DocHdl1OnPTR1tmpTarget - RGPsrgps.on.ca/PDFfiles/2011AnnualReport.pdf · as guiding blueprints. 2....

2011AnnuAl RepoRt

(November 4, 2011 / 10:50:44)

74286-1_RGP Annual Report_p01.pdf .1

ContentsJoint Message from the Executive Director and Board Chair . . . . . . 1

RGP Network: Adding Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

RGP’s Strategic Plan: 2010-2015 . . . . . . . . . . . . . . . . . . . . . . . . . 5

Growing health human resources in specialized geriatric services . . 7

RGP Network Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

New Patients Seen in Specialized Geriatric Services 2010-2011 . . . 8

Auditors’ Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Members of the Board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

RGP Participating Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Vision Better health outcomes for frail seniors .

Mission We support health care providers in the delivery of interprofessional, senior-friendly, and evidence-based care that optimizes the function and independence of seniors and supports aging in place .

This is achieved through:

Service We support a network of health care providers caring for frail seniors .

Education We build our community’s capacity to care for frail seniors through knowledge exchange .

Research We contribute to evaluation and research on best practices for senior friendly care .

Advocacy We advocate for policy development and practice changes that will improve healthcare for frail seniors .

(November 4, 2011 / 10:50:47)


RGP Toronto Annual Report 2011 | 1

The Regional Geriatric Program (RGP) of Toronto, along with our partners at the RGPs of Ontario, endorsed a Senior Friendly Hospitals (SFH) Framework as a blue print for organizational change that supports better care and outcomes for hospi-talized seniors. In our 2009 annual report, we wrote about the SFH framework and our sense of a new readiness among organizations to ad-dress the challenge to become more senior friendly. Last year, the LHIN-led Ontario Senior Friendly Hospital Strategy called upon the RGP to pro-vide clinical expertise and guidance to the provincial initiative. We have enthusiastically accepted this call to action, leveraging the principles of our Senior Friendly Hospitals Frame-work with the accountability and system-wide directives the LHIN has the authority to apply.

While much of the attention on seniors’ health care needs has been and should be focused on enhanc-ing community services, hospitals should not overlook their responsi-bility to provide the right care when the hospital is, in fact, the right place for that care. Much of the functional decline that seniors experience dur-ing a hospital stay can be prevented. To alter that trajectory of decline, se-niors require what is often low “tech” but high quality of care. In some instances, this means employing new evidence-informed processes into practice; in other areas it means rediscovering old ways of simply

providing good care. SFH is a win-win for patients, staff, hospitals and the system. As the provincial strate-gy continues to gain momentum, we are encouraged that new voices in hospital senior leadership teams and front-line clinicians alike can now be heard as part of the conversation on senior friendly care.

In geriatric care, the nature of our patients’ needs requires intervention and support from multiple sources. The multiple domains of the Senior Friendly Hospitals Framework bring this concept to light for hospitals. Teamwork is at the heart of caring for frail older people. Supporting this through the dissemination of best practices, relationship building and serving as a catalyst for collabora-tion, we continue to demonstrate the added value of the RGP of Toronto network.

This year marks the end of Lorne Zon’s term as Chair of the RGP of To-ronto’s Board of Directors. Lorne has a long history of involvement with the RGP, serving as a member of the Board for 11 years and as Chair for the past three years. Even before the RGP in-corporated and established its Board of Directors in 1993, Lorne was actively involved with the RGP’s Management Council. Lorne has been part of the pioneering work that established the RGP, set it on its course and helped to establish many of its innovative and measured strategic priorities.

The RGP has benefited from Lorne’s breadth of experience with the health care system, ranging from the Ministry, the Toronto District Health Council, hospitals and mental health sector. As Chair, he led the Board with a practical wisdom and has consistently provided the RGP Central Office with valuable advice and direction. We are grateful for his willingness to proliferate the good works of the RGP and his unwaver-ing dedication to supporting our mis-sion and shared vision: better health outcomes for frail seniors.

Joint Message from the Executive Director and Board Chair

Barbara LiuExecutive Director

Lorne ZonBoard Chair

(November 7, 2011 / 14:25:21)

74286-1_RGP Annual Report_p03rev.pdf .1


(November 4, 2011 / 10:50:50)



Background As Ontario’s population ages, and hospitals across the province face an increase in older patients requiring acute care, the Regional Geriatric Program of Toronto continues to work towards better health outcomes for frail seniors.

Safely managing the care of seniors while in the hospital and facilitating their discharge back to the community are essential elements of care for seniors. Maintaining optimal health and function while seniors are hospitalized is an important component of integrated health services focused on preventing functional decline during acute care, reducing emergency department wait times, the need for alternate levels of care (ALC) and achieving the quality goals of the Excellent Care for All Act. This is the promise of the Senior Friendly Hospitals (SFH) Framework.

The SFH Framework The SFH Framework, endorsed by the Regional Geriatric Programs of Ontario, offers both an evidence-informed and organization-wide approach for the care of older patients. The framework contains five interrelated domains:1. organizational support, 2. process of care, 3. emotional and behavioural

environment, 4. ethics in clinical care and

research, and 5. physical environment.

Adopting SFH practices assists in the prevention of physical, functional and cognitive decline of seniors during hospitalization; decreases hospital length of stay and rates of institutionalization; and the improvement of patient and family satisfaction with hospital services.

The SFH Self-Assessment Process To assist the Toronto Central LHIN in achieving the goals of their Integrated Health Service Plan 2010-2013 priorities for seniors in acute care, the RGP of Toronto prepared a SFH Background Document and a Self-assessment Template. These materials were distributed regionally by the Toronto Central LHIN to hospitals in its catchment area, and completed assessments were returned to the RGP. Based on the findings, the RGP prepared a report entitled “A Summary of Senior Friendly Care in Toronto Central LHIN Hospitals”. This report provides a portrait of SFH care across the LHIN, including strengths and promising practices for both organization and system-level improvements.

Provincial Implementation The RGP of Toronto continues to coordinate the Toronto Central LHIN-led self-assessment process, which has been adapted for the remaining 13 LHINs across the province. With additional support from the Regional Geriatric Programs of Ontario, SFH self-assessments were completed and summary reports were prepared, describing the state of senior friendly hospital care throughout the province. The summary reports will help all hospitals in Ontario achieve their wait time, length of stay, alternate level of care and transition goals in a manner that aligns with improved quality of care and safety for seniors. A set of provincial indicators will be available in January 2012 with the goal of province-wide implementation of SFH strategies in April 2012. The scope and depth of the Senior Friendly Hospital strategy, and the subsequent provincial reporting that it prompted, makes this initiative the first of its kind in Ontario.

Senior Friendly Hospitals – A Provincial Commitment

(November 4, 2011 / 10:50:55)



(November 4, 2011 / 10:50:56)



Earlier this year, the RGP presented a five-year strategic plan to its Board of Directors. In alignment with the RGP vision and mission statement, the plan outlines three strategic priorities and associated activities (see below) that capitalize on successes to date in meeting our standing commitments.

The strategic priorities and corresponding activities are:

RGP’s Strategic Plan: 2010-2015

1. Advancing senior Friendly Hospital Care

Continue to support the LHINs, our RGP network member organizations, and other external organizations in becoming senior friendly; supporting implementation of the SFH Framework endorsed by the RGPs of Ontario and usage of both the SFH Background Document and the results of the provincial survey as guiding blueprints.

2. specialized Geriatric services (sGs) Renewal and Quality improvement

Support the delivery of SGS through inter-professional teams is the core business of the RGP. Our models of SGS delivery are based on best evidence, however, contextual changes in the system, along with the evolving profile of patients served by SGS teams, demand a reexamination of how SGS is best delivered and the role that it should play in the healthcare continuum. We will provide strategic direction to SGS renewal and quality improvement initiatives among our network organizations.

3. serving as a leading Authority on Frailty and service Development for seniors

Collaborate and build relationships to support the RGP’s commitment to the healthcare needs of frail seniors and build upon the broad scope of existing capacity and knowledge translation that position the RGP to serve as a leading authority on frailty. As a network of providers, the RGP is able to bring a system perspective to service planning and development, leveraging both social and intellectual capital embedded within the network, further enhanced by longstanding academic linkages.

Vision Better Health Outcomes for Frail Seniors

Mission We support health care providers in the delivery of interdisciplinary, senior-friendly, and evidence-based care that optimizes the function and independence of seniors and supports aging in place. This is achieved through: seRViCe, eDuCAtion, ReseARCH, ADVoCACY

strategic Directions Knowledge Transfer Advocacy for Frail Seniors Demonstration of Effectiveness and Accountability

by

priorities 1. Advancing Senior Friendly Hospital (SFH) care

2. SGS renewal and quality improvement

3. Serving as a leading authority on frailty and service development for seniors

outcomes Enhanced senior friendly capacity across the LHINs, the RGP Network and other interested organizations

Service improvement and alignment with current evidence on best practices. Better understanding of role among stakeholders and partners

Increased recognition of the RGP as a leading authority

Free of institutional biases and disease-specific objectives, our activities are driven by system goals and patient-centred care. We are committed to supporting our network and the LHINs to achieve better outcomes for frail seniors.

(November 4, 2011 / 10:50:59)



(November 4, 2011 / 10:51:00)



Over the last decade, specialized geriatric services faced unprecedented challenges in recruiting, and retaining, health human resources with the skills and experience to provide specialized geriatric services to frail seniors. Despite the demographic imperative and the high level of job satisfaction reported in the literature, geriatric medicine in particular experienced a reduction of students enrolled in training programs. The RGP recognized this as an opportunity and therefore focused attention on training in-place clinicians as well as building capacity throughout the various programs and initiatives with which the RGP is involved. For example, the Geriatrics, Inter-professional, and Inter-organizational Collaboration (GiiC) initiative focuses on Family Health Teams, Community Health Centres and Community Service Agencies; the initiative also serves as a platform for a series of continuing education opportunities that support Geriatric Emergency Management (GEM) nurses and Geriatric Outreach Teams. In the last year, an opportunity to contribute to the University of Toronto’s subspecialty program in geriatrics arose and the RGP’s Executive Director accepted the role of Program Director in Canada’s largest geriatric medicine training program.

Fortunately, we have seen a resurgence of interest in geriatric medicine. The Toronto program is now operating with a full complement of trainees for three consecutive years and continues to attract high calibre graduate students. These residents have completed three years of internal medicine residency, are committed to two more years of subspecialty training in geriatric medicine and often enhance their educational experience with certificates in patient safety and quality, master teacher program or masters degrees in related fields. Last year, three of the University of Toronto residents were recognized with prestigious national awards from the Canadian Geriatric Society and the Canadian Conference on Dementia.

This improvement in the health human resources pipeline provides a foundation upon which to build a renewal of specialized geriatric services. SGS renewal is highlighted as a strategic direction within the RGP Strategic Plan 2010-2015 bringing evidence into practice whilst ensuring that our services remain robust and relevant within the continuum of an integrated health care system.

Opposite page photos

• 7th Annual Geriatric Emergency Management Conference

• UofT post-graduate Geriatric Medicine residents

• Geriatrics, Interprofessional and Interorganization Collaboration Conference

Growing health human resources in specialized geriatric services

(November 7, 2011 / 14:25:29)



15%

16%

10%24%

3%32% Outreach Teams* (10)

Clinics* (5)

Geriatric Inpatient Units** (14)

Internal Consultation Teams* (8)

Day Hospitals (7)

GEM (9)

* Geriatric and Psychogeriatric

** Acute Geriatric Units (AGU); Geriatric Rehabilitation Units (GRU); Geriatric Assessment & Treatment Units (GATU)

New Patients Seen in Specialized Geriatric Services 2010-2011

RGP Network ActivityThe following is based on the activity in specialized geriatric services provided by 19 participating organizations in the RGP Network.

Î Almost 3,400 new patients seen by the Outreach Teams (Geriatric and Psychogeriatric)

Î Almost 10,000 home visits by the Outreach Teams (Geriatric and Psychogeriatric)

Î Over 5,600 patients seen by the Internal Consultation Teams (Geriatric and Psychogeriatric)

Î Almost 21,000 visits to Geriatric Outpatient Clinics (Geriatric and Psychogeriatric)

Î Almost 4,000 new patients seen in the Geriatric Outpatient Clinics (Geriatric and Psychogeriatric)

Î Over 7,400 patients assessed by Geriatric Emergency Management (GEM) nurses

Î Over 2,200 admissions to Geriatric Inpatient Units (AGU, GRU, & GATU)

Î Over 10,800 visits to Geriatric Day Hospital

(November 7, 2011 / 14:25:24)



Lorne Zon, ChairCarolyn BakerJane BarrattMarla FryersHeather GilleyKaren GoldenbergLynne Lawrie

Anne-Marie MalekMargaret MottersheadRoss UpshurSue VanDeVelde-CokeMarlene Awad (staff)Barbara Liu (non-voting)

Members of the Board

RGP Participating Organizations

BaycrestBridgepoint HealthHumber River Regional HospitalLakeridge Health CorporationMarkham Stouffville HospitalMount Sinai HospitalNorth York General HospitalOntario Shores Centre for

Mental Health SciencesOrillia Soldiers’ Memorial HospitalPeterborough Regional Health CentreProvidence HealthcareRouge Valley Health System Royal Victoria HospitalSouthlake Regional Health CentreSt. John’s Rehabilitation Hospital

St. Joseph’s Health CentreSt. Michael’s HospitalSunnybrook Health Sciences CentreThe Credit Valley HospitalThe Salvation Army Toronto Grace

Health CentreThe Scarborough HospitalToronto East General HospitalToronto Rehabilitation InstituteTrillium Health Centre University Health NetworkWest Park Healthcare CentreWilliam Osler Health Centre Women’s College HospitalYork Central Hospital

(November 4, 2011 / 10:51:08)


RGP Administrative Head Office:Sunnybrook Health Sciences Centre2075 Bayview Avenue, H478Toronto, ON M4N 3M5Tel: 416.480.6026 Fax: 416.480.6068Email: [email protected]: www.rgp.toronto.on.ca

(November 4, 2011 / 10:51:09)


The senior friendly hospital framework provides a common pathway to engineer positive change in support of evidence-based approaches that promote safety and quality care for frail seniors. It emphasizes the unique issues of older patients’ medical, social and ethical needs within a physical environment that is supportive of their functional abilities. As well, by identifying organizational support as a key domain, the framework recognizes that the success of any senior friendly endeavour is dependent on a thoughtful and informed commitment across the entire organization, from the top levels of leadership to the front-line care providers.

(November 4, 2011 / 12:03:56)

74286-1_RGP Annual Report Fold_p01.pdf .1


The summary financial statements do not contain all the disclosures re-quired by Canadian generally accept-ed accounting principles. Reading the summary financial statements, therefore, is not a substitute for read-ing the audited financial statements of Regional Geriatric Program of Metropolitan Toronto.

Management’s Responsibility Management is responsible for the preparation of a summary of the audited financial statements.

Auditor’s Responsibility Our responsibility is to express an opinion on the summary 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, the summary financial statements derived from the audited financial statements of Regional Geriatric Program of Metro-politan Toronto for the year ended March 31, 2011 are a fair summary of those financial statements.

capital and operating fund special purpose fund total

2011 2010 2011 2010 2011 2010

$ $ $ $ $ $

STATemenT of finAnciAl PoSiTion

Total current assets 2,141,840 1,804,419 1,470,786 1,315, 850 3,612,626 3,120,269

Capital assets 6,881 10,388 - 521 6,881 10,909

Total assets 2,148,721 1,814,807 1,470,786 1,316,371 3,619,507 3,131,178

Total current liabilities 2,109,240 1,770,019 591,799 346,071 2,701,039 2,116,090

Total long-term liabilities and deferred amounts 39,481 44,788 878,987 970,300 918,468 1,015,088

Total liabilities and deferred amounts 2,148,721 1,814,807 1,470,786 1,316,371 3,619,507 3,131,178

STATemenT of oPeRATionS

Revenue:

Operating grant 10,205,897 10,063,896 - - 10,205,897 10,063,896

Investment income 13,161 8,240 676 1,567 13,837 9,807

Other revenue 126,704 110,460 160,570 99,785 287,274 210,245

Amortization of deferred capital grants 3,507 5,236 521 1,044 4,028 6,280

Amortization of special purpose funds - - 2,318,305 1,831,531 2,318,305 1,831,531

Total revenue 10,349,269 10,187,832 2,480,072 1,933,927 12,829,341 12,121,759

Total expenses 10,349,269 10,187,832 2,480,072 1,933,927 12,829,341 12,121,759

Excess of revenue over expenses for the year - - - - - -

independent Auditor’s Report

Chartered Accountants, Licensed Public Accountants Toronto, Ontario, September 15, 2011

To the Members of the Regional Geriatric Program of Metropolitan Toronto:

The accompanying summary finan-cial statements, which comprise the summary statement of financial posi-tion as at March 31, 2011 and the summary statement of operations for the year then ended are derived from the audited financial statements of Regional Geriatric Program of Metro-politan Toronto for the year ended March 31, 2011. We expressed an unmodified audit opinion on those financial statements in our report dated September 15, 2011.

(November 7, 2011 / 14:28:31)

74286-1_RGP Annual Report Fold_p02rev.pdf .1

DocHdl1OnPTR1tmpTarget - RGPsrgps.on.ca/PDFfiles/2011AnnualReport.pdf · as guiding blueprints. 2....

Documents

Transcript of DocHdl1OnPTR1tmpTarget - RGPsrgps.on.ca/PDFfiles/2011AnnualReport.pdf · as guiding blueprints. 2....