Ottawa Hospital: Transforming health care from the inside out
In 1998, The Ottawa Hospital (TOH) came into existence through the merger of four hospitals and has since become one of Canada’s largest academic research hospitals. With a vision “to provide each patient with the world-class care, exceptional service and compassion we would want for our loved ones,” TOH has embarked on a significant redevelopment strategy focused on constructing a new state-of-the-art academic campus.
Cameron Love, TOH’s Executive Vice-President and Chief Operating Officer, is responsible for overseeing the development strategy and plan. Responsible for the overall operations of the hospital, Love has worked in a variety of leadership roles since the merger in 1998 and now oversees the ongoing implementation of the new site development.
“The first 10 years after the merger focused on reorganizing our programs and services across TOH’s three campuses,” he explains. “Creating corporate programs and services, developing an integrated research platform, and expanding our critical-care and tertiary-care programs and services were our main focus.” By 2008 TOH had implemented its merger plan and strategy and evolved its focus to developing a robust Quality Plan and strategy. “In 2008 our CEO, Dr. Jack Kitts, led the development of a new vision [To provide each patient with the world-class care, exceptional service and compassion we would want for our loved ones], which refocused our hospital on becoming a top 10 percent performer in quality and patient safety and focusing on patient experience.” Over the last decade, TOH has drastically improved the care and compassion of services provided to patients and families, becoming a leader in such metrics as Hospital Standardized Mortality Rate, Patient Experience, Surgical Site Infections and Cost per Weighted Case.
This vision and quality platform will guide TOH through its development strategy and planning process. “TOH’s vision centres on compassionate and world-class care, which will guide our planning for developing our new state-of-the-art campus,” explains Love.
The Ottawa Hospital Redevelopment Strategy
TOH operates 19 sites altogether, including three main campuses: the Civic, General and Riverside. However, as a regional provider of adult acute-care programs and services, TOH also operates 16 satellite sites that provide dialysis, cancer and mental-health programs and services throughout the Champlain region.
In 2007-2008, TOH completed its long-term Master Plan, which outlined the future plans for its campuses. TOH’s overall development strategy includes expanding the General and Riverside campuses; however, the flagship component to the development plan is the construction of a new Civic Campus, which currently has infrastructure of almost 100 years old. The Civic Campus is the Ottawa region’s only Trauma Centre and operates a series of regional programs, including Cardiac Care, Vascular Surgery, Neurosciences (neurosurgery and neurology) and minimally invasive surgery, to provide complex academic care to patients across the region, province and country.
With a globally aging population and demographic growth, the expansion of TOH’s programs and services and construction of new Civic Campus will support the health-care demands of the Champlain region’s population. Within the Ottawa area, Love explains “there has been significant volume growth, particularly in patients with multiple medical issues, which are often in patients over age 70.” Such growth is not unique to Ottawa, but is a challenge the entire health industry is currently facing worldwide. Bernie Etzinger, Chief Communications and Outreach Officer at TOH, explains that “the growth in health-care demand coupled with the aging population will result in a shift in the Champlain region’s demographic profile, which is critical for TOH to plan for as part of its development strategy”.
The Civic Campus is a critical element in the Champlain region’s healthcare system because it is the only site that provides care to patients with the most severe and complex care needs. While the programs and services provide world-class care, the future requirements of programs such as Neurosciences, Cardiac Care, Stroke, Trauma and Complex Medical care cannot be effectively or efficiently managed within the aging infrastructure, nor can they accommodate the projected growth in demand and volume. “The current campus is approximately half the size it needs to be to accommodate current and future development standards for a site that will operate 750+ inpatient beds and some of the most advanced health and research infrastructure in the country,” comments Love. “The business case clearly outlines that the time has come to develop a new regional centre.”
The Academic Future
Like the majority of academic centres worldwide, TOH shares a similar tri-partite mandate of clinical care, research and education. TOH’s development strategy will include significantly expanded infrastructure to support the evolving standards needed for new models and advancements in research and education.
In partnership with the University of Ottawa and Algonquin College, TOH will continue to focus on educating future physicians, nurses, other health professionals and support-service workers. Education that includes simulation training, internships, fellowships and apprenticeships will continue to advance and evolve the education spaces the hospital will need to plan for. “The need for advanced simulation training centres and decentralized education spaces integrated with clinical and operational spaces will be essential to support new education training programs in the future,” comments Love. The simulation centre and education conference centre concepts will be integrated with the new Civic Campus development, allowing TOH to continue its mandate as a leading academic institution.
Research is the third mandate, which is a top priority for TOH. Over the last decade, TOH and the Ottawa Hospital Research Institute (OHRI) have achieved tremendous research success, particularly in the fields of cancer, stem cell, neurosciences and translational research. “Research is an essential element to achieving our vision, and our development strategy integrates a robust platform focusing on basic, clinical and translational research,” adds Love. The new Civic Campus vision includes research institutes that will integrate clinical care with research and take the advancements from the bench to the bedside.
The Electronic System Platform
TOH’s redevelopment strategy is one of two critical infrastructure pillars for the future of health-care delivery in the Champlain region. The other significant undertaking is implementing a new integrated health-care information system.
Over the last decade, TOH has implemented a fully electronic back office information system platform in partnership with ORACLE. The system has achieved a variety of significant efficiencies and created a best-practice systems platform for business functions such as supply chain services, financial services and human resources management.
On the clinical side, a variety of systems have been customized to advance the electronic clinical platform; however, the current systems are not fully integrated and require a variety of paper-based functions. To move to a fully integrated electronic clinical delivery system platform, TOH has completed a business plan review and market assessment over the last 18 months. TOH will be partnering with EPIC to implement a fully electronic health-care information system. “To achieve our vision and goals from a quality and patient experience perspective, we have to move to an integrated health-care system, which will allow us to realize the operational benefits and efficiencies that other major centres have achieved by partnering with EPIC,” comments Love. TOH’s major investment of more than $150 million is essential to advance the effectiveness and efficiency of its programs and services.
Implementing the EPIC platform will be one of the largest transformations TOH has undertaken and will positively change many of the hospital’s current practices. The outcome will be a fully electronic infrastructure that will improve the efficiency, effectiveness and “patient-centred” options that TOH envisions for its programs and services. In addition, the EPIC platform will provide a base upon which regional programs and services can be integrated across other health-care providers.
“Implementing the EPIC platform is a critical strategic investment for both TOH and our health-care system in the Champlain region,” adds Love. The future of health care is the integration across multiple sectors. “Whether it is hospitals, home-care, long-term care, post-acute care, support from family physicians or community health centres, we have to look at how we provide care across an entire continuum of what a patient needs, and just not episodic care within a hospital.”
The EPIC platform will enable TOH and all health-care partners across the region to create a fully integrated health-care system that will benefit patients and families accessing all health-care centres.
The Ottawa Hospital – The Future of Health Care
The health-care industry is advancing at an incredible rate. It has been said that the advancements that occur over the next decade will have a greater impact on the health-care system than those over the last half century. “The advances in medical technology, electronic systems and devices, drugs, and research outcomes will continue to evolve at a rapid rate. As we plan the future of health care, we have to take into consideration these evolutions and create flexibility within our hospital and health-care development plans,” comments Love.
The advances in health care will impact all sectors and such transformations will change the landscape of not only health care but also the City of Ottawa’s infrastructure. “When we think about the evolution of health-care technology and where patients will receive care in the future, between hospital and home, the patient experience will be focused on the human vision of care across an integrated health system,” adds Etzinger.
TOH is a leading North American health-care centre focused on compassionate, world-class care. With a robust development and electronic health-care system transformation strategy, the success TOH has achieved to date will evolve further, allowing the hospital to reach its goal of being a top 10 percent performer, benefitting the patients and families of the Champlain region.