Good morning, TeamUHN!

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

Key reminders and updates

  • We are observing a significant increase in COVID-19 cases at UHN and are now caring for six inpatients. Toronto is also reporting a rapid increase in numbers. We need to work together. Join everyone on TeamUHN who is masking, distancing, hand washing, and self-isolating while sick. Please avoid larger social gatherings and wear a mask when in indoor environments.  

 

Overview of last week 

1. Met with Mayor John Tory to discuss Social Medicine and supportive housing

Background: UHN's Social Medicine and Population Health program is focused on integrating the social determinants of health (e.g. poverty, unstable housing, and isolation) into care delivery to improve the health outcomes of disadvantaged populations. In 2019, we reinforced our commitment to this work by signing a Social Medicine Memorandum of Understanding (MOU) with the City of Toronto and United Way – the first agreement of its kind in Canada.

What happened last week? UHN Board Chair Brian Porter and I met with Mayor John Tory to discuss the Social Medicine MOU.

What do I need to know? One of the Social Medicine MOU's key commitments is expanding supportive and affordable housing. In addition to protecting human dignity and preventing avoidable suffering, supportive housing has economic benefits for the public sector. Hospital stays can cost the health system up to $120,000 annually for each patient experiencing homelessness, whereas affordable rental housing can cost $14,000 and provides individuals with stability and necessary social supports. In partnership with community organizations, we are co-designing a supportive housing model that could be scaled nationally to better care for high-needs patients and advance health equity. UHN has dedicated land at our Parkdale site to move this ahead as quickly as possible.

2.  Updated on UHN's Clinical Transformation journey: HIS Assumptions Review

Background: We are moving closer to our Clinical Transformation at UHN – one that will be supercharged by a new Health Information System (HIS). This requires significant investment and we must have an accurate understanding of the financial impact, regardless of which vendor we engage. UHN's HIS project team has been working on a Total Cost of Ownership model which estimates the complete cost of a new HIS over a 10-year period. The model was informed by the HIS toolkit developed by the Ontario Hospital Association, which has been used by many peer organizations to ensure they have the flexibility to assess different HIS scenarios, key assumptions, and cost drivers.

What happened last week? Several colleagues including Sarah Muttitt (Chief Information Officer), Robert Slepin (Senior Project Director, HIS), Barry Rubin and Terri Stuart-McEwan (Co-Chairs, Clinical Transformation Implementation Committee) and I met to review the key assumptions we are making around these costs and associated risks.

What do I need to know? We are aiming to finalize the Total Cost of Ownership by the end of September and determine if me can come to an agreement with the preferred vendor. 


What happened at the bi-weekly 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

COVID-19 Update: Wave 2 planning 

Background and why this was brought to ELF: UHN and the Toronto Region have spent this past summer preparing for various COVID-19 scenarios in the Fall and Winter. The severity of Wave 2 and burden on the health system, along with other respiratory virus activity such as flu, will depend on our efforts to consistently mask, physically distance, wash our hands and self-isolate while sick. We know that the flu vaccine will be especially important this year. Occupational Health is working on ensuring convenient access to the vaccine for TeamUHN. The members of ELF discussed the various scenarios plus their associated risks and actions.

Who presented? Susy Hota (Medical Director, Infection Prevention & Control)

What do I need to know? Best case scenario is that the heightened infection prevention and control measures (e.g. masking, physical distancing, avoiding larger social gatherings outside your bubble) will result in lower incidences of influenza and respiratory viruses, and a stable number of COVID-19 cases. Worst case scenario is that the health system will be overwhelmed because of an overlay between COVID-19 and influenza, RSV (respiratory syncytial virus) etc. Please encourage those around you to redouble their infection prevention efforts – and get your flu vaccine this year when it is available.

Working from home and future directions

Background and why this was brought to ELF: Under the guidance of Ontario Health, UHN is gradually resuming on-site activity across care, research and education. The members of ELF discussed the future of our work-from-home policy and associated factors, including: Safety and physical distancing, quality of work life, productivity and innovation, costs, and opportunity to enhance our position as an employer of choice. Based on the comments we received at previous Virtual Open Forums, we know we need equity, consistency and transparency in the approach – not only across professions and within UHN, but also across the sector with our peer hospitals. Any decision that is made at UHN should be scrutinized when it comes to standards and consistency.

Who presented? Diana Elder (Interim Vice President, Human Resources)

What do I need to know? An interdisciplinary task force is working on a recommendation for UHN's work-from-home policy moving forward. They will present the recommendation to ELF for review in six weeks. There is much to nail down. We will also be creating a process for members of TeamUHN who have valid reason to appeal the decisions that are made.   

2020/21 Financial Outlook and COVID-19 costs 

Background and why this was brought to ELF: COVID-19 has strained the public sector financially and all future spending must be done with extreme caution. Last week, UHN's Finance & Audit Committee of the Board met to review the risks and actions required for various financial scenarios.

Who presented? Darlene Dasent (Chief Financial Officer)

What do I need to know? This month, we will be meeting with the Ontario Health – Toronto Region to discuss costs related to COVID-19 and overall financial pressures. We remain focused on maintaining a balanced financial position at UHN – especially since we are preparing to invest in a new Health Information System, which will supercharge our upcoming Clinical Transformation journey and advancing our Master Plan to see our physical space redesigned  

Digital multi-year road map

Background and why this was brought to ELF: UHN Digital is developing a multi-year road map which aligns with our vision of A Healthier World and UHN's 2019-23 Strategic Plan. They are working with colleagues across the organization to identify high-priority projects and will be bringing recommendations to ELF to ensure we are focusing our resources in the appropriate areas. 

Who presented? Carl Virtanen (Active Executive Director, Digital Operations, UHN Digital)

What do I need to know? Many of our resources in UHN Digital will be dedicated to the Health Information System project over the next few years. Strategic planning is necessary to ensure we use our remaining bandwidth wisely.   

 

FYI

World Patient Safety Day is coming up on Sept. 17. This year's theme is "Health Worker Safety: A priority for patient safety." Emily Musing (Vice President, Clinical and Chief Patient Safety Officer) will be sending out a message. Stay tuned.

Feedback?

Your feedback is welcome and valued. Please reply directly to me or leave anonymous feedback here

Have a good week,

Kevin 


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