Credit Valley Trillium Health Centre TeleForum Transcription – 07/23/12

Andrew Steel: I want to thank everyone for joining us this evening. My name is Andrew Steel. And I'll be acting as moderator of this telephone town hall. I'm joined by our host, Michelle DiEmanuele. President and CEO of the Credit Valley Hospital and Trillium Health Centre. In addition, we have with us Kathryn Hayward-Murray, vice president of Patient Services, Quality and Practice. And she's nursing executive for the Credit valley site. And we have Dr. Norman Hill, vice president Medical and Academic Affairs and executive lead medical education. The Credit Valley Hospital and Trillium Health Centers were the first hospital to host one of these great telephone town halls in Ontario last year, during the lead up to their recent merger. After the success of their first telephone town hall, they decided to use this forum again to talk to you about their progress in creating a new strategic plan. We’re pleased you’ve decided to take part in this discussion with the Credit Valley hospital and Trillium Health Centre. Our goal tonight is to hear from you and there will be a number of opportunities to ask our host questions throughout the forum.  To ask a question, simply dial star 3 on your phone anytime. Again, dial star 3 on your phone at any time in order to ask a question. There are … let me check the number here, 800 are on the line right now so far tonight, from all across Mississauga and West Toronto. Very shortly, we're going to start open to our lines for your questions, so dial star 3 on your phone if you have questions. And we'll put you through right away. We're going to take new questions right through here and we're going to wrap up around 8pm. I also want to let you know we will be recording this telephone town hall and planning to upload it to our website at cvhthc.ca for those who are not able to join tonight's forum. I'll now head over to Michelle for some opening comments. 

Michelle: Good evening and welcome to our second telephone town hall. I'm Michelle DiEmanuele, the president and CEO of the Credit valley Hospital and Trillium Health Centre, your hospital. On November 30th of last year, the hospitals merged with the vision of creating a new organization that will provide the best quality patient care for our community. We recognized that by bringing these two great hospitals together, we could do more for you, more for our community, more in the area of services, more in the area of improved patient experience while in the hospital and more in helping to simplify services and working together when you are in or out of hospital. We think we can do this in a number of ways. First, we want to discover more about what is it the role you want us to play in healthcare, that unique role that we need to play for our community, that we can play given the work that we do for you. We're also thinking about the journey that patients take each and every day as they come through our doors. Not only when you're in hospital but also when you're interacting with other healthcare services in our community. We need to work together for you. We need to deeply understand your needs, collectively and individually to make sure that journey is as easy and supportive as respectful and ultimately as healing as possible. These are important discussions that will help determine our strategy for the future. Our priorities for the future for the next 3, 5 and maybe even longer as we look forward to hearing what you have to say. We also need to think about a new name. It's one of the questions I get asked many times when I'm out in the community talking to you. That name has to stand for what we are proud of. It has to stand for the work we do. It has to stand for the work we do on your behalf. Ultimately, our new name has to be something you're proud of, that you recognize and that you talk about in your community. I'm interested in both the thoughts on our priorities as we look forward to the future and also our name. Getting your feedback is critical. We know we can't be an outstanding hospital without our community beside us and without your input on how to make things better. Each and every day we come through our doors at our hospital sites to deliver outstanding care on your behalf. It's an honor and a privilege and the responsibility that we take seriously. And our second telephone town hall is another way that we can solicit your feedback in being the best we can be on your behalf. So with that, Andrew, can we get started?

Andrew: Absolutely. So if you have any questions for Michelle and the team from the Credit Valley Hospital and Trillium Health Centre, please just dial star 3 on your phone now. You'll speak to our staff here and get through immediately for a call. So again, that's star 3 for any questions you've got. For those of you who will just join the telephone town hall, we talked thing evening about the priorities of the Credit Valley Hospital and Trillium Health Centre and what they should consider in building their new strategic plan. So we're looking input from residents of Mississauga and West Toronto as we develop these priorities in the direction for the newly merged hospital. Joining me on the line are Michelle DiEmanuele, president and CEO of the Credit Valley Hospital and Trillium Health Centre. And we have with us Kathryn Hayward-Murray, vice president of Patient Services, Quality and Practice, and she's nursing executive for the Credit Valley site. As well as Dr. Norman Hill, vice president of Medical and Academic Affairs and executive lead medical education. Again, if you like to ask your questions, please dial star 3 on your phone at any time and you will be placed in question queue. Michelle, can you expand on the idea that there are different roles that a hospital might play.

Michelle: Sure, Andrew. If you think back a few years. A hospital was often place that you came in to and then left. And it is an event or an episode that occurred in your life. So when we look at the improvements and technology and new drugs and new procedures, and we also look at the advent of disease. We're seeing more and more chronic disease management being an important part of what a hospital has to be involved in. It isn't just about that one time you may come in or out of our doors. And so one of the things I know that we can begin to improve upon is the relationship that we have with all kinds of providers in our community, in our hospital to provide services to patients, to community members on an ongoing basis. It should feel seamless, It should feel like we're working together on your behalf. And I know, if you look to the future that we're going to have to send much more attention on that making more life-long relationship we have as it relates to chronic disease such as cancer, diabetes, hearth health and more. 

Andrew: Perfect. Teresa, Nick, all the different people we have online right now as we're just queuing up your questions, we'd love to get you in just a second. Want to remind everyone who's just joined us here in the telephone town hall. If you like to ask a question or make a comment, please press star 3 on your phone. This will bring into the question queue to speak to one of my colleagues. So as many callers as possible can answer your question. We kindly ask you to keep your questions or comments brief. So we're going to go to our first question of the night. That's going to be from I believe it's Teresa. Teresa, are you there?

Teresa: Yes. 

Andrew: Can you give us your question, Teresa?

Teresa: I was questioning about... I was asking a question about outpatient services.

Andrew: Perfect. You're on the line. Please go ahead. 

Teresa: And whether or not these would be available at both locations. So that people could choose to go to the one that was closer to them rather than have to travel to one location and therefore possibly make a longer trip that would be more difficult  for them and therefore not have sort of the seamless open outpatient services that you were discussing. Would you be localizing outpatient services at one location or another? Or would there be available at both locations?

Michelle: So, Teresa. Thank you for the question. First off, let me just say, the outpatient services and how that evolves overtime is actually extremely important because in some ways, that's our connectivity to the kinds of service available in the community, and so if you look to the future, I think there's a couple of things we take into account. Firstly, it's important to remember that you have to have a critical mass of any particular service to ensure that you can deliver it in a quality way. Tracking professionals who can do it means that we have to have enough work for them to do at any one location. Secondly, as you mentioned, we also have to look at the navigation pattern of patients in the community to make sure that services are acceptable. And that issue of quality and acceptability has to constantly be reviewed and calibrated. One of the things I believe that we will do is in the coming year is begin a project or a dialogue around how we should be aligning our outpatient clinics to best meet services. Almost half of all the interactions we have in the hospital are done through outpatient clinics. And so I think they have an enormous responsibility to make sure as we look at the benefits of the merger, and we believe one of those benefits is to improve on, even further, the high quality services we already deliver and part of that rests in how we best use our clinics. So I can certainly assure you that if there are changes, there'll be change that will be well contemplated, balance in quality and access and certainly understanding that when our patients are in need of services, having things accessible is really key.

Andrew: Okay. We have another call here. I think we want to go to, is it Norma? Norma, are you on the line there, Norma?

Norma: Yes.

Andrew: Hi, Norma. Can you give us your question please. 

Norma: Question for Michelle and I think I heard Dr. Norman Hill also. It's Norma Nicholson, past president of Peel Chapter, hello. My question is preventative treatment and diagnosis for children in youth with mental health. There are many children in our school in the Peel region who are not diagnosed and who are presenting a lot of challenges in school or not even attending school. Will our new hospital combine their pediatric and psychiatric expertise to facilitate some outpatient studying for early diagnosis?

Michelle: Well, Norma. Thank you for the question. I think one of the things that I think I'm always reminded of is we talked about our growing seniors population but in our west Toronto, Mississauga Community, we have one of the fastest growing pediatric population and in fact some would say we're in a mini baby broom. And so your question is a very important one because as we know, those mental health services are so critical at the early stages of growth and also as children enter their youth. And our two founding hospitals, our new hospital is rich in being a regional pediatric centre, it's rich with mental health services including those quite steeped within the community setting. And so our goal is as, we develop our new strategy to be able to speak to the kinds of things we need to be doing to help children be successful. Whether that is at birth, during the key development stages in youth, and then the important transitions from youth to adulthood. So yes, I think you can be assured that there'll be certainly activity in those areas and our LHIN, our local health integration network is also going though their planning and we've been strongly advocating for key strategy in this area. 

Andrew: Thanks everybody for your great questions so far. I just want to remind everybody who's joined us to dial star 3 if you have any questions. Again, dial star 3 on your phone if you have any questions for Michelle DiEmanuele and the team here from the Credit Valley hospital and Trillium Health Centre. Want to go to another caller, Barbara. Are you on the line there, Barbara?

Barbara: Yes.

Andrew: Well, do you have a question for Michelle?

Barbara: Yes. I wanted to find out if smart beds and other advanced technology that remove or reduce personnel need in the hospital are part of the plan? Because I like them to be not part of the plan. 

Michelle: Barbara, can you just repeat that first part of your question?

Barbara: Smart beds and other advanced technology systems that might be considered so that personnel can be reduced and personnel cost be reduced. I would like to know if those were in the plan because I would like them to be not in the plan.

Michelle: So, Barbara. Let me talk about very specifically the issue around work force and the plan going forward. We have a growing need in this community for services. Whether that's for chronic disease, for seniors, for children, and I can assure you that even in our first year, we have filed with the hospital board a plan for a balanced budget even given the demands that are being placed on us as a hospital and we have not reduced our very needed nursing and service staff and clinical professionals given the growth that we're seeing. That doesn't mean from time to time we don't need to move those staff around in the hospital to more effective, deliver higher quality, to respond to changing technologies etcetera. But we'd certainly been in I would characterize more of a stable to growth mode than a reduction mode, and we don't certainly see that in our future. Just to again state the obvious and I know you know this, living in this community. Our hospitals are stretched because of the growing demands that we already have is already very key. The other component though specifically on smart bed is that there is some benefits, there is certainly evidence that would suggest from a staff safety perspective, they can actually, that use of technology can actually be quite beneficial for staff safety and reducing risk of injury etcetera. So those certainly we wouldn't want to ignore that, but I think the two issues are somewhat separate. Using technology to improve safety, improve quality, reduce risk will always be something we reflect on. But in terms of a reduction in our staff at this point, we're certainly not contemplating that. 

Andrew: Thank you very much. We're going to go now to ask you guys a question. Before I do that though, I just want to remind everybody if you just joined us, we're here with Michelle DiEmanuele and the team from the Credit Valley Hospital Trillium Health Centre. If you have a question for Michelle and the team, please dial star 3 on your phone. With this already we have more than 6,000 people on the line who are taking part of our call tonight. It's very exciting. We're doing very well. We want to try and hear from as many of you as possible. So to do that, we're going to ask you guys to call in question. So if you answer this polling question, please just hit the 1, 2, 3 or 4 buttons on your phone. So let me give you the question. When considering the values that are important for health care provider, what do you think should be the highest priority? If you think it's simplifying health care, please press 1. Active participation of patient, please press 2. Trusted relationships, please press 3 on your phone and if the power of the team, please press 4. So again, when considering the value that are important for health care provider, what do you think should be the highest priory? Simplifying health care, please press 1. Active participation of patient, please press 2. Trusted relationships, please press 3 on your phone and if it’s the power of the team, please press 4. So we’re just going to everybody a moment to start answering those questions. They're starting to come in quite quickly now, that's great. In the mean time, we're going to go another person on the phone. We'll just set that up in the moment and then we will get our next call. I think we're going to go with Chuck if that’s possible. One second here. Chuck, can we get you on the line there, are you there?

Chuck: Yes, I am. 

Andrew: And you have a question for Michelle. 

Chuck: I have a question and a comment. First, the question. What kind of cost benefit have you done to presume that we should be spending good healthcare dollars on changing the name and the signage and all that goes with it with your hospital? We've been quite happy with the name of the hospital and we understand the hospital. My comment now is I really enjoyed going to some of the educational evening sessions that Trillium put on last year, and I was disappointed that not enough people from the community took advantage of that. I think more of that should be done so we learn better how to look after ourselves. 

Andrew: Excellent. Thank you. 

Michelle: So Chuck. First of all, one of the reasons we're doing the telephone town halls is in fact to try to reach out to as many people as we possibly can. The physical town halls that we've held in the past are just one of many mechanisms and certainly the use of technology in this case has allowed us as Andrew has said we're already up to about 6,000 people who've been participating on this call. The name change I think it's clear to say that we have a very very rich history whether it's at the Credit Valley Hospital or the Trillium Health Centre. Both those names invoke I think a great sense of pride, a track record that is known to be of extremely high quality. And we certainly are very respectable of that. We actually don't have a name. We have several names and one of things that we look to is to be able to have a naming regime or architecture that allows patients to know where they need to be for the work that needs to be done or the procedures to be carried out as a visit that you have, and so that's an important reason by which we would be naming the hospital. Secondly, it binds us together as a community, as an organization and helps us to be able to articulate and aspire to the kind of level of organization, care, compassion, whatever that inspirational name may invoke. And so I certainly agree with you that we heard very loud and clear from our community that history of the names of these two organizations is one that needs to be respected and thought of. Having said that, we are looking at a naming process. And we've already stopped doing something to ensure that the cross benefit as we review it is one that is favorable and not using valuable tax payer and health care dollars for administrative changes that aren't necessary. And so things like signage that we knew needed to be replaced over this past year either because it's lifespan had just ended in terms of its usefulness or that there were feedback, pieces of feedback we've received from patients that said we could make signage more clear. Those kinds of things we are accepting regularly so that we're not replacing anything that we know needs to be replaced in the future given a name change, but only that which is from a safety or risk perspective needs to be changed right now. We've also been looking at how we can roll out a name change maybe over a serious of phases as opposed to one quick change that may invoke, in fact, needless cost and so we're reflecting on that as well. And lastly, you know, simple things like business cards and those sorts of things. You know, we’ll move to technology in a way that will enable us to do this very cost effectively. So I can assure you as we go through the process, and the part of the process where in right now is soliciting the feedback from our community on the name, soliciting feedback in focus groups and through staff events, through community events. And then we will move to a selection process, and then through that selection process a cost benefit analysis. I guess I would end with is saying I will say that the overwhelming comment we have received is that we do need a new name and that we do need to be mindful of cost in doing that and going through that process. 

Andrew: Excellent. So guys, I just want to remind everybody who's on the line with us tonight to dial star 3 if you have any questions. Nancy, Darlene, Beverly, John, Delilah, Catherine, Lisa, Madeleine, lots more people are on the line wanting to talk to us and trying to get everybody tonight. Nancy, we're going to go to your next if that's possible. Nancy, are you on the line?

Nancy: I am and thank you very much. Michelle, my question really, my comment really is the two priorities that I see in healthcare these days are one word that we (??) freely like patient centered care and seamless care. And I'm sure you recognize too that the literature is full of the benefits of approaching these kinds of things with real integrity. Now recently, I've watched family and friends go through the health care system and sometimes it's very difficult to see that it is patient centered and sometimes it's hard to see that there is coordination. I think one of the answers to this is  a far more active role for the people who consume healthcare services and I'm just, I'm very much aware that healthcare professionals play a big role in helping people become more active feeling comfortable. I'm wondering in your facility what you do to monitor and evaluate, if indeed you do have that patient centered climate, and if there is patient involvement. 

Michelle: Thank you. So first off, let me say that it is important I think to separate a great experience as it relates to the specific care and then a great experience. And certainly, I think we like to think about both of our roles around our relationship with the patient, not just about the specific treatment they receive but also about the overall experience, and I think that's what you were getting at. You know, I wanted to share with you a couple of examples of things that we've heard from patients as we've been going through this strategy development. It's simple things, but we've heard things like I just need help finding where to go. I just need people to understand my need for dignity. I mean that's all about respect. I'm scared and I don't know who to talk to. I need you to wash your hands before you take care of me, about infection control. One patient said very simply, I need a blanket. That's about work. You know, sometimes the experience is about some of the most simplest things and yet the most important things. And I do think it's important that the hospital, particularly as it has become larger has many way in which it is listening constantly to the feedback of our patients on the experience. So let me tell you about a couple of things that we’ve done in the early days but we have more work to do for sure. Firstly, one of the most important committees of our board is our quality committee. And that committee is constantly looking at the information associated with both the quality of care but also the patient experience. We have a patient sitting on that board subcommittee. And I think they provide us with a very very important set of information. We have patient advisers in our hospital and although they work directly with the VPs in our respective areas, they have absolutely open access to the CEO and our chief of medical staff in bringing forward patient stories and patient concerns. On a daily, monthly basis, I regularly get information not just about the satisfaction patients are having with the hospital but also specifically about the areas where they have been unsatisfied with either care or the experience. We constantly monitor through our picker survey the results about that patient experience. And we are starting to do more reporting right at the bedside as we do transfers etcetera so that our clinical staff, who are right there at the ground level working with patients, are having a constant dialogue. These are just a few ways. One of the things we want to do is use this telephone town hall to hear more about what you like to see in your hospital.

Andrew: Thanks, Michelle. So if you have a question to Michelle and the team of the Credit Valley Hospital and Trillium Health Centre, I'll remind you, please dial star 3. Thanks for joining us tonight. Great to have all you here with us. I want to give you some of the results from our first survey. Then I'm going to ask you a second question. So first of all, we asked you when considering the values that are important for health care provider, what do you think should be the highest priority? Interesting answers; 32% of you said simplifying healthcare. 30% said of you said, active participation of patient. And 19% said constant relationship and the further 19% said the power of the team. Various answers. So I'm going to go to our next question here. Which is; when you or family member need care, what are the most important to you personally? So let me give you all the choices here. Again, press 1, 2, 3 or 4 on your phone. When you or family member need care, what are the most important to you personally? Getting clear information and answers to your questions please press 1. Being able to speak to someone in your own language, please press 2. Getting a care you need quickly without having to wait, please press 3. Feel that your caregiver is understanding and responsive to your need, please press 4. So let me give that to you again. When you or family member need care, what are the most important to you personally? Getting clear information and answer to your questions, please press 1. Being able to speak to someone in your own language, please press 2. Getting a care you need quickly without having to wait, please press 3. Feel that your caregiver is understanding and responsive to your need, please press 4. So please put those in right now. Also, if you have any questions for us, dial star 3 on your phone and you'd be queued up in order. So now I have lots of people who have questions but actually, Michelle I had a question for you. You spoke very briefly about the need to name the new hospital. We have a little bit of questions about that. Just wanted you to expand a little bit on the need to have the new hospital name. 

Michelle: Sure, Andrew. So in developing our brand, there's a few things that we're certainly weighing in the new name of the hospital. Does it support our opportunity and our strategy for the future? Does it help people navigate and understand where they need to be? Does the name of the hospital represent the whole? something that is greater than any one part of the hospital might be on its own. Does it reflect the culture and the values of the new organization, and the diversity in which we serve our community? And it is something that when we look to the future, it's flexible enough that it can evolve with that future and still ring true. So those are the kinds of things we're considering. 

Andrew: So we're going to go to Darlene next. Before I do that, Darlene. I just wanted to give the answer to the polling question that we've got here. So in terms of feedback; the majority of you had said that when you or a patient member need care, most important is getting the care you need quickly. 56% of people said that. 24% said getting clear information and answers to your question. 17% said knowing that your caregiver is understanding and responsive to your needs and just 3% said being able to speak to someone in your own language. Very interesting results. So we're going to go to Darlene is we could now. Darlene, are you on the line there?

Darlene: Yes. Good evening. And thank you very much for taking my call. I am interested in relaying to you my opinion about the name for the hospital. I was part of the focus group that was at Credit Valley for the volunteers this past Thursday, and I relayed my feelings at that point and I would like to relay my feelings to the members that are out there right now, the 6 to 8,000 people that are listening. There are three hospitals, two of which have already merged. There is the Old Queensway site, the old Mississauga site, and the Credit Valley site. The name's have been changed for the Queensway and the to Trillium now and the Mississauga hospital is now Trillium so there's two Trilliums. And Trillium is our Ontario flower. It is a three pedaled flower. We are 3 hospitals that are coming to merge as one hospital. I think Trillium is a perfect name a lot of forethought went in to having this name picked out in the first place, a lot of time, effort and money into choosing this name. And I think we should ride the crest of this wave and just continue it on to the future. To separate the hospitals, or to show which wing, I would suggest that they be named wings. That they be the east wing for the old Queensway hospital. That they be the south wing for the Trillium Hospital, and that they be the west wing for the Credit Valley Hospital location. I think this is an ideal choice. I think that cost effectiveness would come into play as there is a lot of Trillium, it’s out there already. A lot of expenditures have already gone through the filtration system and we would just be riding the crest. My second comment is that for people who need to go from different locations, that there be a shuttle service provided to go from Queensway to Trillium, Trillium to Queensway to Credit valley back and forth. So people don't feel so disjointed and alienated, and they're here under stress to begin with having to have treatment that this will distress them. Thank you for taking my call. 

Michelle: Darlene, if I could just say thank you so much. You've clearly given us a great deal of thought, and these are certainly many of the considerations that we are reviewing and looking at and as our other caller advised.  The cost effectiveness couples with the kind of logic that should prevail in the new name are certainly in the forefront, but thank you so much for that outstanding feedback. 

Andrew: So Beverly, we're going to go with you next and then we're going to go to John. Just wanting to give you a heads up there John. So Beverly you had a question about making sure the clear distinction between the names.

Beverly: That's right, I just like to piggy back on what Darlene said. Good evening and thank you for taking my call. I am a hospital volunteer and right now I find very frequently, almost every time I'm on service, there is a great frustration among people coming because they end up coming to the wrong Trillium. So I would just like to say I understand the need for one name, I think it's wonderful but I think we will have to be very careful about these distinctions of which one they're going to be going, because we'll be adding one more petal to the flower that we have right now. And my other concern was with communication. As we grow larger and the sphere the hospital becomes larger, again as a volunteer, I see a greater need for clearer communication, and communication at all levels from doctors, secretaries, patients and volunteers. And thank you very much for taking my call. 

Andrew: Thank you, Beverly. So, John, I wanted to go to you. You're up next. 

John. Okay. Thank you very much. My call is based on some experiences I had with my 80-year-old father in law. I’ve been to Credit Valley a number of times dealing with health issues as they arose. But he was a long time diabetic. And we became concerned over a number of occasions where, his diabetes didn't seem to be well controlled, and it seemed that the philosophy was to not worry about the diet but to control the diabetes with insulin. And that resulted in him having many highs and many lows and quite dangerously so, and we had a specialist intervene once, and thought that it should be more controlled, that his diet should be restricted and insulin given only when the numbers reached a certain level. Is there any common... it maybe sounds critical but there seem to be a lack of hospital wide training in regards to dealing with diabetics, and that would be sad because there's so many people diabetics that don't go there for a diabetes really, they have other health issues. But the diabetes is so prevalent now. It would seem to me that it should be looked at more closely. That's my question. Is that a question or comment? 

Norman: Diabetes is one of our chronic diseases, which impacts a huge portion of population, and seem to be increasing frequency over the years. So there's no question that management of diabetes is high on our priority list and we have a very large outpatient (sound was muffled, could’t make out what was said) that are we also have inpatient educators for diabetes all in the hopes to manage this thing. And a few things such as (sound was muffled) check their feet, making sure that they're monitoring their diabetes, and (H1C?). The challenge with diet, specifically with the men who are patients, as we get older don't really follow our diet. So sometimes we do (sound is muffled) that we monitor the diabetes but we don't monitor the diet because they don't follow the diet all that well. 

Speaker: That was Dr. Norman Hill. He's the vice president in Medical and Academic Affairs and executive lead for medical education at the hospital. And I wanted to thank you very much for that question. I also want to remind everybody who's on the line with us right now. We have more than 5600 people on the phone with us. Can you please dial star 3 if you have any question for the team here. We've got a whole bunch of people in the queue and I’d like to go to Delilah next, but just reminding everybody star 3 will get you put through to have your question asked to the team here. So Delilah, are you on the line there?

Delilah: I am. Good evening everybody. I'm both a member...

Andrew: Can you speak up a little bit, Delilah?

Delilah: Sorry. Hi. Good evening everybody. I'm both a member of the community that our organization serves and an employee of our organization. And in listening into the first half of this town hall meeting it became very prevalent that our organization is trying to find ways to improve, I guess the for a lack of a better term, the way to improve our health service delivery. And so I was wondering, because research was identified as one of the pillars of this new organization and one of the things that we would like take on, whether or not health service delivery has emerged or will emerge as a team to focus on in terms of our research initiative and helping us get to improving the health care we provide and the health service delivery we provide in collaborating with CAD? partners. 

Andrew: So let me get...I just wanted to repeat that back because you were a little quiet on the phone. I think we might not have the best connection with you. You were trying to find out what the research vision is of the new hospital. Is that the best way to summarize it?

Delilah: Not so much what it is but whether or not health service delivery has been considered as one of.... has been considered for one of the themes or our research vision. 

Andrew: Got it. Perfect. Okay. Yeah.

Michelle: So thank you for your question. As you look to the future we know that we're always going to be a hospital that is delivering outstanding care to our community and those comprehensive set of needs. But we also have an opportunity with our new hospital to enter into a research area but also in our academic mission. And so this is an area that we are spending some time thinking about and we believe one of the areas that we can add tremendous value as we move forward is actually in the area of health service delivery. The transition from hospital to home, or hospital to community setting. As we think through services and how they might need to be bundled in a way to support you in complex needs. As we think through your consumer needs in health care over and above your needs or the patients', information for instance, often is a big need, even when you're not specifically a patient in the hospital. So, all of these things we actually, Delilah, are pleased to say are areas that we would agree with you are opportunities for us to really make a difference in that care in our community as we see people moving through the community to hospitals, community service providers, primary care, your family doc and beyond that. So this is an area that I do hope as the strategy emerges, will see very front and center. We're certainly hearing that a lot from our community about an area they would like to see us spend more time on. 

Andrew: Great. I want to remind everybody, please dial star 3 if you have any questions for the team here at the Credit Valley Hospital and Trillium Health Centre. We’ve Got a lot of people still online and lot of people queued up to ask questions. Catherine, I'm going to ask you a question and then we're going to go to our next polling question for you guys. So Catherine, you had a question for us. Are you on the line there Catherine?

Catherine: Yes I am. Hi. First of all I just want to thank everyone. Most of us we work 9 to 5 and we are home (??) and you guys don't have time in helping all of us and that's really really Thank you very much for everything. My question is about our ER department. Any plan to improve our emergency services? Because, I'm not sure if you know that but at least it's 8 hour time and when we go to ER I took my mom and dad many times, it's not just because they have a cold or something minor, they are in a huge pain. My mom has a heart disease. My dad has many complications. So they have to wait 8 hours and then even when they enter that department, no beds. It's just really frustrating at that moment wait 8 hour when you are in pain. So I was hoping, is there a plan to improve our ER?

Michelle: So thank you so much. We are most likely by the end of this year we will have found a place in emergency services that says we're probably the third if not fourth busiest emergency department set of services in the province. We have almost 250,000 people coming through one of our sites in any given year for emergency care, so this is a really important area that we continue to focus on. In essence the front doors of the hospitals, and so generally speaking hospitals already do perform very well in particular around it's wait time between 4 to 8 hours against the provincial averages and the provincial target. The area you eluded to this in your question, the area as it relates to those people who require then to be admitted into hospital, there can sometimes be a greater way to get a bed. And this is the area I can tell you on the very first day that the team and I were appointed to the hospital as the new CEO and our new senior team, on that very first day we began a series of exercises to look at how we could improve flow in each of our hospitals, and improve the ability to reduce wait time for admission, and we have been slowly reducing that wait time. It is a challenge though because on any given day for instance, at our site we are seeing 7, 8, 9 and 10% growth in the area. And so the challenge of this demand coming in, while we continue to try and make even more efficient, what is already a high quality low cost efficient service has been certainly a challenge. We believe over time, with the collective expertise of all of our sites, we will be able to improve it. There are two other things I want to just quickly elude to that we're doing. Three other things. First, we are looking at how we can be more effective on discharge. To see, people coming in now to the hospital in the most effective, safest manner. Secondly, we are looking at changes to the Credit Valley hospital site emergency department and there is as we develop a plan for that particular site that we believe will add again some additional capacity. And lastly, and this is the long term, medium to longer transition, we believe there is a need for an urgent care center in the North part of Mississauga, not unlike what we see at the West Toronto site in the west Etobicoke south area. That west Toronto site sees almost 50,000 patients a year and through their urgent care center. And they don't even have to go to an emergency department. So we believe by doing these two or three things, we’ll be able to in fact continue to not only deal with the demand that we’re seeing increased, but also provide safe quality care. But I do want to say to our community, we know that when you come to the emergency department that it's an important moment in our relationship with you and the work that we do. And we are continuing to try to make that a better experience. 

Andrew: Thanks, Michelle and Thank you for your questions. We've got about 13 minutes left. I'm going to ask everybody on the line one more polling question. But I want to get to James and Susan, few more polls as well. Please stay on the line there and then I'm going to have a fourth polling question then we'll hear a little bit more from Michelle. So let me go with this first question to you guys and you can all use your phones again to vote on the responses. As we consider a new name for the organization, it's important we select something that defines the organization and is meaningful to our community, staff and patient. What do you feel are some options we should consider to… pardon me, what do you feel are some options we should consider to identify ourselves. Any places, names, people or geographic feature. So using the key pad on your phone, we’d like to know what you think our name should consider. If you think we should consider naming the hospital after a place, press 1. If you think we should consider naming the hospital after a specific individual, name it after a person, please press 2. We should name the hospital after a geographic landmark, please press 3. If you think we should leave the name as the Credit Valley Hospital and Trillium Health Centre, please press 4. So again, naming the hospital after a place, press 1. If you think we should consider naming the hospital after a specific individual, name it after a person, please press 2. We should name the hospital after a geographic landmark, please press 3. If you think we should leave the name as the Credit Valley Hospital and Trillium Health Centre, please press 4. So if you can vote on that now, using your touch pad phones, that will be great. Thanks everybody who's been able to vote so far. And I like to go if we have a chance to James on the line. James are you on line with a question? Are you there James, are you there? Sorry, it just sounds like we've lost James. We’re going to try Susan then. Susan, are you on the phone? Susan, can I get you on the phone here. 

Susan: Hi. This is Susan. 

Andrew: There you are Susan. Great.

Susan: Okay. So you want me to go ahead?

Andrew: We can hear you Susan. Go ahead. 

Susan: Okay. The question was I heard earlier that you do take into consideration and you do some sort of customer feedback kind of inquiries with patients that has been in your hospital, and I just wanted to ensure that you would do something like that with the mental health service on an input or, not an input but an inpatient or outpatient criteria that sometimes the mental health services area get forgotten in some of these questions or surveys. Not that Oakville is part of your area but I haven't received one yet or we haven't received one from Oakville. And I just want to make sure Credit Valley and Trillium are doing that part in their business. Being a Mississauga resident unfortunately we didn't end up in a hospital in Mississauga so we can't provide you with that input. But will that be a part of your criteria when you're submitting or requesting surveys and input. 

Michelle: I can assure you that all our programs have regular surveys conducted by an independent party as well as we have a number of our programs including mental health where we are soliciting feedback from patients on a very regular basis. And as I eluded before, on those rare occasions where we have constructive or critical feedback, that is also captured and our board receives a full briefing and debrief on every single program through the course of the year, through the quality committee, and that information is also shared there. 

Andrew: That's great. Let me go to the phones again. If we can get (can’t understand the name) on the phone there. Are we able to go to that?

Speaker: Yes. My name is Maria. And I have a question. Okay. Can you please tell me, I know that you're trying to improve the emergency services. Unfortunately I have been there many many times and 8 hours is really nothing. I've been there for 14 and 15 hours. And I want to know at any one time how many doctors do you have in emergency department? And the reason for my question is the fact that my dad was taken by ambulance with a broken hip at 5:30 in the afternoon and there was nothing given to him for pain. And when I questioned it, it said because the doctor is very busy and we only have one doctor. I finally got him to see the doctor at 1:00 in the morning. That is a man that had liver cancer, a heart problem and broken hip. Taken to the hospital by ambulance. Sorry. I just don't figure that one doctor can look after so many emergency problems in the emergency department. 

Michelle: So first off, let me say I certainly apologize for clearly was not a good experience for you as a family member to a patient. The question specifically related to the number of doctors on staff at any one time in the emergency department. We constantly monitor the volumes that we're seeing in our emergency departments and urgent care center. And adjust staffing level accordingly so it is not unusual for instance is we see a spiking volume or an increase during the course of the day to call staff in. So nursing staff, physician staff and other specialties as needed depending on what is transpired in any course of the day. So there's certainly is a flexibility to be able to expand or contract the numbers on any given day, and we do that on a regular basis. There is always a fleet of physicians available on call in the specialty areas such as the operating room, if somebody needs an emergency surgery for example. So it would be hard for me to give you a specific number but what I can say is we are constantly monitoring any adjusting staffing levels given the needs and the numbers that we're seeing come to the door. 

Andrew: So we're going to go to Rada in a moment. Before we do, I just want to run it through the rest of the call here. We’re going to hear from Rada. We have one last poll in question. I'm going to give you guys a little bit more information as well. I would want to remind any of our callers tonight, if you like more information, would like to express your thoughts in more detail, please go to our website at cvhthc.ca and take an online survey. Your opinion is vital. So please stay with us on this journey and continue to tell us your thoughts and ideas. Rada, I'd like to get on the line if we could. Rada are you there?

Rada: Yes, I'm here. I an here, I'm on the line. Can you hear me?

Andrew: Yes, I can. I can hear you.

Rada. Okay. My comment, it's not a question it's a comment. It's the best hospital in the world. My husband and I were there so many times and we had an excellent attendants and help. So anybody that has any complaints about the hospital, something, some place doesn't fit. So thank you guys for being what you are. Thanks a million.

Michelle: Thank you so much, Rada. 

Andrew: That's great. Thank you so much. So we're going to go to our last call in question now. So this one's 1 to 5. So on a scale of 1 to 5 where 5 is extremely valuable, and 1 is not at all valuable, please use the keypad on your phone to rate the value of this telephone town hall to you. Again, 5 where it's extremely valuable, and 1 where it's not valuable at all. So please if we can get some feedback, that'll be great. Just wanted to do a quick wrap up here. Thank you everybody for coming. So I want to thank our host of the evening, Michelle. Want to give everybody a quick feedback on the grand new question. So in terms of names we should consider, about 4% said name it after a specific individual. 11% naming it after a place. 20% after a geographic landmark and 65% that it'll be Credit Valley Hospital and Trillium Health Center. So I want to thank everyone in participating in out process tonight. It's fabulous. Very great feedback and in terms of our latest call in question. Using the keypad to rate the value of the town hall, 30% of you said it's extremely valuable. 33% gave it a 4. 45% a 3 and a handful of people said it was either a 2 or 1. 1 being the worst. So I wanted to thank everyone. Remember, please stay on the line and you'll hear some instruction about how to leave a message for the Credit Valley Hospital and Trillium Health Centre. Just a reminder, stay on the line and you'll be able to leave a voicemail that everyone will be able to get back to you. And just want to turn it over to Michelle. 

Michelle: So first off I just want to make a comment about our last caller who complemented the hospital for the services. It would be remised for me not to acknowledge over 8,000 volunteers and staff, physicians, nurses and leaders who come in and do outstanding work on behalf of patient care each and every day. So I do want to just acknowledge their work. I also just want to say Thank you to the thousands of people who in their very busy schedule tonight tuned in to hear a little bit about some of the changes that we're thinking about, but more importantly, to offer us their feedback on where they would like to see their hospital go in the future. It’s been an exceptionally helpful set of feedback and we will put this in with the thousands of comments we already have to date and continue on our journey. We’re seeking to get the input from 30,00 people in the next coming weeks as we build our new strategic plan and name our hospital, and so I do want to Thank you. And Thank you for entrusting your family, your friends, your self in our care when you need it most. And so we will continue to take that responsibility very seriously, and work on your behalf each and every day. And so again, thank you. Tonight has been very helpful and we appreciate you taking the time. 

Andrew: Thanks Michelle, and remember; leave your message after we're off the phone, you’ll be able to leave a message for the Credit Valley Trillium Health Centre. So thank you all very much tonight. Have a great night."