ANNUAL REPORT – 2002–2003

PRESENTATION OF THE ESTABLISHMENT

Mission Statement

Maimonides Geriatric Centre strives to provide the best possible quality geriatric care to the frail elderly Jewish population of the Province of Quebec.

Philosophy

Maimonides Geriatric Centre is founded on the Jewish tradition of caring for our elders.

We believe that everyone should be treated with dignity and respect.

We believe in promoting self-determination and autonomy.

We believe in an interdisciplinary approach to care, taking into account individualized needs.

We believe that the family must be involved in all aspects of care.

We believe in promoting a caring approach through the development of our staff.

We believe in research and education in order to ensure the highest quality of care.

We believe in being an active participant in the Jewish community and with our partner organizations.

Organizational Structure

During the year 2002-2003, a few organizational changes took place. After many years at Maimonides, Christine Boyle, Director of Finance, took a position at the Mackay Center as the Executive Director. Her contribution over the years was outstanding and she will be missed by all. However, we were very fortunate to recruit a new Director of Finance who spent thirteen (13) years at Richter, Usher & Vineberg. Carrie Bogante has joined our senior management team with an expertise garnered from many years in a major audit firm. We look forward to her participation and contribution at Maimonides over the next many years.

In addition, after ten years of association on a part-time basis, Bram Rubinger from Rubinger Communications who instituted and developed our Public Relations program left his consulting position at Maimonides. Over the years, our needs have grown and, as a result, a part-time communications position was no longer enough. Lisa Blobstein was hired as a full-time Communications Officer jointly with the Foundation in the Fall of 2002.

CADRESFull time21

Part time 3

Availability 2

EMPLOYEESFull time 303

Part time 218

Availability 120

667

MAJOR ACTIVITIES OF THE ESTABLISHMENT

On behalf of the Board of Directors, we are pleased to report on the major activities of the Board that took place during the fiscal year 2002 – 2003.

Board of Directors

The year 2002-2003 was a very busy year for the Board of Directors. Elections took place in the Fall of 2002 based on the changes adopted in the Law Respecting Health & Social Service L.R.Q. S-4.2. The list of Board Members can be found at the end of this report. Archie Deskin was nominated as President of the Centre Board and Larry Nachshen was nominated as President of the Foundation Board. At our Annual Meeting held on November 13, 2002, recognition was extended to Mitchell Klein for his contribution during his three-year term between 1999-2002 as President of Maimonides Geriatric Centre.

In addition, Ben Cobrin and the late Phil Levenson received the first ever outstanding service award. This award recognized those individuals whose contribution has made a significant difference in the development of Maimonides Geriatric Centre.

Finally, the Board of Directors is currently working to implement Bill 113 which amends the act respecting health and social services. This act was assented to on December 19, 2002 and covers the rights of users to be informed of any incidents or accidents, the development of a risk management committee and the rules of disclosure.

Strategic Plan

As reported in the Annual Report of 2001-2002, a Strategic Plan was adopted for the years 2001-2006.

Three (3) major goals, which were adopted, concern the Delivery of Care, Integrated Geriatric Care and Community Leadership. As demonstrated last year, we are working on an annual basis to achieve the implementation of these goals through a variety of programs. This Annual Report will outline some of the major activities which took place during the year as we move forward towards achieving these goals.

GOAL

Delivery of Care
  • Continue to excel in delivering personalized care
  • Develop additional programs for specific groups
  • Increase Sephardic involvement
  • Continue to promote training and educational opportunities
  • Expand research program
  • Promote established leadership in clinical programming
SICHELD (Systèmes d’information sur la clientèle hébergée en soins de longue durée)

SICHELD, the computerized care plan system for residents at Maimonides was implemented over the last two (2) years. Now that it has been implemented on all nursing units, we are starting to see that the continuity of care and communication among team members on various units is improving. Very specifically, on some of the units which had implemented this system last Summer, the complaints in reference to replacement staff were reduced during the vacation period as a result of a better communication system about the personalized care of the residents.

Staff Retention and Recruitment

In order to excel at delivering care to our residents, Maimonides counts on attracting and retaining competent staff. The severe nursing shortage both in Montreal and nationally has continued to persist over the past year. As was reported last year, approximately ten per cent (10%) of our nursing positions are not filled. Over the course of the year, a lot of our attention was directed towards recruitment. A recruitment video was developed and was extremely helpful along with our web site in getting our information out to the community. We are happy to report that, although we still do face a shortage, we did recruit many more nurses this year compared to last year.

Finally, many educational opportunities have also been offered to our nursing staff in order to encourage their continuing education. With the commitment of the Foundation, we have been able to offer scholarships to many of our nursing staff who wish to upgrade their skills. In addition, a nursing bursary was offered for the first time this year to a graduate student in the McGill School of Nursing who has a specific interest in geriatrics. This commitment by our Foundation to the funding of educational opportunities together with the development of our web site and our recruitment video have all helped in our increasingly successful efforts at recruiting nurses.

Abuse Prevention

This program continues to draw the attention of many of our partners in the network of health and social services. Because of our expertise, we were invited to join a project which is developing a Provincial network to improve prevention of abuse towards the elderly.

Dental Program

The Accredited Homes services in partnership with the McGill Dental Outreach Program continues to deliver free dental care to the residents of the Accredited Homes. This is a creative project and the first of its kind in Quebec. This program has been submitted by Maimonides to the Association des CLSC et des CHSLD de Québec for the Quality Prize 2003.

R.S.V.P. (Resident Student Visiting Program)

With special funding from the Users’ Committee, Social Service and Volunteers collaborated to provide an opportunity for socially isolated residents to receive regular visits and to be taken out of doors. Students were hired over the Summer months and some part-time students were hired during the course of the year. Social Services coordinated the visits, the scheduling and provided supervision around clinical issues.

Increase Sephardic Involvement

The Moroccan Tea Room program is now held weekly with all Sephardic residents. Specialized outings and celebration of the Jewish holidays is continuing. An intergenerational outreach program within the Sephardic schools and centres took place during the year.

Capital and Environmental Improvements

Food Service Renovation

After ten (10) long years, we finally completed the centralization of our food service. Construction started in the Fall of 2001 and the entire system was in place by June 2002. After an initial period of adjustment, the system is now functioning extremely smoothly and food is being served hot and in a timely fashion to all residents. In addition, the savings forecasted in the vicinity of $400,000 for this department are finally being achieved and will allow us to reimburse the cost of the renovation over a five (5)-year period.

Ceiling Lifts

A special grant was received from the Regional Board of $186,000 in order to install ceiling lifts. Seventy-five (75) ceiling lifts were installed on the second and fifth floors. These lifts are an important addition to the improvement of both the quality of life for the residents and for the staff working with our residents.

Fire System Upgrade

A special grant of $189,000 was also received from the Regional Board in order to upgrade our smoke detector system. A state-of-the-art alarm system has been installed throughout the building and the controls have been moved to our security area.

Specialized Wheelchairs

In response to a special need, the Foundation generously allocated $20,000 to immediately purchase specialized wheelchairs for residents with specialized needs. With this grant, we were able to purchase thirteen wheelchairs. In addition, with the profits of our own business club which is run by our residents, we were also able to purchase another wheelchair.

Coffee Shop/Gift Shop/Lobby Renovation

By far, the biggest change at Maimonides in the last number of years has been the renovation of the Coffee Shop/Gift Shop/Lobby area. Thanks to extremely generous funding by the Foundation and the Auxiliary, the whole first floor of Maimonides has been given a new, open and updated look. Our residents and their families can now sit in a beautiful seating area and enjoy their visits with families and friends. In addition, the Gift Shop is now in an outstanding location. The Coffee Shop continues to improve its menus and is attracting visitors from all over the city. The Lobby/Coffee Shop is now truly the heart of Maimonides and is the place to be seen.

Teaching and Research

The geriatric expertise at Maimonides has become more and more well-known over the past year. Education sessions were organized jointly by the Multidisciplinary Council and the Council of Nurses. Sessions were offered monthly to all our staff and all our partners in the healthcare network. On average, fifty (50) people attended each of these sessions. The list of topics included:

  • You’ll Never Be Alone: A Documentary Film by Terry Fishman
  • Square Peg in a Round Hole (Peg-Feeding)
  • Brush Up on Oral Care
  • Osteoporosis: Prevention and Treatment
  • Maximizing Transfer of Training: The Role of the Supervisor
  • Therapeutic Recreation in a Geriatric Facility
  • Dysphagia: A Team Approach That Works
  • Development of an Integrated Eating Assistance Program for Seniors at Home
  • Disturbing Behaviour Project
  • Treatment of Fractures in the Elderly
  • Cardio-Pulmonary Resuscitation

We held our third annual retreat with the Division of Geriatrics of The Jewish General Hospital in October 2002. The theme was “Challenging Families” and many presentations were made by our Maimonides team.

In reference to research being funded by the Maimonides Medical Research Foundation, our part-time Research Coordinator continued studies in the following areas:

  • The antibiotic evaluation study, after being successfully piloted at Maimonides, is being made available and extended to other institutions in our collaborative network. The objective is to improve the prescribing practices of physicians in long term care institutions using a therapeutic guide recommending treatments selected by infectious disease specialists.
  • The pilot project on anti-ulcer drug treatments was completed at Maimonides. The objective was to develop a useful educational tool to improve the prescribing practices of physicians at Maimonides. A grant proposal was submitted by the Research Coordinator and several collaborating physicians for funding to the FRSQ to extend the research project to other network members.
  • Data collection of an international (Israel-Canada) enteral feeding study, was completed and the data is being analyzed in Israel at this time.

Over the course of the year, at least fifty (50) presentations were given by Maimonides staff outside the facility on subjects ranging from our abuse prevention program, family dynamics, the restraint-reduction program and the healing circle.

Finally, one hundred and seventy-seven (177) students from various universities, CEGEPs and school boards were received over the year in most of our clinical service departments (7,838 stage hours, the equivalent of 4.3 FTE). Nursing students from John Abbott College and McGill University have also joined this group.

Complaints

During the year, seventy (70) people filed formal complaints resulting in a total of ninety-five (95) complaints. Nine (9) of the complaints were presented in a written manner and eighty-six (86) were represented verbally. No complaints were directed to Le Commissaire des Plaintes. The number of complaints filed this year was very similar to last year in terms of major themes and volume of complaints.

A new Complaints Examination Policy and Procedure was adopted by the Board of Directors. It reflects the changes in the complaints process according to Bill 113. In addition, a Satisfaction Survey of residents and families was created and distributed during the month of March to all residents and families. Results will be published in the next few months.

The Ombudsman also worked very closely with our Users’ Committee under the co-chairmanship of Marilyn Berman and Marjorie Black to deal with any unusual problems. As stipulated in our By-Laws, all significant complaints are brought to and discussed at the Quality Improvement/Risk Management Committee, a committee of the Board responsible for ensuring the quality of care at Maimonides.

GOAL

Integrated Geriatric Care

  • Develop intermediate resources
  • Develop links with CLSCs
  • Improve relationships with other healthcare establishments
  • Encourage the development of the continuum of care for the Jewish

community

Intermediate Resources

In September of 2002, Maimonides was asked by the Regional Board to resume the development of the intermediate resource project. As noted last year, Maimonides had been mandated to establish these resources for both the Jewish and the Anglophone populations of the city. An information session was held in November that was open to all members of the Anglophone and Jewish communities. Three (3) applications were received for intermediate resources and were analyzed by our team.

After doing a thorough evaluation, a contract was signed with the Lev Tov Seniors Residence to become the first intermediate resource for both Jewish and Anglophone clients in Montreal. Lev Tov has a capacity for twenty-five (25) Jewish clients and ten (10) Anglophone clients.

We have also been working over the past few months with Maison Paternelle which may also be designated a Ressource Intermédiaire.

These are very exciting projects which should improve the system of access to care for both Jewish and Anglophone clients in the Montreal region. Intermediate resources provide care for clients who can no longer live in their own homes or in our network of Accredited Homes but do not require the level of care that is provided at Maimonides Geriatric Centre.

Links with CLSCs

Our Accredited Home service continues in its efforts to develop links with various CLSCs in Montreal. Most of our work right now is done with the CLSCs René Cassin and Côte-des-Neiges.

Relationships with other Healthcare Establishments

Over the past year, we have begun to provide clinical nurse specialist and physiotherapy services on a regular basis to The Griffith McConnell Residence.

Respite Bed Program

In order to improve the continuum of care to the Jewish community, Maimonides is now providing respite care on a regular basis. At the request of the Regional Board, two (2) respite beds which used to open only for a four (4)-month period over the Summer, are now open on a year-round basis. Due to the success of this bed program, two (2) additional beds will be offered during the Summer of 2003.

Accredited Homes

The Accredited Home service opened three (3) new homes during 2002-2003. These homes respond to the growing need for more private rooms, spacious living arrangements and more bathrooms.

GOAL

Community Leadership

  • Encourage participation and involvement with other organizations to deal with Jewish issues
  • Improve Jewish community network of services for the frail elderly
  • Increase external visibility
  • Reinforce Jewish heritage

One of the links made this year was between Jewish Vocational Service and

the Accredited Homes. An evening of information sharing was planned to recruit members of the Jewish community to become Accredited Home managers.

External Visibility

Members of Maimonides staff are present on many committees in the region. These committees range from:

  • the Regional Commission on Nursing of Montreal
  • the Ministerial Committee on Restraint Reduction
  • membership on a committee which is revising the electric bed norms for the Bureau des Normes de Québec
  • membership on the Board of Directors of the Association of Jewish Aging Services of North America
  • membership on the Board of Directors of ASSTAS
  • membership on the Board of Directors of the Alzheimer Group
  • membership on the Search Committee of the Alzheimer Group for the Executive Director
  • Various nursing programs and liaison committees at the various CLSCs
  • The Caldwell Advisory Committee
  • Assisting Caldwell with problems in terms of their food service, etc.

Awards