Mount Sinai Hospital Strategic Plan 2010-2013

Mount Sinai HospitalStrategic Plan 2010-2013

Mount Sinai Hospital Strategic PlanThe Mount Sinai Hospital Strategic Plan, 2010-2013, reaffirmsthe Hospital’s long-standing commitment to excellencein patient care, teaching and research. Since our modestbeginnings Mount Sinai Hospital has developed a strong cultureof excellence and caring and has established several leading,national and international programs. Our strategic plan sets thedirection that Mount Sinai will take over the coming years tomaintain and enhance its leadership position in these areas.In addition, we believe by focusing on the patient experiencewe will emerge a stronger organization, better positioned andprepared to deal with the challenges of our health-care system.We are on the cusp of a new era in health care, termedpersonalized medicine, which will profoundly change patientcare — delivering the most effective and timely interventionto each individual patient. This is possible because of theadvances in gene-based research and information technology.We have therefore incorporated a strategy focused onpersonalized medicine. The Samuel Lunenfeld ResearchInstitute has been a key attractor of clinical/research talent,which not only enables us to provide “The Best Medicine” butis also setting the foundation for translating the most recentadvances in research into personalized medicine.In today’s world, resilient organizations distinguish themselvesby continuous evaluation and an unrelenting drive towardsimprovement. There are a number of ways we intend to dothis through this strategic planning exercise:Our strategy is to advance a patient-oriented approach in ourCentres of Excellence which enables us to take a leadershipposition and to most effectively serve our stakeholders:For Patients and Families: a Hospital committed to servingpatients’ needs, in our key areas of focus, from wellness anddisease prevention to treatment and follow-up.For Staff: a healthy, supportive, interdisciplinary workenvironment in which each member of the Mount SinaiHospital team continues to feel connected with ourpatient-centred approach and the importance of his/herrole in its successful implementation.For Government and the Local Health Integration Network(LHIN): a hospital delivering on its promise and vital role withinthe health-care system.For our Partners, including Hospitals, Educational Institutionsand Community Agencies: a committed partner workingtogether for effective co-ordinated and integrated services.For our Financial Partners and Donors: a fiduciary commitmentto financial responsibility, risk management and innovation.For our Board: a Hospital where the status quo is not an option.If we are standing still, we are regressing.• Renewed focus on the experience of our patientsand employees.• Increased performance measurement and managementand promoting transparency with the public.• Heightened focus on clinical and research integrationto improve clinical practice and deliver “personalizedmedicine”.• Targeted partnerships with other organizationsto co-ordinate patient care in order to promoteco-ordinated care for our clients both when they are inand out of our institution.• Vigilant attention to the financial health and viabilityof our key programs.1920s: Ladies of the Auxiliary (Ezras Noshem Society)of Mount Sinai Hospital.1

Our HistoryMount Sinai Hospital was established in 1923 as a 33-bed maternityand convalescent hospital on Yorkville Avenue by a group of dedicatedJewish women volunteers. In 1953, the Hospital relocated to UniversityAvenue and formed an affiliation with the University of Toronto.Since that time the Hospital has continued to grow, serving Toronto andOntario as a world-class centre for patient care, teaching and researchwith leading clinical specialty areas and an internationally renownedresearch institute. Our ability to create a culture of excellence and carehas made Mount Sinai an institution where patients want to comefor care — and staff and trainees want to work. We remain inspired bythe dedication of our founders and we are committed to their vision ofproviding excellent care, now and in the future.Our Mission, Vision and ValuesMissionDiscover and deliver the best patient care, research and education withthe heart and values true to our heritage.VisionProvide and be recognized for The Best Medicine.ValuesExcellence and Innovation in Clinical Care, Teaching and ResearchPursue excellence in everything we do with continuous improvementsin quality, service and cost-effectiveness.Patient-Centred CarePrioritize safety, quality and the patient experience in everything we do.TeamworkEmbrace a collaborative and interdisciplinary approach to clinical care,teaching and research.CollaborationEstablish internal and external partnerships to integrate and coordinatepatient services effectively.Respect and DiversityValue and respect the differences of the patients and families whoseek our care as well as those who provide that care.LeadershipPromote the development and growth of leaders throughout theorganization and continue to allow our leading programs to export ourknowledge nationally and internationally.2

A description of each clinical Centre of Excellence, including its core andcomplementary service lines and the Samuel Lunenfeld Research Institute follows.Figure 1The Best MedicineImproved Patient ExperienceFrances Bloomberg Centre forWomen’s and Infants’ HealthChristopher Sharp Centrefor Surgical Oncology(Interprofessional Teams)Daryl A. Katz Centre forUrgent and Critical Care(Interprofessional Teams)Translational Research(Interprofessional Teams)Centre for MusculoskeletalDiseaseSamuel LunenfeldResearch Institute(Research Laboratories)Centre for InflammatoryBowel Disease (IBD)(Interprofessional Teams)(Interprofessional Teams)diagnosticcentresclinicaldepartmentsMedical Imaging, Pathology & Laboratory Medicine and Microbiology & Infection ControlAnesthesiology, Dentistry, Family Medicine, Medicine, Obstetrics and Gynaecology, Ophthalmology,Otolaryngology, Paediatrics, Psychiatry, Surgerynursing &allied healthcorporatecommunityNursing, Clinical Nutrition, Occupational Therapy, Pharmacy, Physiotherapy, Respiratory Therapy, Social Work,Speech Language PathologyCorporate and Support ServicesCommunity Networks and Partnerships4

Business Strategy 1 ContinuedFrances Bloomberg Centrefor Women’s and Infants’ HealthThis is the Hospital’s largest program with an average 6,500deliveries annually. It features a Level III perinatal centre withfetal therapy and translational research programs. The Centrewill further develop its highly regarded high-risk obstetricsprogram and continue to serve as a hub for obstetrics,gynaecology and neonatal care. The program is aligned withthe provincial government’s priority of improvingmaternal/child health.Core Service LinesHigh-Risk Pregnancy, Fetal Health andNeonatal Intensive Care, In vitrofertilization and UrogynaecologyComplementary Service LinesLow-Risk Obstetrics andGynaecologyDaryl A. Katz Centre for Urgent and Critical CareThis Centre includes the Hospital’s core inpatient andambulatory care programs, including Diabetes, General InternalMedicine, Critical Care/Respiratory Failure and Cardiology.A major thrust of this Centre will be to provide innovative andcomprehensive care to manage the increasingly complex andchronic needs of elderly patients.This program, with its highly regarded teachers andclinician-scientists, will continue to carry out a significantproportion of the Hospital’s undergraduate training. Its focuswill encompass the full cycle of care by employing the skills andresources of its ambulatory and primary care programs includingthe Schwartz/Reisman Emergency Centre as well as thoseof its partners.Core Service LinesCritical Care/Respiratory Failure,General Internal Medicine,Diabetes, Cardiology, EmergencyCare, and GeriatricsComplementary Service LinesMental Health/Psychiatry,Family Medicine, PalliativeCare, Endocrinology and PainManagementChristopher Sharp Centre for Surgical OncologyThe core elements of our Surgical Oncology Centre ofExcellence are: Sarcoma, Head and Neck, Breast, Urological andOculoplastics. Mount Sinai Hospital is a designated provincialtreatment centre for sarcoma, drawing approximately85 per cent of its patients from outside the Toronto CentralLHIN. We have gained an international reputation in the areaof head and neck oncology, which is one of the main foci of theJoseph and Mildred Sonshine Family Centre for Head and NeckDiseases. Through the Marvelle Koffler Breast Centre, a premierfacility specializing in breast health and disease, more than33,000 women annually receive multidisciplinary care.The focus of this Centre of Excellence aligns with the increasingincidence of cancer and responds to Cancer Care Ontario’sstrategy of expanding cancer service capacity in the GreaterToronto Area.Core Service LinesSarcoma, Head and Neck,Breast, Urological, OculoplasticsComplementary Service LinesOral and Maxillofacial, MedicalOncology, Cancer Preventionand ScreeningCentre for Inflammatory Bowel DiseaseThe Centre, with its evidence-based care and leading edgeresearch, is unique in the corrective procedures it provides. Itserves a significant portion of the market, with over 60 per centof its referrals coming from outside the Toronto Central LHIN.The Centre has a leadership position in the Familial GastrointestinalCancer registry and the Ontario Registry for Studies of FamilialColorectal Cancer and is recognized internationally for its ColorectalFellowship Program. Our focus in this area is consistent with ourclinical strengths and supports the government’s colorectal cancerprevention strategy.Core Service LinesCancer, Inflammatory BowelDisease, Crohn’s and ColitisComplementary Service LinesGastroenterology andColorectal Surgery5

Centre for Musculoskeletal DiseaseSimilar to Inflammatory Bowel Disease, the musculoskeletalprogram is unique in the corrective procedures it provides.To serve its patients better, Mount Sinai will expand its focuson bone and musculoskeletal research, chronic diseases(e.g., arthritis, rheumatology) and health and wellness programs.Further growth is expected in this program, particularly in thearea of primary and revision hip and knee replacement due tothe growing needs of the aging demographic.Core Service LinesOrthopaedics, Hip and KneeReplacements/Revisions,Cartilage Transplantation,Arthritis/Rheumatology,Regenerative Medicineand ImagingComplementary Service LinesRehabilitation and Wellbeing,Sports MedicineNana AsomaningNurse, Emergency DepartmentSamuel Lunenfeld Research InstituteThe Samuel Lunenfeld Research Institute (Lunenfeld) ofMount Sinai Hospital is one of the world’s leading centresin biomedical research and is committed to excellence indiscovery, translation and application of health research. TheLunenfeld has a strong portfolio of leading edge scientificprograms that include systems biology, women’s and infants’health, cancer biology, neurobiology, diabetes, arthritis andgenetic disorders. Its researchers work collaboratively withphysicians and clinicians to foster the cross-pollination ofideas and concepts that are key factors to bringing researchdiscoveries to the patient’s bedside.Tiomi GaoRegistered TherapistBrendan D’SouzaRegistered TherapistDr. Jay WunderSurgeon-in-Chief6

Business Strategy 2Advance Translational Research forPersonalized Health careMount Sinai Hospital, a world-renowned centre of clinical andresearch excellence, will bring the promise of personalizedmedicine to our patients. An early adopter of this newhealth-care paradigm, we will begin by seeding personalizedmedicine in two key areas where Mount Sinai hasworld-renown clinical and research strength:1. Maternal and Infant Health/Neonatology, where apersonalized approach can help to prevent and bettertreat pregnancy complications such as high blood pressureand gestational diabetes, and help ensure that timelyinterventions are in place to promote healthy deliveriesand healthy starts for infants and neonates;2. Rheumatoid Arthritis (RA), a chronic disease where greaterunderstanding of the causes of a patient’s disease, andwhich medications they are likely to respond to, can helpalleviate and even reverse the severity of the disease.Mount Sinai is embarking on a seven year pilot project, inwhich patients in these areas will receive more extensivediagnostic testing to help clinicians better assess their health inorder to tailor their care. We have already made encouragingstrides in these areas. Our plan is now to implement andclosely study the impact of personalized medicine in thesepilot areas, perfect the model, and then expand it across theHospital’s clinical areas, and ultimately across the provinceand beyond. To do this, we will partner with key provincialagencies, including the Ontario Ministry of Health andLong-Term Care and other key stakeholders.Business Strategy 3Expand Partnerships for Co-ordinated CarePartnerships and collaborations are an important component inthe delivery of clinical services at Mount Sinai. Mount Sinai iscommitted to ensure better co-ordination of patient care before,during, and after a patient visits the Hospital in its efforts toenhance the patient experience. Mount Sinai is also committedto facilitating, to the best it can, areas of service that we do notcurrently provide. To accomplish these goals we will not onlyreview our existing partnerships but also identify and pursueother opportunities. For example, we will explore preferredprovider relationships and/or other forms of partnership withrehabilitation and complex continuing care facilities. We may alsowish to increase our offerings in neurosciences, for example, bydeveloping stronger partnerships with organizations that providesuch services (i.e., Baycrest).Key Operational Initiatives• Re-focusing current partnerships for improved serviceco-ordination along the continuum of care, healthequity, access to care and economies of scale• Forming new relationships with health-care providersin York region to serve a growing population.Our proposed Mount Sinai Wellness Centre on theJoseph and Wolf Lebovic Jewish Community Campus willbe a focal point for these activities• Forge partnership arrangements and preferred providerrelationships with specific organizations in areas thatenhance our array of servicesAn external blue ribbon panel from leading centres in theUnited States has indicated that the Hospital, with its clinicalCentres of Excellence and Samuel Lunenfeld Research Institute,is well positioned to successfully execute a personalizedmedicine strategy.Key Operational Initiatives• Securing strategic partners to leverage funding andresources for our two pilot projects• Establishing a Council on Bridging Clinical Care andResearch with a focus on translational research/personalized medicine• Developing a comprehensive informatics infrastructureto transform and synthesize clinical and research datainto new patient interventions7

Business Strategy 4Improved Cost PerformancePatient value includes the concept of superior cost performanceas compared to peer organizations. The need for rigorousexpense management is consistent with government fundingrequirements and the Hospital’s long-term strategy to generateoperating surpluses to reinvest in technology, equipmentand infrastructure.Key Operational Initiatives• Continued implementation and tracking of KeyPerformance Indicators (KPI’s)• Reviewing major programs to identify opportunitiesfor cost control and performance improvement• Productivity improvements and financial accountabilityat all levels• Development of an Effective and Efficient UtilizationCommittee that integrates best/evidence-based careinto the process• Seeking cost savings through outsourcing/collaborative/shared services initiativesLinnette LivingstonClinical HousekeeperSabrina MastronardiInfection Control PractionerTory PerkinRegistered NurseDr. Samir K. SinhaDirector of Geriatrics8

Corporate-wide OperatingStrategies in Supportof Our Business StrategiesThe four business strategies will be supported by the following fiveoperating strategies:1. A re-designed organizational structure to support our Centresof Excellence and the patient experience2. A talent management strategy focused on leadership andinterdisciplinary team development3. Development of a fully integrated electronic patient record4. Renewed facilities and equipment5. Financial healthOperating Strategy 1A re-designed organizational structure to supportour Centres of Excellences and the patientexperienceA key enabler of our strategy is a new organizational structure thatintegrates clinical activities of our Centres of Excellence under a singleleader. The objective of the new organizational structure is to createeffective linkages and develop better communication within andamong our Centres of Excellence which will lead to betterco-ordination of patient care. In parallel, the Operations Portfolio willcome under a single leader as will our Organizational Developmentand Performance portfolio, both of which aim to support our Centres ofExcellence.A new Office of Performance Optimization, staffed with planners,data support specialists and process review experts, will serve asan essential resource to our Centres of Excellence, departments andcorporate functions. The focus of this new office will be on costing,measurement, reporting, monitoring, process improvements,co-ordination and productivity improvements.9

Operating Strategy 2A talent management strategy focusedon leadership and interdisciplinary teamdevelopmentOur talent management strategy will have a strong focus oninterdisciplinary team development as well as training in processimprovement methodologies. These additional skills are key toorientating staff to a culture of patient value, productivity andcontinuous improvement. As a top employer and to meet theneeds of our diverse communities, we will also continue our focuson leadership development, wellness, diversity and equity andwork life balance.Operating Strategy 3Development of a fully integrated electronicpatient recordOur Hospital, like the rest of the health-care sector, is laggingbehind in effective IT systems and a comprehensive electronichealth record. We are therefore aggressively re-aligningour IT strategy to better support our corporate strategy,including translational research. The objective is to ensure astrong operational base and prioritize the resources and keyinvestments that will enable our corporate strategy. Key to thisinitiative is the development of an integrated health record,which is essential to improving patient safety, co-ordination ofcare among professionals, patient information, and productivityand quality improvements.Operating Strategy 4Renewed Facilities and EquipmentModernization of our facilities, equipment and technology willcontinue to be a major initiative in improving the delivery ofcare and the overall patient experience. The Hospital is in themidst of a major capital redevelopment with investments inbuilding, equipment and technology.Operating Strategy 5Financial HealthIn addition to securing appropriate levels of governmentfunding and taking advantage of opportunities under newfunding programs, initiatives will be undertaken in threekey areas — business development, research commercializationand philanthropy. Each of these areas will be reviewed andrestructured as required to maximize revenues and impact.The financial health of the organization will continue to bemeasured through comprehensive performance measuresthat critically assess our progress in this area.10

600 University AvenueToronto, Ontario, Canada M5G 1X5t 416-596-4200 www.mountsinai.ca200902546