Good Monday morning,

1) Here are last week's safety highlights for UHN:

  • Effects of UHN's bed map: I'll start with "wow" news – we had zero admitted patients to Toronto General's (TG) Emergency Department (ED) twice this last week. A great step towards ending hallway medicine! Many thanks to the many teams responsible for this outcome.
    • Impact on surgical services: We want all patients to be in the right place receiving the specialized care they need so it's concerning to hear that our colleagues in surgery are facing challenges. For those who don't know, surgery was consolidated from four units into three as part of our new bed map, although we made no change to our levels of surgical staffing or the number of budgeted beds. Despite this, our surgical colleagues tell me that their patients are being spread across TG and that we're seeing a higher volume of off-service patients within the surgical program – so I have asked Shaf Keshavjee (Surgeon-in-Chief), Scott McIntaggart (Senior Vice President, Executive Lead, Toronto General) and Mary Ann Neary (Senior Clinical Director, Surgical Services) to find out why. Data suggests this may relate to an increase in operating room time and the changes in case mix. Stay tuned for what the team has discovered.
  • Equipment down: Several key pieces of equipment were down at UHN last week, pointing to our urgent need for critical infrastructure investments. Princess Margaret's CT (computed tomography) system was down; Toronto Western had 1.5 MRIs down as well as their chemistry testing analyzer and a sterilizer in MDRD (Medical Device Reprocessing Department); and Toronto Rehab's University Centre Pharma Clean Room is down due to construction at Mount Sinai Hospital. Fortunately, no negative safety outcomes were reported.

2) Next, we've started Code Orange training workshops for our inpatient units. Our city experienced terrible events this year including the Danforth shooting and last week a TTC bus crashed into a hydro pole, resulting in a number of patients needing treatment. Toronto Western received half of the bus riders and I understand their injuries were relatively minor. My thanks to our staff for the seamless delivery of care – but all this underscores the need for emergency preparedness. These workshops are led by our new Code Orange Improvement Steering Committee co-chaired by Janet Newton (Vice President, Site Lead, Toronto Western) and Sam Sabbah (Assistant Medical Director, Emergency Medicine). Our UHN Emergency Preparedness team will work with all areas of UHN to prepare for a major Code Orange exercise in June 2019. My thanks to all involved for making this possible – June will come quickly but it's crucial to be well prepared.

3) Another highlight from last week was attending UHN's New Physician Orientation. I enjoyed hearing from some of our newest medical staff colleagues, who expressed the need for us to continue investing in wellness initiatives and to help foster a collegial work environment. UHN is a big place and sometimes it can be hard to find the support you need, especially as a new person. Our colleagues in Human Resources are working to better provide resources for our staff including our Employee Assistance Program [Editor's Note: Link is no longer available].

4) And now, some friendly competition! We have a goal set for myUHN Patient Portal and hope to reach our goal of 75,000 registrations by year end. myUHN is a wonderful, digitally-enabled way of engaging our patients and their families and it is important to empower them as much as possible with equitable access to their information. To help achieve our goal, we're running a contest and the department who offers the most registration codes to patients will win bragging rights and a catered lunch. Here are the frontrunners thus far:

  • Princess Margaret: JDMI (Joint Department of Medical Imaging) currently in the lead. Eye Clinic and Genitourinary Clinic close behind.
  • Toronto General: 5th floor Cardiology Clinic. Though Liver Clinic and JDMI (Joint Department of Medical Imaging) aren't far off!
  • Toronto Western: Neurology Clinic enjoying #1 status – but Rheumatology Prognostic Studies and Movement Disorders Clinic are catching up.
  • Toronto Rehab: Lyndhurst Outpatient feeling confident but 9 South is very close…!

5) Of course, while technology brings many benefits, we know it must be used wisely. I read this article on Healthy Debate this past weekend about whether hospital staff should be allowed to use their phones for personal reasons and wonder what you all think. When working with patients and families, please be mindful of how our actions might be perceived – not just with the use of technology but in all respects.

6) Quick note of congratulations: Angela Cheung (Director, Osteoporosis Program; Women's Health Program) is the 2018 recipient of the Chinese Canadian Legend Award organized by the Asian Business Network Association. Great to see our valued colleague celebrated for her remarkable accomplishments! Previous recipients have included Tak Mak and Victor Ling so Angela is in excellent company.

Finally, I'd like to issue a correction. In last week's update, I said that our Q2 scorecard reported a 17.5% drop in our ALC (alternate level of care) rate last quarter when I meant to say last fiscal. Thank you to Adrienne Hughes (Manager of Centralized Admitting, Patient Discharge, Flow and Cardiac Clinic, Toronto Western) for noticing and letting me know.

Have a good week,


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