Driving Performance Improvement and Innovation: Improve knowledge transfer of leading practices to strengthen health system performance.

Leading practices should be collected, shared and implemented across the health system so that meaningful change can be achieved.

• The OHA, on behalf of Ontario’s hospitals, initiated and supported numerous leading practices in different areas of health care, such as the Pandemic Planning Toolkit; implementation of nine patient safety indicators; the ED Medical Directives Implementation Kit; the Guide to Mental Health in Ontario; the Green Hospital Champion Fund (GHCF); the ED Process Improvement Program; the PHA Emergency Management Toolkit; the OR Supply Chain program; the PharmaTrust partnership which enables remote dispensing of pharmaceuticals; and ER Patient Satisfaction Surveys.
• The OHA launched the "Quality and Patient Safety Plan (QPSP) 2010-2013", which was developed by a Quality and Patient Safety Working Group to help guide the OHA’s work over the next three years, and will be integrated with the implementation of the OHA’s Strategic Plan 2010-2013.
• The OHA, in partnership with the MOHLTC, developed the "Surgical Safety Checklist Implementation Toolkit" and hosted regional training sessions across the province, with 99% of hospitals that have Operating Rooms attending a session.
• The OHA launched the 2010 Guidebook to Patient Safety Leading Practice, “Advancing Patient Safety through Ideas and Innovations” at HealthAchieve, to recognize and highlight innovative patient safety initiatives in Ontario hospitals and share lessons learned. One submission was awarded the 2010 Patient Safety Award, to acknowledge exemplary work in the area of patient safety.
• In September 2010, the OHA launched the “Resource Manual for Sustaining Quality Midwifery Services in Hospitals”, developed in collaboration with CMO and AOM. The manual is intended to assist hospitals with the integration of midwives into their organizations.
• In 2009, the OHA and the OACCAC partnered in the development and launch of the “Your Health Care – Be Involved” campaign for the home and community sector.
• The OHA launched myhospitalcare.ca, giving users easy access to information about how their hospitals are performing by location, type of care, or one of 39 different indicators.
• The OHA also partnered with LHINs to develop a standardized HSAA template for use through the 2008-2010 negotiations.
• The OHA partnered with the Ontario Government to create the GHCF to help Ontario’s hospitals improve their environmental performance and reduce operating costs by implementing “green” projects. The OHA completed nine pilot studies focused on identifying opportunities to improve the hospitals’ fiscal and environmental performance through energy and waste audits. The GHCF Audit Program plans to offer financial support to hospitals, establish a baseline of Ontario hospitals’ waste and energy performance, and share best practices. This will be followed by a program focused on implementing green projects that will support energy efficiency and reduction of waste.
• In 2010, the OHA partnered with Open Source Order Sets (OSOS) providing access to over 400 comprehensive and interdisciplinary best practice order sets and clinical protocols that incorporate feedback from many years of clinical experience. The OSOS partnership aims to improve patient safety and quality while reducing costs for hospitals.
• Ontario’s hospitals now have access to leading HR practices and research through the Advisory Board Company HR Investment Centre program, which offers hospitals leading HR research, practices, implementation support, and tools.
• In partnership with PwC Saratoga, a global leader in the measurement and benchmarking of human capital, the OHA launched a provincial HR benchmarking program, including a survey, with over 100 health care organizations signed up to participate in its first year.
• A new web-based labour relations rights and interest arbitration case law search engine (ARISE) was developed for Ontario’s hospitals to help advance the system-wide adoption of leading evidence-based strategic HHR policies and practices.
• To help evidence-based forecasting data drive recruitment planning, the OHA, in partnership with six hospitals, worked on a Nursing Secretariat nursing HR planning project to investigate the applicability of using an Excel-based forecasting tool (the Workforce Demand Forecaster). This project was the first in Ontario to use a forecasting tool as a standardized approach to HR planning across health care organizations. It allows hospitals to create one to five-year workforce forecasts for critical professions using their own data.
• The Quality Healthcare Workplace Awards program, in partnership with HealthForceOntario, was launched in 2010, replacing the Healthy Hospital Innovators Award. Twenty-three hospitals participated in the inaugural year. These awards recognize organizational efforts to improve healthcare workplaces in ways that contribute to providers’ quality of work life and the quality of the care and services they deliver.
• The OHA Benefit Plans, in partnership with Desjardins Financial Services, initiated Extended Health and Dental benefit products under the OHA Benefit Plans which adhere to the collective agreements and have flexible funding arrangements. This centrally coordinated extended coverage for Ontario hospital employees helps improve efficiency for organizations, and provides important benefits for hospital staff.
• The OHA developed a Disability Management Certification Course, designed and launched in early 2009, to address the growing challenges of providing efficient and appropriate disability management in health care. The course continues to be extremely successful as it provides members with a good understanding of the legislative requirements, fundamental principles and best practices for the practical application of a disability management program.
• The annual HealthAchieve conference and exhibit showcases advancements in health care, such as the annual Leading Practices Display. In 2009, 9,474 delegates attended HealthAchieve, 230 speakers participated in the show, and 350 exhibiting companies occupied 455 booth spaces on the exhibit floor, which was sold out with a waiting list.
• In 2009 and 2010, HealthAchieve and the MOHLTC partnered to present “Celebrating Innovations in Health Care Expo”, showcasing successful projects from health care organizations across the province, and helping organizations learn from each other and share best practices.
• The OHA developed a number of important resources to provide members with support and updates on legislative issues affecting hospitals. The OHA Legislative Updates and Frequently Asked Questions address the implications of new and current legislation for health care. Once example is the Quality of Care Information Protection Act (QCIPA) toolkit, developed to assist hospitals and other health care organizations understand and apply the legislation.
• In 2008, the OHA initiated a series of communiqués called “Tom Talks”, in which OHA President and CEO Tom Closson, shared information on key health system issues with members and other system leaders. Its primary purpose is to inform members about what the OHA is doing on their behalf and encourage two-way feedback about the most important and challenging issues facing member hospitals.
• In June 2010, the OHA launched a new online resource, "OHA Today", in response to member requests for improved OHA e-communications. This new website offers Members a one-stop-shop for viewing information from across the OHA and beyond, in a relevant, user-friendly, and engaging format.
• The OHA published “Supporting Transformation: A Vision for e-Health Human Resources for Ontario” – a report that highlights emerging human resource challenges surrounding the growth of eHealth systems, and launched the eHealth Applications Viewer to create greater transparency around eHealth adoption at hospitals and provide tools for benchmarking and collaboration.
• The OHA developed the eHealth Applications Viewer to enable easy access to and greater transparency around health information technologies and applications at hospitals, and provides tools for benchmarking and collaboration. Since the launch in 2009, 625 hospital staff and health system stewards, such as LHINs, eHealth Ontario and the MOHLTC, have signed up for access to the dynamic online portal.

Leading Excellence in Governance: Strengthen governance throughout the health care sector.

The OHA has developed a wide-range of governance resources to support health care boards as they acquire expanded roles and take on greater accountability with respect to quality of care.

• The OHA led the creation of a comprehensive governance program that builds on the Guide to Good Governance – the License rights of which were sold to the American Hospital Association.
• The OHA undertook the first-ever governance survey on hospital governance practices. The second survey was sent in May 2010. Data from these surveys will help establish performance indicators for health system governance practices in Ontario to help drive improvement throughout the sector.
• In May 2008, the MOHLTC announced new public reporting requirements on a number of patient safety indicators as part of a comprehensive plan to create an unprecedented level of transparency in Ontario hospitals. The OHA provided and continues to provide tremendous support to hospitals including targeted communication and education to reinforce the importance of transparency and accountability, inspire improved performance, enhance patient safety, and strengthen public confidence in Ontario’s hospitals.
• Hospitals, through the OHA, helped advance thought leadership on a range of health system governance issues. This included expanding the mandate and membership of the OHA’s Governance Leadership Council to include broader system representation from LHINs, the Ontario Health Quality Council (OHQC), and the Community for Excellence in Health Governance.
• Trustees have improved access to education through distance learning technology through the OHA, such as the GCE Pay per access webcasts, and interview series, “Leaders Building the Health System of Tomorrow”, which is important for meeting the educational needs and catering to diverse schedules, including weekends. Leadership forums for hospital Board Chairs have also been organized, to help them improve their knowledge and expertise, and to learn from peers.
• The OHA collaborated with LHINS and other provider associations to develop EPIC -- a Community Engagement e-Resource that provides practical tools and guidance on the issue.
• The OHA released its new By-laws (Prototype Corporate By-Laws and the Board-Appointed Professional Staff By-Laws) on February 3, 2010. The By-laws were updated to ensure that they effectively meet the needs of Ontario hospitals. The OHA has been supporting members as they begin to adopt them.
• The OHA supported health care trustees throughout the sector with a variety of education and resources, including the “Guide to Good Governance: Not-for-Profit and Charitable Organizations”.

Fostering Health System Leadership: Improve executive and management leadership capacity within the health care sector through a new leadership institute.

With the development of the 2007-2010 Strategic Plan, the OHA set out to establish a health care leadership institute to support health care leaders across all stages of their careers.

• Recognizing the changing health human resource landscape, the LDI began promiting inter-professional collaboration with offerings for administrative and clinical leaders.
• Since its establishment, the LDI has developed a number of important resources such as competency models for Executives, Directors, Managers, and Supervisors in partnership with the Hay Group; competency-based 360 degree feedback surveys and self- assessments; a Talent Management Framework and piloted the framework across seven sites; new resources such as the CEO Competency Dictionary, CEO Success Profile Template, and CEO Competency Questionnaire; and behaviour-based interviewing workshops; and external leadership coaching along with coaching workshops.

Advancing Health Policy Solutions: Provide thought leadership on health system issues based on facts, evidence and or hospital expertise.

The OHA is committed to work with its partners, use evidence, encourage the creation of incentives, and help implement the changes necessary to make Ontario’s health system among the best in the world.

• A number of the OHA’s recommendations to the Ontario Government have been announced as future initiatives, or integrated as current priorities. These include the province-wide and government recognition of ALC as a key issue for the health sector; key legislative changes clarifying the Board and CEO roles in monitoring and improving quality of care; a public commitment by the government to examine the Public Hospitals Act and to begin addressing hospitals’ working capital deficits; the introduction of a patient–based payment system for appropriate hospitals; and the establishment of a Capacity Planning Task Force and a Transition Planning Committee for new construction projects.
• The OHA supported and advised the MOHLTC and Cancer Care Ontario on a number of initiatives, activities and strategies concerning ER/ALC over the last three years including: provincial definitions for ALC and Transitional Care; educational initiatives and sessions on Aging at Home, ERP4R and ALC (in partnership with the OACCAC); Expert Panels including the current ER/ALC Expert Panel and ER/ALC Data Certification Committee.
• The 2010 Member Engagement Forums (MEFs) focused on developing strategic performance indicators for the OHA’s new Strategic Plan. Based on member and staff input, the Board of Directors approved eight Strategic Indicators: Number of ALC Patients, Patient Satisfaction, Staff Engagement, Patient Safety Composite, Adoption of Governance Leading Practices, Wait Times Composite, Health Information, and Cost per Capita.
• The OHA’s “Hospital Expense Policy Guidelines”, launched in March 2010, provide recommendations and examples to hospitals creating or updating their expense policies in the areas of personal business expenses (meals, travel, accommodations, etc.), hospitality, and corporate events.
• The OHA has also supported its rural and northern members assisting with the development of a Rural/Northern Hospital Strategy, and by participating in the 2010 Emergency Room Taskforce.
• The OHA completed a process review of the 2008/2010 HSAAs as part of an OHA/LHIN Review Task Force.
• The OHA formed an Advocacy Priorities Special Purpose Working Group and identified funding as the central piece of an escalating three-phase 2009 Pre-Budget Advocacy Strategy, which secured the 2.1% increase in the hospital base funding formula in 2009-10.
• The OHA provided advice to the Minister’s Advisory Panel on Mental Health and Addictions as well as the Ontario Legislature’s Select Committee on Mental Health and Addictions to advance the development of a mental health strategy for Ontario.
• With the release of its policy paper, “Incentives for Transformation: eHealth as a Strategic Health System Priority”, the OHA actively advocated for the provincial government to invest in eHealth, an enabler for quality, access to care and efficiency. This paper, along with recommendations in the OHA’s pre-election policy paper, was the foundation of the OHA’s efforts to highlight the importance of eHealth on behalf of its members.
• Working closely with government, including the MOHLTC Lead of Access to Services and Wait Times, and an expert in Health Studies and Gerontology, the OHA helped facilitate the use of the Resident Assessment Instrument for Home Care (RAI-HC) for planning and evaluating community care programs required to transition people home or to community care.
• The OHA supported, and continues to support members on the Government’s Excellent Care for All strategy (ECFA), which includes Bill 46, through legislative backgrounders, member teleconferences, webcasts, online updates, and a conference held in October 2010.
  • The OHA also worked with the MOHLTC, the OACCAC and the OCFP to assist with the collection of information on leading practices and innovative models of care that reduce readmissions in Ontario as part of its ECFA strategy. Hospitals were asked to contribute information in stages on innovative models of care.
  • The OHA also continues to work with the OACCAC in 2010 to assist them in developing a collaborative approach to mandate setting and strategic collective bargaining across all 14 CCACs.
  • An educational conference was held in October 2010 in partnership with the MOHLTC, to provide practical information to help operationalize the legislation within the hospital sector. Speaker presentations were archived on the OHA website, to give members convenient access to this information.
• Following the release of the Auditor General of Ontario's (AGO) Report in October 2010, the Minister of Health and Long-Term Care introduced Bill 122, the Broader Public Sector Accountability Act, 2010. In addition to supporting Members during the lead up to the release of the AGO’s report, the OHA monitored the progress of the legislation, provided members with advice with the help of the OHA Freedom of Information (FOI) task force. The OHA continues to advocate on hospitals’ behalf to ensure that Bill 122 can most effectively meet the needs of hospitals and their patients.