Deputy premier visits UHN, Epic upgrade, and more

​Good morning, TeamUHN!

It is a pleasure to connect with you across care, research, and education through this weekly CEO update – all in service of A Healthier World.

Key reminders and updates

• Last Thursday, we hosted Deputy Premier and Health Minister Sylvia Jones at Toronto General Hospital, where she announced $10 million in funding for maintenance projects at UHN. Through its Hospital Infrastructure Renewal Fund (HIRF), the Ontario government is investing more than $182 million this year to support critical upgrades, repairs, and maintenance in 131 hospitals and 65 community health service providers across the province. I was pleased to meet with Minister Jones before the announcement to discuss the current challenges and opportunities, both at UHN and in the wider system. Learn more about Minister Jones' infrastructure announcement in this UHN News story.
• We were also pleased to host a delegation from the embassy of the United Arab Emirates last week, which visited Toronto General to learn more about artificial intelligence at UHN. The delegation included the United Arab Emirates ambassador to Canada, Fahad Saeed Al Raqbani, as well as Kuwaiti ambassador Reem AlKhaled and Lebanese ambassador Fadi Ziadeh. In addition to exploring innovation projects at UHN, the group learned about AI-enabled surgery and pathology, as well as AI for lung and liver transplants. The delegation also visited the Toronto General Organ Repair lab. The visit was another example of how UHN is rightly recognized as a world-class hub for innovation, discovery, learning, and of course, patient care – all things that help build A Healthier World.
• UHN's Board of Trustees met Wednesday. The Board was provided with an update on a range of topics, including the current and anticipated impact of COVID-19 combined with RSV and influenza surges on ED and critical care capacity across the province. The Board was also updated on the impact of system pressures on our clinical programs, with a focus on surgical activity and ED capacity. It was noted that the well-being, retention, and recruitment of staff remains a top priority, in particular our nursing colleagues, and the Board was informed of recent nursing engagement initiatives. On the planning front, we discussed UHN's approach to operational planning for 2023/24 and the refresh of our Strategic Plan in the new year. Finally, the Board was provided with details regarding how UHN manages Serious Safety Events, and on recent enhancements to our Enterprise Risk Management framework. The Board and Management engaged in discussion on strategies to help address the system-wide pressures that UHN and our peers are facing and the Board expressed support for UHN's continued implementation of innovative, community-based care models to ensure patients get timely access to the right care in the right place. The next Board of Trustees meeting will be held in February 2023.
• In the early morning hours on Nov 16, UHN successfully implemented its first Epic upgrade. Reports from across the organization indicate that end users are easily adopting the new functionality and improved interfaces that came with the more than 400 low-high impact changes implemented with this upgrade. Some highlights of improvement implemented include:
  • Research: End users are now able to add new orders to existing order panels.
  • Lumens: Endoscopy images can now display in the external and Chart Review result reports.
  • ClinDoc: Nurses and Rehab PT, OT, SLP now have access to a condensed version of the Brain, allowing them to see more patients on the screen.
  • Handoff Using Rover: Handoff is now available in Haiku and Rover on both iOS and Android, allowing clinicians to document information vital for passing care from one shift to the next.
  • In Basket: The In Basket has been optimized to better fit workflows and preferences.
  
  An upgrade is no small feat. Much like Go-Live, this upgrade required collaboration and coordination from many teams across the organization working together to ensure success. Epic updates and upgrades are now part of business as usual here at UHN, and by continuously improving our state-of-the-art Health Information System we solidify our organization as a leader in healthcare.
• UHN is working hard to create a pipeline of nurses to address health human resources challenges. UHN has partnered with the Supervised Practice Experience Partnership (SPEP), a program for internationally educated nurses (IEN) run by the College of Nurses of Ontario and Ontario Health. The program allows for equal opportunity and proper training for IENs at hospitals within the Toronto Academic Health Sciences Network by providing paid, supervised work placements for IENs and internships to become nurses certified to work in Ontario. Since January, UHN has hired 25 IENs, with 39 awaiting placement. As you can read in this UHN News story, this program is also helping IENs realize dreams that they once feared were impossible. As Sheila O'Brien, our Executive Vice President of People & Culture, recently wrote in a column for The Globe and Mail, we need to be bold and "look beyond the traditional tools" to help our system. "We should start with the idea that there is no bad idea – let's ask the big 'what if' questions, and be resourceful," she wrote. Read her full column here, if you have a Globe subscription.
• The confidential IDEAA Self-Identification and Inclusion survey will close on Nov. 30. Those who have not yet completed the survey can do so through the survey link in the WorkTango reminder emails sent from pulse@worktango.io (contact support@worktango.com for help). As we announced last week, those who prefer to have the survey sent to a personal email account can contact support@worktango.com. We can't stress enough: this survey is for everyone at UHN. The anonymous information gathered about the different experiences TeamUHN members have had in the organization will help guide policies to make this a more inclusive place. As we've said from the beginning of this process, absolutely no one at UHN can access your identity or comments and the survey takes just 15 minutes. Your voice matters. Please make time for this important initiative. As of this morning, 5,305 TeamUHN members have completed the survey. Let's keep it up!
• Last chance for UHN's 2022 Local Impact Awards submissions. The forms on the Intranet are open until Nov. 23 (Corporate Intranet > Departments > Public Affairs and Communications > UHN Local Impact Awards Submission Form). There are 10 individual and team awards that align with our five Strategic Priorities. Winners will be revealed in December.

What happened at the Executive Leadership Forum meeting

UHN's Executive Leadership Forum (ELF) represents a broad range of voices and skill sets from across the organization and provides direction and oversight in service of patients, TeamUHN and our vision of A Healthier World. See the full membership on UHN.ca. The last ELF meeting was held on Thursday, Nov. 17.

Research and Talent Strategy for Principal Investigators Update

• Background and why this was brought to ELF: The Research and Human Resources Committees of the Board proposed development of a forward-looking talent management strategy to address potential risks with faculty recruitment, development, and retention for Research Principal Investigators. A working group, which included research and administrative leaders, and principal investigators, used surveys, institute faculty data, and environmental scans to develop a series of recommendations taken to ELF.
• Who Presented? Brad Wouters (Executive Vice President, Science & Research) and Anna Gordon (Director, People Consultants - Research)
• What do I need to know: ELF offered feedback and endorsed key elements of Phase I of the strategy, including proposals to streamline and standardize existing strengths for recruitment; implement more career development programs; enhance advocacy efforts; provide organizational or administrative support to enable scientific success and reduce silos; and develop additional approaches to reward performance. For the next steps this Fall, the group will prioritize initiatives for implementation, including incorporating a mentorship program into existing UHN programs and creating an implementation roadmap. The strategy will formally launch in Winter 2023 after an assessment of longer-term and high-impact initiatives.

Outpatient and Virtual Care Strategies Update

• Background and why this was brought to ELF: UHN's 5-year Outpatient Care strategy is underway. Key leaders behind the plan sought an endorsement from ELF on Phase 1, focusing on the enterprise implementation approach for eReferral already in progress. They also provided an overview of the status of virtual care at UHN and discussed a proposed approach to implement enterprise-wide remote patient monitoring.
• Who Presented? Catherine Wang (EVP, Education and Chief Medical Officer) and Jennifer Catton (Director, Outpatient Strategy & Diagnostic Performance)
• What do I need to know: An eReferral pilot began at the Princess Margaret on Nov. 17 with the radiation oncology and medical oncology groups, using the Ocean eReferral platform. It is expected that eReferral will allow for more complete referrals and optimized clinical workflows, streamlining the process in an important initiative for patient quality and safety. The initial rollout solely focuses on bringing external referrals to UHN. The Outpatient Strategy team, in collaboration with UHN Digital, will continue with the implementation of eReferral across UHN departments over two years and aims to integrate Ocean with Epic by March 2023.
  
  When it comes to virtual care, ELF learned that 47% of outpatient appointments continue to be provided virtually – exceeding UHNs target of 42%. Remote patient monitoring (RPM) is embedded within several programmatic strategies across UHN, including Connected Care, Cancer Digital Intelligence and UHN @ Home. Virtual Care @ UHN will continue to maintain partnerships across programs with RPM in their strategy as well as engage and consult groups such as Patient Experience, Digital and Data, Privacy & Security and others as identified.

Closing Notes

November 25 International Day for the Elimination of Violence Against Women. Already one of the most widespread human rights violations in the world, violence against women has sadly increased throughout the pandemic. In what UN Women has described as a "shadow pandemic," 45 per cent of women reported that they or a woman they know experienced a form of violence against women since the pandemic's start, with seven-in-10 saying they think verbal or physical abuse by a partner has become more common since the outset of the COVID crisis. From intimate partner violence, including psychological abuses, to sexual harassment and violence, and human trafficking, violence against women and girls is too often unreported because of stigma, fear of retaliation, shame, and existing societal imbalances. On Nov. 25, the UN will launch the UNiTE campaign – 16 days of activism to end violence against women and girls of all identities including BIPOC (Black, Indigenous, and People of Colour) and 2SLGBTQIA+ people. Here is a list of resources from the United Nations.

Be sure to check out this great UHN News storyabout our Connected Care Clinical Hub, and how it is bridging systemic barriers to healthcare outside the walls of the hospital. Since April 2020, the Clinical Hub has had 53,000 visits and more than 30,000 referrals, helping to prevent ED visits and readmissions. Learn more.

And now.. our TikTok of the week. This video takes you inside Toronto General Hospital's bike vault, showing that secure bike parking and sustainable travel isn't a problem at UHN.

Feedback?

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Have a good week,

Kevin