Annual Activities Report Adopted by the Board of Directors on June 14, 2012

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1 Annual Activities Report Adopted by the Board of Directors on June 14, 2012

2 ACRONYMS : (CSSS) Centre de santé et de services sociaux (CH) Centre hospitalier (CLSC) Centre local de services communautaires (BD) Board of directors (Agence) Agence de la santé et des services sociaux de l Outaouais (ASSSO) Agence de la santé et des services sociaux de l Outaouais (SAD) Soins à domicile

3 TABLE OF CONTENTS Message from the President of the Board of Directors and the Executive Director... 1 Statement of reliability of the data contained in this activities report and related control measures... 2 Mission and organizational structure... 3 Values... 5 Health and well-being of the population of des Collines territory... 6 Highlights... 8 Department of the Executive Director... 8 Community Services Department... 8 Nursing Care Department Department of Human Resources, Information and Organizational Development Financial and Technical Services Department Strategic issues, objectives, targets: results obtained Quality and safety of care and services A) Accreditation B) Report on the activities of the Local Service Quality and Complaints Commissioner C) Annual assessment of the application of user restraint measures D) Corrective measures implemented to apply the recommendations of the coroner and/or the Ombudsman E) Information and consultation of the population Councils Board of Directors (BD) Council of Physicians, Dentists and Pharmacists Council of Nurses Multidisciplinary Council Committees Watchdog Committee Users Committee Risk Management Committee Infection Prevention and Control Committee Financial Statements and Analysis of Results of Operations Management Report Balanced budget Bill Financial results for Fiscal Year Notes to financial statements Auditor s report on financial statements Annual Activities Report i

4 Appendix List of members of councils and committees Appendix Human resources of the institution Appendix Details of amounts received from the Foundation for the year ending March 31, 2012 Appendix Code of ethics and deontology of the Board of Directors of the Centre de Santé et de Services Sociaux des Collines Annual Activities Report ii

5 MESSAGE FROM THE PRESIDENT OF THE BOARD OF DIRECTORS AND THE EXECUTIVE DIRECTOR The year was particularly eventful, with several new achievements and advances in certain files. First of all, the and its population have had a new Board of Directors (BD), since February 1, Several training and information sessions were provided, to equip the board with the tools needed to skilfully carry out its functions. In addition, the has put great effort into the development of its Business Plan, which aims essentially at enhancing the technical support centre in the hospital, the number of places in long-term residential care, and the services offered in the community (CLSC). Discussions took place between the CSSS, the Agence de la santé et des services sociaux de l Outaouais and the minister of health. Further steps in this direction are planned in , since both the Board of Directors and the hold dear the development of the resources needed to ensure that its fast-growing population receives the services it needs at present and in the future. The has also been heavily involved in an important exercise aimed at a maximum reduction of its budget deficit. Different measures have been implemented to ensure this control. The has paid close attention to the development of its Strategic Plan, which set out six major orientations: to develop and consolidate effective actions before problems arise; to ensure the accessibility and intensity of existing services; to develop secondary services locally, in line with volumes observed; to maintain seniors with diminishing autonomy in the community for as long as possible; to continually improve the quality and safe delivery of services; to ensure optimal utilization of resources. The degree to which the targets attached to these orientations have been attained is presented in detail in this activities report, along with relevant explanations. Continuous quality improvement actions, resulting from different suggestions made by Accreditation Canada and the Watchdog Committee, have been carried out and remain at the core of the concerns of the and its BD. The accreditation process is forging ahead, with the self-assessment carried out in the fall by the staff members, management and clientele. A continuous improvement plan was developed and different objectives have been reached or are in progress, such as the emergency measures file (practices, training, evacuations, roles and responsibilities). This process shows how seriously the members of the Board of Directors and the managers take the delivery of safe high-quality services. The has seen its organization move forward thanks to the tremendous input of all the members who constitute it: a dedicated staff members, professional councils, active committees and a Board of Directors that is very involved in the institution. Finally, we must emphasize the unfailing support of the volunteers and administrators of the Des Collines Health Foundation in tirelessly carrying out fund-raisers for our organization. André Désilets Executive Director Jean-Paul Racine President of the Board of Directors Annual Activities Report 1

6 STATEMENT OF RELIABILITY OF THE DATA CONTAINED IN THIS ACTIVITIES REPORT AND RELATED CONTROL MEASURES The information contained in this annual activities report falls under my responsibility, which is to ensure the reliability of the data contained in the report and the related control measures. The results and data of the activities report of the Centre de santé et de services sociaux des Collines: - accurately describe the institution s mission, mandates, values and strategic orientations; - present the indicators, targets and results obtained; - present accurate and reliable data. I hereby declare that the data contained in this annual activities report are reliable, i.e. objective, free of errors and verifiable. This also applies to the related control measures. These data correspond to the real situation for the fiscal year ending on March 31, André Désilets Executive Director Annual Activities Report 2

7 MISSION AND ORGANIZATIONAL STRUCTURE The objective of the Centre de santé et de services sociaux des Collines is to maintain and improve the health and well-being of children, young people, adults and seniors living in its territory, by providing a wide range of diagnostic, general and specialized services of a preventive or curative nature, and rehabilitation, reintegration and residential services. These services are offered in the person s natural environment or in permanent or temporary alternative environments. In short, the is constituted by three interrelated missions: CLSC, residential centre and hospital missions. Below are the details of these three missions: MISSION OF THE HOSPITAL CENTRE The mission of a hospital centre is to offer diagnostic services and general and specialized medical care. To that end, an institution which operates a hospital centre shall admit the persons who require such services or care, ensure that their needs are assessed and that the required services, including nursing care and specialized, preventive or rehabilitative psychosocial services, are offered within the facilities or, where necessary, that the persons are referred as soon as possible to the centres, organizations or persons best suited to assist them. MISSION OF THE RESIDENTIAL AND LONG-TERM CENTRE The mission of a residential and long-term care centre is to offer, on a temporary or permanent basis, an alternative environment, lodging, assistance, support and supervision services as well as rehabilitation, psychosocial and nursing care, and pharmaceutical and medical services to adults who, by reason of loss of functional or psychosocial autonomy can no longer live in their natural environment, despite the support of their families and friends. CLSC MISSION The mission of a local community service centre is to offer, at the primary level of care, basic health and social services, and to offer health and social services of a preventive or curative nature and rehabilitation or reintegration services to the population of the territory served by it. To that end, an institution which operates such a centre shall see to it that the persons who require such services for themselves or for their families are contacted; it shall assess their needs, dispense the required services in its facilities, or in the persons' own environment, in school, at work or at home or, where necessary, refer the persons to the centres, organizations or persons best suited to assist them. ORGANIZATIONAL STRUCTURE The has made some changes to its organizational structure, in particular through the creation of a new position of quality and risk management senior adviser Annual Activities Report 3

8 The organization plan of the is made up of two service-program departments and two support-program departments. A service-program can be defined as a group of services and activities organized for the purpose of meeting the health and social services needs of the population, or the needs of a group of persons sharing a common problem. A support-program designates a group of activities of an administrative or technical nature, designed to support the service-programs. The organization chart, as of March 31, 2012, is presented below: Annual Activities Report 4

9 VALUES The has adopted values to guide its orientations and actions: Quality Service quality is a constant concern for the organization. In this regard, the organization seeks to satisfy the needs and expectations of its clients, while respecting standards or according to best practices, and at the lowest cost. This quality should be found in our actions and personal relations. Safety Safety is a notion that implies that every user should receive reliable service, free of risk and sheltered from danger. We are not speaking here of the normal risks associated with a treatment or intervention. We are speaking rather of actions or situations which entail negative consequences for a user s state of health or well-being. Integrity The organization promotes impartiality and honesty in its actions. Staff members must avoid putting themselves in a situation where they are indebted to someone, as this could influence them unduly in the exercise of their functions. Excellence Excellence is defined as an exceptional level of success. The Centre de santé et de services sociaux des Collines strives for excellence in the fulfilment of all its tasks and all the interventions of its staff members, while respecting both personal and organizational limits. The CSSS recognizes employee actions that deserve special mention and acknowledges the value of the work accomplished. In its quest for excellence, the Centre de santé et de services sociaux des Collines seeks to offer the population the highest possible quality of services and constantly strives to improve its organization. Responsibility Responsibility is the obligation to carry out various functions according to established criteria, to fully assume one s actions and be accountable for them. This obligation applies equally to all the hierarchical levels of the organization and the users receiving services. Fairness Fairness is a notion derived from natural justice. The organization takes the specific characteristics of individuals and groups into consideration in order to place them on an equal footing or, at least, to deal with them more fairly. The principle of fairness should apply in the management, organization and delivery of services to the population of the territory Annual Activities Report 5

10 HEALTH AND WELL-BEING OF THE POPULATION OF DES COLLINES TERRITORY According to the report of the public health director published in and a populational study carried out as part of our business plan 2, here are some of the characteristics inherent in the health profile of the territory: The local services network territory (Val-des-Monts, Cantley, Chelsea, La Pêche) numbered 34,652 residents in 2011; The fertility rate is the highest in the region and the population is experiencing strong growth; In 2031, the population will be the youngest in Québec, considering the current babyboom ; In the next few years the population will grow twice as fast as the average Québec growth; The age structure of the population indicates a very high proportion of children, adolescents and young adults, as well as a significant proportion of persons aged 65 or over. The expectation is therefore that the proportion of seniors will increase more rapidly than elsewhere in the Outaouais in the course of the next few years; With the ageing of the population, an increase in the number of persons suffering from chronic illnesses is expected. This profile indicates a need for taking these persons in charge in all activity spheres of the CSSS; Life expectancy in good health for the population of the territory is higher than in the region, but weaker than that calculated for the whole of Québec; On the geographic level, the south of the territory is in immediate proximity to Gatineau and Ottawa and this phenomenon has an impact on the supply profile, with regard to retention, source and range of services; More than a quarter of the territory s residents say that English is the language most often spoken in the home, a slightly lower proportion than that noted in the 1966 census; Most couples with children are married and a relatively low proportion of children live with a single parent; A major proportion of persons over 75 years of age state that they live alone; The population is relatively well educated, compared to Québec as a whole; 1 Source: Portrait de santé de la population de l Outaouais 2011, Gatineau, Direction de santé publique, Agence de la santé et des services sociaux de l Outaouais. 2 Source: Plan d affaires du approved by the Board of Directors on December 15, Annual Activities Report 6

11 The proportion of families living below the low income rate was the lowest in the Outaouais region in The census data on median income nevertheless show major economic disparities between the territory s municipalities, with the municipality of Chelsea in particular showing a large proportion of persons and households enjoying a high income; The population of the territory does not have a living habits profile as favourable as one might expect from its socioeconomic profile. The proportion of regular smokers is higher than the Québec average, but lower than the Outaouais average; overweight is more widespread than in Québec as a whole, and findings on consumption of fruits and vegetables are unfavourable. High frequency of recreational physical activities has been noted, however. Suicide rates in the territory have been historically lower than or similar to Outaouais and Québec rates; Premature and low birth-weight births are on the same scale as those observed in the Outaouais and Québec as a whole. This is a worrisome tendency, which remains partly unexplained; All causes mortality rates and mortality associated with chronic diseases are generally on the same scale as those noted in Québec as a whole, despite the favourable determinants noted in the state of health of the population; Growing numbers of emergency services users, including a large number of users from other Outaouais territories; growing volumes of consumption of CLSC services Annual Activities Report 7

12 HIGHLIGHTS The Centre de santé et de services sociaux des Collines has pursued its development, with several achievements realized in each department. All the staff members were mobilized in order to meet the growing needs of the clientele. New services have been created, in particular transitional functional recovery beds. The specific mandate of this program is to optimize the autonomy of seniors following a period spent in hospital, with a view to their return home or, if appropriate, referral to an alternative living environment adapted to their needs. The ministry has also initiated a new program for seniorfriendly hospital care. In addition, the opening hours for primary care have been increased on weekends and statutory holidays. Finally, in order to ensure optimal follow-up on continuous quality and safety improvement, a quality and risk management senior adviser position was created. Below are the major points: Department of the Executive Director Constitution of a new Board of Directors; Preparation and continuation of the continuous quality improvement plan, in the context of the third accreditation process; Development of the emergency measures file aimed at the safety of the staff and users; Ongoing efforts to put the business plan into effect, in particular through representations made to the Minister of Health and Social Services; Planning and start of work to reorganize the waiting room in the hospital emergency room; Sustained efforts in a major exercise to reduce the deficit as much as possible; Recruitment of a medical records manager; revision and creation of organizational procedures and policies to ensure safe and high-quality management of medical records; Communication: survey on satisfaction regarding intranet; creation of a new web site in conjunction with the ASSSO. Department of Community Services In the context of optisad: Portrait of current organization of services in home care (SAD) and primary health care; Development of an action plan to optimize SAD services, in line with the increase in requests for primary health care services; Consultation of the teams in collaboration with the department managers and Human Resources; Restructuring of the work of the SAD and primary health care nurses; Annual Activities Report 8

13 Increase in the number of opening hours for primary health care on weekends and statutory holidays; Equipment loan Lean Project Significant increase in direct hours with clientele by SAD team; Installation of an agenda for appointments through Lotus. Sound management of direct allocation activities budgets Return to balanced budget Restructuring of criteria for CASSAD presentations Priorities management Vaccination Mass vaccination clinics: Fluviral Measles in schools Reorganization of vaccination activities in perinatal care: Development of tools to improve vaccination services Training of receptionists in the points of service Significant increase in the level of attainment of management targets Completion of a local portrait of the volumes of nursing services in the territory Increase in vaccination time slots in Cantley Restructuring of vaccination services in perinatal care in Chelsea Development and implementation of a vaccine supply procedure Reduction of risk of cold chain breaks Improvement in stock management Perinatal and early childhood services: Adoption of Baby-Friendly Initiative policy Presentation to BD. Development of an action plan Development of a procedure for loan of breast milk pumps Revision of speech therapy services (better management of waiting list) Mental Health Services: Creation of a pamphlet on psychosocial intervention in the distributed to clientele Implementation of services for clients presenting borderline personality disorders Training of professionals Development of the program and the frame of reference (sub-committee) Promotion of the program with various bodies Partnership agreement with the Centre Jellinek Annual Activities Report 9

14 Development of a collaboration guide for the staff members, in the context of a psychosocial crisis or a suicidal crisis (still a working document). Implementation and consolidation of Variable Intensity Support for clientele dealing with serious mental health disorders. Management targets attained Collaboration with the Centre québécois d excellence en santé mentale Partnership agreement established with the CSSS Gatineau to implement a regional crisis intervention service for adolescents in Des Collines territory. Consolidation of the role of the psychiatrist responsible for Des Collines territory. Meetings with the primary mental health care teams Establishment of a support network for natural caregivers Needs profile Local information session for various bodies Collaboration in development of new partnerships with Hébergevac, the CRFO and the CRÉO Active participation in the regional APPUI process Creation of a directory for natural caregivers Reorganisation of integrated day activities [AJI] Optimization of services in all the CSSS departments Integration of recreational services in non-institutional resources Development of a transversal vision of recreational activities in the Prevention and promotion Training of two new Sentinels in the community Various commitments and involvement in promotion of Healthy Living Habits and prevention-promotion activities. Implementation of PAL Participation in different concertation tables (collines en forme, table des Lac, Foire santé des collines, etc.) survey of CSSS employees, and partnership with the wellness committee (Healthy Enterprise). Collaboration in regional and local process to fight against cancer Development of a clinical project to fight against cancer Preparation of a memorandum of understanding with the CSSS Gatineau Annual Activities Report 10

15 Collaboration and mobilization of the teams in the various procedures related to the coming Accreditation Canada inspection Development of an information pamphlet on the access gateway for orphan patients. Concertation and partnership: Active partnership in the local concertation Avenir d enfants Participation in the needs profile Development of a local action plan Contribution to promotion of various projects to increase early childhood stimulation services in the territory of des Collines Participation and leadership in realization of the Communities Profile. Participation and leadership in local concertation concerning the local plan to fight against poverty Visits by mayors of three municipalities Coordination of the local MELS-MSSS committee Nursing Care Department Participation in revision of Accreditation Canada standards, by initiating continuous quality improvement plans for the department s teams, and in preparation for the inspection in November 2012; Collaboration in the Business Plan, specifically for the hospital and residential care missions; Collaboration in the Strategic Plan Nursing Care Establishment of the clinical support program Mentoring section, providing individual assistance by a buddy nurse for nurses and nursing assistants with less than 2 years experience, or who obtain a position for which they do not have all the skills required, in order to meet the needs relative to professional integration and acquisition of new knowledge and skills; Supervision of candidates in the exercise of the nursing profession (CEPI) during their integration into the care units; Annual Activities Report 11

16 Establishment of a plan for continuous improvement in the quality of nursing care, following the Inspection professionnelle de l exercice collectif des infirmières in the. This plan particularly targets supervision of users during administration of narcotics, initial assessment and systematic follow-up after a user s fall, identification of the supervision level required for users whose physical or mental condition presents a risk for themselves or for others, and assessment of the development of the mental state of hospitalized users, in close collaboration with the CECII (Council of Nurses Executive Committee); Implementation of a policy on use of collective prescriptions, medical and nursing protocols and nursing care rules, in collaboration with the Professional Services department; Collaboration with the Professional Services Department and the Department of the Executive Director in revision of the Emergency Measures Plan, especially in the event of a fire or medical emergency; In collaboration with the Professional Services Department, establishment of a professional practices committee, whose principal function will be to direct and coordinate professional practices; Planning for the arrival in the near future of nurse practitioners in primary health care (IPS- SPL); Organization of a palliative care room in the acute-care unit; Revision of the emergency overflow management plan, which identifies the persons responsible for systematically initiating and applying the mechanisms required in such situations; Regional collaboration in the traumatology committee, in order to consolidate the service corridors for emergency clientele, particularly children; Establishment of Télé Santé, a virtual distance teleconsultation centre, throughout the CSSS; Residential Care Collaboration with the Community Services Department to integrate recreational services into all the residential environments; Initial revision of the temporary lodging program, which offers, on occasion, a temporary residential resource for clients in the territory, in complementarity with the other services provided in the community; Annual Activities Report 12

17 Updating of the plan for improvement of the quality of services provided in residential centres and implementation of the Living Environment approach, following the quality assessment inspections by the Ministry; Diagnostic Services Laboratory: New immunobiochemistry equipment in operation; Collaboration in the regional committee on laboratory optimization; Radiology: Rehabilitation Reorganization of the radiology room and replacement of the radiology equipment; Regional collaboration for establishment of digital dictation; Development and implementation of the new ministry program Senior-Friendly Approach in hospitals, aimed at adapting hospital services to the special characteristics of seniors, by preserving their functional autonomy; Establishment of transitional functional recovery beds. The specific mandate of this program is to optimize the autonomy of seniors following a stay in hospital, with a view to their return home or, if applicable, referral to an alternative living environment adapted to their needs; Infection Prevention Formalized screening and follow-up procedures on MRSA and Vancomycin-resistant Enterococcus (VRE) in residential centres Registration in Canada s hand hygiene challenge day: STOP! WASH YOUR HANDS! ; Development of a hand-washing policy Annual Activities Report 13

18 Department of Human Resources, Information and Organizational Development A) Establishment of the Healthy Enterprise process: Roles and responsibilities of the local project manager Ms Roxanne Primeau, Human Resources administrative officer, is the project manager and her role is to promote the health and wellness program in the institution and mobilize the staff members; 1) Coordinate the activities of the Health and Wellness Committee (CSME) 2) Ensure follow-up with the department representative 3) Operationalize the requirements of the standard (expert-contents) 4) Develop tools; 5) Ensure coherent communication for everything touching the Healthy Enterprise process 6) Participate in the meetings of the Health and Wellness Committee meetings. Frame of reference Annual Activities Report 14

19 B) Health and Wellness Committee (CSME) Committee Members Huguette Cloutier member of the Board of Directors. Danielle Paquette, management representative Chantal Meunier, CSN category 1 Réjean Biron, CSN category 2 Denis Houde, CSN category 3 Lyne Chayer, APTS category 4 Émilie Castonguay, Multi Committee representative Ginette Leblanc, CECII committee representative Nicolas Proulx, healthy living habits team Christine St-Arnaud, healthy living habits team Paulette Legros, HR Manager Roxane Charette, HR department representative Roxanne Primeau, committee project manager Pauline Mineault, accreditation copresident Roles and responsibilities 1) To study relevant information, including the depersonalized results of the data collection; 2) To develop the implementation plan, taking into consideration the needs of the staff revealed through the data collection, as well as the institution s resources and priorities; 3) To ensure the promotion and implementation of the program; 4) To assess the interventions carried out in the context of the health and wellness program. C) Recruiting: Despite the recruitment efforts to alleviate the personnel shortage caused by numerous maternity leaves, the institution had to have recourse to independent manpower, notwithstanding the fact that all positions were filled as a result of the 12-hour shifts. This is a structural situation and resources should be stabilized between now and Tabling of Manpower Plan (PMO); below are certain statistics: Annual Activities Report 15

20 PMO (Manpower) Data Année Financière Données Taux CSST (MSSS) 2,05% 1,32% 1,10% 1,21% 1,13% Taux assurance salaire en hres (MSSS) 5,54% 4,41% 3,33% 3,36% 2,94% Taux précarité en hres trav (MSSS) 17,94% 35,91% 27,17% 30,30% 33,70% Taux précarité individus (MSSS) 17,25% 36,16% 39,41% 33,20% 38,68% Taux prise congé parental individus (MSSS) 5,77% 3,70% 3,07% 3,23% 5,31% Taux de prise de congé parental en hres (MSSS) 5,83% 4,54% 4,32% 4,84% 5,00% Taux prise congé sans solde (MSSS) 1,85% 2,63% 1,89% 1,60% 2,49% Taux retrait préventif (MSSS) 2,56% 0,87% 0,11% 0,88% 1,57% Taux embauche (MSSS) 23,59% 18,08% 27,51% 28,06% 25,10% Taux occupation des postes 82,61% 52,00% 55,05% 44,62% 38,82% Taux formation des ressources 1,17% 1,24% 1,45% 2,04% 1,40% Nb embauches (incluant réembauches) Nb départs Taux postes vacants 6,72% 26,40% 15,60% 17,13% 16,88% Âge moyen employés 41,28 41,02 41,24 41,17 41,08 Taux encadrement global 6,38% 5,62% 5,51% 6,94% 6,26% Taux infirmière bachelière 38,71% 35,09% 35,09% 29,41% 40,00% Nb postes vacants attente transition Taux maladie court terme 2,32% 2,44% 2,23% 2,17% 2,15% Nb postes à la structure Nb employés titulaires Taux postes temporaires actifs 2,37% 20,40% 25,69% 5,18% 4,64% Taux absentéisme court terme 8,90% 7,62% 7,32% 6,36% 7,80% Number of employees Annual Activities Report 16

21 Number of employees per category Nombre d embauches et départs : Annual Activities Report 17

22 Facteur moyen Maternité : Taux d assurance salaire : Taux temps supplémentaire : Annual Activities Report 18

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