·        “The Peer Review Team supports the position that RVHS should continue as a merged organization with two hospital sites - Centenary and Ajax Pickering.”  p.4

 

·        “The Ajax Pickering site is in a rapidly growing region of the province.  This site is physically constrained and it will take investment in order to further refurbish existing space.  Readily available capacity exists at the Centenary site.  The opportunity for program consolidation to the Centenary site needs to be given full consideration.  This site should be leveraged to accommodate existing needs with the RVHS.”  p.4 

 

·        “Senior leadership does not appear to have functioned effectively as a team, and has not demonstrated collective accountability for the financial outcome of the organization.”  p.4 

 

·        “Fatigue is evident in all levels of management.”  p.5 

 

·        “ ..... RVHS is responding to preliminary findings of the Peer Review process and has begun to look at additional strategies: ........ implementation of the Clinical Services Plan (2005).  p.15 

 

·        “The working capital deficit is 36.2 million as of July 31, 2007. ....... This working capital deficit is among the worst in the province for a community hospital.”  p.17  

 

·        “While this inpatient expansion (40 continuing care beds in the redevelopment at Ajax Pickering) is intended for continuing care beds, the ER volume needs to be supported and RVHS should work with the LHIN to determine is this is the most appropriate use of these beds.  The Ajax Pickering site will triple in size following these two redevelopment projects.”   p.18 

 

·        “At the Centenary site, redevelopment of the Birthing Centre is underway.  The need for a Birthing Centre at the Centenary site does NOT align with current population projections and may not be justified from that perspective ......... RVHS will need to consider how best to provide for high-risk and low-risk pregnancies across the RVHS sites.”  p.18 

 

·        “Recently the LHIN advised that the wait list for MRI at RVHS is the longest in the region.  RVHS then proposed that an additional MRI be located to the Ajax Pickering site ....... The Review team does NOT support proceeding with the MRI at this time.”  p.19 

 

·        “Readily available capacity exists only at the Centenary site.  The opportunity for program consolidation to this site needs to be given full consideration.”  p.19 

 

·        “RVHS activity at Centenary appears to be growing at a slower rate than other community hospitals in the surrounding areas.”  p.22

 

·        “RVHS needs to work with the LHIN to define an appropriate catchment area.”  p.22 

 

·        “There is evidence of inappropriate behaviours of blame, intimidation and threats.  There is a pressing need to ensure respectful behaviour and implement a code of appropriate conduct.  Also, an atmosphere of competition and jealousy across the two sites has led to a “me too attitude.” ....... RVHS is more than two solitudes but has evolved into two silos.” p.24

 

·        “The Board must ensure that processes are in place to balance localized advocacy groups and are not aligned with only one of the many community-based coalitions.  This does not mean isolating themselves from community input.  The Board needs to understand its multiple communities and listen beyond selective loud voices.”  p.25 

 

·        “It is also important that each Board member speaks with one voice outside the Board room.”  p.25

 

·        There is a hunger for leadership, for someone to set the direction, manage the implementation and build a team to lead the organization.” p.27

 

·        “Fatigue is evident at all levels of management.”  p.27

 

·        “The population base and projected growth plans must be considered in terms of the collective not as individual sites.  RVHS Centenary and Ajax Pickering cannot both be full service stand alone organizations” .......

           

·        “Recommendation 11:

That the Board senior leadership and medical staff redefine the strategic direction for RVHS in collaboration with the LHIN and other key stakeholders.  This process will need to include:

 

ü      confirming the catchment area to be served by RVHS;

ü      defining the core primary and secondary services to be provided at each site ....... ;

ü      identifying the potential to consolidate and relocate clinical services and leverage capacity at existing hospital sites;

ü      leveraging clinical consolidation plans with the LHIN and with adjacent hospitals.”  p.33                   

 

·        Recommendation 20:

That the CEO defer capital development and MRI installation at Ajax Pickering site ........”  p.37

 

·        “RVHS may have lands that could be sold” p.17

(Note: approximately three acres bounded by Harwood Avenue, Clements Road, Centennial Road.)