Grand River Hospital Annual
Report
2019/20

A year defined by partnerships

Message from our Chair

On behalf of Grand River Hospital’s volunteer Board of Directors I am pleased to share with you this look back to the opportunities that defined our 2019-20 year. We’re also highlighting the tremendous work of our staff and our community over the last several months during what is now referred to as “the first wave” of the Coronavirus pandemic.

As with every year, our focus throughout 2019-20 was on the experience of our staff, volunteers, patients and their families. However, this past year felt different than others. So much of what we accomplished was through partnerships and with a lens that provided a view that was broader than ever before.

You’ll learn more about our successful partnership with St. Mary’s General Hospital which saw the launch of the largest implementation of the Cerner Millennium health information system in Canada. This state-of-the-art tool supports the work of our people and the experience of our patients.

In 2019, we joined the CANHealth Network, a national partnership of leading Canadian medical and technology institutions, taking a nationwide approach to speeding up the introduction of new technologies into the health care system to the benefit of patients and health care providers.

Throughout this past year Grand River came together with dozens of like-minded individuals and organizations to develop a vision and action plan for creating a more connected, sustainable and accessible health care system for Kitchener, Waterloo and our adjacent townships. I’m pleased to share that on November 18, 2020 our submission to the Ministry of Health for the KW4 Ontario Health Team was officially approved.

While planning for the pandemic started in January 2020, as we entered this current fiscal year, we experienced the impact of COVID-19. Read on to learn more about Grand River Hospital’s remarkable response to the pandemic – made possible by our people and the powerful partnerships we have forged.

Dr. Harry Hoediono's Signature
Dr. Harry Hoediono
Chair of the GRH board of directors

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 19/20

Beds

665
18/19 574

Patient Stays

25,500
18/19 25,000

Emergency Visits

67,000
18/19 67,000

Babies Born

4,200
18/19 4,100

Surgeries

18,400
18/19 18,000

Outpatient Visits

243,000
18/19 237,400

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

Staff Members

3,800+

Medical Staff

696

Physicians, dentists, midwives and nurse practitioners credentialed through the Chief of Staff's office

Learners

1,000+

Volunteers

1,000

Financials

Grand River Hospital's 2019/20 revenue was $424 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 2019/20 expenses were $424 million. They were mainly attributed to compensation for over 3,700 staff, pharmaceuticals and gases, and medical, surgical and general supplies.

Grand River Hospital Summary Statement of operations
year ended March 31, 2020

(In thousands of dollars)
Revenue
2020
$
Ontario Health (75%)
319,280
Other Government (1%)
5,377
Miscellaneous Revenue and Recoveries (4%)
16,568
Patient Revenue (7%)
30,536
Commercial (7%)
27,751
Grants
Equipment (2%)
7,048
Building (2%)
8,053
Other (2%)
10,060
Total
424,673
2020 Annual Revenue Graph
Revenue
Expenses
Compensation (57%)
243,522
Medical Staff (6%)
26,687
Supplies and Other (11%)
46,618
Medical and Surgical (5%)
20,936
Drugs and Gases (7%)
31,517
Amortization
Equipment (3%)
12,382
Building (2%)
10,447
Commercial (5%)
22,498
Other (2%)
10,059
Total
424,668
2020 Annual Expenses Graph
Expenses
Excess of revenue over expenses for the year
5

Update: Making good on our promises

Transforming care: We committed to transforming the way we work by focusing on implementing a shared hospital information system, enhancing how we approach priority setting, pursuing governance excellence, advancing our work related to research and innovation, and strengthening our strategic relationships and partnerships.

Grh Ar2020 Update 3
  • Following several years of planning and work to get ready, and together with our partner, St. Mary’s General Hospital, GRH successfully went live with our new hospital information system on September 22, 2019. This marks a tremendous milestone for our organization and is a reflection of the hard work of the entire organization to transform how we work together to care for our patients and improve the quality of care we provide.
  • We implemented a stronger integrated process to plan, manage our resources and optimize our ability to deliver on our commitments. We also initiated a process to develop our renewed strategic plan. Our process has focused on engaging and integrating the voices of our community, staff, physicians, volunteers, and many partners.
  • In 2019, GRH became a partner in the CANHealth Network, a national partnership of leading Canadian medical and technology institutions, taking a nationwide approach to introduce technology into the health care system. The CANHealth Network will allow promising companies to work directly with health care organizations to understand their needs and commercialize health technologies to meet those needs and scale up their companies.
  • Twenty-four (24) new research studies were brought forward for review and approval, building our growing partnerships with the University of Waterloo and five in partnership with McMaster University. In addition to these newly approved studies, there continues to be active work on 49 studies.
  • GRH continues to actively participate in the province’s objective to create a more connected, sustainable and accessible health care system that puts patients’ needs first. The KW4 OHT continues to evolve with GRH in a key leadership role. KW4 OHT received approval on October 22, 2020 from the Ministry regarding our designation. The KW4 OHT was formally announced on November 18, 2020.
  • GRH continued to work with SMGH on integrated opportunities with diagnostic imaging, lab and pharmacy. Strong regional partnerships were formed in medical imaging and pharmacy. Regional plans for renal and oncology were developed based on the provincial plans allowing for high quality of care delivery close to home.
  • GRH developed a strategic partnership framework and strategy to increase leadership involvement in community events and Foundation outreach activities to improve key stakeholder knowledge of our value to the community.

Investing in our people: We committed to investing in our people by focusing on staff safety and supporting our people through our transformation initiatives.

  • A Violence Prevention Committee (VPC) was established as part of overall efforts to reduce incidents of workplace violence, and to support a healthy and safe workplace.
  • As part of the hospital information system project we developed and rolled-out an organizational-wide change management program in support of our people.
Grh Ar2020 Update 2

Improving the patient experience: We committed to provide exceptional care for our community by focusing on improving access to care, patient flow and patient experience and by preparing for and completing the first year of a multi-year accreditation process.

  • Access to diagnostic imaging was and continues to be a priority for GRH. In May 2020 GRH received a substantial donation from Equitable Life in honour of their 100th Anniversary. This generous gift will help with the cost of the MRI replacement. GRH has also been working collaboratively with all Waterloo Wellington hospitals to address the backlog of tests that have been exacerbated as a result of COVID 19.
  • Our emergency Department (ED) P4R (pay for results) ranking has improved but GRH continues to focus on addressing ED wait times. P4R is funding that is provided to help hospitals meet ED wait time targets.
  • A Patient Flow initiative was launched and target areas for improvement were identified. Work continues to get patients the right care, in the right place, as soon as possible through work with our partner organizations to implement creative solutions for our Alternate Level of Care (ALC) patients who no longer require hospitalization but are waiting for care and support in another setting.
  • GRH successfully completed the first phase of our multi-year accreditation process with Accreditation Canada, meeting 99.4% of the criterion. We continue to maintain our Accredited with Commendation standing and look forward to preparing for and completing the second phase of accreditation in 2021, with a focus on our clinical programs and services.
  • Resources dedicated to continue to develop a patient and family centred environment were approved which further demonstrates our commitment to patient experience. Patient and Family Advisors have been invaluable to improving care at GRH and we thank them for their insights and countless volunteer hours.
Grh Ar2020 Update 1

Master planning: We committed to focus on financial recovery and sustainability including addressing our physical space needs both in the short and long term.

  • Management has undertaken measures to increase revenues and to reduce administrative and support expenses in the 19/20 budget and ended the year with a balanced bottom line, $2M ahead of plan.
  • Work related to the replacement/refurbishing of the KW campus parking structure continued.
  • GRH and SMGH are partnering for future health care infrastructure to support the health and wellness of patients and families in Waterloo Region.
Grh Ar2020 Update 4

In this together: GRH’s response to the COVID-19 pandemic

On March 5, 2020, the first COVID case in Waterloo Region was confirmed, and work to prepare us for this global pandemic that had been underway for months was put into action.

Grh Ar2020 Covid 1

To accommodate an anticipated influx of COVID patients, GRH postponed elective surgeries, temporarily closed outpatient clinics, and moved to virtual care where possible. Staff were redeployed to new roles as we adapted to new procedures including active screening at our entrances. Specific spaces at both our KW and Freeport Campuses were identified for COVID care. Together with our regional hospital partners, we assisted our partners in long-term care by providing staff and expertise, and temporarily accepting residents of the Forest Heights Long-Term Care Home. We added more than 100 new beds at our Freeport Campus and partnered regionally on a 600-bed field hospital, in case the demand for beds surged beyond what local hospitals could provide.

Grh Ar2020 Covid 2

A number of precautions were put in place to minimize the risk of transmitting the virus, including screening of patients and staff, changes to the hospital environment to support physical distancing, and enhancing the frequency and scope of cleaning. Virtual care also enabled patients to safely access the specialized services, like mental health group therapy, they needed. A temporary no visitor guideline reduced the risk of transmission for patients and staff, and a virtual connection program enabled patients to stay in contact with families and loved ones.

Grh Ar2020 Covid 3

The pandemic enabled innovation across our hospital. Through careful conservation and preservation, including innovative practices like reprocessing N95 masks for future use, and through generous donations from our community, GRH made it through the first wave with the right equipment to support safe care. As part of a provincial hub, Grand River Hospital now operates the Waterloo-Wellington Area Warehouse which supplies PPE and COVID swabs to all health care partners in our region and beyond.

Grh Ar2020 Covid 4

To balance the need for community testing while conserving much-needed PPE, in June 2020, GRH partnered with local business, Catalyst 137, to establish a COVID drive-thru testing model that would both increase the number of COVID tests we could process daily while limiting the amount of PPE used by our clinicians. Originally approved to provide just over 300 tests a day, the clinic completed over 600 community tests at its peak and continues to offer convenient testing for residents of Waterloo Region and beyond.

Grh Ar2020 Covid 5

As the demand for testing increased over the first few months of the pandemic, Grand River Hospital’s lab - Waterloo Region’s largest laboratory - acquired two state-of-the-art testing systems to increase the number of COVID tests the hospital could process and get results to the community faster. By fall 2020, GRH’s lab was processing all COVID tests in Waterloo Region and many from Wellington County including Fergus, Palmerston and Mount Forest with an average result time of less than 24 hours.

Grh Ar2020 Covid 6

We couldn’t have done it without the support of our community. From cash to meal donations, to gifts from community groups, Waterloo Region rallied to support GRH throughout the pandemic.

Learn about how our community has supported us in our response to COVID-19: https://grhf.ca/pages/covid-19-impact-page

Grh Ar2020 Covid 7

Our plans moving forward: Positioning for the future

An exciting health care transformation is underway and as a trusted partner, GRH has the experience, expertise and commitment to provide a leadership role as we work to achieve improved health outcomes, patient and provider experience and value for our community.

Moving Forward 1

COVID-19 response, recovery, and renewal: The safety of our patients, families, staff and volunteers is always our priority and has continued to be paramount during this pandemic. As we continue to respond to this current wave and plan and prepare for future challenges we are also focused on new and innovative approaches to advancing care delivery and supporting mental health and wellbeing.

Moving Forward 2

Sustainability: To ensure we are able to provide exceptional, person-centered care to our community in this fiscally constrained environment well into the future, we need to continue to focus on an operating budget that returns us to financial stability and a balanced budget.

Moving Forward 3

Address critical infrastructure: To ensure we can continue to serve our growing community for years to come, investments in our equipment and physical infrastructure are essential. Replacing equipment with advanced technology will allow us to quickly and accurately diagnose urgent medical conditions and ultimately save lives.

Moving Forward 4

Grand River Hospital Foundation raises funds to help Grand River Hospital provide exceptional health care.

With the support from generous donors and loyal community partnerships, Grand River Hospital Foundation is able to grant funds for medical equipment and technology; renovation projects; and local clinical and health research and education.

The commitment to health care in our region ensures that the residents of Waterloo Region and Guelph Wellington will have access to the best health care services close to home.

Learn more about Grand River Hospital Foundation

Grand River Facts

GRH has conducted over 80 clinical trials at our hospital since 2003