As mentioned in my last post, this one will focus on some myths and truths about Holland Bloorview (spoiler alert: there will be numbers!).
How do we share information?
Every summer we issue our annual Impact Report where we share some of the stories we are most proud of from the previous year from care, research and teaching and learning that demonstrate how we are making progress on our No Boundaries strategic plan and how community and donor support is advancing our work.
Our Impact Report also shares some of the key numbers that help describe who we are. I’m using this post to focus on these numbers and to do some gentle myth busting!
By dollars, Holland Bloorview is a $94M hospital. This makes us the smallest by funding (but certainly one of the mightiest by impact!) of Ontario’s academic health science centres, but there are many community hospitals that are smaller than us across the province.
Myth #1: “There are more management at Holland Bloorview than any other hospital!”
Myth-buster: We have only 16 people who are Directors or Senior Directors! We have 6 Vice Presidents who along with our Chief Financial Officer, our Chief Nursing Executive and the President and CEO of the Holland Bloorview Foundation, make up our Senior Management Team. Our overall management (managers and above) is only 5% of our total staff. 72% of our funds are spent on care and only 13% on administration.
That would make us among the leanest management teams out there especially when you take into consideration the complexity of our client population, that we serve the province (2/3 of our clients come from outside our Local Health Integration Network) and the fact that we are a teaching and research hospital with responsibilities to our trainees, learners and clinical supervisors!
We have just over 1000 staff with virtually a 50/50 split of full and part-time. Of this staff, a majority are physicians, nurses, members of health disciplines and family and caregiver support.
Myth #2: “When clinicians leave or retire they are never replaced!”
Myth-buster: Also not true! But I can understand where the misunderstanding comes from. Sometimes when a person leaves (happily we have incredibly low turnover) we consolidate their responsibilities with another position and even sometimes in a different area or clinic. Here’s an example of how this works: clinician A who works part-time leaves and clinician B who also works part-time moves into a full-time role by the combination of two part-time positions. While in that scenario we have gone from two to one staff, we have maintained the amount of clinical resource (what is referred to as “full-time equivalent” or “FTE”).
So to be fair, a particular individual or team may feel like “their” person hasn’t been replaced, and the loss in expertise, knowledge, experience and camaraderie is real for them.
Fact: We work hard to fill vacancies in clinical positions even if that means we have to keep vacancies in administrative positions in order to ensure we have the money we need to fill clinical jobs. Retaining clinical capacity is always (and will always be) our top priority.
What IS absolutely true:
Your work is getting harder and more complex. Even with the same amount of clinical resource available, there is more work and it is harder.
We are seeing more children and youth every year because the need just continues to expand and we doing everything we can not to turn families away.
The children we are seeing are more complex. 71% have two or more diagnoses. The number of rare conditions continues to expand as science progresses and diagnostic processes become increasingly specific. There were children with more than 2000 different diagnoses served at Holland Bloorview last year.
Children are also more complex because we are seeing them at a younger age. When I started at Holland Bloorview (just under four years ago) we rarely saw infants. We now routinely admit infants and very young children.
In addition, with the length of stay at acute care hospitals becoming shorter than it used to be, children arrive at Holland Bloorview with greater medical acuity than they ever have. That fact changes our required knowledge and capacity and we have worked hard to build that through professional development, training and new equipment.
The psychosocial needs of families are greater than they have ever been. What does this mean? For example:
- Half of our clients have a family income less than $50,000.
- Many of our clients are food-insecure.
- Sources of funding for equipment families need are dwindling.
- Waitlists for services (including those in the community or at other hospitals/service providers e.g. mental health) are long.
- Children and families are living with trauma.
- Parents (and other caregivers) are under relentless stress and sometimes appointments with Holland Bloorview care teams are where that frustration gets aired.
We are proud to extend Holland Bloorview’s care to some of Ontario’s most complex children and children and families across Ontario who need us most. But, that makes the work hard and it means fewer and fewer client visits are straight-forward and routine. It also means, that physicians and clinicians also live the pressure of never feeling like they are doing enough. I hear directly from clinicians that they frequently go home demoralized because they know that they haven’t been able to meet all the hopes and needs of the children and families they have seen that day. Fewer days end on an optimistic high note.
Myth #3: Children who come to Holland Bloorview receive extraordinary care and benefit from programs and services and work done by all of our teams that changes lives every day.
Oops, sorry, that one is true. And I could not be more grateful to every single person who has chosen to make Holland Bloorview the place to spend a career. These are not jobs they are callings and I am humbled to work alongside the Holland Bloorview team every day.
Best of the holiday season, and a safe, healthy and joyful 2019 to all.