Through the Eyes of the Patient


The Annual Report of the
Board Chair, Geoff Watson
President and CEO, Michelle E. DiEmanuele


Most of us don't choose to become hospital patients. At The Credit Valley Hospital we understand that coming to hospital can produce significant anxiety and in some instances, life-changing circumstances.  Recognizing this, Credit Valley, since it opened its doors almost 25 years ago, has sought to create a less threatening environment that speaks to healing and hope – salus et spes. 

The theme of this year’s annual report is "Through the Eyes of the Patient" a testament to our promise to provide and enhance patient and family centred care.  Human capital – our "people power" is the reason for Credit Valley’s can-do approach to providing excellent community based patient and family centred care. The Credit Valley Hospital’s employees, physicians and volunteers are our most treasured resource.

Get the Flash Player to see this player.


We are proud to feature our special guest speaker, Dr. Iqbal "Ike" Ahmed, a
world-renowned fellowship-trained glaucoma, cataract, and anterior segment surgeon practicing at The Credit Valley Hospital, whose quest to provide the best patient care has led him to design and construct microscopic surgical instruments to enable the most delicate and intricate patient surgeries in the eye. His life work is driven "through the eyes of the patient".

On August 12th we welcomed our new president and CEO, Michelle DiEmanuele, a visionary and exemplary leader from the public and private sector. Her insight and collaboration with experts inside and outside our hospital resulted in a more focused and streamlined administrative structure that lays the foundation for our future. Our values of excellence in patient care, teamwork, partnership, respect, accountability and leadership remain key to our success. The new structure aligns our programs and services to enable effective collaboration, strategic decision-making and quality performance at all levels of the organization.  

Get the Flash Player to see this player.


Our community within the Mississauga Halton LHIN accounts for the highest growth annually of any of the LHINs at 17% of the entire provincial growth.  Last year our community grew by 6%.  In real terms we provided care to

  • 2,000 more ER patients than last year
  • Delivered 4,930 babies this year (down 20 from last year)
  • Cared for 5,223 neonates
  • Saw a whopping 393,296 patients in our outpatient clinics
  • Performed 15,683 surgeries (down 178 from last year)
  • Performed 13,792,808 laboratory workload units – an increase of 436,331 units over last year
  • Performed 5,327,433 diagnostic imaging workload units – an increase of 240,416 units over last year
  • Provided inpatient care to 24,409 patients this year – about the same number as last year.

This year, we have taken significant steps to enhance patient care, patient safety and patient and support processes.

Get the Flash Player to see this player.


Below we outline just some of the initiatives that have been undertaken and achieved during this very busy fiscal year.  These achievements are recorded beneath each of our five strategic directions.

concentrate on operational excellence of core programs and services

Strategic Direction

  • Survey by Accreditation Canada in March 2009 focused on our ability to meet national standards of patient safety, quality and excellence.  Overall, CVH meeting the standard but there are areas for improvement, duly noted by CVH in the self-assessment phase last fall and confirmed by the surveyors during their on-site visit.
  • With limited resources and a focus on health outcomes, systems integration and alignment makes sense.  To that end, we have integrated thoracic and vascular services at Trillium Health Centre and The Credit Valley Hospital.  All malignant thoracic oncology surgeries are now performed at CVH while major vascular surgeries at performed at Trillium Health Centre.
  • Two members of this year’s FMTU graduating class of residents will stay at CVH and set up family medicine practices.  This is in keeping with our strategy to train  more doctors here hoping they will in turn set up their practices in Mississauga.
  • Working with five Mississauga MPPs/Cabinet ministers to expedite capital planning grant for offsite ambulatory surgery centre.
  • The donor of our first digital mammography unit has provided funding for a second unit.  This will have a tremendous impact on our ability to add in urgent cases, provide pre surgical procedures and reduce our wait time now at 6 weeks.  The new unit has the capability to do tomosynthesis, (with a future upgrade) which is quickly being recognized as a very useful tool in breast cancer detection.
  • New senior leadership structure focusing energies on patients and aligning administrative structure will support operational excellence.

show leadership as health system partner in fostering collaboration and integration with our external and internal stakeholders

Strategic Direction

  • Today up to 47% of all hospital admissions in the Mississauga/Halton LHIN are seniors.  Former chief of staff, Dr. Barbara Clive and Peel’s Senior Link CEO, Ray Applebaum co-chair a 19 member Geriatric Advisory Task Force that is developing an action plan for an integrated prevention and promotion program for seniors that provides one-stop shopping to enable seniors to navigate through the maze of support services, whether it’s health care, social assistance, transportation, meals on wheels and other services they may require.  It will be a geriatric service delivery model  that will be community focused, close to home -- designed to cut through the red tape that often inhibits those who really need help, from seeking it.  It will be fashioned to meet the needs of our diverse population.
  • Moving forward in partnership with the MH LHIN with the development of the regional maternal/child program to be housed at Credit Valley’s new A and H wings. Key to this will also be strengthening our excellent relationship with Sick Kids and the Child Health Network.
  • Working with Trillium, Halton, William Osler to integrate supply chain management (iSCM) to create more efficient and cost effective support services.
  • SSW president hired between MH LHIN and Central West LHIN and affiliation with OntarioBuys program.  Purchasing, materiels management and accounts payable functions at The Credit Valley Hospital, Trillium Health Centre, Halton Healthcare Services and William Osler Health Centre will be integrated into one provider under the Shared Services West initiative.  The goal is to centralize supply chain operations wherever possible to realize potential operating efficiencies and the streamlining of operating practices.
  • Recruitment of a regional bioethicist to service the needs of Credit Valley patients and those within the Mississauga-Halton LHIN.
  • A regional credentialing initiative is being finalized between the three hospital corporations in the Mississauga-Halton LHIN.

Developing the Academy of Medicine at University of Toronto at Mississauga with Trillium Health Centre.  Funding for the campus construction has been awarded and capacity for 54 medical trainees has been approved. Working with the Trillium Gift of Life Network staff, two organs (liver and heart as well as 2 corneas) were donated from one patient over the Christmas holidays.  This is a first for CVH and what a wonderful time of year for this to happen.

create and enhance evidence based safety focused and patient centered systems for patients, their families and staff, physicians and volunteers

Strategic Direction

  • Emergency department flow project supporting the swifter movement of patients to the appropriate diagnostics/care professionals and/or expediting the movement from ER to patient unit when required. Between 220 and 260 patients moving through ER daily.
  • First nursery in Canada to implement Bedside Medication Verification which will reduce errors and protect the safety of our tiniest patients. (BSMART) eMAR BMV in our Special Care Nursery improves safety through electronic documentation as well as barcode verification of patients and medications at time of medication administration. Clinicians in the Special Care Nursery scan barcodes on the infant identification band and medication packaging to ensure that the patient is receiving the correct drug, in the correct dose, and at the correct time.
  • Credit Valley’s paediatric unit is one of the first in Canada to pilot Bedside Paediatric Evaluation Warning System, an evaluation tool that helps the health care professional determine if inpatient paediatric patients are deteriorating.  The project was completed in partnership with The Hospital for Sick Children.
  • The restructuring initiative has enabled a more integrated approach to quality, risk management and standards more aligned to delivery rather than administration. 
  • CVH willing participant in the web-posting of patient safety and Safer Healthcare Now initiatives (such as C-difficile, HSMR, MRSA, VRE among others) to create more transparency and accountability in our patient community.
  • Working with Trillium to integrate their patient data into our regional electronic health record portal (REACH) to support a broader patient/physician information network.
  • Created satellite Critical Care Unit to support cardiac stepdown for patient safety and optimum and safe management of most critically ill patients.
  • Inpatient mental health has enhanced unit safety checks resulting in the identification or many unsafe items such as plastic towel racks, blinds with cords, hidden medications, tears in the floor that a patient could trip and fall on have been repaired.
  • Also on the psychiatric special care unit tieless patient gowns, paper bedpans and urinals were introduced resulting in improved patient and staff safety.
  • Just Clean Your Hands campaign and handwashing audits in all clinical areas.

Our communities health and wellness education continues to be a significant focus of activity through community health education seminars, teddy bear and teen health fairs, audio and video podcasts and our new health and wellness magazine, Thrive.

be the workplace of choice that provides an enriching experience for staff, physicians, volunteers and maintains required human resource capacity

Strategic Direction

  • Staff, volunteer and physician surveys completed in fall 2008.  Our satisfaction rate is 61% and requires significant improvement. 
  • New human resources strategic plan to address recruitment, retention and overall satisfaction among CVH staff.
  • Attendance Management Program in place to support staff who are off work for extended periods of time and/or assimilate them into a “modified work” environment until such as time as they can return to their full time job. 

demonstrate a solid financial performance and a strong commitment to accountability

Strategic Direction

  • Budget for 2009/10 embeds savings as approved by the board for the HAPS agreement as well as investments in such areas as infection control and quality.
  • We are an efficient and well run hospital but we are in a very high growth area.  The government does not fund the levels we need to address this growing and aging population and the acuity of illness we treat.
  • CVH will run a deficit this year.  Simply put, there is more demand for our care than we have funding to deliver from government and our LHIN. This is the primary reason for our deficit.
  • There is no question that in our region and our city our growth justifies greater health care funding.  However we recognize the strain on all government funded services and the challenges our Government faces to be fiscally responsible.
  • We have developed a two year plan with our LHIN to reduce our deficit and by definition to manage effectively the needs of our community. Even then we will still provide care to more patients (higher volumes) than we are funded to do.
  • Everything that we do will be measured against our guiding principle; we will maintain patient safety, while doing our best to achieve good patient outcomes. We will not compromise that principle and as such we have made strategic investments to support this.
  • This year we undertook comprehensive internal and external review of best practices to support our strategic direction and definition of core business.
  • Core business strategy resulted in elimination of outpatient rehabilitation centre for chronic conditions (service available in community) and elimination of outpatient laboratory procedures excepting those necessary for clinic.
  • Still, in these times of economic crisis and growing demand, there will be stresses on the services provided.  Wait times will increase, we will need to work with our community partners and other hospitals to find ways to address the demands through regional service delivery. New services will have to wait for new funding.
  • Credit Valley’s new A and H wings will open in 2011. This will definitely present us with opportunities to better meet the demand. 
  • Green Team initiatives recognized with Ontario Hospital Association (OHA) Green Award – resulting in reduced consumption of electricity by 13%, natural gas by 16% and water by 4% totaling savings of $255,914. Also reduced Green House Emissions, equaling 750 tonnes. 

These are but a few of the accomplishments pursued to further our strategic directions during the past fiscal year. We are proud of the strides we have made to ensure sustainable, reliable and safe patient care but there is much more we can do.

We will do so with the support of our staff, physicians and volunteers.  During the past year, our volunteers have provided 111,309 hours of service.  We are truly blessed with a strong and committed team of volunteers – last year 748 adults and 577 youth donated time to CVH. Not only do these volunteers give of their time, through the Gift Shoppe and other fundraising initiatives such as the HELPP Lottery, the volunteer partners financially support the Hospital Foundation’s Lifetime of Care Campaign.

The Foundation has raised approximately $23 million of its $45 million goal for the Lifetime of Care campaign and will officially launch this ambitious campaign in the fall of this year.  Recognizing that the recession has impacted corporate and individual donor contributions, we are especially proud of our Foundation and its staff for their determination and drive to succeed. The February Gala was testament to their stamina – despite lower attendance than previous years, the Gala raised a whopping $400,000 -- the most successful Gala to date.

Our new administrative structure lends itself to a more streamlined and proactive approach which is focused on patient care, safety and quality.

In April 2008, approximately 200 staff began parking offsite at rented space at Erin Mills Town Centre in order to provide adequate parking for patients and visitors while a four storey addition was constructed on the primary parking garage on the hospital grounds.  As of April 2009, up to 675 staff and some volunteers are parking offsite. We are grateful to the staff and volunteers who, despite personal inconvenience, are supporting our patients and families.  We expect to open the expanded parking garage and move the staff back to hospital parking in the fall.

We have accomplished a great deal during this fiscal year, but there is much more to do.
We will continue to advocate for appropriate funding to support patient volumes. Not to do so would challenge our pledge that we will not compromise patient care. As noted within the body of this report, the actual volume of service we provided in 2008-09 was more than available funding. Our hospital is situated within the Mississauga Halton Local Health Integrated Network (MH LHIN) which has the largest Provincial gap (10.6%) between demand for healthcare services and supply of funds available. In 2008/09, the MH LHIN received less per capita ($282 per person) to provide the same level of care as hospitals in the rest of the province.

Although we have provided a plan to balance our budget within two years, in reality, this will be a challenge without the appropriate infusion of funding added to our base to reflect real growth..

These facts and the relevant supporting data will figure prominently in our planning cycle and submission documents to our LHIN as we embark on next year’s planning cycle in the coming weeks.

We have an outstanding team of dedicated health professionals, physicians and leaders. They are our most valuable resource. We owe it to them to provide them with the funding and the tools to care for our patients because they see the world through the eyes of our patients.