Creating a Culture of Workplace Safety at Trillium Health Centre March 31, 2008 Healthcare Workplace Safety Conferen

1. Creating a Culture of Workplace Safety at Trillium Health CentreMarch 31, 2008Healthcare Workplace Safety ConferenceGander, NL

2. Trillium: Fast Facts Mississauga Halton LHIN Serving >1,000,000 people Two Main Locations Trillium Health Centre � Mississauga (acute services) Trillium Health Centre � West Toronto (ambulatory services) Regional Programs Advanced Cardiac Stroke Neurosurgery Orthopaedics Sexual Assault and Domestic Violence

3. Our People 4,400 staff + 748 physicians + 1,100 volunteers Average annual staff growth rate: 4% in past two fiscal years 50% of employees relatively new to Trillium: 0-4 years of service Turnover rate improving over last 3 fiscal years: 7.56% in 05/06 Continue to build internal capacity: 52% internal hiring Overall nursing (RN and RPN) headcount has increased slightly to 1,695: RN positions accounting for 90.5% of this number The average RN age is 44. 18% of RNs are 55 years of age or more. 43% of RPNs are 50 years of age or more. 77% of RNs have 7 years or more experience in the professionThe average RN age is 44. 18% of RNs are 55 years of age or more. 43% of RPNs are 50 years of age or more. 77% of RNs have 7 years or more experience in the profession

4. Change Drivers Cannot separate employee health and safety from patient safety Attract and retain the best Reduce sick days Reduce WSIB claims Want to be employer of choice Learning organization Increased reporting requirements Occupational Health and Safety Act

5. Journey to Creating a Healthy Workplace Our Vision and Philosophy Values-based Philosophy Philosophy of Care � Patient Centredness National Quality Institute Criteria Integrated, holistic and progressive approach to organizational excellence Performance Excellence and Healthy Workplace Continuous improvement in quality and workplace wellness to achieve and sustain performance excellence Healthy Workplace Committee Advisory and participative role in leading Healthy Workplace initiatives Increased reporting requirements

6. Performance Excellence:Aligning Quality and Healthy Workplace Inspired by our Vision and Mission Guided by our Core Values: Service, Excellence, Teamwork, Integrity, Learning, Diversity Clear accountabilities, for results and relationships Reinvest efficiencies Engage People Fully Continuously improve and innovate Agile � distributed leadership � just do it Journey towards Patient Centredness Creating the best patient experience Understanding what we need to improve upon: Philosophy of Care Healthy Workplace Understand how to improve our staff�s work experience/life: Vital Few Inspired by our Vision and Mission Guided by our Core Values: Service, Excellence, Teamwork, Integrity, Learning, Diversity Clear accountabilities, for results and relationships Reinvest efficiencies Engage People Fully Continuously improve and innovate Agile � distributed leadership � just do it Journey towards Patient Centredness Creating the best patient experience Understanding what we need to improve upon: Philosophy of Care Healthy Workplace Understand how to improve our staff�s work experience/life: Vital Few

7. Initiatives Assessment Healthy Workplace Survey, 2003, 2004, 2005,2006, 2008 �Putting Our Results To Action� National Quality Institute (NQI) Leadership Assessment, 2004 Self Assessment: Focus Groups - 2004, 2006, 2008 Accreditation 2007 WSIB safety group � 5 year project to further develop our health & safety management system Responses Reporting without blame (shift from blame to learning) Infection prevention and control Lifts initiative (eg MSK) Flu clinics TB vaccinations Mask fitting (since SARS) Smoking cessation

8. Standardized Services, Tools and Practices Healthy Workplace Survey Learning and Behaviours Personal health and well-being ISO 14001 Infrastructure renewal: innovative designs New patient wing and new administrative building NQI Level 3 People support � shared services with local hospitals Safer Healthcare Now Joint Health and Safety Committees (3) - we have 3 committees, Multi-disciplinary Health and Safety Committee draws from every area, union representation on the committees. Perform monthly physical inspections of the work place - we have 3 committees, Multi-disciplinary Health and Safety Committee draws from every area, union representation on the committees. Perform monthly physical inspections of the work place

9. Integrated Health Strategy Needs Assessment Healthy Workplace Survey Applause! Satisfaction Role/Process Redesign Commitment Communications Values Renewal Health Needs & Interest Assessment Health status/Risk Healthy Weight Physical Environment Stress Management HEART Mobile Workplace Violence Survey � EHS&W Due Diligence & OHS Benefits, EAP, LTD/STD NQI Assessment/Verification Accreditation 2007 Sustaining Performance Excellence Others� through quality and wellness

10. Outcome of our work Leading organization in Healthy Workplace scores High retention rates Low vacancy rates Significantly below peers for sick time Very positive employee relations, small number of unionized staff Capacity to meet the needs of our Community Resilient organization in times of change

11. Key Success Factors Action Plans are completed by Partnership Councils (unit level approach) Unit level champions resulted in significant increase in completion of surveys Health and safety issues are addressed Healthy Workplace objectives are embedded and monitored as part of the annual operating planning process NQI criteria/Canada Award of Excellence provided necessary support for Healthy Workplace objectives Ability to see healthy workplace as truly part of what we do each day Importance of doing multi-surveys (staff, physicians and volunteers) Layering for dialogue with groups Integrating healthy workplace with quality model

12. Pulling the key players together Example: Annual TB immunization updates 20% compliance rate in 2006 � now at 80%. How did we do this? Support system: Trillium has a culture of learning, consultation, education, process Multi-disciplinary Health and Safety Committee Education Leaders supported compliance Employee Health and Wellness brought the service to the staff Result � 80% compliance rate now; won a 3M quality award Other similar successes: Used the same approach with the mask fit strategy Good results with flu shots: 24% (2006) to 40% (2007) 20% compliance rate in 2006 � now at 80%. How did we do this? Multi-disciplinary Health and Safety Committee, draws stakeholders from every area Education: engage leadership to solicit feedback, advice, build the buy-in, develop appreciation of the importance of the program and their leadership Leaders supported compliance, giving staff time to be educated, get their test Employee Health and Wellness brought the service to the staff Took a lot of energy in the beginning Result � 80% compliance rate now; won a 3M quality award Used the same approach with the fit strategy Good results with flu shots with rates growing from 24 to 40% this year Support system: Trillium has a culture of learning, consultation, education, process 20% compliance rate in 2006 � now at 80%. How did we do this? Multi-disciplinary Health and Safety Committee, draws stakeholders from every area Education: engage leadership to solicit feedback, advice, build the buy-in, develop appreciation of the importance of the program and their leadership Leaders supported compliance, giving staff time to be educated, get their test Employee Health and Wellness brought the service to the staff Took a lot of energy in the beginning Result � 80% compliance rate now; won a 3M quality award Used the same approach with the fit strategy Good results with flu shots with rates growing from 24 to 40% this year Support system: Trillium has a culture of learning, consultation, education, process

13. Recognition National Quality Institute Canada PEP Level 3 and Silver Leaf Award for Excellence (Quality Excellence and Healthy Workplace) Accreditation 2007 Ontario's 1st Innovation Award For Improving Quality & Patient Safety 1st Multi-Site Hospital in the World to be Awarded International Environmental Standard (ISO 14001) OHA Healthy Hospital Innovators Award � Healthy Workplace Governance Award � Mississauga Board of Trade 3M Quality Award (Ambulatory Care & Dashboard) Medical Users Software Exchange (MUSE) - Dashboard

14. Questions?

15. Thank YouJanet Davidson, O.C.President and CEOTrillium Health Centrejdavidson@thc.on.ca