Grand River Hospital Annual Report 2021/2022
Resiliency, flexibility, collaboration and courage
Joint Message from our Board Chair and President and CEO
Throughout the second year of a global pandemic in 2021-22, all health care providers, individually and collectively, faced uncertainties, fatigue and relentless emerging challenges.
During these unprecedented times, while it was necessary to respond to the day-to-day challenges, we focused on three priorities:
- Protect the safety of patients, families and staff members;
- Promote the wellbeing of the hospital team; and
- Advance our commitment to building a strong foundation for the future of the health care system in the communities we serve.
We applied a flexible mindset, adapted to the rapidly changing environment as new challenges arose, responded to new waves of COVID-19 and executed on foundation-building initiatives, starting with the completion of a 5-year Strategic Plan.
The Board approved GRH’s Strategic Plan for 2021-25 at the very beginning of the year. The plan was developed to achieve ambitious goals. It articulates our vision, mission and, perhaps most importantly, our values to guide our actions, planning and decision making. We identified three strategic directions and key initiatives to realize our vision of a world class health care system supporting healthier lives.
Our first strategic direction is to deliver a world class experience for patients, families and team members. This past year we developed our people plan and our patient engagement and experience strategies to guide our work in the coming years. We also made a number of investments to recruit more team members and support their wellness and wellbeing.
The hospital continued our work on Diversity, Equity and Inclusion and Truth and Reconciliation (DEI & TR) by recruiting an experienced leader to help guide this important work, collecting data on the current state, and providing learning opportunities to all team members on DEI &TR.
We proudly achieved exemplary standing from Accreditation Canada, the highest possible award and a first for GRH.
Financially, we again achieved a surplus and continued to strengthen all aspects of the hospital’s financial health. We were also able to make additional operational and capital investment within the year to help move strategic initiatives forward.
Our second strategic direction is to partner to create a world class health system and this year we made progress in a number of key areas.
The Joint Master Plan is a partnership between St. Mary’s General Hospital and Grand River Hospital to develop and renew joint hospital facilities. It is undoubtedly the most important foundation-building work that we advanced in 2021-22. Led by the Boards of both hospitals, and facilitated by a Joint Project team, the hospitals made a Pre-capital Submission to the Ministry of Health, and subsequently received a capital planning grant of $5 million. This milestone marks a monumental collaboration between the two hospitals, demonstrating both hospitals’ commitment to delivering world-class health care that meets the future needs of the communities we serve, builds on the two hospitals individual legacies, and harnesses the innovation and engagement that the Waterloo region is known for.
We continued to operate nearly 30% more beds than our pre-pandemic number in order to support the patient care needs of the broader region. We also began operating 14 additional rehabilitation beds on behalf of Cambridge Memorial Hospital as they undergo the next phase of their hospital redevelopment.
The Kw4 Ontario Health Team (OHT), consisting of 40 member agencies, has grown into an emergent health and wellness system whose vision is to support the voices of the community where everyone thrives and no one is left behind. This past year, the OHT’s primary goal was to keep our communities safe during the global pandemic. GRH collaborated with the OHT on COVID response on many fronts including primary care, vaccination, testing, PPE distribution, development of digital health and information sharing, hiring of the Executive Director, and identification of collaborative quality improvement initiatives for 2022/23.
In January 2022 we operationalized a new MRI machine. Along with St. Mary’s General Hospital we also received approval to operate two additional MRIs between us and we are now jointly fundraising to support the capital costs of these much needed investments.
Our third strategic direction is to innovate and transform healthcare delivery. We continued to work with our partners to move our innovation agenda forward this past year.
This year, we completed our first CanHealth project, strengthened our innovation collaborative locally, worked with the ministry of health and a local innovation company to gain approval to undertake a study to demonstrate the system impact of an innovative surgical solution, adopted new technologies to help improve the patient and provider experience and continued to grow our reputation as a trusted partner in innovation and research.
The GRH team achieved all the above, and more, amidst three additional waves of a remarkable COVID-19 response! We stepped up in many ways to support our community, region and province through the spirit of “finding a way”.
We attribute such an outstanding year to every team member’s commitment to our values – Care!; Welcome One to Welcome All; Trust and be Trust Worthy; Courage to Start, Heart to Finish!
With profound gratitude,
GRH by the numbers
Grand River Hospital is the largest health service provider in Waterloo Region and Guelph-Wellington and provides regional services in a number of programs.
Year in Review 21/22
Bed
Patient stays
Emergency visits
Babies born
Surgeries
Outpatient visits
Our care services
- Cancer Care
- Childbirth
- Children's
- Complex Continuing Care
- Critical Care (ICU)
- Emergency
- Laboratory Medicine
- Medical Imaging
- Medicine
- Mental Health and Addictions
- Pharmacy
- Rehabilitation
- Renal (Kidney)
- Stroke
- Surgery
Our Team
Team members
including clinical and corporate staff.
Medical team
Physicians, dentists, midwives and nurse practitioners credentialed through the Chief of Staff's office.
Learners
including nursing students, medical learners, residents, and more.
Volunteers
with more than 100 active throughout the COVID-19 pandemic.
Financials
Grand River Hospital's 2021/22 revenue was $525 million. It was mainly comprised of Ontario Health funding, with other revenue sources including patient revenues, grants from our Foundation and commercial operations such as retail pharmacy and staff, patient and visitor parking. Grand River Hospital’s 2021/22 expenses were $519 million. They were mainly attributed to compensation for over 4,200 staff, pharmaceuticals and gases, and medical, surgical and general supplies.
GRH achieved strong financial results, exceeding targets in 2021/2022. Year end audited financial results include a surplus from operations of $8.7 millon, and a bottom-line surplus of $6.1 million in comparison to the budget surplus of $0.65M.
Grand River Hospital
Summary Statement of operations
year ended March 31, 2022
$
Delivering on our commitments
Deliver a world class experience for patients, families and team members:
We value people above all else and our aim is to make a positive difference in their lives every day. We will put the experience of patients and their families, our team members, and our partners at the very top of our agenda.
- GRH receives highest accreditation standing: The Grand River Hospital team received the highest accreditation designation from Accreditation Canada – exemplary status! This is the first time we have achieved this designation and we are pleased that patients in our community receive high quality care. The hospital met 98.4 per cent of the total criteria for high-quality patient care. These criteria cover all aspects of a hospital’s patient care practices, as well as how an organization continuously improves quality, innovation and includes partners in the provision of care.
- Integrating the patient and family experience: Patients and their loved ones are at the center of everything we do. We finalized a Patient and Family Engagement Strategy and have worked to recruit members for a new Patient and Family Advisory Network (PFAN). Members of the PFAN provide their expertise and voice at all levels of planning across the organization.
- Organizational culture and effectiveness: GRH was named both one of Forbes Canada’s Best Employers for 2022 and Business of the Year for 2022 by the Greater Kitchener-Waterloo Chamber of Commerce. These achievements are a direct reflection of the dedication and hard work of the GRH team in continuously improving the care we provide to patients and making the hospital a great place to work. We are proud of the team for their passion and ingenuity to strive for world class care for our community.
- Leadership development: A strategy is underway to ensure we recruit, train and retain world class healthcare leaders. An organization-wide framework is being developed and elements of the framework have already been launched.
- Employee health and wellness: Grand River Hospital continues to focus on the health and wellness of team members in many ways including the implementation of temporary mental health benefits. A role, dedicated to the advancement of employee wellness, has been created and the team continues to investigate new, creative and innovative opportunities to build wellness and resiliency across the team.
- Diversity, equity and inclusion: The first draft of the Diversity, Equity and Inclusion and the Truth and Reconciliation (DEI and T&R) Strategy was developed. We will continue to engage our team members and community to validate our direction to finalize our approach.
Partner to create a world class health system
We will be an engaged partner working with our partners, patients and their families to co-develop a truly world class system to advance the health and health outcomes of people in our community.
- Building the Future of Care Together: Together with St. Mary’s General Hospital, we are making progress on exciting plans to renew and expand the hospital infrastructure in Kitchener-Waterloo. The plans include a new acute care hospital, an ambulatory and urgent care centre at 835 King St West and expansion of post-acute service at the Freeport site through renovation. In April, the Ontario Ministry of Health provided a $5 million capital planning grant to support the planning for the project. Lastly, Grand River Hospital and St. Mary’s General Hospital Joint Redevelopment Project to build a new joint acute care facility and expand existing facilities in the Kitchener Waterloo region was included in the 22/23 Provincial Budget.
- Collaboration with Ontario Health Teams: Grand River Hospital continued to play a strong leadership role in developing and the execution of KW4 OHT plans to support world class care for our community. GRH participated in integrated care groups to increase access to services for the refugee community members and for patients that are awaiting specialized geriatric services. The hospital continued to play a significant role in the management of COVID-19 care and prevention throughout the community. GRH continued to align work with KW4 OHT priorities including work that includes the Collaborative Quality Improvement Plan (cQIP), population health management approach, digital health strategy, and co-designing person-centered care models.
- A New Clinical Services Plan: The team has started the work on the hospital’s Clinical Services Plan (CSP) which will guide clinical work and define clinical priorities for the next three to five years. The plan will support the achievement of our strategic plan vision, align our goals, improve the patient experience, inform planning for the future care and infrastructure needs for our community, identify and leverage efficiencies and identify opportunities for additional funding.
- Medical Imaging: GRH made major progress in imaging over this past year with funding and operation of a second MRI as of January 2022 and receiving Ministry approval in Spring of 2022 to begin the Nuclear Medicine project.
Innovate and transform healthcare delivery
We will leverage the collective talents and strengths of GRH, our community, and our partners to innovate and accelerate the transformation of health care delivery.
- Patient Portal and Virtual care: Grand River Hospital is partnering with St. Mary's General Hospital (SMGH) to build a Patient Portal to support patients to access their health data. This portal will support patients to have more control over their health information.
We are also working to improve Virtual Care by expanding the number of access platforms patients can choose. The project will be expanding with the addition of Oncology in September and will roll out to the rest of GRH and SMGH later this Fall.
Care! Grand River Hospital achieves Accreditation Canada's highest standing, validating high-quality patient care
Late 2021, Grand River Hospital joined Cambridge Memorial and St. Mary’s general hospitals to receive full accreditation with exemplary standing from Accreditation Canada, following a review of nearly 3,000 patient care and safety criteria.
Accreditation Canada surveys health organizations to measure compliance with the latest in patient care and safety standards.
“This is a tremendous achievement for our organization and great news for the community with all three Waterloo Region hospitals acknowledged for providing high quality, patient-centred care,” said Ron Gagnon, President and CEO of Grand River Hospital. “This is the highest possible designation an organization can achieve, and the first time that Grand River Hospital has achieved it. It is a direct reflection of their dedication to high quality patient care and their willingness to focus on the needs of others."
Accreditation surveyors found GRH met 98.4 per cent of the total criteria for high-quality patient care. These criteria cover all aspects of a hospital’s patient care practices, as well as how an organization continuously improves quality, innovation and includes partners in the provision of care.
“The team comes to work every day with the goal of continuously improving the care we provide to patients,” said Gagnon. “This designation and the hospital’s other achievements are a result of the tireless efforts of the Grand River Hospital team and their passion and ingenuity to strive for world class care for our community."
Welcome One to Welcome All. Vaccine program managed by Grand River Hospital expands service to provide vaccines to vulnerable populations
In support of the Region of Waterloo’s COVID-19 vaccine strategy, the Grand River Hospital Pinebush vaccine team hopped on a Grand River Transit bus, designated as a mobile vaccination station to visit local hotels in Waterloo Region where Reception House provides temporary residence for refugees that have recently arrived.
This outreach supported residents, who have limited resources to get to a clinic, to receive their COVID-19 vaccine.
“These clinics emphasize work that is happening to continually shape and improve our services to meet the needs of everyone in our community to protect our community,” said Lisa Anstey, Manager of the Pinebush Vaccine Clinic and Grand River Hospital staff member. “This is an incredible partnership between the Region of Waterloo, Grand River Transit, Reception House and Grand River Hospital and reflects our value; Welcome one to welcome all. We are extremely proud to be a part of this amazing outreach and partnership and proud of the team that has come together to provide doses of the vaccine, wherever the need may be.”
Each family had the opportunity to get vaccinated and appointments were not required. The team bought a nurse that speaks Arabic and an interpreter who speaks Dari to support communications, inviting everyone to ask questions in a language they are most comfortable speaking.
Read more about this partnership here: https://aroundtheregion.ca/2022/02/01/removing-barriers-to-vaccines-for-waterloo-regions-refugees/.
Courage to Start, Heart to Finish! Winter storm doesn't stop Grand River Hospital Palmerston Renal clinic staff from providing life-saving care
Grand River Hospital celebrates the work of dialysis nurses at the Palmerston renal satellite clinic for demonstrating courage to find a way to provide life sustaining care for their patients.
Mid-February, a winter storm swept its way through Waterloo Region, forcing the closure of all roads in Wellington County making it impossible for dialysis patients and nurses to get to the clinic for treatment.
“Dialysis patients receive life-saving dialysis treatments three times a week. Missing a treatment for more than three days can make them very unwell and has the potential to put them into an emergency health situation,” said Heidi Ziegler, clinical manager of the renal program.
Two unit clinic nurses (RN), Jean and Shelagh worked quickly to contact each patient to reschedule appointments for the following day, Sunday, despite the fact that the clinic would be closed. Joined by their colleague Cindy, RN they opened the dialysis unit that Sunday to ensure that patients received the care they needed.
“These three nurses went above and beyond to coordinate an emergency plan for our dialysis patients. Their care and compassion fueled this self-directed initiative,” said James Bellamy, director of the regional renal program at GRH. “We are very proud and cannot thank them enough for demonstrating courage and flexibility, and above all else, putting our patients first.”
Pictured are renal clinic nurses Jean and Cindy.
Trust and be Trustworthy. Grand River Hospital recognized as a destination for learners and for their support of students to become the health care practitioners of tomorrow
Grand River Hospital collaborates with more than 50 academic institutions across North America to support learners and advance research initiatives to enhance care practices and improve patient experiences. Last year, the hospital was proud to support more than 700 students to gain hands-on experience and develop key skills that will enhance their learning and professional journeys.
Through these experiences, four GRH physicians were nominated and received Excellence in Teaching honours From the Waterloo Regional Campus of the Michael G. DeGroote School of Medicine for their work with student learners, while another physician received an Excellence in Undergraduate Medical Education (UGME) Mentorship designation.
“We are proud of this recognition," said Dr. Rebecca Kruisselbrink, Chief of Academic Affairs at Grand River Hospital who was this year's recipient of one of the Excellence in Teaching awards as well as the Waterloo Regional Campus Internal Medicine award."This work will continue to grow to benefit both students and patients as we formalize partnerships, and identify new opportunities to establish the hospital as a preferred destination for learners, researchers and future care providers.”
These partnerships – which include local organizations like Conestoga, Trios, and Centennial colleges, McMaster, Wilfrid Laurier and Waterloo universities – continued to thrive throughout the pandemic which altered the learning landscape.
"The benefits of placements are many, and one is that placements aid in developing skills and building confidence,” explained Victoria Crowder-Bansen, Director of Professional Practice at GRH. “Placements are a great way to pair what students learn in the classroom with real-world practical experience, and learn from, and about other hospital roles. We are committed to providing placements that support and shape the graduates of the future.”
Students are invited to gain experience across the hospital from a number of disciplines. Student projects in nutrition and food services have led to practice changes and specialized nutrition programming that are enhancing care, and reducing risk for patients that are at a higher risk of experiencing a second stroke.
Grand River Hospital has also partnered with Conestoga College to bring hospital computer systems (Cerner) to the classrooms of health and nursing students. Future clinicians learn how to document care electronically in the classroom to help better prepare them for real health care environments and scenarios.
"In my learning experience, I gained an appreciation for how long it takes to create clear policies and procedures to reduce the practice variability that may result in substandard care and patient harm," said Samira Yusuf, a fourth year nursing student. "The team I worked with was great and supportive and I will treasure this once-in-a-lifetime opportunity wherever I go in life.”
Grand River Hospital is committed to continuing this work to support student learning, advocate for excellence in care and education and establish the hospital as a preferred destination for learners and future care providers.
Looking forward Building the Future of Care Together
Grand River Hospital and St. Mary’s General Hospital are working together to plan for the future of hospital-based services to meet the needs of the growing community of Waterloo Region and beyond. Following a commitment from the Ontario government to invest $5 million to support planning, the hospitals launched the next phase of this project; “Building the Future of Care Together”.
Waterloo Region will experience significant growth in the future. The entire population will grow by at least 45% over the next 25 years and approach 900,000 people, based on the 2016 census. Within that, our population over the age of 75, which is in greater need of health care facilities and resources, will grow by almost 170%.
The changing needs of our community will place considerable demand on the health system in our region and indicate a need for almost double the number of beds across both hospitals.
By working and planning together, we can accomplish so much more than we ever could individually. This joint planning with St. Mary's General Hospital will ensure that we can build the infrastructure our community needs, and put the right resources in place to meet these needs, today and for tomorrow.
Both hospitals already deliver high quality results when you look at some of the performance metrics that compare ourselves to other organizations and other communities. We want to be able to provide services and facilities that continue to best meet the needs of our community, and that leverage the high quality care we already provide.
Planning is still in the early stages of a process that typically spans between 10 to 15 years.
We will share more about this project; Building the Future of Care Together and this partnership as we go forward. Already we've had input from a number of people, and as we get into more detail around planning there will be opportunities for everyone to share their input on plans for a shared organization.
Shaping our Future
Within the context of what we have already achieved this past year, and in looking out to the future of care in Waterloo Region, Grand River Hospital will continue to strive to provide high quality care and services, and strengthen partnerships across the system to build a world class health system that supports healthier lives, together. To support the achievement of this vision, we will focus on work that drives our strategic directions over the next year:
Deliver a world class experience for patients, families and team members: We value people above all else and our aim is to make a positive difference in their lives every day. We will put the experience of patients and their families, our team members, and our partners at the very top of our agenda.
Partner to create a world class health system: We will be an engaged partner working with our partners, patients and their families to co-develop a truly world class system to advance the health and health outcomes of people in our community.
Innovate and transform healthcare delivery: We will leverage the collective talents and strengths of GRH, our community, and our partners to innovate and accelerate the transformation of health care delivery.
