​​​​​Good morning, TeamUHN!

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

Key reminders and updates​​

  • UHN's Annual Flu Campaign has begun. Here are the three ways you can get your flu shot this year:
    • Book an individual flu vaccine appointment at Health Services ​here. Note: booking is only accessible using the Chrome browser.
    • Managers/Leaders at TG, PM, TW and TR can book a flu cart to be stationed in their units/area for 2 hours. There is a minimum requirement of 10 staff to be vaccinated when booking these carts. Note: bookings will only be done on-site. Booking information was provided to managers in a separate communication.
    • During flu season, you can also get a free flu shot from: your primary care provider, participating pharmacies, or some public health units. If you get your flu shot from outside UHN, please upload your proof of vaccination to https://tinyurl.com/FluVaccineReporting.

    For questions about booking an appointment, call 416 97​9 4441. Thank you for keeping yourself, TeamUHN, and patients healthy this flu season.

  • Congratulations to Toronto Western Hospital for again receiving Distinction in Stroke Services from Accreditation Canada. This achievement is granted to organizations that demonstrate national leadership, clinical excellence and a commitment to continuing ​to improve the level of care for these patients. TW first achieved Stroke Distinction in 2017, and this is the first renewal of that status. A huge congratulations to the inter-disciplinary team across the Krembil Brain Institute and Joint Department of Medical Imaging (JDMI) who worked very hard to prepare for this review.
  • Accreditation is fast approaching and I know everyone at UHN is preparing to demonstrate our deep commitment to operational excellence. Our Surgical teams are focusing on the ever-important Surgical Safety Checklist Policy and Tools. The 3-phased checklist has been refreshed and relaunched after extensive research that included observation, onsite interviews, and the input of patient partners. Led by an inter-professional team of UHN surgeons, nurses, anesthesiologists, anesthesiologist assistants, perfusionists, and others, this work will benefit all our patients and our collective culture of safety. The team also found a moment to share their joy and sense of fun – check out the video here.​

What happened at the Executive COVID-19 IMS Table

In response to COVID-19, UHN activated its Executive COVID-19 IMS (Incident Management System) table. Membership includes our Executive Leadership Forum and other members of COVID-19 work streams. The group meets on Tuesdays and Thursdays. This is a snapshot of the discussion.

Executive COVID-19 Table Meeting Frequency

  • Background: The Executive COVID-19 Table has been meeting twice per week since August. With the relative stability of COVID-19 cases in the community, and low hospital admissions for the virus, the group will now meet once per week.
  • Who presented? Kevin Smith (President & CEO)
  • What do I need to know? The continued stability of COVID-19 in the community is encouraging. This meeting will now move to a weekly cadence. This will be reconsidered should there be any significant change in COVID-19 activity.

COVID-19 Vaccine Third Doses

  • Background: The Ministry of Health makes all decision around vaccination eligibility in Ontario, including who should receive a third dose of the COVID-19 vaccine. Third doses are currently only available for specific populations and conditions. We know that third doses are important to many staff who received their first and second dose early on in the vaccination roll out. UHN has been advocating to have the eligibility criteria expanded to include healthcare workers.
  • Who presented? Emily Musing (Vice President, Clinical; Chief Patient Safety Officer)
  • What do I need to know? In anticipation of third doses being made available for health care workers, UHN has been working on a plan for administering vaccines to TeamUHN and our partner hospitals, which include Mount Sinai, Sick Kids, Toronto Grace and Women's College. Our thanks to UHN's Vaccine Team for their tireless work on the vaccine front. Eligibility criteria will be shared once it is made available by the Ministry of Health.

What happened at the Senior Management Forum meeting

UHN's Senior Management Forum (SMF) 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. SMF meets monthly.

Finance Update

  • Background: The financial results for the six months ended September 30, 2021 were reviewed. As we look ahead to the fiscal year end, we are projecting to be in a deficit position on March 31, 2022 due to increasing operating pressures. Financial planning is underway to ensure UHN achieves a balanced operating position to meet its financial targets to support care, education and research.
  • Who Presented: Kelly Enair (Deputy Chief Financial Officer), Ivan Lara (Senior Director of Finance, Clinical Programs)
  • What do I need to know? Utilization and benchmarking data is being reviewed to inform opportunities as we develop plans to return to the baseline hospital budget for the upcoming 2022/23 fiscal year. Preliminary initiatives to balance the budget are under development with a focus to align activity with budgeted levels, and will then be reviewed by the Clinical Operations Group / Medical Leadership Committee (COG/MLC), comprised of Clinical Vice Presidents and Program Medical Directors. We will continue to share information as this plan progresses and initiatives are finalized over the next few months.

Overview of last week

Outcome of the Mandatory Vaccine Policy Injunction at the Ontario Superior Court

  • Background: UHN's case before the court was heard last Thursday, October 28 and Superior Court Justice Sean Dunphy's decision was given the following day. The case concerned an interim injunction granted by the court on October 22 to a small group of employees who were not in compliance with UHN's Mandatory Vaccination Policy. The court had ordered at that time the terminations be paused for any plaintiff who had not yet been terminated until the court could determine whether it had jurisdiction over the matter in a separate hearing (which took place on October 28).
  • What happened last week? At Thursday's hearing, UHN's position was that the court lacked the jurisdiction to grant an injunction in the matter. The OHA (Ontario Hospital Association), on behalf of Ontario hospitals, supported UHN's position in court, which was further supported on almost all issues by the unions in attendance. On Friday, October 29, the court determined that it lacked the jurisdiction to grant an injunction in respect of either unionized or non-unionized employees and the interim injunction was lifted. Accordingly, UHN can proceed with the implementation of the Mandatory Vaccination Policy, which means that a total of 158 people have now left the organization for non-compliancy with UHN's policy.
  • What do I need to know? I had hoped that all staff would choose to be fully vaccinated and am very grateful that over 99% of TeamUHN made that choice. We're very grateful to those who have left UHN and, should they get vaccinated, I hope they will consider returning if positions remain open. We now move on to the work needed to support the roll out of third doses, and will let everyone know what the plans are once the Ministry of Health provides their recommendations with regard to third dose eligibility. I think we'll hear more this week.

Closing notes

On October 7 at 16:01, UHN Connect answered its 1 millionth call since January 1, 2021, which is an amazing milestone. UHN Connect is an amalgamation of the Switchboard departments at TG, TW, PM and TR. The department has approximately 40 Operators and Reception staff working from two centralized communication centres, ​with one at TG and the other at TR-UC. UHN Connect works to support UHN's vision of A Healthier World by providing accurate, efficient and timely call management. The team's responsibilities include critical day to day operations such as Code activation and 5555 emergency response, alarm monitoring, Locating Services (14-3155), Web Paging, overhead announcements, patient inquiry, and internal/external call answer. Click here to see month​ly stats and to learn more about the team​.​

November is Fall Prevention Month. Thank you to our colleagues across UHN who are​ supporting the safe mobility of patients and the community. Falls are a leading cause of injury and hospitalization for seniors. Recognizing this, Toronto Rehab offers an outpatient Falls Prevention Program that focuses on education and exercise. Since 2013, over 700 seniors have joined the 10-week program, which explores risks, safe footwear, fear of falling, stair safety, community resources, and more. At The KIT​E Research Institute, UHN scientists are engaged in research projects to understand why people fall and what tools, devices and design innovations can help prevent future injuries. At Altum Health, innovative programs and services such as the Hip & Knee Bundled Care and Workplace Safety Insurance Board treatment programs help clients reach their maximum potential for returning to work and life after a fall-related injury. Altum consistently achieves strong clinical and vocational outcomes, such as 90% client treatment satisfaction with 11,000 clients seen annually.

November is Osteoporosis Month. Thank you to our colleagues at UHN's Osteoporosis Program and Centre of Excellence in Skeletal Health Assessment (CESHA) at TG, TW, PM and TR-LC for their remarkable work across care, research and education. The program led by Angela Cheung, and multidisciplinary clinic led by Lianne Tile, is home to the first and largest longitudinal cohort of patients with atypical femur fractures worldwide. As part of the Schroeder Arthritis Institute, it has expanded to become one of the world's largest centres for specialized osteoporosis, metabolic and rare bone disease care, and research. With more than 5,900 patients, it has also become a leader in musculoskeletal medical education, training more than 300 fellows from Canada and around the world. At least 1 in 3 women and 1 in 5 men will break a bone due to osteoporosis in their lifetime. At UHN, a quality improvement project in the Fracture Clinic at TW has bridged the gap between osteoporosis and fractures, maki​ng sure patients with fractures are looked after and their recent fracture is their last.

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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