Table of Contents

ANNUAL ACCESSIBILITY PLAN 2006-2007
Executive Summary
The purpose of the Ontarians with Disabilities Act, 2001 (ODA) is to improve opportunities for people with disabilities and to provide for their involvement in the identification, removal and prevention of barriers to full participation in the life of the province. To this end, the ODA mandates that each hospital prepare an annual accessibility plan.

On June 13, 2005, the Accessibility for Ontarians with Disabilities Act received Royal Assent and became law. Its purpose is to develop, implement and enforce accessibility standards. Since these standards are not yet developed, the ODA remains in force, until such time that the Act is repealed.

This is the fourth year annual plan (2006 - 2007) prepared by the Accessibility Working Group of St. Francis Memorial Hospital (SFMH). The plan describes: (1) the measures/achievements that SFMH has taken over the past year, and (2) the measures that the Hospital will take in the year (2006 - 2007) to identify, remove and prevent barriers to people with disabilities who live, work in or use the facilities and services of SFMH, including patients and their family members, employees, health care practitioners, volunteers and members of the community.

The Board of Trustees and Administration of the Hospital is committed to the continual improvement of access to hospital facilities, policies, programs, practices and services for patients and their family members, employees, health care practitioners, volunteers and members of the community with disabilities; and to the participation of persons with disabilities in the development and review of the Hospital’s annual accessibility plans.

In the first year plan (2003-2004) The Accessibility Working Group (AWG) identified 45 barriers to persons with disabilities. Our goal at that time was to address 13 barriers.

In the year (2004-2005), the working group focused on removing and preventing seven barriers that were identified in the initial inventory list.

In the year (2005-2006), our goal at the time was to address six goals. Some goals were partially met; others are ongoing and will be repeated on the 2006-2007 plan.

At the Accessibility Working Group meeting held December 13, 2006, the members reviewed the recent barrier-removal initiatives, the accomplishments for 2005-2006 and identified barriers that are still outstanding. Refer to Section 7 Table 2 for the revised inventory.

In the year (2006-2007), we will focus our attention on removing and preventing five barriers. Refer to Section 8 Table 3 Barriers identified for the 2006-2007 plan.

There has been no funding provided by the provincial government for the implementation of the ODA and this will continue to present a challenge to the hospital in its efforts to remove and prevent barriers to individuals with disabilities.

Annual Accessibility Plan 2006-2007

1. Aim
This plan describes: (1) the measures that St. Francis Memorial Hospital has taken in 2005-2006, and (2) the measures that St. Francis Memorial Hospital will take in 2006 -2007 to identify, remove and prevent barriers to people with disabilities who live, work in or use the Hospital, including patients and their family members, employees, health care practitioners, volunteers and members of the community.

2. Objectives of this plan:

1. Describes the process by which SFMH will identify, remove and prevent barriers to people with disabilities.

2. Reviews earlier efforts at SFMH to remove and prevent barriers to people with disabilities.

3. Lists the policies, programs, practices and services that the Hospital will review in the coming year to identify barriers to people with disabilities.

4. Describes the measures the Hospital will take in the coming year to identify, remove and prevent barriers to people with disabilities.

5. Describes how the Hospital will make this accessibility plan available to the public.

3. Description of St. Francis Memorial Hospital
This 27-bed hospital provides 24-hour Emergency Care, Inpatient Medical Care, Complex Continuing Care and a wide range of outpatient diagnostic and treatment services. A Primary Care Health Centre houses office space for five physicians; optometrist; geriatric mental health outreach service; a retail pharmacy; Community Care Access Center office and a dialysis unit. The Health Centre is linked to the hospital via walkway.

St. Francis Memorial Hospital is defined in the Rural and Northern Healthcare Framework as a rural and isolated hospital. The Hospital has almost 45,000 patient visits per year, 125 employees, 36 volunteers including the Hospital Auxiliary Volunteers, 6 physicians with admitting privileges, and 63 physicians with hospital privileges. The catchment area includes the townships of South Algonquin, the Madawaska Valley, Killaloe and Hagarty/Richards, and areas of Hastings Highlands and the Bonnechere Valley. The population catchment of about 10,000 people swells to 30,000 in the summer months due to recreational attractions such as Algonquin Provincial Park.

4. Hospital Commitment to Accessibility Planning

St. Francis Memorial Hospital is committed to:

• The provision of quality services to all patients and their family members and members of the community with disabilities
• The continual improvement of access to facilities, policies, programs, practices and services for patients and their family members, employees, health care practitioners, volunteers and members of the community with disabilities through the identification, removal and prevention of barriers
• The participation of people with disabilities in the development and review of the Hospital’s annual accessibility plan
• Ensuring hospital by-laws and policies are consistent with the principles of accessibility

5. Establishment of the Accessibility Working Group

Cathy Pecarski was appointed the Accessibility Coordinator by Darlene Sernoskie, Director of Hospital Operations in December 2003.

The Accessibility Coordinator will be identified as the main contact person for inquiries and issues related to barriers and accessibility.

The Working Group is authorized to:

• Review and list by-laws, policies, programs, practices and services that cause or may cause barriers to people with disabilities
• Identify barriers that will be removed or prevented in the coming year
• Describe how these barriers will be removed or prevented in the coming year
• Include people with disabilities and others in identifying barriers and preparing the accessibility plan to prevent, and remove barriers
• Prepare a plan on these activities, and after its approval by the Board, make the plan available to the public

ST. FRANCIS MEMORIAL HOSPITAL
ACCESSIBILITY WORKING GROUP
5 (a) Members of the Accessibility Working Group (AWG) 2006-2007

ACCESSIBILITY WORKING GROUP

5 (b) TERMS OF REFERENCE

Purpose: To assist St. Francis Memorial Hospital to fulfill its obligations under the Ontarians with Disabilities Act, 2001. Assisted by an Accessibility Planning Coordinator, the Accessibility Working Group will develop, review, implement, publish and evaluate an annual accessibility plan for the identification, prevention and removal of barriers to persons with disabilities.

Goal: To prevent or eliminate barriers which may exist in our facilities, policies, programs, practices and services for the following persons with disabilities: patients, family, volunteers, employees, health care practitioners, members of the community.

Members: Managers, trustees, volunteers and employees will participate as standing or ad hoc members of the working group. Persons with disability and others from the community will participate as standing or ad hoc members.

Functions:

• Review and list by-laws, policies, programs, practices and services that cause or may cause barriers to clients, employees, volunteers or health care providers with disabilities
• Identify barriers and set priorities for barriers that will be removed or prevented in the coming year;
• Develop key actions for the removal or prevention of these barriers in the coming year
• Include people with disabilities and others in identifying barriers and preparing the accessibility plan
• Prepare a plan to prevent, and remove barriers, and after its approval by the Board, communicate the plan to the public
• Review objectives of the previous year and monitor and report on progress in implementing the accessibility plan
  

6 a.) Recent barrier removal initiatives for 2005-2006
The Accessibility Plan was approved by the Board of Trustees in January 2006. The Plan was posted on the St. Francis Memorial Hospital website and hard copies were made available in the main lobby; the waiting rooms and patient care areas.

During the last year, there have been a number of initiatives at St. Francis Memorial Hospital to identify, remove and prevent barriers to people with disabilities. Refer to Table 1.

In December 2006, the Accessibility Working Group met to review our objectives and ascertain whether barrier-removal and barrier-prevention strategies were being implemented effectively and on time. The inventory list of identified barriers was also reviewed at this time.

Our goal for 2005-2006 year plan was to address 6 barriers. To date, one barrier was removed and two barriers have been partially addressed.

Three barriers are still outstanding due to limited financial resources. These barriers involve 1) installation of automatic door openers or motion sensors to the doors linking the hospital to the Health Center 2) installation of handrails in designated areas of the hospital. The Accessibility Working Group recommends that these (2) barriers be considered during the hospital’s capitol planning for 2006-2007. The third barrier involves replacement of the physiotherapy door, which will be considered for the 2007-2008 Accessibility Plan.

The hospital signage working group identified priority areas for signage upgrades in the 2004-2005 Plan. These upgrades were completed in the spring of 2006.

As hospital brochures are being revised, letter size, typeface and approved stationary colour will comply according to CNIB standards. Our goal is to have hospital brochures standardized by the year 2008.

Staff education and sensitivity training relevant to individuals with developmental and emotional disabilities has been partially addressed. A survey was distributed to all hospital departments in December 2006 to identify staff education and training needs. Staff responses to the survey indicated an interest in these topics in addition to development of effective communication skills in dealing with individuals with depression and suicidal tendencies. The Accessibility Working Group recommends that Madawaska Valley Association for Community Living be contacted for suggestions relating to these topics as well as Mental Health Services.

Other:

During the 2005-2006 year, additional barrier- removal initiatives were taken, ensuring ongoing adherence to the Disabilities Act:

• Installation of (2) bariatric patient ceiling lifts on the Medical Unit and the Emergency Department for physically impaired patients with a higher body mass index, ensuring safety for both patients and staff;
• Installation of a patient ceiling lift in the bath area;
• Equipment needs arising from ergonomic assessment (s) recommendations were supported through the operating budget. For example: purchase of an automatic floor scrubber/polisher; ergonomic chairs; ergonomic cleaning tools purchased for the Environmental Services Department.

The above purchases are of assistance to patients, but they have also allowed some staff with physical work restrictions to return back into the SFMH team.

• Upgrades to the hospital’s fire alarm and security systems;
• Education sessions on the Return to Work Program (RTW), to enhance staff understanding of modified work plans for their colleagues requiring permanent or temporary accommodations in the workplace;
• Patient information handbook on Complex Continuing Care services, includes information on the Ontarians with Disabilities Act and the contact person responsible for addressing complaints and suggestions on behalf of the Accessibility Working Group.

b.) Review of complaints and suggestions

The Accessibility Coordinator conducts a comprehensive review of each complaint or suggestion and identifies corrective action in consultation with the Director of Operations and the Accessibility Working Group members.

In the year 2005-2006, we have not received any complaints or suggestions regarding accessibility for disabled individuals.

ST. FRANCIS MEMORIAL HOSPITAL

6 C) 2005- 2006 RECENT INITIATIVES AND SUCCESSES IN IDENTIFYING, REMOVING AND PREVENTING BARRIERS (Table 1)

Type of Barrier
Description of Barrier and Location
Strategy for removal/prevention

PHYSICAL
Difficulty transferring persons with functional/physical disabilities Equipment not available for transferring patients with a higher body mass index from ambulance stretcher to a bed Installation of a bariatric patient ceiling lift in the Emergency Department and a second lift installed on the Medical Unit
Completed in the Fall of 2006

Difficulty transferring persons with functional/physical disabilities Equipment not suitable for transferring patients with functional/physical disabilities from chair/bed into the tub Installation of a patient ceiling lift in the bath area
Completed in the Fall of 2006

Accommodating employees with physical limitations and work restrictions Limited adaptive and ergonomic equipment in Environmental Services Ergonomist assessments conducted in Environmental Services and Nursing
Physical Demands Analysis conducted in Environmental Services and the Dietary Department.

Ergonomic equipment purchased for Environmental Services

Completed in 2005-2006

Type of Barrier Description of Barrier and Location Strategy for Removal/Prevention
INFORMATIONAL
Inconsistent signage throughout the hospital
Lack of signage in some areas of the hospital

Inconsistent signage throughout the hospital for location of departments, clinics, etc. Signage in some locations is of low contrast and small font size.
A more visual prompt required to direct patients to Admitting and/or Emergency Department
A signage working group was established in 2004-2005 to review existing signage and identify areas requiring signage and/or replacement. A list of priority areas for additional signage and replacements were reviewed by the AWG and estimates were received.
Signage upgrades completed

Patient information on hospital brochures not clear or easily understood

Letter size; typeface and technical terms inconsistent for individuals with visual impairment and/or language difficulties

Brochures are being standardized as they are being revised. White stationary and black lettering will apply to hospital brochures.
This process is ongoing

Limited patient information on the Ontarians with Disabilities Act Patients not aware of the Ontarians with Disabilities Act; the hospital’s commitment to accessibility planning and the process of reporting complaints and/or suggestions Patient information handbook includes information on the Act and the contact person responsible for addressing complaints and suggestions
Completed

ATTITUDINAL
Limited staff knowledge of the Return to Work Program; Modified Work Plans and Employer’s responsibilities On occasion, staff not accepting of colleagues who require work accommodations Education sessions on the RTW Program, held for the environmental service staff and nursing in the Summer of 2005 and a repeat session held in the Spring of 2006

Completed

Limited staff experience on how to effectively communicate with individuals with developmental and/or mental disabilities Staff not aware how to best communicate with an individual with developmental and/or mental disabilities A survey was conducted in all departments in December 2006 to identify staff education and training needs. Education and sensitivity training planned for 2007.
Partially addressed

OTHER
Physical Fire Alarm and Security Systems upgraded in 2006

ST.FRANCIS MEMORIAL HOSPITAL (Table 2)

7. CURRENT BARRIER INVENTORY (REVISED: DECEMBER 2006)

Type of Barrier Description of Barrier and Location Strategy for removal/prevention
1. Physical, Architectural

Patient rooms on the Medical Unit are too small to permit persons using wheelchairs to be independently mobile. Identify individual patient needs for additional space when assigning room and develop strategies to address this need.
2. Architectural

The majority of washrooms on the Medical Unit are too small and not accessible for persons requiring mobility aids. Renovate to allow access by walker or wheelchair.

3. Architectural

No wheelchair accessible public bathroom on the second floor.

Renovation to ensure one barrier-free washroom accessible to disabled persons is being planned for 2007.
4. Physical
High gloss floor tiles create glare for persons with low vision. Explore low-gloss floor waxes. Select low-gloss flooring materials when replacing floor tiles.
Replacement of floor tiles on the Medical Unit is planned for in 2007.

Type of Barrier Description of Barrier and Location Suggested Strategy removal/prevention
5. Physical
Entrance door to Physiotherapy is heavy and difficult for frail persons or persons using mobility aids to open, and hold open while passing through. Installation of a power door operator will be considered for the capitol equipment list in 2008.
6. Physical Dim lighting (pot lights) in lobby vestibule outside physiotherapy, business office and E.R. entrance from lobby. Poor lighting at public telephone in this area. Replace with fluorescent or other lighting enhancement.
Consider light over public telephone in this location.

7. Physical

Main entrance doors involve entering through two heavy doors. Many frail or disabled persons require the use of automatic door controls. The controls are located 800mm (2.5 ft.) from entrance. Persons in wheelchairs must manoeuvre to press button, manoeuvre to doorway, enter, and then repeat for next set of doors. The power button does not always activate the door.

Explore options: system whereby both doors open when one button is activated; move control pads closer to entrance; increase sensitivity of control pads; increase the time interval for the door to remain open; automatic sensor devices to open doors
8. Architectural

Patient washroom room 207 and 211 on Continuing Care not wide enough for wheelchair or geriatric chair to access. Angular design of building and sliding bathroom doors do not allow for renovations. Consider patient needs when allocating room.
Type of Barrier

Description of Barrier and Location Suggested Strategy removal/prevention

9. Physical

Handrails in several areas of the hospital lack colour contrast and persons with low vision would have difficulty locating them. Determine which areas require enhanced contrast. Explore other options such as coloured tape, painting, and stripe on wall. Some handrails have fluorescent lighting tubes under the railing that have burned out, or have been removed. Explore whether this is a viable option.

10. Physical
Handrail design does not provide ease of use for persons with loss of manual dexterity. (difficult to grip) Any new handrails installed in hospital should be designed to allow ease of grip.

11. Physical
There are no handrails in the corridor from Diagnostic Imaging to Maintenance on the main floor. Railings are not continuous/complete on the Medical Unit.

Install full handrails at least in the areas where many outpatient services are located. Install full railings on the Medical Unit.
Barrier # 9, 10 and 11 will be addressed in 2007

12. Informational/ Communication

Type of Barrier
Prepared materials for patient information may have print or language difficulties due to size and technical terms.

Description of Barrier And Location
As brochures are revised, employ ‘clear language’ and CNIB standards for low vision. Signage should indicate that
Suggested Strategy removal/prevention brochures are also available in alternate formats upon request. (audio or large print)

Ongoing

13. Informational

Communication
Intercom announcing of all code procedures are auditory alarms only. Persons with hearing impairment would not be able to hear.

Investigate the possibility of incorporating a visual component into the current alarm system i.e. strobe lights in the primary areas.
Invite resource person from Ontario Society for the Deaf to complete audit tour of SFMH.

14. Attitudinal

Individuals with a mental health disability may not receive the same treatment. Education and sensitivity training of staff in 2007.

15. Attitudinal

Staff not aware how to best communicate with an individual with developmental disabilities. Education and sensitivity training for staff in 2007.

16. Bylaws

Barriers to persons with disabilities may exist in the Hospital Bylaws. Board Governance Committee to review the Hospital Bylaws in 2007.

17. Physical
Poor outside lighting in area from Physiotherapy Department to Ambulance area. Explore installation of additional lighting.

Type of Barrier
Description of Barrier and Location Suggested Strategy removal/prevention

18. Policy, Practice

Barriers to persons with disabilities may exist in human resources and personnel policies.

Human Resources Department to undertake a review of recruitment, hiring, interviewing, and accommodation policies to ensure barriers are removed.
Commit to accessibility in the SFMH Values Statement, and develop a Statement of Accommodation.

19. Physical
In front parking lot area, persons using mobility devices must pass behind cars. There is no barrier-free bath of travel for individuals who wish to spend time outdoors, or to smoke 9 m. from front entrance. Cement parking curbs obstruct the only outside path. Bicycles and scooters are parked in front of main entrance creating further obstructions. Establish defined barrier-free path of travel outside main entrance.

Designated parking area for scooters will be considered during re-paving of parking lot.

20. Attitudinal

Staff not aware of barriers encountered in day-to-day life of persons with disabilities. Education and sensitivity training of staff in 2007.
Type of Barrier
Description of Barrier and Location Suggested Strategy removal/prevention

21. Physical
Dining Room Tables on Continuing Care Unit are too high for many patients. Overbed tables cannot be adjusted low enough for many patients who are of smaller stature and/or cannot raise their arms or shoulders due to their medical condition. Explore options such as cushions or higher seating. When replacing, explore more adjustable overbed tables and adjustable dining room tables.

22. Physical
Entrance door to Physiotherapy is heavy and difficult for frail persons using mobility aids to open, and hold while passing through. Explore option: adjustments to the door and/or automatic door opener.

Will be considered during hospital capitol planning in 2008.

Barriers for removal will be selected from the inventory annually and the list will be updated at this time.

ST. FRANCIS MEMORIAL HOSPITAL
8. Barriers that will be addressed 2006–2007 (Table 3)
The Accessibility Working Group will address five barriers during the coming year.

Barrier
Objective
Means to remove/prevent
Performance criteria
Resources
Timing
Responsibility

Doors linking the hospital to the Health Centre are difficult to open for individuals using mobility aids, to open and hold while passing through.
Doors linking the hospital to the Health Centre will be accessible to persons with disabilities.
Explore option:
Automatic door openers.

Installation of motion sensors.

(3) automatic door openers are required.
Individuals with disabilities will be able to open doors to the hospital and the Health Centre, independently.

Financial Human Resources
Automatic door openers or motion sensors will be considered in 2007. Dir. Of Hospital Operations;

Maintenance

There are no handrails in the corridor from Diagnostic Imaging to Maintenance on the main floor. Railings are not continuous on the Medical Unit for individuals with mobility impairment and/or loss of manual dexterity (difficult to grip). Railings will provide ease of use and security/safety for persons with mobility impairment and loss of manual dexterity. Explore options: design and colour contrasts

Individuals with disabilities will feel more confident and safe, walking down the corridor.

Financial
Human Resources
Install additional handrails in designated corridors by the end of the next fiscal year (2006-2007). Dir. Hospital Operations;
Maintenance;

Physiotherapy

Barrier Objective Means to remove/prevent Performance Criteria Resources Timing Responsibility
Barriers to persons may exist in the hospital by-laws. Knowledge of the ODA 2001 and AODA (Accessibility for Ontarians with Disabilities Act).
Maintain awareness and compliance with the Acts.
Review of the Hospital’s by-laws Hospital by-laws are consistent with the principles of accessibility. August 2007. Board Governance Committee
Director of Operations

Tables in the patient’s dining room are too high to accommodate some patients of smaller stature and/or have limited function of their arms or shoulders. Tables will be accessible to patients experiencing various degrees of physical impairment. Explore options:
Chair cushions

Purchase of adjustable tables.
Upgraded furniture in the patient’s dining room will facilitate hospital’s commitment to accessibility. Financial Replace 1-2 tables
August 2007.
Director of Operations
Hospital Foundation

Staff not aware how to best communicate with persons who have developmental, or mental health disabilities; may not be aware of barriers faced in day-to-day life. Enhance staff understanding of the needs of the disabilities and difficulties experienced by individuals. Develop an education plan: arrange an employee sensitivity awareness training workshop by the Coalition of Persons with Disabilities and/or MVACL. And Mental Health Services All staff will be aware of ways to accommodate patients, visitors and staff with developmental or mental health disabilities Financial
Human Resources
By June 2007 Accessibility Coordinator
Inservice Education

ST. FRANCIS MEMORIAL HOSPITAL

ANNUAL ACCESSIBILITY PLAN

2006-2007

9. Review and Monitoring Process

The Accessibility Working Group established priorities for the coming year and will meet biannually (May and November) to review progress in achieving objectives. At each meeting, the AWG will receive an update on the progress of the objectives in the accessibility plan from managers or departments responsible for follow-up. The Accessibility Coordinator will also commit to updating the Director of Hospital Operations on a regular basis. Organizations and individuals that provided input into barrier identification will be invited to participate in evaluation.

10. Communication of the Plan

The final draft will be submitted to the Accessibility Working Group, and then to the Board of Trustees for approval. The Accessibility Plan will be posted on the St. Francis Memorial Hospital website and hard copies will be available throughout the organization, the main lobby of the hospital and upon request from the Accessibility Coordinator. The Plan will be made available in alternative formats upon request, such as Braille, computer disk in electronic text, audiocassette or in large print.