CHATHAM-KENT HEALTH ALLIANCE
Stage 1: Proposal – Part A
Service Delivery Model Report
FINAL DRAFT
© August 8, 2011
This document was developed by Agnew Peckham, Health Care Consultants, for Chatham-Kent Health Alliance and
reflects the collaboration between the Agnew Peckham consulting team and the Chatham-Kent Health Alliance. The
project and information included in this document was directed by the senior team and the !magine Steering
Committee of the Chatham-Kent Health Alliance. Prior to its use for subsequent stages of planning and design, the
contents of this document require formal approval from the Erie St. Clair Local Health Integration Network.
In addition to the information and the planning direction contained within this document, Chatham-Kent Health
Alliances’ planning and design consulting team is responsible for developing a facility plan that achieves the required
clinical function and meets all applicable building codes and design and construction standards. This document does
not negate or supersede such requirements or the responsibilities of the design consultant in developing a compliant
building.
The work produced by Agnew Peckham for this project will be for Chatham-Kent Health Alliance’s sole use on the
project for which this document was prepared. It cannot be used for other projects, nor can it be shared with others
outside of Chatham-Kent Health Alliance, except for use on this project. The documents cannot be reproduced or
copied in any form, without written permission of Agnew Peckham. As the author of the document, Agnew Peckham
must make any required changes and will retain the copyright on all aspects.
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Peckham.
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Executive Summary .......................................................................................... i
1.0 Service Delivery Model Report
 Background .......................................................................................1
 Mission, Vision, Values and Strategy ...............................................3
 History of Capital Planning ...............................................................4
 The Community Served/Population Needs .......................................5
 Health Status .....................................................................................8
 Implications for Service Planning ...................................................12
 Consistency with MOHLTC and LHIN Expectations for the
Planning Process .............................................................................12
 MOHLTC Priorities ........................................................................13
 Erie St. Clair LHIN Action Plan .....................................................13
1.1 Master Program
 Master Program ...............................................................................16
 Planning Context and Role of CKHA .............................................19
 Population Projections.....................................................................20
 Walpole Island (Bkejwanong) First Nation ....................................21
1.1.1 Present Service Delivery
 Scope of Services Provided ............................................................23
 Volume Projection Methodology ....................................................27
 Clinical Efficiencies ........................................................................28
 Historical and Projected Beds and Workload .................................29
1.1.2 Current and Projected Activity ............................................................ 26
1.1.3 Future Model of Care ........................................................................... 38
1.2 Human Resources Plan for 3 Year Timeframe
 Staffing Plan ....................................................................................49
 Project Impact .................................................................................50
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1.3 Preliminary Operating Cost Estimate
1.3.1 Changes in Model of Care
 Scope of Services ............................................................................51
 New Initiative – System Integration Project ...................................53
1.3.2 Operating Cost Estimate
 Operating Cost Estimates ................................................................54
Appendices
A CKHA Organization Chart
B Master Program (to be provided in Stage 1 Proposal Submission)
C Partnerships and Alliances Inventory
D Human Resources Plan and Operating Cost Projections
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Executive Summary
Chatham Kent Health Alliance (CKHA) is a corporate alliance of three
hospital corporations with a shared governance model that was
established in 1998, Sydenham District Hospital (the Sydenham campus)
in Wallaceburg and Public General Hospital (PGH) and St. Joseph’s
Hospital (SJH) collocated in Chatham (the Chatham campus). With
inpatient, emergency and ambulatory services provided at each campus,
CKHA offers a comprehensive range of core hospital services to local
residents of Chatham-Kent, south Lambton and Walpole Island.
Through linkages to tertiary centres in London and Windsor and with
several academic affiliations, the hospital offers key specialty services in
the local community to facilitate access to patient care for local
residents. CKHA is a strong proponent of service delivery through
partnership and collaboration, working closely with health service
providers within the Erie St. Clair LHIN and throughout southwestern
Ontario. The hospital is known for its service excellence, being
recognized as one of Canada’ Top Employers, and named as a Best
Practice Spotlight organization.
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This Part A: Service Delivery Model Report summarizes the hospital’s
initial capital planning efforts, including the results of the Master
Program process, priorities for redevelopment and identification of
future service delivery options. The report highlights population
projections, historical and projected patient care activity/ volumes and
high level space requirements for the next 20 year period. The socio
demographic health status profile of the community being served
supports the hospital’s current and future role as an important core
service provider for local residents, with an increasing emphasis on
collaboration and partnership to ensure programs are developed to
manage the increasing prevalence of chronic conditions being seen
within the Erie St. Clair LHIN, support primary care and create key
services to further address the mental health and addiction needs of the
community.
CKHA is presently undertaking a Stage 1 Proposal to support
redevelopment of both campuses. Numerous facility assessments have
pointed out the need to correct facility deficiencies, including building
infrastructure, design challenges, inability to meet infection control
guidelines, functional obsolescence and operational inefficiencies. The
facilities in most need of immediate regeneration are the entire
Sydenham campus and the Public General Hospital buildings,
emergency department and surgical services at the Chatham campus.
In looking at how best to regenerate its facilities, CKHA is presenting an
exciting opportunity to develop a new and innovative service delivery
model. While the hospital is proposing that services continue to be
provided at two campuses – one in Wallaceburg and one in Chatham –
the roles of each are anticipated to change as the hospital outlines its
vision for an improved and integrated service delivery within the
community:
 Sydenham campus: Develop a campus of care, focusing on hospital
based emergency and primary care services, and create an
opportunity for residents to access an integrated range of health care
services in a single location. Both public and private health care
providers are anticipated to come together, singly and as partners, to
provide access to services that may include long term care beds, a
Family Health Team, a Community Health Centre, professional and
allied health providers and other community based services. Two
options are being proposed for the Sydenham campus– a campus of
care with inpatient beds (5 acute and 20 complex continuing
care/rehab beds) and an alternative option that consolidates inpatient
beds at the Chatham campus. The latter option will facilitate further
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integration of ambulatory and inpatient services between the two
campuses of CKHA, as well as with community based health care
providers.
In Chatham, CKHA will focus on continuing its role as the largest
multi service acute care centre within Chatham Kent, south
Lambton and Walpole Island, by strengthening provision of core and
specialty regional services, in close partnership with regional centres
and local community based agencies. Core services will focus on
emergency care supported by surgery and ambulatory services.
CKHA will build its existing program base to ensure that emerging
community needs will be addressed and is prepared to take on a more
extensive regional role, particularly in women’s and children’s and
mental health and addictions services, as regional programs evolve
within the Erie St. Clair LHIN. Integration of service delivery with
local health service providers will be promoted at the Chatham
campus.
As an additional enhancement to system integration, CKHA has also
partnered with the (CMHA Lambton-Kent (Community Mental Health
Association) and Chatham-Kent Community Health Centre (CHC) in a
special project to determine the potential for how best to integrate
clinical services that are provided by all three organizations. A proposal
for a unique service delivery model involving all three organizations is
expected in the fall.
A community engagement process is currently underway to provide an
opportunity for both residents and service providers to learn of the
hospital’s vision and provide feedback. The engagement will conclude in
September with a series of open community meetings. In October,
CKHA will be finalizing its preferred master plan option and completing
the Stage 1 Proposal submission.
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1.0 Service Delivery Model Report
Chatham-Kent Health Alliance (CKHA) began its Stage 1 Proposal and
planning activity by ensuring that its processes incorporated the
hospital’s overall vision, previous capital planning efforts, key drivers
and influencers including community involvement, system trends and
gaps in services, and consideration of its preferred role within Erie St.
Clair Local Health Integration Network (Erie St. Clair LHIN) and health
system. These fundamentals provided an important context for service
delivery discussions and are summarized below.
Background
Formed in 1998, CKHA is a 300 bed community hospital located in the
Erie St. Clair LHIN. CKHA was created from a partnership of three
hospital corporations located in the Municipality of Chatham-Kent
 Public General Hospital, Chatham (PGH)
 St. Joseph’s Hospital, Chatham (SJH)
 Sydenham District Hospital, Wallaceburg (the Sydenham campus)
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The Public General Hospital and St. Joseph’s Hospital are collocated on
a shared site in Chatham (the Chatham campus); Sydenham District
Hospital is located in Wallaceburg, about 28 kilometres west of
Chatham. CKHA is the only provider of hospital based services within
Chatham Kent.
CKHA is a progressive multi service community hospital delivering a
comprehensive range of core clinical services on its three campuses
 inpatient acute (medicine and surgery)
 women’s and children’s
 mental health and addictions
 rehabilitation/complex continuing care
 diagnostics
 emergency and community health services
Specialty services offered at CKHA include:
 a provincially designated stroke centre
 Ontario Breast Screening Program (high risk centre)
 cardiac rehabilitation
 satellite haemodialysis
 neonatal and intensive care
 satellite chemotherapy
 early psychosis intervention program for youth
CKHA is clinically linked to tertiary centres in London and Windsor and
is academically affiliated with the Schulich School of Medicine at the
University of Western Ontario in London and with St. Clair College in
Windsor.
CKHA is a strong promoter of service delivery through partnership and
collaboration, having established key service delivery relationships with
local service providers within the Erie St. Clair LHIN and with regional
providers in south western Ontario.
The hospital is known for its service excellence, achieving patient
satisfaction rates of over 90 per cent:
 recognized as one of Canada’s Top 100 employers in both 2009 and
2010
 named a Best Practice Spotlight Organization by the Registered
Nurses Association of Ontario (RNAO)
 received a Quality Healthcare Workplace Award (Gold Level).
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In addition, CKHA is the recipient of several provincial awards for
employment excellence, information technology, communications and
environmental efforts.
The hospital’s organization charts are attached as Appendix A.
Mission, Vision, Values and Strategy
To achieve the hospital’s mission and purpose of “Together advancing
compassionate quality care”, CKHA embraced a bold new vision: “An
Exceptional Community Hospital, Setting Standards, Exceeding
Expectations”, a system focused and integrated organization playing a
major role in providing hospital based services within the region and a
leader in innovation, best practices and change.
These are supported by the strategic directions of CKHA.




Patients: Integrate care across the continuum to better serve our
patients and community
People: Enable a culture of empowerment, compassion and caring
Innovation: Be a centre for key community needs
Performance: Generate results worthy of a model community
hospital
To deliver compassionate, quality care, CKHA is guided by its core
values:

Respect
 Teamwork
 Compassion



Trust
Knowledge
Accountability
CKHA’s long term success as a health care centre and leader in the
community reflects its ability to readily adapt to changes in its
environment, including community need and alignment with external
directions from the Erie St. Clair LHIN and the Ministry of Health and
Long-Term Care (MOHLTC).
Achievement of the hospital’s healthcare vision in the future will
incorporate the following key features:
 create an innovative campus of care model to facilitate
 collocation of health service providers (HSPs) on the hospital’s
redeveloped campuses
 collaboration among local HSPs in ensuring patient focused care
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

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
delivery of fully integrated health care services to the local
community
focus on the hospital’s service delivery priorities, including:
 quality of care
 continued implementation of best practice
 standardization of protocols and guidelines
 efficient and effective service models
develop and implement chronic disease management and prevention
(CDMP) initiatives through a collaborative delivery model for
services
provide core hospital based services for Chatham Kent, south
Lambton and Walpole Island
maximize efficient processes and service delivery for health care
services to ensure efficient ongoing operating costs
advance back office and support service integration
offer a greater role in learning and education through increased
student placements and support as a key to successful recruitment of
highly trained professional staff to provide high quality care
continue its position as an economic driver within Chatham Kent.
History of Capital Planning
The hospital completed a capital redevelopment project in Chatham in
2004 that addressed the directives of the Health Services Restructuring
Commission (HSRC) regarding St. Joseph’s Hospital and replaced the
SJH facility, collocating with the PGH campus. Renovations to selected
areas of PGH were undertaken at that time and included the surgical
suite. Since that time, an update of facilities for Women’s and Children’s
services has also been completed to address care requirements. While in
reasonable repair for its age, PGH faces significant challenges in design
(e.g., narrow door openings), single glazed windows, roofing repairs and
asbestos issues. In addition, there are numerous functional issues that
create challenges in achieving operational efficiency, accessibility,
privacy, safety and security infection prevention and control
sustainability.
In 2005, CKHA commissioned a building condition report on the
Sydenham campus in Wallaceburg which concluded that the Sydenham
campus facility is at the end of its life and needs replacement. Further,
significant upgrades are immediately required to several infrastructure
systems, including the building exterior, windows and doors, roof,
removal of asbestos, HVAC, etc., suggesting that an upgrade may not be
a cost effective solution for that campus.
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Subsequently, the hospital conducted a planning process in 2009 that
resulted in a Master Program for both campuses and Pre-proposal
submission to MOHLTC for renewal of all facilities. A Capital Request
Form to identify the future scope of work for the proposed capital
redevelopment project and an associated capital cost estimate was
requested by MOHLTC; these were developed by CKHA, endorsed by
the Erie St. Clair LHIN and submitted to the MOHLTC in October,
2010.
The hospital then embarked on the process of developing a full Stage 1
Proposal submission for MOHLTC and the LHIN, including an updated
Master Program, Master Plan and Business Case/Options Analysis, with
a target date of submission of the end of October, 2011. This
documentation will address the components of the MOHLTC’s/LHIN’s
current capital planning process and provide a context and strategy for
the long term redevelopment of the CKHA sites and buildings.
The Community Served/Population Needs
The population and health status information in this section has been
sourced from the Erie St. Clair LHIN Document: Integrated Health
Service Plan 2, Appendix B: Population Profile, December, 2009.
CKHA is located in the Erie St. Clair LHIN, home to 5.2 per cent of the
province’s population. A map of the LHIN geography is provided in
Table 1 on the next page.
CKHA serves over 100,000 residents of the Regional Municipality of
Chatham-Kent, which is comprised of the communities of Wallaceburg,
Bleinheim, Tilbury, Ridgetown, Dresden, Wheatley, Bothwell,
Thamesville and the City of Chatham. In addition, the hospital serves
part of south Lambton County (4 per cent of the population served),
including Walpole Island First Nation and Essex (3 per cent).
The demographic data for the Erie St. Clair LHIN indicates
 17.2 per cent of the population lives within Chatham-Kent
 the LHIN has a larger rural population (5.4 per cent larger) than the
province and has a lower population density
 there is a slightly higher proportion of the population over the age of
60 years and a slightly lower proportion of the population between
the ages of 30-34, compared to Ontario
 the population is projected to grow by 3.9 per cent, between 2010
and 2020 significantly less than that of the province (12.0 per cent)
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Figure 1: Erie St. Clair LHIN Geography
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Based on the 2006 census data, Table 1 below summarizes the
population demographics of the Erie St. Clair LHIN.
Table 1: Population Statistics
Chatham-Kent
Total Population
108,590
(2006)
Chatham-Kent
% of
Chatham-Kent
Population
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-74
75+
5.4
5.9
6.9
7.2
6.4
5.1
5.3
6.1
7.9
8.3
7.4
6.8
5.4
8.2
7.7
Essex
393,400
Lambton
128,205
Erie St. Clair
630,196
Ontario
12,160,287
Essex
% of
Essex
Population
5.9
Lambton
% of
Lambton
Population
4.9
Erie St. Clair
% of
Change
Erie St. Clair from 2001
Population
to 2006
5.6
↓
Ontario
% of
Change
Ontario
from 2001
Population to 2006
5.5
↓
6.3
6.8
6.9
6.7
6.2
6.8
7.3
8.2
7.8
6.8
6.2
4.7
6.9
6.4
5.4
6.7
7.3
6.3
5.0
5.0
5.6
7.3
8.3
8.1
7.4
5.9
8.7
8.2
6.0
6.8
7.0
6.6
5.8
6.2
6.8
8.0
8.0
7.2
6.5
5.1
7.5
7.0
5.9
6.7
6.9
6.6
6.1
6.5
7.3
8.5
8.2
7.1
6.4
4.8
7.1
6.4
↓
↓
↑
↑
↓
↓
↓
↑
↑
↑
↑
↑
↑
↑
↓
↑
↑
↑
↑
↓
↓
↑
↑
↑
↑
↑
↑
↑
Source: Statistics Canada, 2006 Census, www.statcan.gc.ca
Determinants of Health
It is important to recognize and plan for a number of factors which
impact health and, ultimately, access to care. The sociodemographic
indicators for Chatham-Kent and Erie St. Clair LHIN are presented in
Table 2.
When compared to Ontario, in Chatham-Kent and Erie St. Clair LHIN,
 there is less diversity and population with French as the mother
tongue
 the proportion of single parent families is higher in Chatham and
Erie St. Clair LHIN
 the population is less educated
 the unemployment rate is higher
 the proportion of residents with low incomes is less
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Table 2: Sociodemographic Indicators (based on 2006 Canadian Census)
Indicator
8
Chatham-Kent
Erie St. Clair
LHIN
Ontario
10.1
2.5
3.0
25.9
44.9
7.2
11.9
18.1
2.4
3.3
25.4
50.6
7.5
12.2
28.3
2.0
4.4
24.5
56.8
6.4
14.7
Diversity (% immigrants)
% Aboriginal Identity
% Population with French Mother Tongue
Single Parent Families
Education (%> 25 years with completed post secondary education)
Unemployment Rate
Low Income (%)
Health Behaviours
When compared to the Ontario average, there are significant variances
that impact the health service needs of Erie St. Clair residents. They
report higher rates of smoking, alcohol consumption and self-reported
rates of obesity in concert with lower rates of physical activity and
healthy eating. This places them at a higher risk for developing chronic
conditions such as diabetes, vascular and pulmonary disease. However,
the majority of residents in Erie St. Clair LHIN have a regular primary
care physician (89.1 per cent) and 80.3 per cent had at least one contact
with a physician in the past year.
Health Status
A summary of key health status indicators is shown in Table 3 for Erie
St. Clair.
Table 3: Health Status – Erie St. Clair LHIN
Indicator
Erie St. Clair LHIN
Ontario
77.5
81.8
5.6
3.8
626.2
78.6
82.7
6.1
5.4
559.0
Life Expectancy, Males (years)
Life Expectancy, Females (years)
Low Birth Weight, Rate
Infant Mortality Rate/1000 Live Births
Age Standardized Mortality Rate/100,000
When compared to Ontario, in the Erie St. Clair LHIN,
 low birth rates are lower
 infant mortality rate is lower; but
 life expectancy is lower
 age standardized mortality rates are higher
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Chronic Conditions
Residents of the Erie St. Clair LHIN have higher prevalence rates than
Ontario residents for
 Arthritis
 Asthma
 Chronic Obstructive Pulmonary Disease (COPD)
 Diabetes
 Heart Disease
 Hypertension
 Mood Disorder
Arthritis and hypertension are the most prevalent of all of the conditions.
Further characteristics include:
 Residents over the age of 65 have the highest prevalence rates of all
the conditions.
 In Chatham-Kent, approximately 50 per cent of the diabetes
diagnoses are patients aged 50-64, compared to 20 per cent in
Sarnia/Lambton and Windsor/Essex.
 The largest proportion of emergency department (ED) visits for
chronic conditions are associated with arthritis, heart disease and
COPD.
 The residents of Erie St. Clair often have more than one chronic
condition; over 65.5 per cent of Erie St. Clair residents > 45 years
have at least 1 chronic condition and about 49 per cent over the age
of 65 have at least 2 chronic conditions.
 The residents of Erie St. Clair are at a higher risk for developing
chronic conditions, especially diabetes
The outcome of these characteristics is higher mortality, higher potential
years lost and higher hospitalization rates.
Perceived Health Status
Self-reported health, an indicator of overall health status, can reflect
aspects of health not captured in other measures (e.g. disease severity,
aspects of positive health status, physiological and psychological
reserves and social and mental function). The key indicators are
 In 2007, 59.1 per cent of the residents in Erie St. Clair reported that
their perceived health status to be ‘excellent’ or ‘very good’, lower
than the Ontario comparator.
 73.5 per cent of residents reported that their perceived mental health
status was ‘excellent’ or ‘very good’, a rate higher than the
provincial comparator.
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Only 56.8 per cent of males in Chatham-Kent aged 12-19 years
reported that their perceived mental health status was ‘excellent’ or
‘very good’.
Access to Primary Care
Challenges in accessing primary care within Erie St. Clair LHIN include:
 Health Human Resources
 Lowest ratio of family physicians to residents in the Province
 Second lowest ratio of physicians to residents in the Province
 Admits for Ambulatory Care Sensitive Conditions (ACSC)
 Higher that the provincial rate
 Top four chronic conditions: Chronic Obstructive Pulmonary
Disease, Congestive Heart Failure (CHF), Angina and Diabetes
 ED visits that could be Managed Elsewhere
 Top conditions: Upper respiratory, bladder infection, ear
infection, eye infection
 Mental Health Services
 Between 2006/07 and 2008/09, the number of mental health
diagnoses and individuals served increased by 7 per cent for Erie
St. Clair residents
 Community Care
 Demand is highest in Chatham-Kent and Sarnia Lambton, when
standardized per 1,000 population
 Chronic Disease (Diabetes, COPD, Arthritis)
 In general, prevalence increases with age, with rates
substantially higher in populations over 75
 Incidence rates are highest in Chatham-Kent
Other Indicators
The Integrated Health Service Plan (IHSP) 2 document also highlights
several specific issues that impact Chatham-Kent health care providers:
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Indicator
Chatham-Kent
Mortality
Mortality rates for Chatham-Kent residents were higher than those for Ontario
residents for cancer, diabetes, high blood pressure, ischemic heart disease (IHD),
stroke, and COPD.
Chatham-Kent residents had higher hospital separation rates than Ontario
residents for all conditions, with the exception of depression and asthma.
Chatham-Kent residents had higher ED visit rates compared to provincial rates for
all of the chronic conditions presented. Of note, the COPD rate was 2.5 times
higher than that for Ontario residents and the rate for arthritis and related
conditions was more than 1.5 times the provincial rate. However, emergency
department visits have remained stable since 2005/06.
Hospital Separations
Emergency Visits
ED visits that could be managed elsewhere
(alternative primary care settings)
ALC
The majority of patients are discharged home, similar to other areas of Erie St.
Clair LHIN
CKHA has double the rate across the LHIN (87.1%).
77% of total visits at the Sydenham campus were non urgent and deferrable
cases.
ALC days decreased 2005/06 to 2007/08 from 6.6% to 4.7%, only area with
decrease within Erie St. Clair LHIN.
Summary
In summary, the sociodemographic and health status profile for the
residents of the Erie St. Clair LHIN shows the following relative to
findings for the province:
 a higher proportion of seniors and a lower proportion of individuals
in the 25-39 year age group
 a higher unemployment rate
 a significantly higher incidence of overweight/obese individuals
 a slightly higher proportion of individuals who practice poor lifestyle
habits such as smoking, drinking, poor nutrition and inactivity
 a significantly higher prevalence of arthritis/rheumatism
 a slightly higher rate of other chronic conditions such as asthma,
diabetes, heart disease and high blood pressure
 significantly higher rates of hospitalization, potential years of life
lost, and mortality due to higher rates of neoplasm, circulatory
disease and external causes such as injury
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Implications for Service Planning
The sociodemographic health status profile identifies several areas of
focus when planning for CKHA’s future services, specifically, to
 maintain core hospital services for the residents of Chatham-Kent,
south Lambton and Walpole Island
 ensure programs to manage chronic conditions, particularly those of
most prevalence (diabetes, arthritis, COPD, hypertension) including
strategies with partners for illness prevention and health promotion,
diagnosis and treatment (within the hospital and in the community),
 make certain appropriate primary care support is provided to address
high rates of non-urgent and deferrable cases seen in the emergency
departments, and
 continue to address mental health needs of community, particularly
mental health support for youth.
For the period 2010-2020, the population of Erie St. Clair LHIN will
grow by 3.9 per cent. However, the population of Chatham-Kent will
decline by 1.1 per cent, compared to provincial growth of 12.0 per cent.
Consistency with MOHLTC and LHIN Expectations for the Planning Process
The approach and planning timeframes for the Master Program (and
business case as a whole) were discussed with the MOHLTC and Erie
St. Clair LHIN.
 The volume projections reflect the years 2017/18 and 2027/28, using
the base year data of 2009/10, and are based on an established
methodology, applied by HCM Group, Inc., for many Ontario
hospitals.
 The proposed scope and organization of services are congruent with
the corporate strategic directions for CKHA and the Erie St. Clair
LHIN and MOHLTC priorities.
 The MOHLTC’s principles/OASIS (operational effectiveness/
efficiency, accessibility, safety and security, infection prevention and
control, and sustainability) criteria are applied in the assessment of
space and directions for planning.
 The space projections reflect the application of contemporary
guidelines including the 2007 Ontario Building Code and the
MOHLTC’s Generic Output Specification (GOS)
 The MOHLTC-LHIN Joint Review Framework for Early Capital
Planning Stages Toolkit, November 2010 was used as a guideline for
the document.
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The facility planning also incorporated strategies to address key
directions from the Erie St. Clair LHIN’s Integrated Health Services
Plan 2 (December 2009), recommendations from the Accreditation
Canada December 2010 Final Report, facility assessment studies, other
condition assessment reports and the priorities of MOHLTC.
MOHLTC Priorities
MOHLTC priorities support equitable access to health and health care
for all Ontarians and improve access to care in three areas
 reducing wait times in emergency departments
 reducing the time patients spend in alternate level of care beds in
hospitals
 supporting the Ontario diabetes strategy
The Ministry has also identified mental health and addictions and
eHealth initiatives as key focus areas.
Erie St. Clair LHIN Action Plan
The IHSP for 2010 to 2013 identifies the priorities for the next three
years.
Figure 2 summarizes key areas of the Erie St. Clair LHIN’s Action Plan
Strategy, and how relevant Hospital initiatives and the CKHA Master
Program will support LHIN initiatives and health care services provided
locally.
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Figure 2: Erie St. Clair LHIN Action Plans and CKHA Initiatives
IHSP 2010-2013 Action Plan
Priority Populations
Five Confirmed Strategic Directions
CCC, Mental Health, post- acute
 Improved outcomes in alternate
level of care
(convalescent), rehabilitation (ST and
LT), bariatric, pre-existing infectious
disease, hospitalized/ambulation,
chronic disease, elders/seniors at home
System Specific Goals
14
CKHA Initiative
Redevelopment Project

ensure appropriate community care, maximize • System Integration
• Emergency Dept.
Project with CMHA,
functional conditioning, improve ED wait times,
• Ambulatory Care
CHC
improve placement times for LTC patients,
• Inpatient Units
develop falls prevention program, create
• Diagnostics
• Home First Initiative
effective standardized educational programs, • Assess/Restore Project • Surgery
Predictive Discharge
reduce inpatient hospital fall rates, reduce
and Utilization
acute LOS for chronic disease populations
Management
 improved outcomes in emergency
department care
admitted patients waiting for transfer,
those waiting for urgent
testing/consultation services not
available in community, high intensity of
care patients, patients with CTAS 3,4,
and 5, wound/soft tissue infections,
infection control risks (MRSA, VRE),
stabilization of mental health issues
streamline MH services between hospitals and
community providers, enhanced referral to
existing primary care providers, enhance after
hours care of primary care practitioners,
improve access to primary care assessment in
LTC facilities, improved access to critical care
beds, improve response rate to lower acuity
patients in ED, reduce ED visits and
readmission for chronic disease management
patients, determine appropriate care pathways
for patients with known community acquired
infections
 improved outcomes in diabetes
management
individuals with diabetes: with no
primary care provider, seniors, women
with gestational diabetes, individuals
who have mental illness, First Nations
People, ethnic populations, rural or
geographically isolated residents,
paediatric population
improve streamlined coordination within LHIN • Integrated Planning
- CHC
sub regions, improved system navigation,
reduce avoidable ED visits, improved, shared • Care Continuum
Project, Primary 
and standardized educational programming,
Acute
expand existing care capacity (primary care),
optimize wait times, improved and timely
• Home First
access to specialized consultations, increased
compliance of health care practitioners with
existing clinical practice guidelines, improved
screening of identified high risk populations
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
• Primary Care
Integration
• Diagnostics
- CHC
• ER departments
- FHT
• Patient Flow Initiatives
- P4R/PIP
• NP Clinic Development
• Pod '5' Program
• CTAS 4/5 diversion
• Treat and Release

• Ambulatory Care
• Emergency Dept.
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Figure 2: Erie St. Clair LHIN Action Plans and CKHA Initiatives
IHSP 2010-2013 Action Plan
Priority Populations
System Specific Goals
15
CKHA Initiative
Redevelopment Project
 improved outcomes in mental health adults with opiate dependency, youth
and addictions
with addictions issues, seniors 65+ with
addictions issues
increase access to withdrawal management
services, reduce reliance on primary care, ED
and inpatient services for withdrawal
management and addictions services,
increase capacity and reduce wait times of Op
services for opiate dependent adults, youth
and seniors, improved integration and revised
delivery models to better meet needs across
lifespan, ensure continuum of addiction
services for opiate dependent individuals
• System Integration
Initiatives - CMHA
• Enhanced
liaison/partnership
with local HSPs
• Urgent Care Clinic
(Psychiatry)
• Regional Mental
Health program
divestiture from
London/St. Thomas

• MH Inpatient
• MH Ambulatory Care
• Emergency Dept.
 improved outcomes in rehabilitation
care and interventions
improve access to outpatient rehab services
and day programs for stable patients not
requiring IP bed, facilitate appropriate use of
IP beds, improve activation for complex IP
geriatric population with low intensity, long
duration rehab services, provide access to
pulmonary rehab program service delivery
model, improve flow through patient/family self
management, create/expand/enhance subacute, primary care and community
partnerships to facilitate transition to community,
create/expand/enhance feedback linkages
from community to primary health to maintain
successful healthy living in the community,
avoid ED visits and ED acute readmissions
• Assess/Restore
• Home First Project
• Pre-Admit
Redevelopment
• Surgical Efficiency
and Utilization
Review
• Integration Planning
- CHC/CMHA

• Ambulatory Care
• Diagnostics
• IP Units
- CCC/Rehab
- Medicine
- Surgery
frail individuals >65 with multiple chronic
conditions, complex disability patients
(stroke), individuals with chronic
respiratory diseases/heart failure,
neurological, vascular and orthopaedic
populations, frail individuals >65 with
reduced mobility, strength etc.
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1.1 Master Program
Master Program
Process
The process to develop the master program was guided by the !magine
Steering Committee composed of representatives of senior leadership
and the Board of CKHA. It involved several steps including:
 confirmation of the clinical program planning assumptions and
guiding principles for all programs and departments
 development of volume projections
 development of the master program through tours, meetings and
review of draft and final materials with the program and department
working groups
Consultation/Engagement
Development of the Master Program involved a series of meetings with
the following individuals/groups.
The Steering Committee (!magine Steering Committee), comprised of
representatives of the Board, Erie St. Clair LHIN, Consolidated Health
Information System (CHIS), and senior leadership of the hospital and of
the CKHA Foundation, developed the conceptual models for service
delivery, reviewed methodologies and materials, provided direction and
responses to issues and recommended the redevelopment priorities and
strategy.
User groups/service leads/physicians met with the consultants to
provide information and perspectives regarding scope of service, activity
and space, and to provide a tour of the facilities for the consultants, and
reviewed draft documents. Second drafts were provided for sign-off and
feedback with teleconference follow-up, as required.
Early in the process (2009) there was engagement with the community
on the establishment of guiding principles for the project. Further
community engagement has been ongoing since May 2011 with a
rigorous strategy to ensure that key stakeholders, including the public,
patients and their families, community leaders, community
organizations, local health care providers and partners, hospital staff,
physicians and volunteers are aware of the hospital’s future service plans
and have an opportunity to comment on the proposed master plan
options. Community open houses will be conducted during September
as the final phase of consultation. A summary of the feedback will be
included in the Stage 1 Proposal Submission.
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Guiding Principles
The guiding principles for developing the master program and master
plan are outlined below
 patient and family centered care
 patient and staff safety
 address regulatory conformance and accreditation
 infection prevention and control
 accessibility
 process and system redesign
 “Green Health” care
 flexibility and adaptability
 efficiency enabling design
Organization of the Master Program
The following pages provide a summary of the Master Program. The
complete Master Program document is appended to this submission as
Appendix B.
The Master Program document includes an introduction and summary,
forty-nine (49) component sections and appendices which present detail
related to market share, workload and staffing, provided by HCM Group,
Inc., the data partner for the integrated planning team. Twenty-nine (29)
program sections were created for the Chatham site; twenty (20) for the
Sydenham campus.
The Master Program for CKHA contains an overarching introduction
and summary, two chapters that are site specific, one for Chatham and
one for the Sydenham campus and three appendices that contain
supporting information.
The document provides key information for the development of the
master plan for each of the sites and for the business case for the CKHA
Stage 1 Proposal Submission. Together, the master program and master
plan provide a strategy for long term redevelopment of the buildings at
both campuses to meet current and future demands for quality patient
care, as documented in recent reports including the IHSP 2 of the Erie
St. Clair LHIN.
For the Chatham site, the master programming reflects its continuing
important role as a multi service acute care centre for Chatham-Kent.
The Chatham campus will provide core services, including emergency,
supported by ambulatory care, and surgery, and regional specialty
services in close partnership with regional centres and community
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agencies. CKHA is prepared to take on increasing regional roles as
opportunities arise within the LHIN.
For the Sydenham campus, a health campus of care concept is being
envisioned. Two roles for the campus are proposed – one supported by
inpatient beds and one without inpatient beds and both options are
reflected in the Master Program document.
There is a ripple effect on the master program for the Chatham campus,
depending on which option is elected for the Sydenham campus; the
major area of impact is in the space allocation for complex continuing
care and rehabilitation beds at the Chatham site; the Stage 1 Proposal
will reflect the preferred option selected by the hospital. However, space
requirements have been developed for each of the options.
Each Master Program component section includes the following
information:
 scope of service, including future initiatives
 key planning assumptions, including current and projected workload
and staffing for the approved time horizons
 a facility assessment of the existing facilities, including location,
adjacencies required, room elements that are missing, undersized and
insufficient in number and departmental layout
 directions for the Master Plan
 current and projected major room elements
 current and projected space allocation (in departmental gross square
feet).
Agnew Peckham Healthcare Consultants assisted CKHA in the
following areas:
 facilitating meetings, assessing the facilities and developing draft and
final documents
 working with staff, leaders and physicians of CKHA to develop the
service delivery model report as presented in this document
 contributing as part of the integrated planning team with the
hospital’s architects, DIALOG, to the interpretation of the Master
Program in the Master Plan, as well as the development and
assessment of options
 HCM Group, Inc., provided the demographic, market share, and
activity data and projections that inform the Master Program.
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Planning Context and Role of CKHA
CKHA is the single hospital service provider within Chatham-Kent, and
in this role plays a vital role in supporting its residents, providing
immediate care and treatment and ensuring appropriate and timely
referrals to other providers. The three hospital corporations that make up
CKHA have been a foundation for health care over the past 60 years
with a rich history of providing compassionate care to meet the needs of
its local communities.
The population’s socioeconomic status, income, education, cultural
background and geography contribute to its ability to access care and
will continue to be a focus of CKHA in planning health services.
CKHA provides a comprehensive range of primary and secondary
inpatient and ambulatory care programs and services to residents of the
Regional Municipality of Chatham-Kent, south Lambton, Walpole
Island and a small area of Essex in the following clinical program areas:
 inpatient acute (medicine and surgery)
 women’s and children’s
 mental health and addictions
 rehabilitation/complex continuing care
 diagnostics
 emergency and community health services
Inpatient and ambulatory services are provided at the Sydenham campus
in Wallaceburg and in Chatham. The Chatham site provides a wide
range of primary, secondary and regional services; the Sydenham
campus site is focused on medical inpatient, diagnostic and emergency
services with referral to Chatham, as appropriate. Both campuses are
closely linked to community providers for care, treatment and follow-up.
CKHA has linkages with regional centres in southwestern Ontario to
provide satellite specialty services and with education institutions to
support health professional education.
Many of CKHA’s services are delivered within provincial, regional and
LHIN partnership arrangements and the hospital is focused on further
strengthening the integration and collaboration of its service delivery
model with other providers.
Although the focus has been on care within the hospital setting, CKHA’s
service delivery has been evolving through formal and informal
relationships with other providers, exploration of alternate care models,
including involvement in regional networks and the development of
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partnerships to examine new service delivery approaches. As a result of
this concerted effort by CKHA to develop strong program partnerships
with community based providers, the beginning of a shift to community
based services provided in collaboration is occurring.
Further, the hospital has utilized a contemporary mix of health service
providers to address its accessibility strategy. For example, nurse
practitioners are used in both emergency departments to support
assessment, triage and treatment initiatives. These individuals have a
strong link with other primary care providers, including family
physicians and community based agencies and are able to ensure that
patients are seen quickly and receive appropriate treatment whether in
the hospital or in other appropriate settings for both treatment and
follow-up. Close partnerships with key community stakeholders support
prevention and health promotion.
The Master Program has been developed in order for CKHA to
redevelop and renew its facilities based on the following pressures:
 The changing needs in the community with stable/little growth but
aging of the population, and increasing prevalence of chronic
conditions, particularly diabetes, arthritis and vascular disease,
requiring new models for the delivery of care.
 Poor quality of the existing physical environment for patients and
their families, physicians and staff resulting in operational
inefficiencies and safety concerns, particularly at the Sydenham
campus where the aged facility is not designed for contemporary care
delivery.
 Inadequate facilities for managing infection prevention and control
 Existing gaps in the continuum of care needed by the community,
including ambulatory care services, not addressed in the Health
Services Restructuring Commission (HSRC) recommendations.
 Other factors including:
 new/emerging service delivery models which focus on
collaboration of service providers
 quality of work life and safety
 support for wider application of best practices, improved early
detection, timely interventions and reduced inappropriate use of
hospital based services.
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Population Projections
The primary catchment area of CKHA is the Chatham-Kent census
division (representing 92 per cent of CKHA 2009/10 inpatient
separations). Lambton and Essex census divisions represented 4 per cent
and 3 per cent of CKHA inpatient separations, respectively. Notably, the
Sydenham campus had 15 per cent of inpatient separations from
Lambton, more than half of whom were residents from Walpole Island.
Table 4 shows the current and projected population by age group for the
Chatham-Kent census division.
Table 4: Chatham-Kent Population Projections
2007
2017
% Change from
2007 to 2017
2027
% Change from
2007 to 2027
0-19
20-44
45-64
65-74
75-84
85+
27,765
35,258
31,304
9,053
6,203
2,220
25,857
32,483
31,969
11,878
6,676
2,923
-6.87%
-7.87%
2.12%
31.21%
7.63%
31.67%
25,731
31,883
26,924
15,439
9,367
3,660
-7.33%
-9.57%
-13.99%
70.54%
51.01%
64.86%
Total
111,803
111,786
-0.02%
113,004
1.07%
65+
75+
17,476
8,423
21,477
9,599
22.89%
13.96%
28,466
13,027
62.89%
54.66%
Age Cohort
Source: Ministry of Finance Population Estimates and Projections (Spring 2010 Release).
Although current projections indicate a relatively stable total population,
the growth among older cohorts is significant. Age is the greatest
predictor of increased illness and use of health care services and a higher
proportion of residents in older age cohorts will have greater demands on
the local health system. However, it is important to note that increased
health services utilization among older age groups may also be a result
of the need for increased intensity of services as well as demographic
shifts.
Walpole Island (Bkejwanong) First Nation
Within the Lambton census division, the Statistics Canada 2006 Census
indicates a population of 1,875 on Walpole Island. However, Indian and
Northern Affairs Canada indicates an on Reserve population of 2,215 as
of February 2011. Population projections are not readily available for
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Walpole Island due to the relatively small population count and
variability inherent with projections at the census sub-division level.
1.1.1 Present Service Delivery
CKHA operates 287 acute and non-acute beds (220 in Chatham, 67 at
the Sydenham campus) and a range of ambulatory services, including
medical and surgical clinics on its campuses. CKHA is a major provider
of core services to its community (i.e., surgical services, medicine and
emergency care). Through linkages with regional centres in Windsor
and London, the hospital actively supports specific regional programs
such as cancer care, dialysis, stroke and diabetes care. Nephrology,
cancer clinics, mental health services and videoconferencing/telehealth
capability for specialty services are based at the Chatham campus. An
active emergency department serving over 64,000 visits (43,331 in
Chatham, 20,700 at the Sydenham campus) annually in both
communities complements this service base. Details of the scope of
services by program by site can be found in the complete Master
Program (see Appendix A).
CKHA is a progressive organization, seen as a leader on many fronts,
creating programs and services that are sustainable and cost effective.
The hospital has been a front-runner in developing medical learners,
supporting its employees, physicians and volunteers and being at the
leading edge of best practice clinical service delivery. The hospital has
been recognized both nationally and provincially for awards such as:
 Green Healthcare Leadership
 Best Practice Organization – Spotlight Award – Registered
Nurses of Ontario
 Top 100 Employer Award
The organization is also a leader in the development of integration
strategies with other hospitals in the region as a founding member of
both Consolidated Health Information Services (CHIS), the region’s
information technology provider, and PROcure, the region’s supply
chain shared service organization.
The hospital provides services through a program based model of care in
the following areas:
 inpatient acute (medicine and surgery)
 women’s and children’s
 mental health and addictions
 rehabilitation/complex continuing care
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

23
diagnostics
emergency and community health services
Each program operates inpatient and ambulatory services. Each program
is co-led by a physician and clinical leader who are responsible for
planning and operationalizing the program to meet patient needs in a
high quality and safe manner. The programs are supported by a full
range of diagnostic and support services, administered by a single
leadership across the campuses. A single senior leadership team is
responsible for the services at both campuses.
Scope of Services Provided
The current scope/service profile is summarized in Figure 3.
Figure 3: Current Scope/Service Profile















Ambulatory Care Services
Critical Care Services
Medical/Surgical/Rehab Inpatient Units
Mental Health Inpatient Units
CCC Inpatient Unit
CCC/Medical Inpatient Unit
Women's & Children's Inpatient Unit
Cardiac, Respiratory and Vascular Services
Diagnostic Imaging
Emergency
Laboratory
Pharmacy
Rehabilitation Services
Surgical Suite
Ambulatory Procedures Unit
Chatham
Sydenham























Source: CK0920 CKHA Master Program; Introduction and Summary
In organizing its services, CKHA provides local services in both
communities and regional/specialty services in Chatham, as shown in
Figure 4.
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Figure 4: Service Delivery Model 2010
SYDENHAM
• Emergency
• Ambulatory Care
• Cardiac, Respiratory, Vascular
• Diagnostic Imaging
• Laboratory
• Pharmacy
• Rehabilitation Services
• Medical Inpatient Units
• Complex Continuing Care
CKHA
• Emergency
• Ambulatory Care
• Cardiac, Respiratory, Vascular
• Diagnostic Imaging
• Laboratory
• Pharmacy
• Rehabilitation Services
• Critical Care
• Medical Surgical Inpatient Units
• Complex Continuing Care
• Women's and Children’s
• Surgical Suite
• Mental Health Inpatient
REGIONAL
SPECIALTY
LOCAL
CHATHAM
• Chemotherapy
• Stroke Care
• Cardiac Rehab
• Haemodialysis
Partnerships and Integration
As the single hospital provider in Chatham-Kent supporting region wide
services and a continuum of care for its residents, the hospital
participates in a significant number of networks and partnerships within
the Erie St. Clair LHIN that contribute to enhancement of patient care
and efficient service provision, and promote collaboration and
integration of service delivery. A summary of partnership, collaboration
and integration activities by program are detailed in Appendix C.
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Key initiatives include the following:
 The hospital supports the regional cancer program through cancer
surgery, as well as hosting a satellite cancer clinic. The hospital is
also a site for the Ontario Breast Screening Program and Breast
Assessment Clinic and has recently been designated as a high risk
centre for breast screening. Through these services, CKHA is able to
promote early interventions, systemic therapy and palliative care
initiatives, using the quality standards developed by the regional
centre. Patients are referred from both the Windsor Regional Cancer
Centre and London Health Sciences Centre (LHSC) and can receive
their chemotherapy treatments at CKHA, ensuring care is delivered
as close to home as possible.
 CKHA operates a satellite dialysis program under the regional lead
of LHSC and provides diabetes education (adult and paediatric) as
part of the Ontario Diabetes Network.
 In mental health, the hospital provides leadership for an extensive
range of inpatient and ambulatory services, including eating
disorders, early psychosis intervention, concurrent disorders,
psychiatric consultation, support to community response initiatives
and medical education.
 In diabetes services, CKHA has taken a major role in providing
education, diagnosis and treatment. Through formal agreements,
CKHA provides paediatric services as well as adult diabetes
education services. Close linkages with community partners are
facilitating examination of service delivery strategies for the future.
 CKHA is a member of the Coordinated Stroke Strategy, participating
in region wide stroke care. CKHA has been a designated District
Stroke Centre for Chatham-Kent since 2003/04 and is affiliated with
the SouthWest Regional Stroke Centre (London) through the Ontario
Stroke Network. A Secondary Prevention Clinic was designated in
2005.
 CKHA was an early implementer of telehealth and now supports a
large number of telehealth initiatives through Ontario Telemedicine
Network (OTN). The mental health program is one of the largest
providers of clinical telehealth services in the region, providing the
highest number of care hours via the system.
 CKHA lab services operates a fully Accredited Laboratory (Ontario
Laboratory Accreditation Program) that focuses on core community
hospital laboratory services, including pathology, histology and
microbiology.
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





26
CKHA is a member of the South Western Ontario Perinatal
Partnership (SWOPP), actively participating in the perinatal and
paediatric networks and working to advance perinatal and paediatric
care regionally.
CKHA is partnered with LHSC for cardiac rehabilitation.
A founding member of both CHIS and PROcure - CKHA has been a
leader in developing shared service organizations across the region in
partnership with all hospitals in Erie St. Clair LHIN.
Affiliations with universities and colleges for education include St.
Clair College, Humber College, Fanshawe College, Ryerson
University, University of Windsor, University of Western Ontario,
Assumption University and University of Toronto.
Memorandums of Understanding (MOU) exist with the University of
Western Ontario and Windsor for medical residency and family
practice teaching unit.
CCAC ambulatory clinics are provided on site at CKHA.
The CKHA Pharmacy department has been working with the
University of Waterloo for many years in the placement of Pharmacy
residents.
CKHA has recognized the special needs of Walpole Island residents
through the implementation of a monthly, in-community, diabetes clinic
in partnership with the Home and Community Care Program of Walpole
Island. In addition, there are community initiated measures such as the
100 mile walking club to prevent diabetes. CKHA has a demonstrated
commitment to collaborate and provide culturally sensitive care to this
population.
These existing connections will continue to facilitate closer relationships
among the HSPs in the local health system and support new initiatives,
such as the development of a comprehensive chronic disease
management and prevention strategy within Chatham-Kent.
1.1.2 Current and Projected Activity
Planning Horizon
Projections were developed for 2017/18 and 2027/28, specific to each
program/service. This was achieved by applying the drivers (populationbased percentage changes from the 2009/10 base year for a given
program/service) to the relevant Management Information System (MIS)
Trial Balance statistics.
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Methodology Overview
The methodology incorporates population-based volume projections that
are highly sensitive to age, sex and patient residence characteristics and
hence reflects each hospital program/service’s specific catchment area
and patient demographics. This methodology has been used for many
Ontario hospitals and has been reviewed with the MOHLTC.
In essence, the volume projection methodology marries actual volumes
by functional centre from MIS Trial Balance data, with population
change drivers to develop future volume projections. Drivers are
developed from Canadian Institute for Health Information (CIHI),
Discharge Abstracts Database (DAD) and National Ambulatory Care
Reporting System (NACRS) data. Then, known or anticipated changes
to overall role are incorporated to fine-tune the projections in
consultation with the organization.
Data Sources
Data sources were CKHA and the Ministry of Finance.
 MIS Trial Balance files from 2006/07 to 2009/10 (base year). CIHI
DAD and NACRS patient-specific data for 2009/10 were obtained
from CKHA, containing detailed population characteristics (e.g., age,
sex, municipality of residence) and utilization statistics (e.g., number
of cases and days).
 Ministry of Finance five-year age cohort, sex and census division
population projections (based on the 2006 Census and released
Spring 2010).
Methodology
Activity drivers represent mathematical multipliers that capture the
projected change in activity based on population demographics. To
calculate the drivers, projected population percent changes at 5-year age,
sex and census division level were applied to CIHI, DAD and NACRS
data, to obtain future volumes. Multiple drivers were developed to be
sensitive to projecting activity by program/service (or as specific as data
allow). Growth was applied to all CKHA activity, regardless of patient
residence. The methodology projected beds using occupancy rate
targets. Diagnostic and therapeutic services were adjusted in line with
relevant inpatient and ambulatory care activity levels.
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Adjustments
Projections incorporated natural growth as described above, as well as a
number of adjustments directed by CKHA.
 Medical/Surgical Inpatient
Population projections based on demographics resulted
in a low volume of projected beds. Therefore, two
options were created:
Option A: retention of 5 acute inpatient beds and 20
CCC beds at Sydenham campus.
Option B: all inpatient activity centralized at Chatham
campus.
 Operating Room
Adjusted cases to keep total projected cases as per
population growth and aging; but shift inpatient to
outpatient ratio to 30:70 (excluding ophthalmology
cases).
 Specialized Concurrent
Disorders/Addiction Treatment
added 3 and 6 beds for 2017/18 and 2027/28,
respectively (to address unmet need in the community).
 Dialysis
assumed increase from 36 to 54 patients in 2012/13 for
CKHA expansion; natural growth after that
 Complex Continuing Care
Option A: assumed 50 and 55 CCC beds for Chatham
Campus for 2017/18 and 2027/28, respectively; and 20
beds for the Sydenham campus (population based
methodology with clinical efficiencies of approximately 2
per cent).
Option B: all CCC beds Centralized at the Chatham
campus.
Clinical Efficiencies
It is important to recognize historical trends, clinical efficiencies and
other factors that may continue to influence future utilization profiles
(e.g., conversion of inpatient to outpatient modality, technology
changing the type of treatment and care, etc.). Therefore, the
methodology incorporated an adjustment to reflect recent changes in
provincial inpatient trends.
 Chatham campus: a clinical efficiency of 1.5 per cent per year was
applied to medical inpatient days and 0.75 per cent per year was
applied to surgical inpatient days (excluding ICU) to account for
changing future utilization profiles.
 Sydenham campus: a clinical efficiency of 1.25 per cent was applied
to the combined medical inpatient days.
 The adjustment was applied after increases in activity to population
growth and aging.
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Historical and Projected Beds and Workload
Historical and Projected Beds
A summary of the historical and projected beds is presented in Table 5.
Table 5: Bed Summary
Projected Beds b
2006/07
Chatham/St. Joseph's
Medical Inpatient Services
Surgical Inpatient
Short Stay
Gynaecology
60
30
-6
ICU - Combined Med/Surg
22
a
2007/08
a
2008/09
60
40
-6
c
60
28
12
6
c
a
60
28
12
6
c
c
2027/28
61
37
---
64
41
---
--
--
--
--
11
13
-12
10
21
--
-12
10
21
--
-12
10
21
--
-12
10
21
--
13
11
5
18
3
161
171
171
171
159
172
Combined Rehabilitation
23
23
23
23
24
26
Complex Continuing Care c
Neurology (Integrated Stroke)
29
5
21
5
21
5
21
5
50
4
55
4
218
220
220
220
237
257
Sydenham
Combined Medical/Surgical
ICU - Combined Med/Surg
Labour, Delivery, Rec, PP (LDRP)
20
---
20
---
20
---
20
---
5
---
5
---
Subtotal - Acute Beds
20
20
20
20
5
5
Complex Continuing Care c
29
47
47
47
20
20
Total Beds
49
67
67
67
25
25
267
287
287
287
262
282
Subtotal - Acute Beds
Total Beds
Grand Total Beds
a
Represents approved beds, not staffed and in operation.
b
Includes adjustments for clinical efficiency and new program development.
c
Critical care and progressive care beds combined.
d
Included in medical/surgical inpatient units.
Source: Historical - Chatham-Kent Health Alliance; Projected HCM Group, Inc.
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22
2017/18
--
Progressive Care Beds
Labour, Delivery, Rec, PP (LDRP)
Paediatric
Acute Psychiatry IP
Specialized Concurrent Disorders/Addiction Treatment
22
2009/10
--
Critical Care Beds
22
a
d
14
11
5
18
6
d
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There were 287 approved at CKHA in 2009/10, with staffing adjusted to
the Census. For the future, bed requirements will decrease for 2017/18
but return to current levels by 2027/28.
Workload by Department/Service
Tables 6a) and 6b) outline the historical and projected workload by
department/service for the Chatham-Kent and Sydenham campuses,
respectively.
Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Ambulatory Care Services
Ambulatory Care Services
1
Indicator
2008/09
2009/10
2017/18
2027/28
3,605
4,529
3,648
4,235
4,136
4,683
4,936
5,330
26,352
3,379
840
2,281
27,289
3,700
619
1,979
30,923
4,193
605
1,936
36,820
4,998
606
1,940
5,240
5,659
9,219
10,418
90
67
68
71
1,385
1,484
1,236
1,343
1,490
1,619
1,798
1,954
Stroke centre (visits)
 Stroke strategy
 Cardiac clinic
368
1,052
343
1,238
391
1,428
472
1,744
Diabetes education
 Adult and paediatrics (Chatham)
 Adult outreach (in other communities)
 Paediatrics
2,834
979
269
5,060
2,838
440
6,557
3,607
570
8,428
4,576
733
628
822
936
1,111
654
2,176
609
1,659
712
1,670
712
1,710
Ambulatory care clinics (visits)
 Chiropody
 Pre-admission
a
 Combined med/surg
 General medical
 Paediatric
 Paediatric nurse practitioner
Chronic kidney disease (nephrology)
 Haemodialysis (D/N) - chronic treatments
Domestic abuse and sexual assault
 Visits
Medical day care, incl. oncology
 Oncology day care (treatment)
 Systemic pre and post (dressing,
specimen collection, etc.)
Nutrition
 Attendance days
Women's Health
 Breast assessment
 Clinic
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Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Indicator
2008/09
2009/10
2017/18
2027/28
Inpatient Units
2
Critical Care Unit
Critical care beds
3
Medical/Surgical and Rehabilitation Chatham beds
10
b
11
c
13
60
60
61
64
12
12
13
14
 Surgery
- Gynaecology e
28
28
37
41
6
6
--
--
- Short stay
Mental Health
10
 Medicine
- PCU d
12
12
--
--
23
22
24
26
5
5
4
4
Ambulatory Mental Health f
Visits
 Psychogeriatrics
 Acute psychiatry clinic
 Crisis intervention
 Addictions - problem gambling
 Addictions - substance abuse
 Dual diagnosis
 Early intervention
 Counselling and treatment
 Aging at home
 Nurse practitioner
 Eating disorder
 Abuse services
833
7,877
1,552
137
7,751
213
1,080
3,312
-621
-279
990
9,497
1,329
241
5,559
163
1,446
7,360
-1,309
204
345
1,137
9,266
1,297
235
5,424
159
1,411
7,182
1,200
1,277
189
337
1,550
9,189
1,286
233
5,379
158
1,399
7,122
1,200
1,266
169
334
Inpatient Mental Health
General Psychiatry
 Patient days
 Discharges
 Beds
 Occupancy (%)
 ALOS
6,070
390
21
79.2
15.6
5,842
336
21
76.2
17.4
5,885
332
18
90.0
17.7
5,860
324
18
90.0
18.1
------
------
986
70
3
90.0
14.1
1,971
141
6
90.0
14.0
-279
0
0.0
0.0
204
345
0
0.0
0.0
1,175
407
3
90.0
17.1
2,140
475
6
90.0
16.8
 Rehabilitation
- Neurology (integrated stroke)
4
b
Specialized Concurrent Disorders/Addiction Treatment
 Patient days
 Discharges
 Beds
 Occupancy (%)
 ALOS
Total Inpatient
 Patient days
 Discharges
 Beds
 Occupancy (%)
 ALOS
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Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Indicator
5
Beds
Complex continuing care
6
Complex Continuing Care
Woman and Child
2008/09
2009/10
2017/18
2027/28
21
21
50
55
1,107
1,017
1,061
1,020
12
12
11
6
8
5
10
6
8
5
10
-9
4
5
3,330
3,215
3,354
539
563
--
2,586
1,790
2,202
1,409
2,532
1,591
3,027
1,866
19,100
925
19,065
975
22,002
1,122
26,871
1,370
1,545
3
1,781
287
2,053
331
Cardiac care rehabilitation clinic
 Visits
 Attendance days
258
3,816
277
3,894
319
4,489
390
5,486
Radiography
Mammography
OBSP
Breast assessment visits
Interventional/angiography
41,803
2,865
5,497
654
145
42,275
3,359
5,424
609
1,085
46,242
3,920
6,338
712
1,242
51,827
3,944
6,338
712
1,470
Births
Inpatient beds
 Labour and delivery




Gynecology
Nursery- Level I (in LBRP)
Nursery- Level II
Paediatrics
Ambulatory visits
 Labour and delivery
 Paediatric day surgery
Clinical, Diagnostic and Therapeutic Services
7 Cardiac, Respiratory and Vascular Respiratory services
Health Services
 Outpatient attendance days
 Respiratory health - asthma visits
Cardiac diagnostic services
 ECG procedures
 Holter monitoring exams
 Exercise stress testing exams
 Non invasive cardiology exams (contracted
out)
8
Diagnostic Imaging





j
 Computed tomography
j
 Diagnostic ultrasound
 Nuclear medicine
j
 MRI
9
Emergency
Emergency
 Outpatient visits
Triage Level
 Resuscitation
 Emergent
 Urgent
 Semi-urgent
 Non-urgent
Nurse Practitioner visits
11
g
-9
4
5
3,223
h
i
--
2,508
404
9,797
10,367
11,537
13,183
16,716
7,464
18,828
7,157
21,123
8,200
24,343
9,724
2,354
5,215
5,978
7,099
43,591
43,331
44,284
45,860
5,659
227
5,699
16,390
20,106
930
6,025
253
6,131
16,949
20,030
921
6,155
288
6,774
17,875
20,016
907
6,373
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Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Indicator
2008/09
2009/10
2017/18
2027/28
10
Performed In-House
 Specimen procurement
 Clinical chemistry
 Haematology
 Transfusion service/blood bank
 Microbiology
 Immunology
92,087
563,944
109,918
28,393
103,443
3,060
87,509
504,356
104,271
28,988
104,187
7,062
96,245
572,729
117,713
32,301
119,191
7,883
106,120
656,680
134,176
36,600
136,535
8,958
121,913
175,600
196,245
223,321
6,450
68
5,695
4,210
59
5,167
4,730
64
5,926
5,385
71
7,021
2,334,905
2,258,429
76,476
37,914
36,679
649
2,134,085
2,059,383
74,702
----
2,303,509
2,225,129
78,380
40,861
39,530
699
2,495,636
2,411,427
84,209
44,261
42,819
758
3,121
3,232
192,932
1,570
998,310
------
3,364
3,896
207,930
1,692
1,075,913
3,643
4,702
225,229
1,833
1,165,427
70,038
11,412
12,420
13,956
3,605
710
38,297
4,398
3,648
817
40,077
4,326
4,136
931
44,254
4,617
4,936
1,122
50,266
5,034
Operating rooms (cases)
 Total
 Inpatient
 Outpatient
9,897
2,459
7,438
9,788
2,191
7,597
10,823
2,287
8,536
12,319
2,441
9,878
Post anaesthetic recovery room (cases)
 Total
 Inpatient
 Outpatient
5,394
2,164
3,230
5,125
1,939
3,187
5,822
2,024
3,798
6,527
2,160
4,367
3,523
706
2,817
3,641
601
3,040
4,120
658
3,462
4,659
713
3,946
Laboratory
k
 Anatomic pathology
Referred-Out
 Clinical chemistry
 Transfusion service/blood bank
 Microbiology
11
Pharmacy
Total Patient Workload
 inpatient
 outpatient
 mini bags dispensed
 vials (currently done on nursing units)
 sterile products prepared (compounding)





12
13
Rehabilitation Services
Surgical Suite
TPN prepared
chemo doses
narcotics issued
purchase orders
doses dispensed
 Occupational therapy (total attendance
days)
 Chiropody (total visits)
 EMG (total in-house exams)
 Physiotherapy (total attendance days)
 Speech language pathology (total
attendance days)
Endoscopy (cases)
 Total surgical
 Inpatient
 Outpatient
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Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Indicator
2008/09
2009/10
2017/18
2027/28
Support and Administrative Areas
14 Administration and Medical Staff
Facilities
--
--
--
--
15
Communications and Public Affairs
--
--
--
--
16
Engineering Services and Facility
Management
--
--
--
--
17
Finance
--
--
--
--
18
Food Services
3,695
3,086
609
32
20
4,614
3,827
787
33
26
5,482
4,470
1,012
42
31
6,317
5,179
1,138
48
38
19
Foundation
--
--
--
--
20
Health Records
--
--
--
--
21
Housekeeping
--
476,230
492,530
22
Human Resources
--
--
--
--
23
Information Management Services
incl. Telecommunications
--
--
--
--
24
Materiel Management
60
28
12
21
23
5
60
28
12
21
23
5
61
37
-50
24
4
64
41
-55
26
4
25
Mission, Quality and Learning
Resources
--
--
--
--
26
Occupational Health & Safety &
Healthy Workplace
--
--
--
--
27
Public Spaces
3,695
3,086
609
32
20
4,614
3,827
787
33
26
5,406
4,470
936
39
31
6,241
5,179
1,062
45
35
Total attendance days
 Inpatient
 Outpatient
Total outpatient attendances - Telephone
Group sessions
Departmental gross square feet
233,290
Medicine
Surgery
 Short stay surgery
Complex continuing care
Rehabilitation
Neurology
Total attendance days
 Inpatient
 Outpatient
Total outpatient attendances - Telephone
Group sessions
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Table 6a): Summary of Historical and Projected Volumes - Chatham
Projected
Program
Indicator
28
Registration/Patient Scheduling
29
Sterile Processing
a
Includes cardiac (546 in 2007/08).
b
ICU/PCU.
c
ICU.
d
Transferred to Medicine from Critical Care Unit.
e
Transferred to Surgery from Women's & Child Inpatient Units.
f
In addition there are telephone attendances and group sessions.
g
Transfer to Surgical Inpatient.
h
Transfer to Adult Pre-admission.
i
Excludes impact of changing clinical practice.
j
Forecast assumes higher growth rate than underlying patient drivers.
k
Forecast assumes higher growth rate than underlying patient drivers.
Sterilizer loads
Washer/decontaminator loads
Pasteurmatic loads
2008/09
2009/10
2017/18
2027/28
--
--
--
--
5,640
6,840
840
----
6,236
7,563
929
7,098
8,609
1,057
2006/07
2007/08
2017/18
2027/28
4,476
4,568
4,936
5,452
518
429
493
587
2,434
78
2,356
2,468
100
2,368
3,494
142
3,352
4,489
182
4,307
136
244
265
295
2,509
2,240
2,273
47
20
47
20
20
5
l
Includes Mental Health Building, does not include off-site buildings.
Source: Chatham-Kent Health Alliance and HCM Group, Inc.
Table 6b): Summary of Historical and Projected Volumes - Sydenham
Projected
Program
Indicator
Ambulatory Care Services
1 Ambulatory Care Services
Medical/surgical
Obstetrics/gynaecology clinics
Diabetes - adult
 Total visits
 Inpatient (acute)
 Outpatient (other)
Nutrition - attendance days
Medical/surgical clinic (nurse practitioner)
Inpatient Units
5 Rehabilitation/Continuing Care
Complex continuing care beds
Combined Medical/Surgical beds
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a
2,332
20
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Table 6b): Summary of Historical and Projected Volumes - Sydenham
Projected
Program
Indicator
2006/07
2007/08
2017/18
2027/28
353
693
464
318
566
322
725
402
Respiratory therapy attendance days
Holter monitoring exams
1,323
N/A
1,215
226
1,320
267
9,692
4,851
9,404
5,121
9,556
5,420
10,120
5,959
22,526
20,700
21,016
21,560
49
1,050
3,916
14,680
1,018
52
1,128
4,043
14,765
1,028
61
1,223
4,249
14,985
1,042
Clinical, Diagnostic and Therapeutic Services
7 Cardiac, Respiratory and Vascular Holter Exams
Stress testing exams
Health Services
ECG exams
8
Diagnostic Imaging
 Radiography
 Ultrasound
9
Emergency
Emergency
 Visits
 Triage Level
- 1 Resuscitation
- 2 Emergency
- 3 Urgent
- 4 Semi-urgent
- 5 Non-urgent
10
Laboratory
42,681
98,810
17,867
2,739
26,858
77,715
12,491
2,695
24,461
74,107
11,504
2,628
25,643
77,698
12,050
2,758
c
 Referred-Out
- Clinical chemistry
- Transfusion service/blood bank
- Microbiology
- Anatomic pathology
9,048
7
7,807
2,911
3,953
20
6,927
3,012
10,759
3,617
19
5,935
3,103
11,388
3,820
19
6,292
3,256
Pharmacy
Total Patient Workload d
12
Rehabilitation Services
Attendance days
e
 Inpatient acute
 Inpatient chronic
 Outpatient visits
Surgical Suite
1,468
341
 Performed In-House
- Specimen procurement
- Clinical chemistry
- Haematology
- Transfusion service/blood bank
11
13
b
Procedures
 Surgical (OR/PARR)
 Endoscopy
e
96
2,171
64
2,007
69
2,330
77
2,567
15
Communications and Public Affairs
--
--
--
--
16
Engineering Service and Facilities
Maintenance
--
--
--
--
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Table 6b): Summary of Historical and Projected Volumes - Sydenham
Projected
Program
Indicator
2006/07
2007/08
2017/18
2027/28
18
Food Services
Total attendance days
 Inpatient
 Outpatient
Total outpatient attendances - Telephone
Group sessions
2,067
524
1,543
30
80
803
663
140
25
8
891
748
143
26
8
1,042
894
148
26
8
19
Foundation
--
--
--
--
20
Health Records
--
--
--
--
21
Housekeeping
--
65,500
67,270
67,270
22
Human Resources
--
--
--
--
23
Information Management Services
incl. Telecommunications
--
--
--
--
24
Material Management
47
20
47
20
20
5
20
5
25
Mission, Quality and Learning Resources
--
--
--
--
26
Occupational Health & Safety & Healthy Workplace
--
--
--
--
27
Public Spaces
3,695
3,086
609
32
20
4,614
3,827
787
33
26
5,406
4,470
936
39
31
6,241
5,179
1,062
45
35
28
Registration/Patient Scheduling
--
--
--
--
a
Assumes doubling of staff.
b
Included in Chatham site (298 in 2017/18 and 363 in 2027/28).
c
To Chatham and community labs.
d
Included in Chatham statistics.
e
Relocate to Chatham site.
Departmental gross square feet
 Complex Continuing Care
 Medical Surgical
Total attendance days
 Inpatient
 Outpatient
Total outpatient attendances - Telephone
Group sessions
f
f
Cleanable square feet calculated based on DGSF.
Source: Chatham-Kent Health Alliance and HCM Group, Inc.
The growth in volumes across all services reflects the effect of the
overall population growth and major impact of the change in seniors
population. The forecast identifies significant growth in ambulatory
clinic, rehabilitation, dialysis, diabetes, cardiac respiratory and vascular,
diagnostic imaging and surgical procedure activity.
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1.1.3 Future Model of Care
The population of Chatham-Kent and surrounding areas is stable and
will not increase in large numbers; however, it is aging and the needs of
an increasingly elderly community will impact CKHA’s services. In
particular, the incidence of chronic disease is increasing and the data
shows the need to further develop services available for chronic
conditions and determine a strategy that will address the increasing
prevalence of these conditions, working closely with community based
partners. Access to preventive, diagnostic and treatment support for
chronic conditions is essential to ensure patients receive the right service
in the right place at the right time.
This will be enabled by developing clinical practices and emerging
technologies, and providing more services on an ambulatory basis.
CKHA will take the opportunity to examine use of hospital services
(e.g., emergency departments and acute inpatient care) and develop an
approach to ensure scarce and costly resources are used appropriately
and efficiently. The workload projections reflect these goals.
Recently, the hospital has been focusing on strengthening a systems
approach to service delivery, which will allow it to serve a broader
population with access to a wider range of services. It will also facilitate
development and implementation of consistent standards, guidelines and
protocols for care with local HSPs.
It is a time for new vision. The service delivery model is changing and
the hospital’s facilities must be redeveloped to support both in hospital
and community based care to ensure a continuum of care and ease of
access for patients. These opportunities have been explored in the
master program and options for innovative approaches to service
delivery will be enabled by the master plan.
Clinical Planning Assumptions
Clinical planning assumptions were based on consideration of patient
needs, gaps in services and roles of other HSPs.
There are assumptions which impact on all clinical programs. These
include continued promotion of patient centered care, including
accessibility, ease of use of services, facilities appropriate to the patients’
needs and consideration of unique patient needs, including privacy and
confidentiality. Development of an electronic health record and use of
contemporary technology such as point of care testing (POCT), use of
robotics and smart bed technology also centre in the approach to care.
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Further, the hospital will continue to ensure linkages and collaboration in
the delivery of services which will facilitate patients receiving the right
care in the right place at the right time. The table below highlights only
the significant changes in the program areas. The hospital will continue
to focus on providing core hospital based services that promote the wellbeing of the residents of Chatham Kent, south Lambton and Walpole
Island.
The clinical planning assumptions as outlined in Table 7, have been
reflected in the master program activity and space projections for the
following programs:
 mental health and addictions
 surgery
 emergency and community health services
 rehabilitation/complex continuing care
 women’s and children’s
 medicine
It should also be noted that there are general planning considerations that
have space and program implications for all departments and services
within the hospital:
 shift to electronic medical records
 changing scope of practice for health care delivery professionals
 patient and family centred care delivery models
 increased requirements for integrated information and service
delivery
 care delivery through a multi-disciplinary care model.
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Table 7: Clinical Planning Assumptions
Direction
Program
Major Expansion
Mental Health
Child/adolescent psychiatric clinic

Implications
Minor Expansion


Geriatric psychiatry


Promote regional mental health


Concurrent disorders treatment/addictions


Telepsychiatry


Medical education (student accommodation)

Space
Program/Operations







Surgery

Impact of new technology on procedures and surgical
practice
High volume surgical centre - Ambulatory Care Surgical Centres




Pain management







Integrated Pre-Admission procedures

Medical education (students/residents)

Capacity exists




Emergency

Increased patient flow - admissions, low acuity


New roles for staff including nurse practitioners


Enhance allied health team support


Privacy and Security requirements for treatment of issues
such as SADV (sexual assault and domestic violence)







Rehabilitation/Continuing Care

Chronic dialysis




Satellite radiation treatment




Expanded chemotherapy




Enhance comprehensive care for patients through
ltidi idisease
li
t approach with clinic support
Chronic
management








Expand transitional programs


Women and Children's

Introduce infertility procedures/investigations



Medicine

Increased patient acuity and "Intensivist lead" ICU planning

Repatriation of care from tertiary and quaternary centres

Ensure appropriate provision of chronic disease
management services in partnership with community based
agencies(e.g., diabetes education and cardiac
rehabilitation, cardiac clinic, TIA respiratory health

Increase use of multidisciplinary teams


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


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
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1.1.4 Options for Delivery Changes in Service Delivery
As indicated previously, the following guiding principles were used to
develop the future service delivery model:
 Patient and family centered care
 Patient and staff safety
 Address regulatory conformance and accreditation
 Infection prevention and control
 Accessibility
 Process and system redesign
 “Green Health” care
 Flexibility and adaptability
 Efficiency enabling design
The Chatham campus will continue to strengthen its role as a multi
service acute care centre, providing core services and regional specialty
services in close partnership with regional centres and community
agencies. Core services focus on emergency services supported by
surgery and ambulatory care. CKHA is prepared to support further
regionalization of programs, particularly for women’s and children’s and
mental health and addictions services, as a more regional approach
evolves within the Erie St. Clair LHIN.
The Sydenham campus is preparing to take on a new and higher profile
in providing emergency services and primary care through an exciting
vision for a campus of care in which there is an opportunity for local
health service providers, both public and private, to come together on a
single site or within a single building to ensure local residents have
access to a wide range of services.
To assist in implementing this vision, two options are being considered
for the Sydenham campus:
 Option A: beds at both Chatham and Sydenham campus; the
Sydenham campus would maintain 5 acute care beds and 20 CCC
beds, with emergency services, ambulatory care, diagnostics and
support services
 Option B: consolidate all beds at the Chatham site and retain
emergency services/urgent care, diagnostics and support services at
the Sydenham campus
Figure 5 outlines the proposed scope of services at each site for
Options A and B.
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Figure 5: CKHA Serviced Delivery Model – 2017/18
OPTION B – Bed Consolidation at Chatham
CHATHAM
SYDENHAM
• Emergency
• Ambulatory Care
• Cardiac, Respiratory,
Vascular
• Diagnostic Imaging
• Laboratory
• Rehab Services
• Ambulatory Procedures
Unit
• Medical Surgical
Inpatient Unit
• Complex Continuing
Care
• Emergency
• Ambulatory Care
• Cardiac, Respiratory,
Vascular
• Diagnostic Imaging
• Laboratory (OP only)
• Rehab Services
• Ambulatory Procedures
Unit
• Medical / Complex
Continuing Care Inpatient
Unit
• Emergency
• Ambulatory Care
• Cardiac, Respiratory,
Vascular
• Diagnostic Imaging
• Rehab Services
• Ambulatory
Procedures Unit
• Emergency
• Ambulatory Care
• Cardiac, Respiratory,
Vascular
• Diagnostic Imaging
• Rehab Services
• Ambulatory Procedures
Unit
CKHA
• Chemotherapy
• Stroke
• Cardiac Rehabilitation
• Haemodialysis
• Medical Surgical Inpatient Unit
• Complex Continuing Care
• Women’s and Children’s
• Critical Care
• Mental Health
• Laboratory
• Pharmacy
REGIONAL
SPECIALTY
• Medical Surgical Inpatient Unit
• Complex Continuing Care
• Women’s and Children’s
• Critical Care
• Mental Health
• Laboratory
• Pharmacy
LOCAL
SYDENHAM
CKHA
CHATHAM
REGIONAL
SPECIALTY
LOCAL
OPTION A – Beds at Both Sites
• Chemotherapy
• Stroke
• Cardiac Rehabilitation
• Haemodialysis
In Option A, inpatient beds would be retained at both sites; the
Sydenham campus would maintain 5 acute care beds and 20 CCC beds,
supported by emergency services, ambulatory care, diagnostics and
support services. The Chatham campus would operate 237 acute, CCC
and rehab beds in 2017/18.
If Option B is selected, the Sydenham campus would continue to provide
24 hour emergency care; patients would be triaged, assessed and either
transferred or observed and discharged, depending on their condition.
All inpatient services would be provided through the facilities in
Chatham. The hospital services available at the Sydenham campus
would include ambulatory care services, diagnostic services and
essential support services. Other health care services at the Sydenham
campus would be identified through development of the concept of an
integrated health care campus and may include:
 Long term care beds
 Family Health Team (FHT)
 Community Health Centre (CHC)
 Other community services
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The Chatham campus would be able to accommodate all inpatient
requirements, but would increase its CCC bed complement by 49 CCC
beds for 2017/18 to accommodate Option B. There would be minimal
impact on support services at the Chatham campus.
Figure 5: Scope of Services by Site
Chatham
Option A: Services (Beds at Both Sites)
 Ambulatory Care Services
 Critical Care Services
 Medical/Surgical/Rehab Inpatient Units
 Mental Health Inpatient Units
 CCC Inpatient Unit
 CCC/Medical Inpatient Unit
 Women's & Children's Inpatient Unit
 Cardiac, Respiratory and Vascular Services
 Diagnostic Imaging
 Emergency
 Laboratory
 Pharmacy
 Rehabilitation Services
 Surgical Suite
 Ambulatory Procedures Unit









Option B: Services (Beds Consolidated at Chatham)
 Ambulatory Care Services
 Critical Care Services
 Medical/Surgical/Rehab Inpatient Units
 Mental Health Inpatient Units
 CCC Inpatient Unit
 Women's & Children's Inpatient Unit
 Cardiac, Respiratory and Vascular Services
 Diagnostic Imaging
 Emergency
 Laboratory
 Pharmacy
 Rehabilitation Services
 Surgical Suite
 Ambulatory Procedures Unit














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




Sydenham















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Further discussions with the LHIN and community based providers with
respect to needs assessment, the service delivery model, and
opportunities for collaboration will be required as part of the process to
develop a business case for these integrated services on a campus of care
at the Sydenham campus.
The modifications to the proposed future service delivery model need to
be supported with adjustments to CKHA’s physical facilities, including:
 Potential to provide a campus of care model for the Sydenham
campus for delivering effective and comprehensive regional services
with partners.

Upgrading of inpatient accommodation. The hospital’s inpatient
units are not appropriately sized based on current planning standards
and infection prevention requirements. In addition, the units are not
configured in an efficient manner, resulting in clinical inefficiencies.

Capacity to support a renewed emphasis on infection prevention and
control and occupational health strategies to ensure standards are
met, including those defined for facility and human resource
requirements.

Redevelopment of the surgical suite to upgrade the undersized
facilities and accommodate current practices.

A continued focus on the hospital’s service delivery priorities, which
include
 quality of care
 standardization of protocols and guidelines
 integration of health providers in care delivery.

Creation of purpose built ambulatory care facilities to support
inpatient care, including ambulatory clinics, medical day care and a
continuum of treatment services; facilitate development of chronic
disease management and prevention initiatives; and support growth
in existing regional programs, such as dialysis.

Establish appropriate facilities for clinical and hospital support
services.
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Space Requirements
Priorities for redevelopment were based on the following criteria:
 improves delivery of patient care services
 provides a safe physical environment
 supports the hospital’s strategic directions
 aligns with previous planning
Each department was reviewed and was ranked and prioritized for
redevelopment. The entire Sydenham campus was ranked as an “A” and
prioritized as the first requiring redevelopment. The complete list of
departments and their priority ranking for redevelopment can be found in
the Master Program.
A Immediate priority for redevelopment (Phase I)
 Sydenham campus
 Chatham
 Medical Inpatient Units
 Women’s and Child Program
 Ambulatory Care
 Inpatient Mental Health
 Cardiac, respiratory and vascular health
 Materials Management
 Pharmacy
 Central Sterile Processing
 Chatham – Core Service Delivery
 Surgical Suite
 Emergency
Current and Projected Space
Tables 8 and 9 reflect the projected space requirements for the two sites,
by program/service, based on the Master Program options, (Option A –
beds at both sites, Option B – consolidation of beds at one site), using
 Agnew Peckham current space standards for contemporary planning
 a contingency (incorporated in the gross to net ratio) to accommodate
changes in the new Ontario Building Code
 application of selected space recommendations in the Generic Output
Specification (GOS) process. Further application of spaces
recommended through the GOS process will require review and
discussion with the MOHLTC, at the time of writing the functional
program.
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The implications of infectious disease prevention and control are also
considered in the Master Program. While these will be more fully
addressed in detailed planning, major requirements include
 80 per cent of inpatient acute care beds will be accommodated in 1bed rooms
 all bedrooms will have 3-pc ensuite washrooms
 each inpatient unit will have two airborne precaution rooms
including a technique room and negative pressure room
 additional airborne precaution rooms will be planned in other clinical
areas such as the surgical suite, ambulatory care and diagnostic
services
 a higher proportion of ambulatory care/medical day/oncology
treatment spaces will be enclosed
 open patient treatment areas will have sufficient separation between
the areas
 patient and family waiting areas will include sufficient space to
separate potentially infectious patients and will have sufficient
separation between seats
 handwash stations will be planned throughout the facility
Overall, to accommodate new and expanded programs and the projected
workload, and bring the facilities to contemporary standards for health
care delivery, the Master Program reflects a percentage increase in space
as follows:
Percentage Increase
2007/08 to 2017/18
2017/18 to 2027/28
Chatham Site
Option A
Option B
91.6
95.5
3.4
13.7
Sydenham Site
Option A
Option B
7.2
(32.8)
7.2
(32.8)
Table 9 reflects the estimated space requirements of the two sites based
on the master program options, (Option A - beds at both sites) (Option B
- consolidation of beds at one site; no beds at the Sydenham campus). In
Option A, the space at the Chatham campus increases by 9,800 CGSF in
2017/18 and 11,400 CGSF in 2027/28 as a result of the consolidation of
the beds. A larger complex continuing care unit will be required. We
have assumed that the clinical, diagnostic/therapeutic services and
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support and administrative areas can support the 25 additional beds with
no space increases. The space at the Sydenham campus decreases by
26,000 CGSF in both 2017/18 and 2027/28. Several clinical, diagnostic/
therapeutic services and support and administrative services areas are
affected in this option (i.e., inpatient unit, pharmacy, food services,
materials management and housekeeping).
Table 8: Projected Space Allocation Summary (CGSF) - Chatham Site
Beds at Two Sites
Program
Beds Centralized at Chatham
Current
2017/18
2027/28
2017/18
2027/28
17,585
37,500
38,500
37,500
38,500
17,585
37,500
38,500
37,500
38,500
Comments/Assumptions
Ambulatory Care Services
A1
Ambulatory Care Services
Subtotal - Ambulatory Care Services
Inpatient Units
A2
Critical Care Unit
11,180
13,300
14,200
13,300
14,200
A3
Medical/Surgical and Rehabilitation Inpatient Units
33,465
105,000
105,000
105,000
109,000
A4
Mental Health
18,300
34,500
37,000
34,500
37,000
A5
Continuing Care Inpatient Units
11,585
43,500
46,000
53,300
53,300
A6
Woman and Child Inpatients Units
23,030
32,300
32,300
32,300
32,300
97,560
228,600
234,500
238,400
245,800
Subtotal - Inpatient Units
Clinical, Diagnostic and Therapeutic Services
A7
Cardiac, Respiratory and Vascular Health Services
950
6,500
6,500
6,500
6,500
A8
Diagnostic Imaging
17,210
18,300
21,800
18,300
21,800
A9
Emergency
10,530
22,600
22,600
22,600
22,600
A10 Laboratory
7,550
9,600
10,100
9,600
10,100
A11 Pharmacy
3,655
5,100
5,575
5,100
5,575
A12 Rehabilitation Services
7,345
8,850
9,200
8,850
9,200
A13 Surgical Suite
19,650
42,000
45,000
42,000
45,000
Subtotal - Clinical, Diagnostic and Therapeutic Services
66,890
112,950
120,775
112,950
120,775
3,625
5,950
5,950
5,950
5,950
835
1,500
1,500
1500
1,500
A16 Engineering Services ands Facility Management
3,750
4,150
4,150
4,150
4,150
A17 Finance
1,790
2,150
2,150
2,150
2,150
10,185
14,200
14,200
14,200
14,200
Support and Administrative Areas
A14 Administration and Medical Staff Facilities
A15 Communications and Public Affairs
A18 Food Services
A19 Foundation
1,125
2,800
2,800
2,800
2,800
A20 Health Records
5,535
3,250
3,125
3,250
3,125
A21 Housekeeping
3,270
4,600
5,000
4,600
5,000
A22 Human Resources
1,820
2,800
2,800
2,800
2,800
A23 Information Management Services incl. Telecommunications
6,795
10,100
10,300
10,100
10,300
A24 Materiel Management
8,345
5,100
5,400
5,100
5,400
A25 Mission, Quality and Learning Resources
9,390
19,745
19,745
19,745
19,745
A26 Occupational Health & Safety & Healthy Workplace
1,210
6,000
6,000
6,000
6,000
A27 Public Spaces
3,145
6,060
6,060
6,060
6,060
A28 Registration/Patient Scheduling
1,680
1,500
1,500
1,500
1,600
A29 Sterile Processing
3,940
7,100
7,800
7,100
7,800
66,440
97,005
98,480
97,005
98,580
248,475
476,055
492,255
485,855
503,655
Subtotal - Support and Administrative Areas
TOTAL
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Table 9: Projected Space Allocation Summary (CGSF) - Sydenham Site
Beds at Two Sites
Program
Beds Centralized at Chatham
Current
2017/18
2027/28
2017/18
2027/28
5,210
9,000
9,000
9,000
9,000
5,210
9,000
9,000
9,000
9,000
Comments/Assumptions
Ambulatory Care Services
B1
Ambulatory Care Services
Subtotal - Ambulatory Care Services
Inpatient Units
B2
Critical Care Unit
N/A
N/A
N/A
N/A
N/A
B3
Medical/Surgical and Rehabilitation Inpatient Units
N/A
N/A
N/A
N/A
N/A
N/A
B4
Mental Health
N/A
N/A
N/A
N/A
B5
Inpatient Unit
22,800
23,300
23,300
--
--
B6
Woman and Child Inpatients Units
N/A
N/A
N/A
N/A
N/A
22,800
23,300
23,300
0
0
Subtotal - Inpatient Units
No inpatient beds
Clinical, Diagnostic and Therapeutic Services
B7
Cardiac, Respiratory and Vascular Health Services
430
500
500
500
500
B8
Diagnostic Imaging
3,510
2,750
2,750
2,750
2,750
B9
Emergency
3,925
8,000
8,000
8,000
8,000
B10
B11
Laboratory
Pharmacy
2,530
630
2,150
950
2,150
950
2,150
700
2,150
700
B12
Rehabilitation Services
1,190
2,500
2,500
2,500
2,500
B13
Surgical Suite
6,180
3,500
3,500
3,500
3,500
18,395
20,350
20,350
20,100
20,100
1,975
Subtotal - Clinical, Diagnostic and Therapeutic Services
Holding beds will not be required
No order entry or picking stations;
reduced med storage
Adjacent to ambulatory care
Support and Administrative Areas
B14
Administration and Medical Staff Facilities
B15
Communications and Public Affairs
B16
Engineering Services ands Facility Management
3,740
1,975
a
0
1,890
1,975
1,975
0
a
0
0
0
1,325
b
1,325
1,325
1,325
b
B17
Finance
B18
Food Services
N/A
N/A
N/A
N/A
N/A
3,740
2,000
2,000
1,000
1,000
B19
Foundation
0
0
B20
Health Records
1,255
0
0
0
0
B21
Housekeeping
3,385
2,000
2,000
1,200
1,200
B22
Human Resources
B23
B24
Information Management Services incl. Telecommunications
Materiel Management
B25
Mission, Quality and Learning Resources
B26
Occupational Health & Safety & Healthy Workplace
B27
0
110
c
d
0
160
c
d
0
d
160
160
190
1,950
520
2,150
520
2,150
520
1,500
520
1,500
470
2,600
2,600
2,600
2,600
0
2,340
2,340
2,340
2,340
Public Spaces
960
1,350
1,350
1,350
1,350
B28
Registration/Patient Scheduling
915
600
600
600
600
B29
Sterile Processing
N/A
N/A
N/A
N/A
N/A
Subtotal - Support and Administrative Areas
18,605
17,020
17,020
14,570
14,570
TOTAL
65,010
69,670
69,670
43,670
43,670
a
See Administration component for swing office.
b
Does not include mechanical spaces such as boiler room, boiler control room or water heater room.
c
See Mission, Quality and Learning Resources component.
d
Space includes 1 union office; see Administration component - shared office.
160
c
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Reduce med gas, flamable storage;
reduce 1 dock; reduce bulk stores
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1.2 Human Resources Plan for 3 Year Timeframe
Staffing Plan
The projected workload demands for CKHA will require a detailed
human resources plan to ensure that appropriate and adequate staffing is
in place. This detailed human resources strategy will be developed in
subsequent stages of planning.
In preparation for the redevelopment project and the increasing demands
at both campuses, CKHA will establish a recruitment strategy assessing
the gap between demand and available resources. Human resources
needs will be addressed through:
 recruitment
 retention/re-training programs for current staff
 linkages with other providers to create a team approach
 partnerships with educational institutions to collaboratively develop
enhanced training programs for key areas of need
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Project Impact
HCM Group, Inc. has developed high level staffing and operating cost
projections based on the anticipated activity.
Using a file of paid hours (or FTEs) by functional centre and occupation,
changes in workload by functional centre was used to forecast future
staffing. Staff categories were fixed (e.g., management and secretarial
staff that are not expected to change with volumes), variable (e.g., RNs
and other front-line staff for whom staffing needs generally vary directly
with workload), or possibly in some instances, semi-fixed (when
volumes increase significantly and there is a fraction of a manager, for
example, treating the position as variable until it hits a target of 1 FTE).
These forecasts were completed for space planning purposes only and
were based on 2009/10 actual staffing levels. The human resources plan
and preliminary operating cost estimate are found in Appendix D, Table
1. The estimates for FTEs are:
 1,140 FTEs for 2017/18
 1,226 FTEs for 2027/28
These should be considered preliminary projections only and, as
planning proceeds, detailed human resource plans, including staff
recruitment and retention strategies, will be established to reflect
organizational priorities. The hospital will continue to review at least
annually, options for service delivery redesign, staff mix changes and
new models of care in partnership with local HSPs. Each of these may
impact the staffing projections.
The redevelopment project will provide staff with a high quality work
environment to support recruitment and retention strategies at CKHA
and provide essential health care services to the community served by
CKHA.
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1.3 Preliminary Operating Cost Estimate
1.3.1 Changes in Model of Care
Scope of Services
The planning for all clinical and support services at CKHA explored the
range of services across both campuses.
There are opportunities to enhance the service delivery model in
Chatham-Kent, south Lambton and Walpole Island as a result of
CKHA’s redevelopment project. Much of the hospital’s focus will be on
further development of partnerships and collaboration with other HSPs.
Specifically CKHA is directing its efforts to:
 Create a campus of care on the Sydenham campus that will promote
the integration of services for local residents.
 Integrate chronic disease management and prevention (CDMP)
initiative in delivery of services
 Focus on the hospital’s service delivery priorities, including:
 quality of care
 infection prevention and control
 standardization of protocols and guidelines
 operational and clinical efficiency
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Providing care and services closer to home for local residents.
Future Vision
CKHA is focused on identifying itself to the community as “An
Exceptional Community Hospital, Setting Standards, Exceeding
Expectations”. In addition to a strong customer focus, this is interpreted
as ensuring CKHA is a model hospital care provider, providing
exceptional care. The hospital’s strategic directions emphasize the
achievement of the vision through integration of care across the
continuum, with a culture of empowerment, compassion and caring.
The hospital is focused on providing excellence throughout, in acute
medical and surgical services, ambulatory services, women’s and
children’s services, mental health and addictions, and rehabilitation/CCC
services and emergency and community health care. The hospital will
also promote chronic disease prevention and management services to
shift services to ambulatory care as part of its vision to improve health
outcomes of the community. A key element of the hospital’s vision is to
engage community-based partners to promote appropriate service
delivery at the right time and in the right care setting to provide patient
focused and family centred care.
The scope of services document identified in this report summarizes the
services at each campus at the present time and in the future. A change
in the service delivery model is being contemplated for the Sydenham
campus where Option B assumes beds for all inpatients will be located in
Chatham. This option will focus the site on creation of an
emergency/urgent care centre at the Sydenham campus supported by
diagnostics and ambulatory care. Further, a campus of care approach at
the Sydenham campus would leverage current service delivery
relationships into a “one stop” access to health care for local residents.
Ongoing discussions with HSPs may identify additional collaborative
clinical directions.
The redevelopment of CKHA presents an exciting opportunity to focus
on the hospital’s core programs, re-structure selected clinical,
administrative and support services and incorporate the MOHLTC and
Erie St. Clair LHIN directives to provide consistent, high quality
services to the communities served by CKHA.
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Redevelopment of the hospital’s physical facilities at both campuses will
support proposed changes in service delivery that
 Provide capacity for enhancing ambulatory services to support
CDMP for diabetes management, arthritis and COPD
 Provide appropriate facilities for infection prevention and control
 Create efficient inpatient units
 Revitalize the hospital’s surgical services
 Create support service efficiencies
New Initiative – System Integration Project
The Change Foundation has recently completed research among
providers and provides the following summary of the respondents’
recommendations for improvement to develop a more integrated system
of care.
“When given a list of 14 strategies for improving integration, all
respondents gave the following three factors the highest ratings in order:
Having the appropriate provider providing care, developing strategies
to promote the health of the client and prevent decline and illness, and
ensuring providers work to the full extent of their training.
Amongst all the suggestions mentioned by respondents, increased
funding, resources, and staff was the most frequently mentioned
recommendation, followed by better collaboration with other providers,
and better information systems.”
Source: The Change Foundation, Summary Report: Integration of Care Perspectives of Home and Community Providers,
December 2010
CKHA has come together with CMHA Lambton-Kent and the ChathamKent Community Health Centre CHC to explore the feasibility of
integrated service delivery models as well as potential collocation of
services within Chatham-Kent. The purpose of such integration would
be to improve access to health care services for patients/clients, address
gaps in service and create a model of care that integrates the services of
all three organizations across the local health system. A Project Charter
was developed by the three organizations and submitted to Erie St. Clair
LHIN for approval, along with a request for pilot funding for this unique
project.
Work is proceeding to develop a master program for an integrated
service delivery system for common groups of patients/clients served by
the three organizations. Following this, a joint Master Plan will be
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created to identify space requirements and collocation opportunities.
This project is expected to be completed by October, 2011.
1.3.2 Operating Cost Estimate
The hospital, with support from HCM Group, Inc. has developed
preliminary cost estimates for operating cost impacts for the relevant
volume changes associated with the options under consideration.
Operating costs for the options reflect the projected patient activity
levels and are the same for each option. We have included the human
resources plan and preliminary operating cost estimate in Appendix D.
Operating Cost Estimates
Using MIS Trial Balance data for the last complete fiscal year, estimates
of annual operating cost impacts by department were calculated using
the percentage change in workload from the base year to the planning
year(s). Corporate (Administration Finance, Education, etc.) cost
impacts used a 50 per cent factor, consistent with the PCOP
methodology (i.e., assumed “indirect” costs will increase at half the pace
of direct costs).
Note that the intention for staffing implications and operating cost
estimates was to identify a relative magnitude of future FTEs and
operating costs, driven by workload forecasts and current performance
levels and not intended to be specific operating requirements.
These are preliminary order-of-magnitude estimates only, not intended
to serve as PCOP estimates. For example, hotel-related costs are
included per changes in square footage. Equipment depreciation costs
associated with new (not replacement) furnishings and equipment are not
included as the capital list has not yet been developed.
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Appendix A: CKHA Organization Chart
July 2011
Board of Directors
Public General Hospital
St. Joseph’s Hospital
Sydenham District Hospital
Board of Directors
Foundation of
CKHA
President and CEO
C. Patey
Executive Director
M. Grzebien
Chief of Staff
Dr. G. Tithecott
PGH Foundation
SJH Foundation
SDH Foundation
Sr. Executive Assistant and
Governance Coordinator
N. Brownlee
Vice President and
Chief Nursing Executive
C. Houze
Vice President and
Chief Financial Officer
S. Padfield
See
VP/CNE Chart
See
VP/CFO Chart
Director
Communications and
Community Relations
Z. Holman
Director
Knowledge and
Innovation
P. Pearce
Director
Medical Affairs and
Medical Recruitment
J. Letourneau*
Medical Recruiter
F. Vavoulis
Medical Recruiter
S. Arnold
Admin Assistant
Chief of Staff
M. Martin
Admin Assistant
Medical Affairs
K. Sutton
Medical Program Directors/Chiefs
See COS Chart
Communication
Specialist
M. Lawton
Multi-media Specialist
M. Lai
Webmaster
R. Barry
Secretary
V. Heyninck
!magine Project
Management Office
Director
Vacant
Executive Assistant
L. Thornton
Librarian/eLearning Lead
M. Campbell
Learning Services Leader
D. Miller
Patient and Family Centred Care
Culture Change
Client Services Innovation
Strategic Planning
Partnerships
*
Effective 15 Aug 2011
* Dual Reporting
** Shared Service
 Maternity LOA
President and CEO
C. Patey
July 2011
VP/CFO
S. Padfield
Executive Assistant
K. Montminy
Director
Finance and
Decision Support
L. VanderVeeken
Director
Support Services*
B. Hall
Director
Occupational
Health and Safety
J. DeActis
Director
Health Information
Services/Privacy Officer
K. Waymouth
Manager
Business Office
D. Tetzlaff
Manager
Engineering Services
H. Bos
Officer, Safety and
Claims Prevention
T. Martin (BWH)
Manager/Project Lead
Health Records
D. Milak
Manager
Decision Support
Vacant
Manager
Nutrition Services
V. McFadden
Disability Case
Coordinator
C. Vanuden (BWH)
Manager
Patient Registration
D. Ellis
Decision-Support
Specialist
D. Caza
Supervisors
MJ Fernandes (SC)
B. Preston
Financial Specialist
L. Walker
AJ Kearney
Supervisor
Materiel Management
T. Cousineau
Payroll Officer
R. A. Howard
Security Services
Manager
Laboratory Services
J. Kresan
Manager
Pharmacy
N. Kay
ESC LHIN Pharmacy
Lead
General Manager
PROcure**
C. Chesler
CEO
Consolidated Health
Information Services**
S. Banyai
Manager
Human Resources
D. Ancocik
Labour Relations
Coordinator
Vacant
Recruitment Specialist
C. Deneau
HR Generalist
S. McClanahan
HR Assistant
B. Bates
A. M. Corrigan
HR Clerk/Receptionist
C. Phipps
Director
Surgery/Women and
Children’s Health
E. Groh
Medical Director – Surgery/
Ambulatory Care
Dr. J. Morrison
Medical Director – OB/GYN
Dr. B. Singh
Medical Director – Paeds
Dr. I. Johnston
Clinical Manager
OR/Endo/Day Surgery
J. Wilmott
Clinical Manager
IP Surgery
A. Purdy
Clinical Manager
Women/Children’s Health
S. Jenkins
Clinical Manager
Ambulatory Care*
S. Saunders
Manager, CSR
D. King
President and CEO
C. Patey
* Dual Reporting
** Temporary Position
VP/CNE
C. Houze
August 2011
Executive Assistant, J. Landry
Director
Medicine/Mission
S. Helgerman
Co-Medical Directors
Dr. D. Brisbin
Dr. D. Atoe
Clinical Manager
IP Medicine
L. Northcott
Clinical Manager
IP/OP Services
C. McFarland
Clinical Manager
ICU/PCU/RRT
J. Houston
Coordinator, Infection
Prevention and Control
C. Turner
Pastoral Care
F. Estoesta
S. Nickel
Volunteer Resources
Director
Support Services*
B. Hall
Manager
Housekeeping/Linen
C. Sophonow
Supervisor, A. Zoumboulis
V. McFadden
Porters
Director
Mental Health and
Addictions/Emergency
P. Reaume-Zimmer
Medical Director, MHAP
Dr. R. Chandrasena
Med Directors – Emergency
Dr. Anthony Dixon
Dr. D. Huffman
Clinical Manager
Emergency
D. Letarte
Coordinator, Sexual
Assault/Domestic Violence
L. Murray
Co-leads, Emergency/
Pandemic Planning
C. McFarland/L. Murray
Coordinator, Research
T. Boersema
Coordinator, Office/Education
M. Weber
Manager, Central Ambulance
Communication Centre
J. Carnegie
Director
Rehab/Complex Continuing
Care/Chronic Disease Mgment
N. Snobelen
Medical Director
Dr. C. Prins
Clinical Manager
CCC/Med, Sydenham
D. Dodman**
Clinical Manager
Rehab/CCC, Chatham
D. Green
Coordinator
Physio/EMG/
Chiropody
G. King
Manager
Chronic Disease
Management*
S. Saunders
Coordinator
Wound and Skin
D. Dodman**
Coordinator
Stroke Strategy
L. Butler**
Coordinator
Occ Therapy/SLP
K. deHaan
Coordinator
Recreational Therapy
F. Fennema
Coordinator
Program Office
A. Marion
Coordinator
Palliative/Supportive
Care/Oncology
V. DeWitte
Manager
Diagnostic Imagining
C. Harper-Little
Director
Quality and Interprofessional Practice
W. Kirenko
Manager, Utilization
Management and Pt. Flow
L. McGivern
Patient Flow Coords
T. Rowe
Vacant
M. C. Pye
P. Easton
Med. Patient Navigators
L. Matteis
L. McCorkle
Social Work/Discharge
Planning
Quality Analyst, J. Whitson
Professional Practice Team
L. Duffield
P. Taylor
K. L. Stennett
L. Brown
J. Desmarais
J. Cousins
B. Oldershaw
Manager, Quality/Risk and
Patient Safety
N. Homewood
Patient Relations Coord
B. Foster
Admin Assistant
N. Ross
Admin Assistant, E. Walker
July 2011
Chief of Staff
Dr. G. Tithecott
Co-Medical Program Director
Medicine
Dr. D. Brisbin
Chief of Family Practice
Co-Medical Program Director
Medicine
Dr. D. Atoe
Chief of Psychiatry
Medical Program Director
Mental Health and Addictions
Dr. R. Chandrasena
Medical Program Director
Rehabilitation/Complex
Continuing Care
Dr. C. Prins
Chief of Internal Medicine
Dr. Q. Tran
Chief of Diagnostic Imaging
Dr. M. Yee
Chief of Paediatrics
Co-Medical Program Director
Women & Children’s Health
Dr. I. Johnston
Chief of Obstetrics
Co-Medical Program Director
Women & Children’s Health
Dr. B. Singh
Chief of Surgery
Medical Program Director
Surgery
Dr. J. Morrison
Chief of Emergency Medicine
Co-Medical Program Director
Emergency
Dr. D. Huffman
Chief of Anaesthesia
Dr. A. Liolli
Chief of Emergency Medicine
Co-Medical Program Director
Emergency
Dr. A. Dixon
Chief of Laboratory Services
Dr. S. Awad
Director
Medical Affairs and
Medical Recruitment
J. Letourneau*
Medical Recruiter
F. Vavoulis
Admin Assistant
Chief of Staff
M. Martin
Medical Recruiter
S. Arnold
Admin Assistant
Medical Affairs
K. Sutton
*
Effective 15 Aug 2011
Appendix C: Partnerships and Alliances Inventory:
To Be Finalized
Partnerships & Alliances Inventory
Summary as at June, 2008
CKHA Program,
Department, Service
Within Erie St. Clair LHIN
(outside our LHIN)
Initiative
Hosp./Org.
Emergency/Ambulatory
Care
Initiative
Transfer agent for C-K Central
Ambulance Communication
Centre.
Emergency Administrator
Group
Emergency Planning
Provision of on-site office
space for case manager
Municipality
CACC
Participation in CK Healthy
Living committee; “Not by
Accident” committee;
Transportation Task team.
Public Health &
Municipality
Improving Access
For Total Joint Replacement
Through Standardizing
Clinical Management
Project with Rehab and
Continuing Care Program
Partnership
Public Health
Chatham-Kent Breastfeeding
Coalition
Community partners
i.e. Public Health,
midwifery, pharmacy,
consumers, doulas
St. Clair College
Partnership
Ministry of Health &
Long Term Care
Ont. Heart & Stroke
Ontario Telehealth
Network
SW Ontario Regional
Stroke Centre &
District Stroke
Centres (LHIN 1&2)
Canadian Patient
Safety Initiative,
Institute for Health
Care Improvements
and CCHSA
No
Networking group with representation from all over Ontario
No
Co-ordination of emergency planning across municipality
CCAC provides a case manager for the ED - effective &
timely response to community support requirements for
patients.
Participation in planning activities.
No
Input into program development.
Yes
Expands education & patient consultation opportunities.
Yes
Region-wide co-ordinated stroke care; decrease incidence
of stroke & improve patient care & outcomes.
Yes
Combination of initiatives to improve access to care for hip
and knee replacement surgery.
Yes
Implementation and evaluation of surgical site best practice
initiatives re: infection.
Yes
Public Health nurses on site with office at CKHA in the
W&C Health program. On –site services available 6 days a
week; improves linkages with community resources and
public health; timely referrals; ability to expand services
within organization to paediatric population served
To advance & promote breastfeeding
No
Yes
Videoconferencing, videoeducation
Fetal Alert Network;
Baby Talk Series
F-1
Benefits
(Brief Qualitative Overview)
Yes
Emergency Medical
Services
Bluewater Health,
CCAC, CKHA and
MOHLTC
Safer Healthcare Now
(national initiative)
Women & Children’s
Health
Hosp./Org.
Formal
Agreement
Yes
No


Yes
Yes
Director is member of Heart &
Stroke Council
Videoconferencing,
telemedicine, video-education
Co-ordinated Stroke Strategy
Rehab. & Continuing
Care
Surgery
Provincial / Regional
No
New 18 hour breastfeeding course for nurses & midwifes
Obstetrical & neonatal educational opportunities via
Ontario Telehealth Network
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Provincial / Regional
(outside our LHIN)
Hosp./Org.
SWOPP (Southwestern Ontario
Perinatal Partnership)
All hospitals
providing obstetrical
care in Erie St. Clair
& SW LHINs
Provincial committee
Yes
Hospitals &
Community partners
in SW & Erie St Clair
LHINs
Yes
Active membership in paediatric network; advance
paediatric care
Yes
Paediatric & obstetrical consultative services
Yes
Active membership in network
Leamington District
Memorial Hospital
(paed only).
Sydenham Campus
Chatham-Kent eating disorder
network
Diagnostic Imaging
Paediatric Speech & Language
Committee
1-Ontario Breast Screening
Program
Prism Centre, Public
Health
Cancer Care Ontario
2- Breast Assessment Clinic
Cancer Care Ontario
London, Windsor,
Chatham-Kent, school
boards, public health,
BANA
Administrative chair of SWOPP Executive; active members
of SWOPP; advance perinatal care regionally.
No
No
Yes
Yes
Medicine
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
Initiative
OP3 (Ontario Perinatal
Partnership)
RPN (Regional Paediatric
Network)
On-site paediatric & OB/GYN
clinics
Formal
Agreement
Yes
No


Provincial Palliative Care
Integration Project (PPCIP)
No
*Windsor Regional
Cancer Center
(WRCC)
**London Regional
Cancer Center
(LRCC)
LHSC- Regional
Dialysis
Walpole Island Home
and Community care
YMCA
*No
**Yes
Yes
Yes
LHSC- Cardiac Rehah
Yes
Windsor Essex Asthma
Strategy Network
No
COPD education series
No
Chatham-Kent Public
Health
No
F-2
Community linkage
Women over 50 year old self refer for mammography.
Provides extra funding for CKHA,
All Women (within OBSP as well as Diagnostic
Mammography) with a questionable “cancer” on
mammography are referred to Breast Assessment for follow
up by surgeons in the Breast Assessment Clinics. Provides
extra funding to CKHA both from Cancer Care Ontario.
CCO initiative to utilize same communication tools and
eventually collaborative care plans.
*Collaboration and referral center
**Create strategic directions for cancer care across the three
LHINS. Chemo training provided to our staff.
Satellite site of LHSC
No
Cardiac Rehab Satellite
Member by position (Chairperson of SWOPP) attends OP3
Linkage of services
Partnership with YMCA to provide space and some
equipment for exercise component of cardiac rehab.
Hub of the network, obtaining funding. Satellite site of
LHSC.
Regional project collaboration within CKHA’s LHIN.
Expanding our current hospital based education program by
expansion into primary care & community outreach-family
health teams
Collaboration with community partners who also provide
some form of COPD education. Sharing of HR from other
agencies to assist with running programs.
Collaboration with municipality during the inception of the
smoking by-law.
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Medicine cont’d
Laboratory Services
& Infection Control
Communications &
Community Relations
Mental Health Services
Provincial / Regional
(outside our LHIN)
Initiative
Hosp./Org.
Northern Diabetes Health
Network
N/A
MOHLTC
Yes
Windsor Regional Cancer
Centre
LHSC Dialysis program
WRCC
Yes
LHSC
Yes
Westover Treatment
Centre
Yes
C-K Municipality,
Ontario Works
Division
C-K Jail &
Probation/Parole
Offices
C-K Highschools
Provide funding which supports our pediatric program.
Agreement requires us to partner with a “Tertiary Centre”.
The tertiary centre provides outreach services to our
pediatric patients at CKHA site 4 times year.
Funding for Adult Diabetes education program.
Immediate crisis response & transportation to Withdrawal
Management Services
Ontario Works planning with an addictions-sensitive focus.
Yes
No
Outreach assessments
Outreach services on as-per-request basis.
Concurrent Disorders program
Medical education
Psychiatric consultation &
ongoing treatment
Televideo Crisis programming
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
N/A
Eating Disorders program
ACCESS Committee member
Yes
Adult Diabetes Education
Addictions Assistance Line
C-K Addictions Program
Outreach
Formal
Agreement
Yes
No


LHSC Eating
Disorders Program
Regional Mental
Health Care, St.
Thomas
Schulich School of
Medicine & Dentistry
UWO
Yes
Regional Mental
Health Care, St.
Thomas & C-K ACT
Team
Yes
C-K ACT Team &
Canadian Mental
Health Association
Sydenham Campus &
Leamington Dist.
Memorial Hospital
No
Yes
Yes
Yes
F-3
Brings program closer to home.
Collaboration for clinical treatment consultation &
professional education opportunities
CKH Mental Health Services provides undergraduate &
postgraduate psychiatry rotation opportunities.
Also integrated with UQO Televideo continuing medical
education program.
Seamless transition from community to inpatient services,
& vice-versa, as well as inpatient to tertiary care.
Provides single point of access for mental health referrals to
provide seamless approach to accessing community mental
health services.
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Mental Health Services
cont’d
On-site Clinics
Early psychosis intervention
program (EPIP)
Advisory Council of youths
Dual Diagnosis Outreach
Program
Provincial / Regional
(outside our LHIN)
Initiative
Leamington Dist.
Memorial Hospital
Community service
agencies
Community
Assoc. for
Community Living
Yes
Mental Health System
Co-ord. Group
Participant
LHIN “Dealing with
the Addictions of
Erie-St. Clair
Committee”
Co-Chair
Member
Health Information
Systems
HELP Team
C-K Police Services
& Can. Mental Health
Assoc. C-K
Solcom-Electronic Document
Mgmt of patient records
HDGH and WRH
Solcom Regional Steering
Committee
HDGH and WRH
Med 2020 Abstracting system
BWH
LHIN Data Management/DST
HDGH,WRH,BWH,
CCAC
Regional Support
Associates
Schedule 1 Facilities,
SW Ontario
Tri-County Mental
Health System Coordination Group
Ont. Mental Health
Hospital Report Card
Advisory Committee
Yes
F-4
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
No
Access to inpatient admissions at Chatham-Kent Health
Alliance
Develop new programming for youth & adolescents
experiencing symptoms of early psychosis.
Council participates in education & marketing initiatives
Integrated treatment for clients with a dual diagnosis.
No
Consultation & collaboration
No
Consultation & collaboration
No
Consultation & collaboration
No
Raising benchmarking standards.
Yes
Directors’ Network
Co-Chair
Hosp./Org.
Formal
Agreement
Yes
No


Increase sensitivity of police to mentally ill, optimize coordination/integration of care for mentally ill, reduce wait
times in ER for police, reduce inappropriate hospital
admissions & provide police services with training for
dealing with mentally ill.
Expanding team to include community response model providing mobile crisis assessment to patients in home.
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Facilities & Engineering
Group tendering and
information exchange
Provincial / Regional
(outside our LHIN)
Initiative
ESC LHIN
Engineering Group
(directors from 5
member hospitals and
manager from
Riverview LTC,
Chatham)
Education and information
Group tendering and
purchasing
Energy recording and
conservation
Materials Management,
Purchasing
Regional Pharmacy integration
Pastoral Care
. Ethics Training
. Pastoral Care Team
Canadian Healthcare
Support Services
Benchmarking Group
(National group)
Medbuy
Energy Innovators,
Office of Energy
Efficiency
No
Exchange of information, policies, procedures.
Annual provincial and national educational conferences
Quarterly regional meetings for presentations and exchange
Reduced material and services costs
No
Development of national performance benchmarks
Reduced material and services costs
No
Yes
Chatham-Kent
Accessibility
Committee
Canadian Mental
Health Association
No
No
Current member of C2P2 green house gas emissions
reduction group for Hospitals
Exchange of ideas and methods for environmental
management
Provision of documentation to the OEE regarding reduction
programs
Access to case studies and other information sources
Assistance in design and attaining accessibility compliance
with Ontario Disabilities Act
Reinforcement of partnership between agencies
All five organizations
in LHIN
Yes
Integrates supply chain across LHIN
All five organizations
in LHIN
Yes
Integrates Pharmacy across LHIN
Ministry of Finance
Yes
Provides measurement for supply chain
. Assumption
University
yes
St. Joseph’s Society,
London
Performance Metrics working
group
. Student placements for
chaplaincy
.London RC Diocese
.Father Frank Leslie assigned
as CKHA RC Chaplain
.Fetal Burial Program
Group tendering -> current diesel contract , others in
development
Group development /standardization of policies and
procedures
Approximate monthly meetings for discussions and
information exchange
Yes
Canadian Centre for
Pollution Prevention
(C2P2)
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
No
Yes
Group tendering and
purchasing
Environmental management
and pollution reduction
Member of building committee
for new planned facilities for
CMHA
Regional Integrated Supply
Chain
Canadian Healthcare
Engineering Society
(CHES)
Chatham-Kent
Lambton
Administrator Group
(CKLAG)
Benchmarking
Consultation and compliance
advice
Hosp./Org.
Formal
Agreement
Yes
No


.McKinlay’s Funeral
Home & Maple Leaf
Cemetery
F-5
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Volunteer Resources
Provincial / Regional
(outside our LHIN)
Initiative
KAVCO (Kent
Association of
Volunteers
Coordinators)
.CAVR (Canadian
Administrators of
Volunteer Resources)
.PAVRO ( Provincial
Administrators of
Volunteer Resources)
.South Western
Ontario Hospital
Managers/Coordinator
s of Volunteers
Organizational
Development
. Student Placements for
medical students, nursing,
other Health professions
.Windsor University
.St Clair College
.Lambton College
.High school Co-op Programs
. School Boards
Hosp./Org.
Formal
Agreement
Yes
No


Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
Yes
yes
. Student Placements for
medical students, nursing,
other Health professions
Western University
Ryerson University
Mohawk College
Yes (all)
. CKHA Librarian is President
of Library group…membership
Windsor/Sarnia/ London.
. share educational
opportunities
.inter-library loans
.group purchasing
. CKHA Librarian is registered
to proctor and teach Library
skills to Ryerson University
students
. Michigan Library
Group (MDMOG,
MHSLA)
Yes (all)
Nutrition Services Purchasing
Group
London Health
Sciences Centre
Yes
Hospital linen provision
London Hospital
Linen Services
Yes
Chemical purchases
MedBuy
Yes
.CKLAG Training and
Development
.CKHEP: Chatham Kent
Health Education Promoters
Library
Nutrition &
Housekeeping Services
Nutrition & Food services
Managers’ Group
.Ontario Hospital
Libraries Association
.
Area hospitals
No
F-6
Best pricing agreements on food & non-food products
Quarterly rebate program
Guaranteed supplier fill rates
Supplier promotional programs
Fixed pricing on all hospital linens
Not-for-profit organization (partnership with numerous
organizations for linen)
Rebate program efficiency
Fixed pricing agreements on chemical purchases
Informal group to share information & best practices.
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
Pharmacy
LHIN Pharmacy
Teleconference
Provincial / Regional
(outside our LHIN)
Initiative
Hosp./Org.
Formal
Agreement
Yes
No


All other LHIN1
pharmacy departments
No
Structured Practical Experience
Program (Pharmacist students)
Pharmacy Technician students
Clozaril Support & Assistance
Network
London Regional Cancer
Program Satellite
Windsor Regional Cancer
Centre
LHSC Dialysis program
Occupational Health &
Safety
Three (3) positions, Director of
Occupational Health and
Safety, Safety Officer and
Disability Claims Officer,
shared between the two
organizations
Bluewater Health
Occupational Health &
Safety (cont’d)
* Member of CKLAG Health
and Safety, sub-committee
CKLAG
University of Toronto
Yes
St. Clair College,
Humber College,
Fanshaw College
CSAN
Yes
LRCP
Yes
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
Collaboration on pharmacy issues to reduce duplication of
research
Yes
WRCC
No
LHSC
Yes
Yes
*Reduces duplication of work being done at both sites.
Health & Safety Policy & procedures can be developed&
shared at each facility.
*Safety Prevention Programs are developed & utilized at
both organizations.
*Committee work is not duplicated - bring a perspective
from both organization & strengthens those committees
drawing on experience of two organizations vs. one.
*Equipment, eg Portocount machine, which is costly to buy
or rent, is utilized by CKHA at no cost.
*Disability Claims Management is a very complex process,
having a designated Disability Claims Officer focus on this
saves WSIB claim, short-term sick pay dollars, as they are
familiar with the legislation and requirements of Disability
Management
*Having a Safety Officer part-time provides a focus on the
prevention aspect of the Health and Safety Program,
reducing/eliminating incidents before they occur.
*Sharing a Director, of Occupational Health and Safety,
provides each organization with an individual who has
years of experience in a health care occupational health and
safety program.
*Reduced salary costs as both organizations share costs to
have these three positions in each organization.
** Member of OHA/WSIB
Safety Group (provincial)
Ontario Hospital
Association
Unsure
Sharing of health and safety information, training
opportunities between members.
*** Member of the OHA
Provincial Health and Safety
Committee
Ontario Hospital
Association
Yes
**Current health & safety information, related to health
care shared at five yearly meetings.
Completing the five elements strengthens Health & Safety
Program as new policy and procedures are developed or
current ones revised.
***Safety Group rebate provided for each year of
membership if criteria met. Funds used to purchase safety
devices that benefit the Health & Safety of employees at
CKHA over last two years ($26,000.00)
F-7
CKHA Partnerships & Alliances
CKHA Program,
Within Erie St. Clair LHIN
Department, Service
Initiative
Hosp./Org.
General Quality Risk &
Patient Safety
Human Resources
Information Systems
Finance
General Professional
Practice & Medical
Education
General Corporate or
Governance
Regional Human Resources
Benefits Steering Committee
Consolidated Health
Information System
Provincial / Regional
(outside our LHIN)
Initiative
Hosp./Org.
Formal
Agreement
Yes
No


Meetings and Annual
Conference – email network
sharing policies and concerns
Ont. Healthcare Risk
Management Network
Membership
Conference, education, policy
advise, bulletins for Health
Care Risk Management
HIROC
Policy/contract
Meetings, email inquiries,
policy sharing for purpose of
enhancing Patient satisfaction
and Feedback management
Ontario Patient
Representative Assoc.
Membership
Newsletters, website access to
leading practices, patient safety
initiatives.
CCHSA Can Council
Health Services
Accreditation
Membership
Fee
Website access to tools and
resources to promote Just
Culture of Safety
Just Culture Org.
Membership
Fee
Staff & Patient Satisfaction
Surveys
NRC Picker
Contract Fee
5 ESC LHIN hospitals
Yes
WRH, Bluewater
Health
Yes
Summary as at June, 2008
Benefits
(Brief Qualitative Overview)
Competitive tendering process to select benefits consultant
to provide services for all members. See MOU on file.
Provision of information systems services to Windsor
Regional Hospital & CKHA
Financial savings, operational efficiencies
N/A
Meetings between LHIN
hospitals Chairs/CEOs.
Sharing of Board Highlights
Across hospitals
Student education / practical
training.
University of Western
Ontario
Yes
Best Practice Spotlight
Organization
RNAO
Yes
WRH
BWH
LDMH
HDG
No
F-8
Collaborate to provide a high standard teaching program for
undergraduate, graduate and postgraduate students of
UWO. CKHA provides facilities, physicians & resources
for clinical & practical training experiences for students in
the health & related fields
Appendix D: Human Resources Plan and
Operating Cost Projections
CKHA: Preliminary Estimate of Annual Operating Cost Impact Upon Completion
Functional Centre
Measure
711100000
711150000
711200000
711250000
711300000
711350000
711400000
711450000
711500000
711550000
711559000
711600000
711650000
711750000
711800000
711852000
711900000
711950000
712051000
712052094
712060000
712071000
712072000
712073000
712100000
712200000
712300000
712403000
712508040
712509000
712600000
712650000
712700000
712762500
712813000
712952000
Indirect Costs
Indirect Costs
Indirect Costs
Indirect Costs
Indirect Costs
(CKHA) (S) OR Cases
Indirect Costs
(CKHA) (S) Cleanable Square Footage
(CKHA) (S) Total Inpt Days
(CKHA) (S) Total Square Footage
(CKHA) (S) Total Square Footage
(CKHA) (S) Total Square Footage
(CKHA) (S) Total Square Footage
(CKHA) (S) Med/Surg Inpt Days
(CKHA) (S) Inpt & Outpt @ 0.10 Registrations
(CKHA) (S) Total Inpt Cases
(CKHA) (S) Inpt & Outpt @ 0.10 Registrations
(CKHA) (S) Total Inpt Days
Indirect Costs
(CH) (S) Palliative Care Visits
Indirect Costs
Indirect Costs
Indirect Costs
Indirect Costs
(CH) (S) Medical (Incl. Neuro) Inpt Days
(CH) (S) Surgical (Incl. SS & Gyne) Inpt Days
(SD) (S) Med/Surg Inpt Days
(CH) (S) ICU Inpt Days
(CH) (S) NICU Inpt Days
(CH) (S) Obstetrics Inpt Days
(CKHA) (S) OR Cases
(CKHA) (S) PARR Cases
(CH) (S) Paediatric Inpt Days
(CH) (S) Mental Hlth Inpt Days
(CH) (S) Rehab Inpt Days
(CKHA) (S) CCC Inpt Days
General Administration
Finance
Personnel Services
Systems Support
Communications
Materiel Management
Volunteer Services
Housekeeping
Laundry and Linen
Plant Operations & Maintenance
Utilities
Plant Security
Plant Maintenance
Bio-Medical Engineering
Registration (Admitting)
Central Patient Portering
Health Records
Patient + Non-Patient Food Svces
Nursing Administration
Palliative Care Team
Program Management
Medical Rsrces - Psychiatrists
Medical Resources - Non-Psych
Medical Resources - Hospitalists
Medical Inpatient Services
Surgical Inpatient
Combined Medical/Surgical
ICU - Combined Med/Surg
Intermediate Nursery (Level 2)
Labour, Delivery, Rec, PP (LDRP)
Operating Rooms
Post-Anesthetic Recovery Rooms
Pediatric
Acute Psychiatry IP
Combined Rehabilitation
Chronic Care
Appendic D ‐ CKHA Volume Projections (2011 07 17) Operating Costs
2009/10
Work-load
2009/10
Cost/ Unit
Projected 2017/18
Projected 2027/28
Annual Cost Annual Cost
Annual Cost Annual Cost
Increase (2011/12 $,
Increase (2011/12 $,
Increase in
Increase in
from
1.5%
from
1.5%
Units from
2009/10 inflation per Units from
2017/18 inflation per
2017/18 (2009/10 $)
2009/10 (2009/10 $)
year)
year)
1,040
$153,089
$158,000
1,504
$221,390
$228,000
274,120 $2,862,839 $2,949,000
4,472
$56,085
$58,000
309,875
$134,986
$139,000
309,875 $1,535,584 $1,582,000
309,875
$152,387
$157,000
309,875
$899,793
$927,000
1,700
$12,481
$13,000
2,715
$148,730
$153,000
680
$23,663
$24,000
2,715
$125,905
$130,000
4,472
$140,699
$145,000
17,480
6,772
19,760
19,760
19,760
19,760
3,486
3,900
870
3,900
6,772
$182,557
$84,934
$8,608
$97,921
$9,717
$57,378
$25,593
$213,610
$30,256
$180,828
$213,071
$188,000
$87,000
$9,000
$101,000
$10,000
$59,000
$26,000
$220,000
$31,000
$186,000
$219,000
$35,000
1,463
$60,066
$62,000
$612,541
$264,378
-$674,920
$495,373
$32,012
$108,178
$556,041
$82,677
$631,000
$272,000
-$695,000
$510,000
$33,000
$111,000
$573,000
$85,000
$381,029
$555,326
$55,575
$861,006
$392,000
$572,000
$57,000
$887,000
$268,783
$89,800
$285,106
$277,000
$92,000
$294,000
1,106
1,254
104
1,022
-32
-91
1,504
953
0
961
683
1,734
$804,121
$90,983
$0
$251,012
$164,875
$378,631
$828,000
$94,000
$0
$259,000
$170,000
$390,000
9,852
$147.20
328,843
78,713
371,735
371,735
371,735
371,735
39,297
32,188
9,506
32,188
78,713
$10.44
$12.54
$0.44
$4.96
$0.49
$2.90
$7.34
$54.78
$34.79
$46.37
$31.46
4,909
$41.06
827
$33,954
19,391
10,904
2,662
6,340
798
2,247
9,852
7,239
1,083
5,842
7,277
22,967
$344.51
$442.84
$534.38
$842.47
$941.53
$1,115.23
$534.65
$95.47
$904.22
$261.34
$241.40
$218.39
1,778
597
-1,263
588
34
97
1,040
866
-31
1,029
372
1,306
Page 1 of 4
CKHA: Preliminary Estimate of Annual Operating Cost Impact Upon Completion
Functional Centre
Measure
713050000
713060000
713072000
713073000
713102000
713102200
713405500
713406610
713408610
713501010
713501030
713501088
713501545
713501710
713501720
713504024
713504200
713506605
713507010
713670000
714060000
714101000
714102100
714104100
714104500
714109900
714151000
714151200
714151800
714152000
714152500
714153000
714153500
714157000
714159900
714252000
Indirect Costs
Indirect Costs
Indirect Costs
Indirect Costs
(CKHA) (S) ED Visits
(CKHA) (S) ED Visits
(CKHA) (S) Endoscopy Cases
(CH) (S) Oncology Cases
(CH) (S) Dialysis Visits
(CH) (S) General Med Clinic Visits
(CH) (S) Chiropody Visits
(CH) (S) Sexual Assault Visits
(CH) (S) Pre-Admit Clinic Visits
(CKHA) (S) Comb Med/Surg Clinic Visits
(CKHA) (S) Comb Obs/Gyn Clinic Visits
(CH) (S) Diabetes Clinic Visits
(CH) (S) Cardiac Clinic Visits
(CH) (S) Oncology Clinic Visits
(CH) (S) Paed Clinic Visits
(CKHA) (S) Pre/Post Op Visits
Indirect Costs
Indirect Costs
(CH) (S) Spec Proc Workload
(CH) (S) Surg Path & Aut Path Workload
(CH) (S) Microbiology Workload
(SD) (S) Total Lab Workload
(CH) (S) Total DI Workload
Indirect Costs
(CH) (S) Radiography (Incl. Inter/Ang) Workload
(CH) (S) Mammography Workload
(CH) (S) CT Workload
(CH) (S) Diag Ultrasound Workload
(CH) (S) Nuclear Medicine Workload
(CH) (S) MRI Workload
(SD) (S) Total DI (Incl. Cardiac DI) Workload
(CH) (S) EMG Workload
Ambulatory Care Administration
Program Mgmt Administration
Medical Rsrces - Non-Psych
Hospital On-Call Coverage
General Emergency
Alternate Funding for Emergency
Endoscopy
Oncology Day Care - Chemo
Hemodialysis Day/Night
General Medical Clinic
Chiropody
Sexual Assault
Pre-Admission
Combined Med/Surg General
Combined OBS/GYN Clinics
Diabetes - Adult
Cardiac Clinics
Systemic Pre- and Post Rx
General Pediatric
Day Surgery Pre-/Post-op Care
Program Management Admin
Clin Lab - General Admin
Lab Pre-/Post- Analysis
Anatomical Pathology
Microbiology
Clinical Laboratory - Combined Functions
Diagnostic Imaging - General
DI Admin - PACS
Radiography
Mammography
Computed Tomography
Diagnostic Ultrasound
Nuclear Medicine - Gamma Cameras
Magnetic Resonance Imaging
Diagnostic Imaging - Combined Functions
EMG
Appendic D ‐ CKHA Volume Projections (2011 07 17) Operating Costs
2009/10
Work-load
2009/10
Cost/ Unit
Projected 2017/18
Projected 2027/28
Annual Cost Annual Cost
Annual Cost Annual Cost
Increase (2011/12 $,
Increase (2011/12 $,
Increase in
Increase in
from
1.5%
from
1.5%
Units from
2009/10 inflation per Units from
2017/18 inflation per
2017/18 (2009/10 $)
2009/10 (2009/10 $)
year)
year)
64,037
64,037
5,718
1,236
5,659
3,700
3,648
67
4,235
31,857
3,644
5,060
1,238
1,343
619
13,244
$118.56
$2.85
$140.75
$491.03
$24.22
$49.65
$31.16
$2,423.81
$111.60
$29.02
$214.13
$67.23
$78.66
$11.46
$163.21
$125.10
1,263
1,263
732
254
3,560
493
488
1
448
4,052
203
1,497
190
276
-14
1,520
$149,742
$3,601
$103,029
$124,723
$86,214
$24,475
$15,204
$2,424
$49,997
$117,597
$43,469
$100,649
$14,946
$3,162
$154,000
$4,000
$106,000
$128,000
$89,000
$25,000
$16,000
$2,000
$51,000
$121,000
$45,000
$104,000
$15,000
$3,000
$251,348
$6,044
$109,222
$151,239
$29,037
$39,965
$24,925
$7,271
$72,205
$184,666
$259,000
$6,000
$112,000
$156,000
$30,000
$41,000
$26,000
$7,000
$74,000
$190,000
$196,000
2,120
2,120
776
308
1,199
805
800
3
647
6,363
-37
1,871
316
335
1
2,079
$125,795
$24,857
$3,838
$163
$260,088
$130,000
$26,000
$4,000
$0
$268,000
$190,156
649,071
679,405
744,792
372,442
2,398,617
$0.86
$1.52
$0.86
$9.22
$0.25
62,604
80,938
116,631
-24,222
300,531
$53,590
$123,297
$100,259
-$223,377
$74,249
$55,000
$127,000
$103,000
-$230,000
$76,000
68,770
106,538
128,575
16,825
402,083
$58,869
$162,295
$110,526
$155,161
$99,338
$61,000
$167,000
$114,000
$160,000
$102,000
519,993
108,748
384,379
749,211
339,014
297,272
127,369
19,860
$1.09
-$0.28
$1.36
$0.04
-$1.57
-$2.06
$1.06
-$0.27
53,471
18,217
45,380
91,123
49,084
43,256
7,270
2,768
$58,216
$60,000
$82,731
$85,000
$61,907
$3,803
$64,000
$4,000
$87,064
$5,301
$90,000
$5,000
$7,694
$8,000
75,988
568
63,821
127,039
71,162
63,505
15,818
4,682
$16,741
$17,000
Page 2 of 4
CKHA: Preliminary Estimate of Annual Operating Cost Impact Upon Completion
Functional Centre
Measure
714302099
714350000
714400500
714450000
714500000
714552000
714602000
714700000
714800000
714851000
715102000
715107630
715504220
715556610
715580500
717761000
718100000
(CH) (S) Holter/EST/ECG Workload
(CKHA) (S) Resp Services Workload
(CH) (S) Pharmacy Workload
(CKHA) (S) Clinical Nutrition Attendances
(CH) (S) Physiotherapy Attendances
(CH) (S) Occ Therapy Attendances
(CH) (S) Speech/Lang Attendances
(CH) (S) Social Work Attendances
(CH) (S) Pastoral Care Attendances
(CH) (S) Recreation Attendances
(CH) (S) Resp Health - Asthma Visits
(CH) (S) MH Comm & Psych Geriatric Visits
(CH) (S) Stroke Strategy Visits
(CH) (S) OBSP Exams
(CH) (S) Cardiac Rehab Clinic Visits
Indirect Costs
Indirect Costs
Non-Invasive Cardiology - Combined Functions
Respiratory Therapy
General Pharmacy
Clinical Nutrition
Physiotherapy
OT Physical Medicine
Speech/Language Pathology
Social Work
Pastoral Care
Therapeutic Recreation - Goal Oriented
General Primary Care (Comm)
Community Mental Health Clinic
Health Promotion - Stroke Strategy
Breast OBSP
Health Promotion & Disease Prevention
Mental Health Research
Hospital Library
718400000 In-Service Education
718600000 Nursing Formal Education
718761000 Mental Health Education
2009/10
Work-load
303,905
892,895
2,134,085
6,051
40,077
11,412
4,326
5,938
7,265
7,841
1,409
10,303
523
5,424
277
2009/10
Cost/ Unit
$0.79
$1.14
$0.97
$59.22
$42.88
$49.60
$74.99
$115.65
$18.67
$26.19
$59.52
$50.29
$941.89
-$12.92
$84.87
Projected 2017/18
Projected 2027/28
Annual Cost Annual Cost
Annual Cost Annual Cost
Increase (2011/12 $,
Increase (2011/12 $,
Increase in
Increase in
from
1.5%
from
1.5%
Units from
2009/10 inflation per Units from
2017/18 inflation per
2017/18 (2009/10 $)
2009/10 (2009/10 $)
year)
year)
46,650
59,701
169,424
596
4,177
1,008
291
422
534
433
182
-111
72
914
42
$36,795
$68,080
$164,406
$35,295
$179,106
$49,999
$21,823
$48,805
$9,969
$11,340
$10,832
$38,000
$70,000
$169,000
$36,000
$184,000
$51,000
$22,000
$50,000
$10,000
$12,000
$11,000
$67,816
$70,000
$3,564
$4,000
77,576
89,956
192,127
633
6,012
1,536
417
516
666
633
275
259
102
0
71
$61,189
$102,581
$186,436
$37,487
$257,790
$76,188
$31,271
$59,676
$12,434
$16,578
$16,367
$13,024
$96,073
$0
$6,026
$63,000
$106,000
$192,000
$39,000
$266,000
$78,000
$32,000
$61,000
$13,000
$17,000
$17,000
$13,000
$99,000
$0
$6,000
Indirect Costs
Indirect Costs
Indirect Costs
Total Ballpark Operating Cost Estimate (Annual Impact) from preceding planning year
Direct Costs
Indirect Costs (based on allowance factor)
Total Costs
Cumulative Impact
Appendic D ‐ CKHA Volume Projections (2011 07 17) Operating Costs
$10,397,000 $10,706,000
$11,155,000 $11,486,000
$7,970,000 $8,207,000
$581,000 $598,000
$8,551,000 $8,805,000
$11,155,000 $11,486,000
$19,706,000 $20,291,000
$758,000
$780,000
Page 3 of 4
CKHA: Preliminary Estimate of Annual Operating Cost Impact Upon Completion
Functional Centre
Measure
2009/10
Work-load
2009/10
Cost/ Unit
Projected 2017/18
Projected 2027/28
Annual Cost Annual Cost
Annual Cost Annual Cost
Increase (2011/12 $,
Increase (2011/12 $,
Increase in
Increase in
from
1.5%
from
1.5%
Units from
2009/10 inflation per Units from
2017/18 inflation per
2017/18 (2009/10 $)
2009/10 (2009/10 $)
year)
year)
Notes to Costing Table:
1. These are very preliminary, order of magnitude impacts based on current estimated rates
2. Estimated rates are taken from MIS Trial Balance data (2009/10), plus 1.5% inflation per year to 2011/12 $
3. Total costs include 7.29% allowance factor (at 50 cents on dollar) for indirect costs (Admin, Program Admin, etc.)
4. Excludes equipment depreciation/leasing and equipment maintenance impacts
5. Excludes marketed services, other votes and non-MOHLTC revenues such as preferred accommodation, parking and cafeteria
6. In practice, there are some small non-MoH revenues that would offset some of these costs (Within the 5% or less margin of error of the above total cost estimate)
Appendic D ‐ CKHA Volume Projections (2011 07 17) Operating Costs
Page 4 of 4
Site
MIS TB FC
Job Code Desc
Chatham
711100000 General Administration
CO-OP ADMINISTRATION
PRESIDENT & CEO
SR EXEC ASST GOV COOR
CNE/CHPO & DIR OF MED
EXECUTIVE ASSISTANT
HEALTHY HOSPITAL CO-OR
STRAT INIT PROJ LEADER
VP-CHIEF HR OFFICER
ADMINISTRATIVE ASST CH
DIR MED AFFAIRS & REC
MED REC EDUCATION & E
ADMIN ASST ORG DEV
DIR MISS/ORG DEV
HRECORDS DATA ANALYST
MGR UTILIZATION
QUALITY&PERF IMP SPEC
QUALITY&PERF IMP SPEC
ADMINISTRATIVE ASST CH
COMM SPECIALIST
DIR COM & COM RELATION
MULTIMEDIA SPECIALIST
SECRETARY
WEBMASTER
CO-OR ENVIRONMENT CONT
DIR MISS/ORG DEV
INFECTION CONTROL PRAC
INFECTION CONTROL PRAC
LAB ASSISTANT
ASST MISS QUALITY IMPR
NURSE PRACTITIONER
PRIMARY HC NURSE PRAC
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
REG RESP THERAPIST
HEALTHY HOSPITAL CO-OR
REGISTERED NURSE
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.0
0.9
1.0
0.3
1.0
0.0
1.0
1.0
2.0
1.0
2.0
0.4
0.2
1.0
1.0
1.0
1.0
0.0
1.0
1.0
0.6
0.3
0.5
1.0
0.2
1.0
0.9
0.0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
0.0
0.9
1.0
0.3
1.0
0.0
1.0
1.0
2.0
1.0
2.0
0.4
0.2
1.0
1.0
1.0
1.0
0.0
1.0
1.0
0.6
0.3
0.5
1.0
0.2
1.1
1.0
0.0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
0.0
0.9
1.0
0.3
1.0
0.0
1.0
1.0
2.0
1.0
2.0
0.4
0.2
1.0
1.0
1.0
1.0
0.0
1.0
1.0
0.6
0.3
0.5
1.0
0.2
1.2
1.1
0.0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
Page 1 of 19
Site
MIS TB FC
711150000 Finance
711200000 Personnel Services
711250000 Systems Support
711300000 Communications
711350000 Materiel Management
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
Job Code Desc
ADMIN ASST ORG DEV
DIR MISS/ORG DEV
QUALITY ASSURANCE COOR
EMG PLANNING CO-OR
CO-ORD MIS & FINANCE
CO-OR, BUDG/REPORTS
DIRECTOR OF FINANCE
SR FINANCIAL ANALYST
A/R CLERK (BILLING)
A/R CLERK (CASHIER)
A/R CLERK (I.S.)
A/R CLERK PHYSICIAN BI
ACCOUNTS REC CO-OR
MATERIAL MGM CLERK
KINESIOLOGIST
RECRUITMENT SPECIALIST
MENTAL HEALTH ASSISTA
REGISTERED NURSE
MGR LAB SERVICES
HELP DESK
MULTIMEDIA SPECIALIST
SR FINANCIAL ANALYST
TECHNICAL ANALYST
REGISTERED NURSE
HEC CLINICAL LEAD
MENTAL HEALTH ASSISTA
REGISTERED NURSE
SECRETARY MHC
REGISTRATION CLERK
SCHEDULING CLERK
ASST BUYER
BUYER
DIR MATERIALS MGR B
MATERIAL HANDLER
MATERIAL MGM CLERK
PERIOPERATIVE MAT MGR
PURCHASING MANAGER
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.6
0.3
1.0
0.0
0.8
0.8
1.0
2.0
2.6
1.0
1.0
0.0
1.0
1.0
0.0
1.0
0.0
0.3
0.0
1.0
0.0
0.6
0.4
0.6
0.9
0.0
0.0
0.0
4.1
0.0
0.5
1.0
1.0
9.9
1.0
0.5
1.0
0.6
0.3
1.0
0.0
0.8
0.8
1.0
2.0
2.9
1.0
1.0
0.0
1.0
1.0
0.0
1.0
0.0
0.3
0.0
1.0
0.0
0.6
0.5
0.6
0.9
0.0
0.0
0.1
4.6
0.0
0.5
1.0
1.0
11.0
1.0
0.5
1.0
0.6
0.3
1.0
0.0
0.8
0.8
1.0
2.0
3.1
1.0
1.0
0.0
1.0
1.0
0.0
1.0
0.0
0.3
0.0
1.0
0.0
0.7
0.5
0.7
0.9
0.0
0.0
0.1
4.8
0.0
0.5
1.0
1.0
11.5
1.0
0.5
1.0
Page 2 of 19
Site
MIS TB FC
711400000 Volunteer Services
711450000 Housekeeping
711500000 Laundry and Linen
711550000 Plant Operations & Maintenance
711650000 Plant Maintenance
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
Job Code Desc
SUPPLY & DIST MGR
SUMMER STUDENTS
TRAN PROJECT LEADER
UNKNOWN LABOUR CLASS
CSR TECH
MATERIAL HANDLER
MANAGER CSR
UNKNOWN LABOUR CLASS
DIR MISS/ORG DEV
ASST MISS QUALITY IMPR
VOLUNTEER SPECIALIST
FOOD SERVICE SUPER
HOUSEKEEPER
MGR HOUSEKEEPING SERV
LAUNDRY GENERAL
SUPPORT SERVICES SUP
DIETARY AIDE
HOUSEKEEPER
MGR HOUSEKEEPING SERV
LAUNDRY GENERAL
BUILDING OPERATOR
BUILDING OPERATOR
ELECTRICIAN
EMG PLANNING CO-OR
MAINTENANCE GENERAL
DIR FOOD&SUPP SERV
PAINTER
PLUMBER
PLANT MTCE MANAGER
REFRIG MECHANIC
SCHEDULING CLERK
SECRETARY ENGIN.SERVI
SUPPORT SERVICES ASSIS
SUMMER STUDENTS
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
1.0
0.1
0.4
0.0
9.0
0.0
1.0
0.1
0.1
0.2
1.0
0.0
46.5
0.9
0.0
0.9
0.0
0.1
0.1
2.1
0.9
3.1
1.0
0.0
1.9
0.6
1.0
1.1
1.0
1.0
0.1
0.3
0.6
0.6
1.0
0.1
0.4
0.0
10.0
0.0
1.0
0.1
0.1
0.2
1.0
0.0
95.7
0.9
0.0
0.9
0.0
0.1
0.1
2.6
1.9
6.4
2.1
0.0
3.9
0.6
2.1
2.3
1.0
2.1
0.2
0.6
1.1
1.2
1.0
0.1
0.4
0.0
11.4
0.0
1.0
0.1
0.1
0.2
1.0
0.0
98.9
0.9
0.0
0.9
0.0
0.1
0.1
2.8
2.0
6.6
2.1
0.0
4.1
0.6
2.1
2.4
1.0
2.2
0.3
0.6
1.2
1.3
Page 3 of 19
Site
MIS TB FC
Job Code Desc
711800000 Registration (Admitting)
ADMITTING CLERK EMERG
REGISTRATION CLERK
A/R CLERK (BILLING)
MANAGER PATIENT REG
REGISTRATION CLERK
SCHEDULING CLERK
SCHEDULING CLERK
PORTER-NURSING UNITS
STUDENT PHARMACY
DIR HEALTH INFO SERV/P
HEALTH INF SERV ASST
HEALTH RECORDS CLERK
HEALTH RECORDS TECH
MED.DICTA TYPIST RAD.
MEDICAL DICTA TYPIST
MENTAL HEALTH ASSISTA
MGR/PROJECT LEADER HR
ASSISTANT COOK
COOK
DIETARY AIDE
FOOD SERVICE SUPER
DIR FOOD&SUPP SERV
MGR NUTRITION SERVICES
SUPPORT SERVICES ASSIS
SUMMER STUDENTS
ADV PRAC RN/CLIN ED LD
CO-OR HEC
ED OFFICE CO-OR/MH
EMG PLANNING CO-OR
EXECUTIVE ASSISTANT
NURSE PRACTITIONER
PROF PRACTICE-CORPORAT
PROF PRACTICE LEADER
PAT&STAF SHIFT CO-OR
UNKNOWN LABOUR CLASS
REGISTERED NURSE
REG PRACTICAL NURSE
711852000 Central Patient Portering
711900000 Health Records
711950000 Patient + Non-Patient Food Svces
712051000 Nursing Administration
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
4.2
0.4
0.0
1.0
11.1
0.4
8.1
5.1
0.0
1.0
0.4
6.2
9.4
0.1
7.8
0.0
1.0
1.5
0.0
18.9
1.2
0.2
1.0
0.2
0.0
0.4
0.0
0.4
0.0
1.0
0.0
2.4
0.0
1.0
0.0
0.0
0.1
4.2
0.4
0.0
1.0
12.2
0.5
8.9
5.6
0.0
1.0
0.5
6.8
10.4
0.1
8.6
0.0
1.0
1.9
0.0
23.1
1.2
0.2
1.0
0.2
0.0
0.4
0.0
0.4
0.0
1.0
0.0
2.4
0.0
1.0
0.0
0.0
0.1
4.4
0.4
0.0
1.0
13.7
0.5
10.0
6.1
0.0
1.0
0.5
7.6
11.6
0.1
9.6
0.0
1.0
2.0
0.0
25.1
1.2
0.2
1.0
0.2
0.0
0.4
0.0
0.4
0.0
1.0
0.0
2.4
0.0
1.0
0.0
0.0
0.1
Page 4 of 19
Site
MIS TB FC
Job Code Desc
712052094 Palliative Care Team
PALL CARE COORDINATOR
REGISTERED NURSE
CNE/CHPO & DIR OF MED
PROG DIR SURGICAL AND
CHARGE TECHNOLOGIST
REGISTERED TECHNOLOGIS
ADV PRACTICE/CLIN LEAD
REGISTERED NURSE
CLIN MAN ER SC/AMB
NURSE PRACTITIONER
UNIT CLIN LEAD EXP
CLINICAL MGR MED/SOCIA
GRADUATE NURSE
REGISTERED NURSE
REG PRACTICAL NURSE
PROGRAM SECRETARY MED
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
CLIN MGR INPA.REHABCON
REGISTERED NURSE
REG PRACTICAL NURSE
WARD CLERK
GRADUATE NURSE
CLIN MGR SURG/PREADM
PROGRAM SECRETARY-SURG
REGISTERED NURSE
REG PRACTICAL NURSE
SUMMER STUDENTS
UNIT AIDE
WARD CLERK
GRADUATE NURSE
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT AIDE
WARD CLERK
712060000 Program Management
712073000 Medical Resources - Hospitalists
712100000 Medical Inpatient
712106100 Neurology (Integrated Stroke)
712200000 Surgical Inpatient
712201000 General Surgical (Short Stay)
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
1.0
1.0
0.7
1.0
0.0
0.0
0.0
0.0
0.0
0.3
0.6
1.0
0.1
28.5
26.4
0.5
1.7
2.1
5.4
0.2
4.5
1.0
0.7
0.1
0.5
0.9
28.4
5.3
0.2
2.5
3.9
0.0
5.3
0.5
0.5
1.2
1.0
1.2
0.7
1.0
0.0
0.0
0.0
0.0
0.0
0.3
0.6
1.0
0.1
31.2
28.9
0.5
1.9
2.1
5.9
0.2
4.8
1.0
0.7
0.2
0.5
1.2
36.4
6.8
0.2
3.2
5.0
0.0
0.0
0.0
0.0
0.0
1.0
1.5
0.7
1.0
0.0
0.0
0.0
0.0
0.0
0.3
0.6
1.0
0.1
32.7
30.3
0.6
2.0
2.1
6.2
0.2
5.3
1.2
0.8
0.2
0.5
1.3
40.4
7.5
0.2
3.5
5.5
0.0
0.0
0.0
0.0
0.0
Page 5 of 19
Site
MIS TB FC
Job Code Desc
712203500 Gynaecology
CLMG WOMAN&CHILDREN
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
CLIN MGR ICU/RESP
NURSE EDUCATOR
NURSE PRACTITIONER
REGISTERED NURSE
REG PRACTICAL NURSE
PROGRAM SECRETARY MED
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
REGISTERED NURSE
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
CLMG WOMAN&CHILDREN
REGISTERED NURSE
REG PRACTICAL NURSE
SECRETARY
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
ADV PRAC RN/CLIN ED LD
CLINICAL EDUCATION LDR
CLTN MGR OR/PACU/DS
OR SUPPORT ASST
OR RESOURCE NURSE
PERIOPERATIVE MAT MGR
REGISTERED NURSE
REG NURSE FIRST ASST
REG PRACTICAL NURSE
712403000 ICU - Combined Med/Surg
712508040 Intermediate Nursery (Level 2)
712509000 Labour, Delivery, Rec, PP (LDRP)
712600000 Operating Rooms
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.0
0.3
0.0
0.1
0.0
0.0
0.6
0.0
1.0
37.2
0.0
0.5
0.6
0.9
4.8
6.4
0.5
0.3
0.4
0.2
18.4
1.3
0.5
1.0
0.7
1.0
0.0
0.0
0.2
4.4
0.6
0.5
17.0
1.0
3.3
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
1.1
40.6
0.0
0.5
0.7
0.9
5.3
6.7
0.5
0.3
0.4
0.2
19.2
1.3
0.5
1.0
0.7
1.1
0.0
0.0
0.2
4.9
0.6
0.5
18.8
1.1
3.7
0.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
1.3
46.6
0.0
0.6
0.8
0.9
6.1
6.4
0.5
0.3
0.4
0.2
18.5
1.3
0.5
1.0
0.7
1.0
0.0
0.0
0.2
5.6
0.7
0.5
21.4
1.2
4.2
Page 6 of 19
Site
MIS TB FC
712650000 Post-Anesthetic Recovery Rooms
712700000 Paediatric
712762500 Mental Health - Acute
(Incl. 712764500 Specialized Con Dis/Add Trtmnt)
712813000 Rehab - Combined
712952000 Complex Continuing Care
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
Job Code Desc
TRAN PROJECT LEADER
UNIT AIDE
WARD CLERK
REGISTERED NURSE
REGISTERED NURSE
CLMG WOMAN&CHILDREN
REGISTERED NURSE
REG PRACTICAL NURSE
SECRETARY
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
CLINICAL MGR PSY/IN/OP
CRISIS REG NURSE
MENTAL HEALTH ASSISTA
REGISTERED NURSE
REG PRACTICAL NURSE
SECRETARY MHC
WARD CLERK
CLIN MGR INPA.REHABCON
NAT REH REPT SYS NURSE
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT AIDE
UNIT CLIN LEAD EXP
WARD CLERK
CLIN MGR INPA.REHABCON
NAT REH REPT SYS NURSE
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT AIDE
WARD CLERK
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.4
0.0
2.2
5.7
0.0
0.2
7.4
0.1
0.1
0.5
0.3
0.7
0.4
0.2
0.6
7.5
7.5
0.3
1.5
0.4
0.2
4.3
14.5
0.3
0.0
0.7
0.4
0.0
6.6
14.7
0.4
1.4
0.4
0.0
2.5
6.5
0.0
0.2
7.2
0.1
0.1
0.5
0.3
0.7
0.4
0.3
0.7
8.8
8.9
0.4
1.8
0.4
0.2
4.5
15.2
0.3
0.0
0.7
0.4
0.0
13.8
30.8
0.8
2.9
0.4
0.0
2.8
7.3
0.0
0.2
7.2
0.1
0.1
0.5
0.3
0.7
0.4
0.3
0.8
10.0
10.1
0.5
2.1
0.4
0.3
4.9
16.6
0.3
0.0
0.8
0.4
0.0
15.2
33.9
0.9
3.2
Page 7 of 19
Site
MIS TB FC
Job Code Desc
713060000 Program Mgmt Administration
713102000 General Emergency
PROG DIR EMERGENCY & M
CLINICAL EDUCATION LDR
CLIN MAN ER SC/AMB
EMG UNIT SECRETARY
HEC CLINICAL LEAD
MENTAL HEALTH ASSISTA
NURSE EDUCATOR
NURSE PRACTITIONER
PROG SECRETARY-ER/W&C
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
NURSE PRACTITIONER
PRIMARY HC NURSE PRAC
REGISTERED NURSE
CLINICAL EDUCATION LDR
CLTN MGR OR/PACU/DS
DATA SUPP&WAIT TIME SP
REGISTERED NURSE
REG PRACTICAL NURSE
WARD CLERK
CLTN MGR OR/PACU/DS
OR SUPPORT ASST
REGISTERED NURSE
REG NURSE FIRST ASST
REG PRACTICAL NURSE
PROG SECRETARY-ER/W&C
REGISTERED NURSE
SECRETARY HEC
CL MGR-AC/CDM
DIALYSIS ASST
REGISTERED NURSE
713670000 Day Surgery Pre/Post-Op Care
713405500 Endoscopy
713406610 Oncology Day Care - Chemotherapy
713408610 Hemodialysis Day/Night
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.4
0.2
0.5
5.0
0.2
0.0
0.0
0.0
0.2
35.7
1.6
0.3
3.5
1.1
0.3
0.1
0.1
0.5
0.0
0.4
1.0
7.2
2.5
1.9
0.2
0.0
1.4
0.0
0.2
0.0
2.7
0.0
0.3
1.8
6.8
0.4
0.2
0.5
5.1
0.2
0.0
0.0
0.0
0.2
36.4
1.6
0.3
3.6
1.1
0.3
0.1
0.1
0.5
0.0
0.4
1.1
8.1
2.8
2.2
0.2
0.0
1.6
0.0
0.2
0.0
3.2
0.0
0.3
3.0
11.0
0.4
0.2
0.5
5.3
0.2
0.0
0.0
0.0
0.3
37.7
1.7
0.3
3.7
1.1
0.3
0.1
0.1
0.5
0.0
0.4
1.3
9.2
3.2
2.5
0.2
0.0
1.8
0.0
0.3
0.0
3.9
0.0
0.3
3.4
12.5
Page 8 of 19
Site
MIS TB FC
Job Code Desc
713501010 General Medical Clinic
CLIN MAN ER SC/AMB
REGISTERED NURSE
WOUND,OSTOMY,CONTINENT
CHIROPODIST
CO-ORD SATC/DV
CRISIS REG NURSE
NURSE EDUCATOR
REGISTERED NURSE
CLIN MGR SURG/PREADM
REGISTERED NURSE
SECRETARY PREADMIJ
CL MGR-AC/CDM
ORTHOPEDIC TECH
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
UNIT AIDE
WARD CLERK
CLMG WOMAN&CHILDREN
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT AIDE
UNIT CLINICAL LEADER
WARD CLERK
CL MGR-AC/CDM
THERAPEUTIC DIETICIAN
KINESIOLOGIST
SOCIAL WORKER MSW
NURSE EDUCATOR
SECRETARY HEC
SECRETARY
THERAPEUTIC DIETICIAN
713501030 Chiropody Clinic
713501088 Sexual Assault & Domestic Violence Clinic
713501545 Pre-Admission Clinic
713501710 Combined Med/Surg General Clinic
713501720 Combined Obs/Gyn Clinic
713504024 Diabetes Clinic - Adult
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.1
1.6
0.2
0.9
1.0
0.0
0.0
0.1
0.5
3.2
1.5
0.3
1.0
3.5
0.1
1.6
1.1
1.4
0.4
5.7
0.2
0.7
0.3
0.9
0.3
0.0
0.2
0.0
1.4
0.9
0.0
1.0
0.1
1.8
0.2
1.0
1.0
0.0
0.0
0.1
0.5
3.5
1.7
0.3
1.1
4.0
0.1
1.8
1.3
1.6
0.4
6.0
0.2
0.7
0.3
0.9
0.3
0.0
0.3
0.0
1.9
1.2
0.0
1.3
0.1
2.2
0.2
1.2
1.1
0.0
0.0
0.2
0.5
4.0
1.9
0.3
1.3
4.8
0.1
2.1
1.5
1.9
0.4
5.7
0.2
0.7
0.3
0.9
0.3
0.0
0.4
0.0
2.4
1.6
0.0
1.7
Page 9 of 19
Site
MIS TB FC
Job Code Desc
713504200 Cardiac Clinic
DIETICIAN-DIETARY
KINESIOLOGIST
REGISTERED NURSE
SECRETARY HEC
SECRETARY
UNIT CLINICAL LEADER
PROG SECRETARY-ER/W&C
REGISTERED NURSE
SECRETARY HEC
PROGRAM SECRETARY MED
CLMG WOMAN&CHILDREN
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT CLINICAL LEADER
WARD CLERK
REGISTERED NURSE
REG PRACTICAL NURSE
MARK&COMM OFFICER
PROG DIR REHAB/CONT/CH
PROG OFFICE CO-OR
CLERK TYPIST
MEDICAL DICTA TYPIST
MEDICAL DICTA TYPIST
CHARGE TECHNOLOGIST
MGR LAB SERVICES
LAB ASSISTANT
SENIOR MLA
CHARGE TECHNOLOGIST
LAB ASSISTANT
PATHOLOGIST
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
LAB ASSISTANT
REGISTERED TECHNOLOGIS
713506605 Systemic Pre and Post Treatment
713507010 General Paediatric
713670000 Day Surgery Pre/Post-Op Care (Paeds Surg D/N Care)
714060000 Program Management Admin
714101000 Clin Lab - General Admin
714102100 Lab Pre-/Post- Analysis
714104100 Anatomical Pathology
714104500 Microbiology
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.0
0.0
0.0
0.4
0.1
0.7
0.0
0.1
0.0
0.0
0.2
0.7
0.0
0.0
0.3
0.4
0.0
0.0
1.0
0.4
0.3
1.1
1.2
1.0
1.1
6.6
0.8
1.6
1.0
0.7
0.1
0.4
1.8
3.1
0.0
0.0
0.0
0.5
0.1
0.7
0.0
0.2
0.0
0.0
0.2
0.7
0.0
0.0
0.3
0.4
0.0
0.0
1.0
0.4
0.3
1.2
1.3
1.1
1.1
7.2
0.9
1.8
1.1
0.8
0.2
0.5
2.1
3.6
0.0
0.0
0.0
0.6
0.1
0.7
0.0
0.2
0.0
0.0
0.2
0.7
0.0
0.0
0.3
0.4
0.0
0.0
1.0
0.4
0.4
1.4
1.5
1.3
1.1
7.9
1.0
2.1
1.3
0.9
0.2
0.6
2.4
4.1
Page 10 of 19
Site
MIS TB FC
Job Code Desc
714109900 Clinical Laboratory - Combined Functions
CHARGE TECHNOLOGIST
LAB ASSISTANT
REGISTERED TECHNOLOGIS
SENIOR MLA
DI SUPPORT TECH
DI SUPPORT TECH
DI CLERK
MANAGER DIAGNOSTIC IMA
MED.DICTA TYPIST RAD.
MEDICAL DICTA TYPIST
DI FILE CLERK
UNKNOWN LABOUR CLASS
CHARGE TECHNOLOGIST
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
CLIN INSTRUCTOR DI
MAGNETIC RESONANCE L T
NON-REGISTERED TECH
REGISTERED NURSE
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
CLIN INSTRUCTOR DI
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
ECHO ULTRASONOGRAPHER
REGISTERED TECHNOLOGIS
ULTRASONOGRAPHER
CHARGE TECHNOLOGIST
CLIN INSTRUCTOR DI
REGISTERED TECHNOLOGIS
REGISTERED TECHNOLOGIS
CHARGE TECHNOLOGIST
MAGNETIC RESONANCE L T
REGISTERED TECHNOLOGIS
ULTRASONOGRAPHER
714151000 Diagnostic Imaging - General
714151200 DI Admin - PACS
714151800 Radiography
714152000 Mammography
714152500 Computed Tomography
714153000 Diagnostic Ultrasound
714154000 Nuclear Medicine
714157000 Magnetic Resonance Imaging
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
3.0
0.6
17.5
0.2
0.4
0.6
2.7
0.9
1.5
1.3
1.9
0.1
0.0
0.0
1.1
1.3
0.3
0.1
1.2
7.6
0.3
0.5
1.1
0.0
2.9
0.8
0.9
0.2
7.0
1.0
0.0
3.3
0.1
1.0
1.1
0.8
0.1
3.4
0.7
19.8
0.2
0.5
0.6
3.1
0.9
1.6
1.4
2.1
0.1
0.0
0.0
1.2
1.4
0.3
0.2
1.3
8.4
0.4
0.5
1.2
0.0
3.3
0.9
1.0
0.2
7.9
1.1
0.0
3.8
0.1
1.2
1.3
0.9
0.1
3.9
0.8
22.6
0.2
0.5
0.7
3.5
0.9
1.9
1.6
2.4
0.2
0.0
0.0
1.4
1.6
0.3
0.2
1.4
9.5
0.4
0.5
1.4
0.0
3.7
1.1
1.2
0.2
9.1
1.3
0.0
4.5
0.1
1.4
1.5
1.1
0.1
Page 11 of 19
Site
MIS TB FC
Job Code Desc
714302099 Non-Invasive Cardiology - Combined Functions
ECG TECHNICIAN
REG RESP THERAPIST
CLIN MGR ICU/RESP
REG RESP THERAPIST
SR REG RESP THERAPIST
CO-OR PHARM
PHARMACIST CO-OP
PHARMACY CPL
STAFF PHARMACIST
PHARMACY TECHNICIAN
STUDENT PHARMACY
DIETICIAN-DIETARY
FOOD SERVICE SUPER
THERAPEUTIC DIETICIAN
CO-OR PHYSIO/CHIR/EMG
CHARGE TECH KIN
KINESIOLOGIST
PHYSIOTHERAPIST
PHYSIO ASSISTANT
SCHEDULING CLERK
SECRETARY
PHYSIO ASSISTANT
CO-OR OCCUP THERAPY
OCCUPATIONAL THERAPIST
OCCUPATIONAL THER ASST
PHYSIO ASSISTANT
COM ASSIST
CO-OR OCCUP THERAPY
SPEECH PATHOLOGIST
SOCIAL WORKER BSW
DISCHARGE PLANNING OFF
SOCIAL WORKER MSW
PATIENT FLOW CO-OR
DIR MISS/ORG DEV
ASST MISS QUALITY IMPR
STAFF CHAPLAIN
714350000 Respiratory Services
714400000 Pharmacy
714450000 Clinical Nutrition
714500000 Physiotherapy
714552000 Occupational Therapy - General
714602000 Speech/Language Pathology
714700000 Social Work
714800000 Pastoral Care
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
5.2
0.5
0.4
10.1
0.2
1.0
0.3
2.0
3.4
18.3
0.2
0.8
0.4
2.0
1.0
0.1
0.6
10.0
8.2
0.0
1.2
0.0
0.6
3.9
1.0
0.4
1.0
0.4
2.0
1.0
3.5
0.9
2.0
0.1
0.2
1.6
6.0
0.6
0.4
11.0
0.2
1.0
0.3
2.2
3.7
19.8
0.2
1.0
0.4
2.3
1.0
0.2
0.7
11.1
9.1
0.0
1.3
0.0
0.6
4.2
1.1
0.4
1.1
0.4
2.1
1.1
3.7
1.0
2.1
0.1
0.2
1.7
7.4
0.7
0.4
12.0
0.2
1.0
0.4
2.4
4.0
21.4
0.2
1.1
0.5
2.6
1.0
0.2
0.8
12.6
10.3
0.0
1.5
0.0
0.6
4.8
1.2
0.5
1.2
0.4
2.3
1.2
4.1
1.0
2.3
0.1
0.2
1.9
Page 12 of 19
Site
MIS TB FC
Job Code Desc
714851000 Therapeutic Recreation - Goal Oriented
CO-OR THER RECREATION
REC. CO-OP STUDENT
RECREATIONAL THERAPIST
SR REG RESP THERAPIST
PROG DIR EMERGENCY & M
OCCUPATIONAL THERAPIST
REGISTERED NURSE
RIGHTS ADVICE CO-OR
REG PRACTICAL NURSE
STATISTICAL SECRETARY
SECRETARY MHC
SOCIAL WORKER
ADV PRAC RN/CLIN ED LD
CO OR STROKE STRAD
NAT REH REPT SYS NURSE
REGISTERED NURSE
SECRETARY HEC
SECRETARY
UNIT CLINICAL LEADER
CHARGE TECHNOLOGIST
CO-OR BREAST ASST
D.I. CLERK
DI FILE CLERK
REGISTERED NURSE
REGISTERED TECHNOLOGIS
CO-OR BREAST ASST
REGISTERED NURSE
ADV PRAC RN/CLIN ED LD
CHARGE TECHNOLOGIST
CHARGE TECH KIN
DIETICIAN-DIETARY
KINESIOLOGIST
REGISTERED NURSE
SECRETARY HEC
SECRETARY
UNIT CLINICAL LEADER
715102000 COM Prim Care - General Clinic (Respiratory Health - Asthma)
715107630 Community Mental Health Clinic
715504220 COM Hlth Prom/Educ - Stroke Strategy
715556610 COM Prev & Control - Breast Screening OBSP
715556612 Breast Assessment Clinic
715580500 COM Prom & Prev - General (Cardiac Rehab Clinic)
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
1.0
0.8
1.1
0.8
0.1
0.7
0.7
0.3
0.3
0.1
1.0
1.0
1.0
1.0
0.1
0.4
0.1
0.4
0.0
0.4
0.8
1.1
0.9
0.9
0.7
0.1
0.1
0.0
0.0
0.2
0.0
0.4
0.0
0.0
0.0
0.3
1.0
0.8
1.2
0.9
0.1
0.7
0.7
0.3
0.3
0.1
1.0
1.0
1.1
1.0
0.1
0.5
0.1
0.5
0.0
0.5
0.8
1.3
1.0
1.0
0.9
0.1
0.2
0.0
0.1
0.2
0.0
0.4
0.0
0.0
0.0
0.3
1.0
0.9
1.3
1.1
0.1
0.7
0.7
0.4
0.3
0.1
1.0
1.0
1.3
1.0
0.1
0.6
0.2
0.5
0.0
0.5
0.8
1.3
1.0
1.0
0.9
0.1
0.2
0.0
0.1
0.2
0.1
0.5
0.0
0.0
0.0
0.3
Page 13 of 19
Site
MIS TB FC
Job Code Desc
717761000 Mental Health Research
RESEARCH CO-ORD
RPN NURS RESEARCHER
LIBRARIAN
PROJECT LEAD-ELEARNING
DIR MISS/ORG DEV
EMG PLANNING CO-OR
ASST MISS QUALITY IMPR
ORG DEVELOPMENT LEADER
PROJECT LEAD-ELEARNING
QUALITY PERF/LEARNING
WEBMASTER
PROFESSIONAL PRACTICE/
ADVANCE PRACTICE LEAD
PROF PRACTICE LEADER
ASSISTANT COOK
COOK
DIETARY AIDE
FOOD SERVICE SUPER
MH THERAPIST
HEALTHY HOSPITAL CO-OR
A/R CLERK (BILLING)
A/R CLERK PHYSICIAN BI
ADMINISTRATIVE ASST CH
APPLICATION ANALYST
CO-OR, BUDG/REPORTS
DIRECTOR OF FINANCE
DIR STRATEGIC SOURCING
EXECUTIVE ASSISTANT
HR SPECIALIST
MARK&COMM OFFICER
GENERAL MANAGER
SUMMER STUDENTS
TRAN PROJECT LEADER
UNKNOWN LABOUR CLASS
718100000 Hospital Library
718400000 In-Service Education
718600000 Nursing Formal Education
719102000 Cafeteria
719203900 Other Sales of Services
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
1.0
0.8
0.3
0.7
0.1
0.0
0.5
0.1
0.0
0.6
0.5
1.0
0.0
2.0
0.1
1.0
1.9
0.2
0.1
0.1
0.1
1.0
0.2
0.1
0.0
0.2
0.2
0.4
0.2
0.6
1.0
0.0
0.0
0.0
1.0
0.8
0.3
0.7
0.1
0.0
0.5
0.1
0.0
0.7
0.5
1.1
0.0
2.0
0.1
1.2
2.4
0.2
0.1
0.1
0.1
1.0
1.0
0.8
0.3
0.7
0.1
0.0
0.6
0.1
0.0
0.7
0.6
1.1
0.0
2.0
0.1
1.3
2.6
0.2
0.1
0.1
0.1
1.0
Page 14 of 19
Site
MIS TB FC
Job Code Desc
719204200 MKS Gift Shop
719400000 Fund Raising
GIFT SHOP SUPERVISOR
ADMINISTRATIVE ASST CH
DEV OFFICER
OFFICE CO-ORDINATOR
DATA BASE ADMINISTRATR
SR DEV OFFICER FOUND
EXECUTIVE DIR FOUND
SR FINANCIAL ANALYST
SUMMER STUDENTS
MAINTENANCE GENERAL
ED OFFICE CO-OR/MH
PROG DIR EMERGENCY & M
MH SECRETARY/RIGHTS AD
MENTAL HEALTH ASSISTA
PROG SECRETARY-ER/W&C
RIGHTS ADVICE CO-OR
STATISTICAL SECRETARY
SECRETARY MHC
FR REGIONAL CONSULTANT
NURSE PRACTITIONER
PRIMARY HC NURSE PRAC
RPN/CLINICAL SUPPORT E
NURSE PRACTITIONER
RPN/CLINICAL SUPPORT E
CL MGR-AC/CDM
DIETICIAN-DIETARY
THERAPEUTIC DIETICIAN
NURSE EDUCATOR
SECRETARY HEC
THERAPEUTIC DIETICIAN
NURSE PRACTITIONER
SECRETARY
NURSE PRACTITIONER
SECRETARY
719208500 Parking
721100000 Other Vote - General Admin
721109000 Other Vote - French Language Services
723102000 OV General Emergency (Nurse Practitioner)
723102001 OV General Emergency (Nurse Practitioner II)
723504024 OV Diabetes Clinic - Adult (Adult Diabetes Outreach)
725101500 OV COM Prim Care - Nursing Clinic (Nurse Practioner Womens Hlth)
725101502 OV COM Prim Care - Nursing Clinic (Nurse Practioner Paeds)
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.7
0.9
1.0
1.0
0.5
0.9
1.0
0.4
0.3
0.2
0.6
0.5
0.4
0.5
0.0
0.7
0.8
1.2
1.0
0.1
0.9
0.0
1.9
0.0
0.1
0.7
0.6
1.4
0.2
0.0
1.0
0.1
1.0
0.1
0.7
0.9
1.0
1.0
0.5
0.9
1.0
0.4
0.3
0.2
0.6
0.5
0.4
0.5
0.0
0.7
0.8
1.2
1.0
0.1
0.9
0.0
2.0
0.0
0.1
0.8
0.8
1.8
0.3
0.0
1.0
0.1
1.0
0.1
0.7
0.9
1.0
1.0
0.5
0.9
1.0
0.4
0.3
0.2
0.6
0.5
0.4
0.5
0.0
0.7
0.8
1.2
1.0
0.1
1.0
0.0
2.0
0.0
0.1
1.1
1.0
2.3
0.4
0.0
1.0
0.1
1.0
0.1
Page 15 of 19
Site
MIS TB FC
Job Code Desc
725101525 OV COM Prim Care - Nursing Clinic (MH Nurse Practitioner)
725107612 OV COM Prim Care - MH Counseling & Treatment
NURSE PRACTITIONER
ADDICTION WORKER
ADV PRACTICE/CLIN LEAD
MH THERAPIST
OCCUPATIONAL THERAPIST
REGISTERED NURSE
REG PRACTICAL NURSE
RPN NURS RESEARCHER
SOCIAL WORKER
CRISIS OUTREACH NURSE
REG PRACTICAL NURSE
SOCIAL WORKER
YOUTH WORKER
CLINICAL MGR PSY/IN/OP
CRISIS OUTREACH NURSE
REGISTERED NURSE
CRISIS OUTREACH NURSE
MENTAL HEALTH ASSISTA
OCCUPATIONAL THERAPIST
REGISTERED NURSE
ADDICTION WORKER
ADDICTION WORKER
ADULT COUN GAMBLING
INTAKE WORKER
YOUTH WORKER
ADDICTION WORKER
ADULT COUN GAMBLING
CO-OP ADMINISTRATION
CRISIS REG NURSE
REGISTERED NURSE
RN CT LEADER
DIETICIAN-DIETARY
SOCIAL WORKER MSW
NURSE EDUCATOR
725107651 OV COM Prim Care - MH Early Intervention
725107660 OV COM Prim Care - MH Abuse Services
725107670 OV COM Prim Care - MH Eating Disorders
725107695 OV COM Prim Care - MH Dual Diagnosis
725107696 OV COM Prim Care - MH Psychogeriatric
725107811 OV COM Prim Care - Addictions Treatment - Substance Abuse
725107812 OV COM Prim Care - Addictions Treatment - Problem Gambling
725157600 OV Community Crisis Intervention - Mental Health
733504022 OV Diabetes - Paediatric
Total
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
1.0
0.4
0.1
1.4
1.0
2.0
0.1
0.0
0.8
0.9
0.7
0.2
0.2
0.6
0.5
0.0
0.4
0.4
0.2
0.9
0.5
2.0
0.1
1.2
1.8
0.0
0.9
0.2
4.3
0.5
1.0
0.2
0.1
0.2
887
1.0
0.3
0.1
1.4
1.0
1.9
0.1
0.0
0.8
0.9
0.7
0.2
0.2
0.5
0.5
0.0
0.4
0.4
0.2
0.9
0.5
2.0
0.1
1.2
1.8
0.0
0.9
0.2
4.2
0.5
1.0
0.2
0.1
0.3
1,040
1.0
0.3
0.1
1.3
1.0
1.9
0.1
0.0
0.8
0.9
0.7
0.2
0.1
0.5
0.5
0.0
0.4
0.4
0.2
0.9
0.5
1.9
0.1
1.2
1.8
0.0
0.9
0.2
4.2
0.5
1.0
0.3
0.2
0.3
1,123
Page 16 of 19
Site
MIS TB FC
Job Code Desc
Sydenham
711100000 General Administration
EXECUTIVE ASSISTANT
VP FINANCE & CFO
PAYROLL OFFICER
PAYROLL REC CLERK
HUMAN RESOURCE ASST
HR CLERK/RECEP
HR GENERALIST
LABOUR RELATIONS CO-OR
MGR HUMAN RESOURCES
SECRETARY
UNKNOWN LABOUR CLASS
CHARGE TECH KIN
FIT TESTER
KINESIOLOGIST
DIR OH&S
OCCUPATIONAL HEALT NUR
OCC HEALTH & SAFE ASST
REGISTERED NURSE
REG PRACTICAL NURSE
HOUSEKEEPER
LAUNDRY GENERAL
DIR FOOD&SUPP SERV
SUPPORT SERVICES ASSIS
SUMMER STUDENTS
HOUSEKEEPER
MGR HOUSEKEEPING SERV
LAUNDRY GENERAL
CLERK/SWITCHBOARD/RECP
PORTER-NURSING UNITS
ASSISTANT COOK
COOK
DIETARY AIDE
FOOD SERVICE SUPER
711150000 Finance
711200000 Personnel Services
711450000 Housekeeping
711500000 Laundry and Linen
711800000 Registration (Admitting)
711852000 Central Patient Portering
711950000 Patient + Non-Patient Food Svces
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.9
0.9
1.0
0.7
1.0
0.6
1.0
1.0
1.0
0.0
0.0
0.0
0.2
0.1
1.0
1.0
1.0
0.1
0.0
9.4
0.0
0.2
0.2
0.2
0.0
0.1
2.1
4.2
1.2
1.5
0.2
3.7
0.5
0.9
1.0
1.0
0.7
1.0
0.6
1.0
1.0
1.0
0.0
0.0
0.0
0.2
0.1
1.0
0.9
0.9
0.1
0.0
10.1
0.0
0.2
0.2
0.3
0.0
0.1
1.0
4.1
0.7
0.7
0.1
1.8
0.5
0.9
1.0
1.0
0.7
1.0
0.6
1.0
1.0
1.0
0.0
0.0
0.0
0.2
0.1
1.0
0.9
0.9
0.1
0.0
10.1
0.0
0.2
0.2
0.3
0.0
0.1
1.0
4.4
0.7
0.7
0.1
1.8
0.5
Page 17 of 19
Site
MIS TB FC
Job Code Desc
712300000 Combined Medical/Surgical
CLIN MGR IP MED/CCC
REGISTERED NURSE
REG PRACTICAL NURSE
UNIT CLIN LEAD EXP
WARD CLERK
OR SUPPORT ASST
REGISTERED NURSE
REG PRACTICAL NURSE
REGISTERED NURSE
ADV PRACTICE/NP LEADER
CLIN MGR IP MED/CCC
GRADUATE NURSE
NURSE PRACTITIONER
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
UNIT AIDE
UNIT CLIN LEAD EXP
WARD CLERK
CLIN MAN ER SC/AMB
MENTAL HEALTH ASSISTA
NURSE EDUCATOR
NURSE PRACTITIONER
PROG SECRETARY-ER/W&C
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
UNIT AIDE
WARD CLERK
NURSE PRACTITIONER
REGISTERED NURSE
REG PRACTICAL NURSE
WARD CLERK
CLTN MGR OR/PACU/DS
OR SUPPORT ASST
REGISTERED NURSE
REG PRACTICAL NURSE
712600000 Operating Rooms
712650000 Post-Anesthetic Recovery Rooms
712952000 Complex Continuing Care
713102000 General Emergency
713670000 Day Surgery Pre/Post-Op Care
713405500 Endoscopy
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.7
7.4
3.6
0.7
0.8
0.2
0.7
0.0
0.1
0.4
0.3
0.0
0.3
4.2
0.4
29.8
1.2
0.3
2.6
0.5
0.0
0.0
0.5
0.2
17.2
2.7
0.2
0.0
0.3
0.2
1.2
0.0
0.5
0.2
0.7
1.2
0.0
0.7
3.9
1.9
0.7
0.4
0.2
0.7
0.0
0.2
0.4
0.3
0.0
0.1
2.0
0.2
14.1
0.6
0.3
1.2
0.5
0.0
0.0
0.5
0.2
17.5
2.7
0.2
0.0
0.3
0.2
1.4
0.0
0.6
0.2
0.8
1.4
0.0
0.7
4.2
2.0
0.7
0.5
0.3
0.8
0.0
0.2
0.4
0.3
0.0
0.1
2.0
0.2
14.1
0.6
0.3
1.2
0.5
0.0
0.0
0.5
0.2
17.9
2.8
0.2
0.0
0.3
0.2
1.5
0.0
0.7
0.2
0.9
1.5
0.0
Page 18 of 19
Site
MIS TB FC
Job Code Desc
713501710 Combined Med/Surg General Clinic
REGISTERED NURSE
RPN/CLINICAL SUPPORT E
REG PRACTICAL NURSE
WARD CLERK
REG PRACTICAL NURSE
LAB ASSISTANT
REGISTERED TECHNOLOGIS
ECHO ULTRASONOGRAPHER
D.I. CLERK
MAGNETIC RESONANCE L T
NON-REGISTERED TECH
DI FILE CLERK
REGISTERED TECHNOLOGIS
ULTRASONOGRAPHER
REG RESP THERAPIST
DIETICIAN-DIETARY
THERAPEUTIC DIETICIAN
FOOD SERVICE SUPER
NURSE PRACTITIONER
713501720 Combined Obs/Gyn Clinic
714109900 Clinical Laboratory - Combined Functions
714159900 Diagnostic Imaging - Combined Functions
714350000 Respiratory Therapy
714450000 Clinical Nutrition
723501714 OV Combined Med/Surg General Clinic (Nurse Practitioner)
Total Sydenham
Total Chatham & Sydenham
Appendic D ‐ CKHA Volume Projections (2011 07 17) Staffing
2009/10
2017/18
2027/28
Actual FTEs Proj'd FTEs Proj'd FTEs
0.7
0.1
0.4
0.0
0.1
0.1
4.9
0.1
0.7
0.1
0.0
0.4
2.7
1.9
0.5
0.0
0.4
0.5
1.0
129
0.8
0.1
0.4
0.0
0.1
0.1
4.6
0.1
0.7
0.1
0.0
0.5
2.8
2.1
0.4
0.0
0.3
0.3
1.0
100
0.8
0.1
0.5
0.0
0.1
0.1
4.8
0.1
0.8
0.1
0.0
0.5
3.1
2.3
0.4
0.0
0.3
0.3
1.0
103
1,016
1,140
1,226
Page 19 of 19