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Changing the way we work

It seems like such a simple idea. Empower staff to innovate for their patients and families. Then watch how the ideas lead to better, more connected care.

That’s the theory behind CHEOworks. And it’s working.

CHEOworks is based on “Lean” principles—a best practice originally used in the manufacturing industry but more recently adopted by leading health care organizations to improve care and streamline workflow.

Last year we successfully completed CHEOworks pilots on our 4 North, 4 East and 4 West inpatient units, and then began the process to roll it out more broadly in the hospital.

So what does it look like? Care teams now come together for short daily huddles to ensure everyone is in the loop and quality improvement “tickets” flag something that needs fixing. Last year we completed 337 tickets!

For example...

Small changes, big impact

  • Patients in isolation on 4 West were frustrated when a food tray delivered to their room was simply left in the ante-room, without notifying the patient. While it was done out of kindness—staff didn’t want to wake a patient or interrupt a meeting—it meant hot meals grew cold. We fixed this with a new system.

  • A patient on 4 West pointed out there was no recycling bin in his room. CHEO actually does provide a recycling bin in every room, but it was under the sink and out of sight. Recycling signs were posted—and recycling increased significantly!

  • Waiting in the Emergency Department feels long and can be quite a stressful experience. It’s made that much more stressful when your cell phone or tablet battery dies. That is why we added a charging station to our waiting room. This simple change has made life a little more liveable for families.

  • During renovations of the 4 North inpatient unit, CHEO’s cancer patients were temporarily admitted to 4 East/West. The team noticed a delay in dealing with pump alarms; non-oncology nurses were hesitant to deal with the alarms since they didn’t know if chemotherapy was running. So the team began clipping small signs to intravenous poles whenever chemo was in progress. A simple solution.

Top hospital in Ontario for pediatric inpatient care

The latest patient satisfaction survey results are in, and we couldn’t be prouder. CHEO was honoured to be named the top hospital in Ontario for pediatric inpatient satisfaction—by the very families we care for.

In a confidential third-party survey, parents were asked to indicate their overall satisfaction with care. Compared to 26 other hospitals, CHEO came out on top for the exceptional patient experience we provide.

CHEO has glimpsed the future and it is paperless

CHEO launched its innovation roadmap and “went live” with the first phase of a fully integrated electronic health record—a massive undertaking necessitating the conversion of two million laboratory records and touching the practice of hundreds of clinicians.

Once complete, all areas of the hospital will use the same technology for patient records and essentially go paperless. This best practice has been used by such respected hospitals as the Cleveland Clinic, Johns Hopkins and The Children’s Hospital of Philadelphia.

We understand the impact of placing the information people need at their fingertips, being able to share that information with community partners, and enabling patients and families to be better engaged in their own care.

While the full roll-out will take a few years, CHEO will be one of the first hospitals in Canada to provide a fully integrated electronic system. Our patients deserve nothing less.

CHEO facelift results in smiles

A newly renovated in-patient unit is providing a welcoming space for kids being treated for cancer, kidney disease, blood disorders and other conditions.

4 North has been refurbished to make it more colourful and child friendly.

We know that a well-designed environment lightens the load for parents and promotes quality care and an exceptional experience for our patients. The new unit includes updated bathrooms, new window coverings, respite nooks and a lively new playroom.

Watch for similar facelifts on other units , thanks to the generous support of our community.

Precious cargo

The first few days of life will be safer for premature and ill newborns across eastern, southeastern and northeastern Ontario. Additional funding from the Ministry of Health will allow CHEO’s neonatal transport team to help even more fragile newborns—up to 425 babies in the coming year.

The neonatal transport team is now available 24 hours a day, seven days a week and will serve an expanded geographic area of almost 440,000 km², connecting our most fragile patients to the care they need. A team of dedicated professionals give these infants the best possible start in life, improving their lifelong health and reducing long-term costs for the health care system. View the video.

It’s a bird, it’s a plane ...

You can find superheroes everywhere at CHEO, even scrubbing and shining the windows outside patient rooms on the fourth floor. What a great way to kick off the Be a Hero for CHEO campaign, which saw community leaders and window washers alike dressing up as Batman, Superman and other heroes—all to the delight of kids stuck in a hospital bed. While it’s no fun to be in the hospital, little things like this make it more fun for our patients and their families and are just another small step in building an exceptional patient experience.

Making tough decisions

Families struggling with tough decisions now have a place to turn for help. CHEO has published the first comprehensive electronic library of pediatric decision aids in the world. These basic tools help families consider all of the options when they need to make a medical decision.

The new library, found on the CHEO website, has more than 50 tools on topics such as allergies, ADHD, diabetes and vaccines. This is just one more example of how CHEO’s innovation is changing young lives around the world.

Playing in the dirt

CHEO opened a healing garden—a therapeutic space that promotes healing, relaxation and sustainability for patients, families and visitors.

The garden is a natural fit with CHEO’s mandate to help kids and families be their healthiest. It includes a vegetable patch, activity areas for kids to play and learn, and common areas where visitors can simply sit, relax and renew energy.

Saving lives with a simple test

Imagine being able to save a baby’s life with a simple test for a deadly illness. Thanks to funding from the Ontario government, CHEO is doing just that.

Every infant born in Ontario is now screened for Severe Combined Immune Deficiency (SCID), a deadly disorder previously known as ‘Bubble Boy Disease’. Newborn Screening Ontario, based at CHEO, conducts the tests.

Newborn screening will detect this problem early before complications can develop, allowing for prompt interventions. It’s literally saving lives.

Helping families in need

Imagine your child is seriously ill and you are facing eviction from your home or denial of your health benefits. Fortunately, legal help is now available to CHEO families, thanks to a new partnership with Pro Bono Law Ontario (PBLO).

CHEO has teamed up with PBLO to help families resolve legal problems and focus on caring for their child in need.

In doing so, we are linking care and services within and beyond CHEO’s walls—ensuring ‘Connected Care’ and greater peace of mind.

On my way

When youth turn 18, it’s time for them to say goodbye to CHEO and move to the adult health system. This can be very stressful. To help our patients, CHEO launched a new transition program, On My Way, in our Nephrology Clinic.

On My Way provides youth with the skills and knowledge that will allow them to understand their chronic health conditions and successfully manage their own care once they transition to adult services. Some of the practical tools we have provided to our patients include a health passport, a transition letter and a three sentence summary, which is an easy way for patients to discuss their health condition(s) with their clinical team at each visit.

The transition program is scheduled to be rolled out to more clinics in the coming year.

e-Consult

CHEO’s eConsult is helping more children and teens in the community get the specialized expertise of our physicians. eConsult is a new way for primary care physicians to get timely consultations with CHEO specialists. Community doctors simply sign on to the secure web-based system, choose a specialty and ask their question. To date, more than a dozen CHEO specialists have signed on to provide answers.

The benefits are clear for families in the community—better connected care and fewer unnecessary referrals to a specialist.

Check out how CHEO is changing lives around the world through education, innovation and discovery:

  • Discovered a new combination drug treatment to better kill cancer cells

  • Discovered a cellular pathway that may prevent Type-2 diabetes

  • Launched a first-of-its-kind web portal to connect clinicians and scientists worldwide in rare disorders research

  • Increased the number of rare disease genes identified at CHEO to 60

  • Discovered a pain-free treatment for injuries using skin glue

  • Discovered that kids with Congenital Heart Disease need Vitamin D to get better faster

  • Discovered and addressed gaps in inpatient psychiatric health care

  • Discovered that frequent breaks from sedentary behaviour make kids healthier

  • Launched a study to learn how YouTube can disseminate information and affect behavioural change

  • Third ranked largest pediatric hospital research institute in Canada.

For further information on the CHEO Research Institute’s discoveries, check out its annual report cheoresearch2013.com

Celebrating 40 years and looking ahead...

For four decades, CHEO has been caring for kids. Thanks to the generous support of this community—and the commitment of community leaders—CHEO has grown and flourished.

In the next 20 years, there will be 70,000 more children and youth in our region than there are today. The need for our services will continue to grow, and we will have a more crucial role than ever.

Our young patients will become tomorrow’s parents, workers, taxpayers and innovators. Their success will be our community’s success.

Health care reform is essential—we all agree. But it would be prudent to place a warning label on it: “may be harmful to children”. Pediatrics needs to be considered uniquely, as Ontario builds a health system plan. Anything less would be short-sighted and not likely to achieve the economic benefits needed to build the sustainable health system to which we all aspire.

We want to create health hubs for kids. CHEO and other child/youth health organizations are best equipped to respond to kids’ unique needs. The result will be focused and faster decision-making where kids do not have to compete with adults for resources.

2013-2014 in numbers

Infographic showing 2013 and 2014 revenues in percentages: Ministry of Health/LHIN: 57%, Patient Revenues: 17%, Sundry & Ancillary: 9%, Preferred Accomodation: 1%, Other Votes: 14%, Amortization of Grants: 2%. Total Revenues: $243,416,000.Infographic showing 2013 and 2014 expenditures in percentages: Salaries/Benefits: 54%, Other Supplies: 18%, Medical Surgical Supplies: 3%, Medical Staff: 3%, Drugs and Gases: 3%, Other Votes: 14%, Depreciation and Amortization: 5%. Total Expenditures: $243,414,000.


Infographic showing 2013 and 2014 in numbers of visits: number of admissions to CHEO is 6,678, number of babies screened by Newborn Screening Ontario is 143,798, number of ED visits is 69,747, number of ambulatory clinic visits is 171,143, number of medical day visits is 10,443, total number of surgeries is 7,796.




Infographic showing 2013 and 2014 revenues in percentages: Ministry of Health/LHIN: 57%, Patient Revenues: 17%, Sundry & Ancillary: 9%, Preferred Accomodation: 1%, Other Votes: 14%, Amortization of Grants: 2%. Total Revenues: $243,416,000.


Infographic showing 2013 and 2014 expenditures in percentages: Salaries/Benefits: 54%, Other Supplies: 18%, Medical Surgical Supplies: 3%, Medical Staff: 3%, Drugs and Gases: 3%, Other Votes: 14%, Depreciation and Amortization: 5%. Total Expenditures: $243,414,000.


Infographic showing 2013 and 2014 in numbers of visits: number of admissions to CHEO is 6,678, number of babies screened by Newborn Screening Ontario is 143,798, number of ED visits is 69,747, number of ambulatory clinic visits is 171,143, number of medical day visits is 10,443, total number of surgeries is 7,796.