communications (telecommunications and mail service). Patient care-related functions: Infection control, patient relations, quality assurance, accreditation, cancer standards and guidelines, bed utilization management, privacy office and visitor information. Human resource and recruitment related functions: Recruitment and retention, labour relations, personnel records, employee benefits, health & assistance programs, occupational health & safety, and payroll.

70%

6%

24%

Administrative Costs 2012/13

Corporate Patient Care Related Human Resources & Recruitment

18

Recent amendments to The Regional Health Authorities Act include provisions related to improved

accountability and transparency and to improved fiscal responsibility and community

involvement. Amendments include:

As per Sections 22 and 51, the establishment by the Minister of terms and conditions of

employment (compensation, etc.) to be included in the employment contract of the chief executive

officer and designated senior officers of a regional health authority.

Employment contracts have been established for the CEO and all Senior Leaders of the

organization. These contracts contain all terms and conditions of employment as set out by the

Minister.

As per Section 23 (2c), the preparation, implementation, posting on the website and updating of the

regional health authority‟s strategic plan.

Prairie Mountain Health‟s Strategic Plan was updated and completed in May 2013 and was

posted on the website.

As per Sections 23.1 and 54, the establishment by the Minister of requirements relating to accreditation of a regional health authority and the accreditation/participation in RHA accreditation

of health corporations and certain health care organizations and publishing of the results.

Prairie Mountain Health has been continuing efforts related to Accreditation and regular updates have been submitted to Accreditation Canada.

Results of recent Accreditation Canada surveys can be found on the region‟s website.

As per Sections 51.4 and 51.5, the establishment of restrictions on regional health authorities rehiring of the chief executive officer and designated senior officers within one year of

termination of employment without prior Ministerial approval, and, in the of case of health corporations, the chief executive officer or equivalent (executive director, COO, etc.) without

RHA approval.

The Board of Directors of Prairie Mountain Health have developed policies related to rehiring of CEO/Senior officers which includes consultation with the Minister‟s office.

Manitoba Health requires that the health authorities report on steps taken and plans to meet the requirements under this Act.

Accountability ProvisionsAccountability ProvisionsAccountability Provisions

19

20

The Public Interest Disclosure (Whistleblower Protection) Act came into effect April 2007. This law gives em-

ployees a clear process for disclosing concerns about significant and serious matters (wrongdoings) in the Mani-

toba public service, and strengthens protection from reprisal. The Act builds on protections already in place un-

der other statutes, as well as collective bargaining rights, policies, practices and processes in the Manitoba public

service. In 2012/2013, Prairie Mountain Health did not receive any disclosures under the legislation, therefore,

no investigations commenced as a result.

Public Interest DisclosurePublic Interest DisclosurePublic Interest Disclosure

French Language ServicesFrench Language ServicesFrench Language Services

Contact Information

Mailing address: Phone: (204) 483-5000

192-1st Avenue West Toll-Free: 1-888-682-2253

Box 579 Fax: (204) 483-5005

Souris, MB. R0K 2C0

Email: pmh@pmh-mb.ca Website: www.prairiemountainhealth.ca

Although Prairie Mountain Health serves a mainly English-speaking population, it maintains bilingual

designation. The following areas within Prairie Mountain Health are designated to receive French Language

Services:

Rural Municipality of Ellice and the Village of St. Lazare;

Ste. Rose du Lac, surrounding municipality of Ste. Rose, Laurier and Ste. Amelie.

The following facilities are designated to provide French Language Services:

Birtle Health Centre;

Ste. Rose General Hospital;

Dr. Gendreau Personal Care Home (Ste. Rose).

Prairie Mountain Health undertakes to provide health care services to its French-speaking population in accord-

ance with the Government of Manitoba‟s French Language Services Policy, Regulation 46/98 of the Regional

Health Authorities Act (C.C.S.M. c R34). The French Language Services (FLS) plans for Prairie Mountain

Health can be accessed by contacting the Regional Office at 1-888-682-2253.

Health and Wellness For All