SECTION 2
Client Care and Service
Community Focused
Continuing Care
Emergency/Trauma
Maternal, Child & Youth
Medical Care
Mental Health
Palliative Care
Specialized Intensive Care
Surgical Care

SECTION 3
Support Services
Information Management
Human Resources
Physical Environment

SECTION 4
Leadership/Partnership
Strategic Directions
Implementing Strategic Directions

Implementing the Strategic Directions

Key strengths of the executive management team (EMT) include the knowledge and experience with program management and regionalization, team composition and excellent medical staff participation. The EMT is providing good leadership in organization-wide quality improvement initiatives.

Physician involvement in planning and implementation of programs is significant. There is ongoing review of current programs that includes reallocation of resources as necessary. Community health profiles and evidence of need are used in program planning. A good example of this is the geriatric outreach program that moved from acute care to the community, following discussion with program staff.

Goals within a strategic framework are used to plan service delivery. Outcomes of goals are measured by indicators that link to a balanced score card reporting format. Progress is monitored and when indicated the EMT will introduce changes, with various team members assuming accountability for specific responsibilities.

The EMT has established population advisory groups which provide feedback and input into care and service. Medical leaders participate in provincial medical director meetings. NSHR participates in provincial networks such as child health and this has lead to the introduction of youth clinics, based on evidence of best practices. Partnerships with municipal family services are in place. There is good liaison with other health organizations in the lower mainland. The discharge planning team is active in identifying gaps in meeting client needs following discharge. All of these mechanisms are good examples of promoting continuity in care and service delivery and facilitating a client centred approach.

In addition to the regional communication plan which is focused on building linkages with external stakeholders, specific communication plans are in place to promote internal organizational initiatives such as the purchase of new software. Efforts to promote the interests of seniors and long term care clients include resident and family councils, senior groups and other public who had input into developing the seniors plan. Clients and staff of continuing care facilities had input into maintaining and enhancing the music therapy and spiritual care programs.

The EMT establishes criteria and parameters for operational planning. The framework is presented throughout the organization and serves as the initial budget which front line staff can comment on. Opportunities are provided for new program proposals and there is extensive discussion around priorities. Regional chief executive officers work collaboratively to obtain funding for new initiatives such as introducing hospitalises in the province. This team and the chief executive officer are currently working closely with the ministry of health for additional funding of programs such as neurosurgery.

In addition to a comprehensive mid-year financial review, there is periodic reporting of variances which require explanation to the EMT. Decisions are made by the EMT for any corrective action and/or reallocation of finances.

NSHR’s strategic goals link to provincial goals. The ministry has recently approved the medical staff bylaws. Regional policies for care and service delivery are under development, and the organization’s mission, vision and values provide good guidance to staff, physicians and volunteers. An interdisciplinary professional practice committee is being established to ensure adherence to practice standards. Recognition is given for exploring opportunities to restore links to medical schools for formal participation in training programs. Currently, medical residency placements are informal.

The vice presidents of programs and finance are responsible for ensuring currency and completeness of contacts. Finance co-ordinates the contracts, and programs develop, maintain and monitor them. Recognition is given for working with private long term care operators such as ILPH (Inglewood Care Centre) to establish contracts.

The team has an excellent understanding of the quality improvement process. The organizational structure supports the implementation of quality management activities. Priorities of each program will be consolidated at a high level and articulated in an overall plan for NSHR. Planning staff will support teams to actualize the plan. Indicators and a balanced score card approach will be used to monitor and report progress. The feedback loop is intended to be via this team to program leaders to the program teams. (See Recommendation 5, page 25.)

As previously mentioned, recognition is given to the cardiac project which improved the management of clients with congestive heart failure. This has lead to a decrease in emergency visits and admissions to acute care.

Risk is well managed and includes ongoing education sessions for physicians, and dedicated human resources for co-ordinating risk management processes. There is a system in place to report incidents of risk. (See Recommendation 6, page 25.)

Encouragement is offered to continue current directions for ensuring that organizational structures support teams in their quality initiatives and tracking of indicators.