Good Monday morning,

Happy Accreditation week! Surveyors from Accreditation Canada are on site until Friday and focusing on UHN's Toronto Rehab and Princess Margaret sites. Remember to wear your ID badge and remember you don't have to know all the answers (which goes for most cases in life!). Just let the surveyor know where you would go to get the information you need. Thank you everyone for your hard work in service of patients, families and each other – not just this week but every day.

1. Highlights on UHN's Essentials

UHN's Essentials are essential to the work we do as a leading academic health sciences centre – hence the name! Read here to learn more. Below, you'll find highlights on UHN's Essentials from last week.

Compassionate Care and Caring Ministry of Health announces an additional $155 M in funding for home and community care: Last week, we gathered at UHN's Hillcrest Reactivation Centre for Deputy Premier and Minister of Health Christine Elliott's funding announcement. Very fitting location for the good news as Hillcrest is one of Ontario's success stories for home and community care (and made possible thanks to Ministry of Health funding). See the release here.

People and Culture It's been a busy September – thanks to Grace Ivo for letting me off the hook so I could attend the Toronto Rehab University Centre and Toronto General site BBQs. Never thought I'd have so much fun serving burgers but it's a sincere pleasure to spend time with you all in a more relaxing environment. Grace and I may be spending too much time together though – our clothing is starting to match. Pink shirts but no pink burgers, we promise!

Partnerships Celebrating The Institute of Education Research (TIER) at UHN – driving the convergence of care, research and education as Canada's first education research institute in a hospital: It was my pleasure to attend the launch of UHN's seventh and newest research institute. TIER is a collaboration between UHN Research, UHN Education and the Michener Institute – and builds on the accomplishments of our Wilson Centre for Research in Education, as well as our many other centres of excellence in education. TIER will help transform healthcare education through cutting-edge research, and help us serve nearly 17,000 learners as Canada's largest training centre for health professions in partnership with the University of Toronto and our very own Michener Institute.

Quality and Safety Attending the 4th annual Krembil Nursing Showcase: Thanks to our many nursing colleagues for driving important quality initiatives in service of patients, families and TeamUHN. I'd also like to thank the Krembil Foundation for giving nurses at UHN the opportunity to engage in important scholarly week – and to Stacey Krembil and the Krembil family for encouraging TeamUHN to bring their ideas to life and establishing an open door policy for any and all questions.

People and Culture UHN security guard Mark Freund jumps into action for a Code Red: Last week, there was a Code Red at our Princess Margaret Lodge. One of the elevator motors caught on fire causing a significant amount of smoke. Huge thanks to Mark for stepping forward and following the steps to safely extinguish the fire. In dangerous situations like these, always remember to assess the environment before proceeding!

2. How UHN, United Way and the City of Toronto are working together to break barriers and deliver A Healthier World

We know that health and poverty are inextricably linked – more than 57% of high-needs patients with chronic disease at UHN are living in low-income neighbourhoods or lack stable housing. If we are to deliver A Healthier World, we must better address the social determinants of health, such as poverty and homelessness, and we cannot do this without co-designing solutions with our community partners.

I'm proud to announce a new partnership between the United Way of Greater Toronto, UHN and the City of Toronto. Together, we will be using our collective resources to create affordable and supportive housing, improve our understanding of patients' social needs, and lower barriers to access social supports and services. This partnership is the first of its kind in Canada and makes me think of the adage you've heard me repeat so many times – we are always stronger when we work together. Read more in today's edition of The Globe and Mail.

This work is being led by UHN's newly formed Social Medicine & Integrated Health Program, which includes our colleagues Andrew Boozary (Executive Director, Health and Social Policy), Lori Seeton (Manager, Strategy and Operations) and Courtney Ferguson (Project Manager, Data and Implementation Science). They will be focused on the strategic priorities of the partnership and any subsequent alignment with the development of Ontario Health Teams.

3. Three things TeamUHN can do to help with our ED pressures

Last week, I stopped by both of UHN's Emergency Departments (EDs). Thanks to the colleagues who shared their (limited!) space with me momentarily so I could get up to speed with our latest activity. Our EDs have been experiencing very high volumes over the summer and these pressures are continuing into the fall. Here are some things that TeamUHN can do to help prevent overcrowding in our EDs and prevent hallway healthcare:

  • Consider alternate plans that don't require the ED when it is safe to do so: For patients who are seen in the clinic and need an inpatient admission, please contact the flow team to see if the patient can be admitted directly (rather than sending them to the ED).
  • Communicate and involve the team: If a patient is being sent to the ED for a subspecialist consult, please contact that service beforehand and ask that they see the patient as a "direct" to that service. Share treatment plans with ED staff and inform the charge nurse of any factors that may delay discharge. If a patient is being sent to the ED for an assessment by ED providers, please call the ED and discuss this with the charge nurse or ED physician on duty.
  • Remember the ripple effect: Timely discharges from the inpatient ward help create capacity and move patients out of the ED.

4. What we discussed at our Executive Leadership Forum meeting

Here is what we discussed at last week's Executive Leadership Forum (ELF) meeting. See who attends these meetings on UHN.ca:

  • Proposed renovations for Peter Munk Cardiac Centre (Barry Rubin, Program Medical Director, Peter Munk Cardiac Centre; Fayez Quereshy, Interim Vice President and Site Lead, Toronto General; Shirley Blumberg, KPMB Architects): Thanks to our colleagues for presenting on the desired wishes of our remarkable donors, Melanie Munk and the late Peter Munk. We discussed the operational implications of the proposed building improvements.
  • Accreditation update (Elisa Chimonides, Lead, Accreditation and Partnerships): Thanks to Elisa for giving us an update on some final details for our upcoming visit from Accreditation Canada (Sept. 16 – 20), including what materials the surveyors received and the schedule of events that will involve ELF.
  • Financial update – UHN's operating deficit continues to grow (Darlene Dasent, Chief Financial Officer and myself): I sent a note about our budgetary pressures on Aug. 20 and included the $9.8 M deficit we were managing at the time (April 1 to July 31). Our deficit is now exceeding $12 M. We understand the impact that our clinical pressures have on TeamUHN and on your work/life balance. This remains a top priority for ELF and with the Ministry of Health. In the meantime, I'll reiterate what we must collectively do moving forward, as stated in the August message: 1) Work as one united team, 2) Be especially vigilant in cost control and 3) Reinforce needed approvals. As always, I welcome your suggestions for helping us be the hospital that is most effective and efficient at serving patients, families and TeamUHN while advancing scholarship.

Have a good week,

Kevin

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