Annual Report 2017-18
A Message from our Leaders
From advances in genetics and AI to our award-winning fundraising campaign, our leaders reflect on a momentous year at SickKids – and what lies ahead. Read our full leaders' letter from our CEOs and Board Chairs.
All In for SickKids
SickKids needs a new hospital. And Toronto is All In.
We'll Be Able to See Cancer Coming
New machine learning techniques are revolutionizing the way we diagnose and treat Li-Fraumeni syndrome.
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At the age of 29, Amy was diagnosed with thyroid cancer. At 36, it was incurable, stage four metastatic breast cancer. Her doctors weren't convinced this was just horribly bad luck, and their suspicions were confirmed by the results of a research trial that Amy had been enrolled in. The genetic testing revealed that Amy had Li-Fraumeni syndrome (LFS), a hereditary predisposition to cancer. At 38, Amy also underwent surgery for lung cancer.
Patients with LFS carry a mutation in a key cancer-fighting gene, called p53, which guarantees them over a 90 per cent lifetime risk of developing cancer.
One of Amy's two daughters has also tested positive for LFS, and is now part of a surveillance program at SickKids. She undergoes blood work and an abdominal ultrasound every three months, and a full-body MRI every year. "My daughter has the opportunity to be watched closely. It's better that we know what we're dealing with so she can be monitored," Amy says.
Dr. David Malkin, Director of the world-leading Cancer Genetics Program at SickKids and Principal Investigator of a multi-disciplinary team studying LFS, agrees. "We're picking up tumours early and intervening, so that the likelihood of survival is far greater," he says. "At the same time, we're working to uncover how to predict which LFS patients will get what type of cancer, when, and how to suppress and prevent it."
With the help of machine learning, a type of artificial intelligence whereby computers "learn" from data, we are transforming research for the treatment of LFS. This year, Anna Goldenberg, Senior Scientist in the Genetics and Genome Biology Research Program at SickKids and Canada Research Chair in Computational Medicine, applied machine learning to data from DNA blood samples to help decipher whether a child with LFS is likely to get cancer before the age of six. "This has significant potential to improve screening protocols in early childhood, sparing patients and their parents from the burden of invasive testing if their cancer onset is predicted to be after the age of six," says Anna.
So far, Amy's daughter is cancer-free. But for current cancer patients, and for those who one day will be, machine learning strategies are helping us to see cancer coming. Amy is very open with her daughter. "We talk a lot about our health," Amy says. "Because of the amazing work being done at SickKids, I am confident when I tell her, 'your story can be very different than mine.'"
Our Digital Revolution
SickKids does away with the disjointed systems and paper charts in exchange for a seamless, state-of-the-art health information system.
Changing Lives With In-Utero Surgery
Innovative in-utero surgeries are healing babies like Eiko and Sebastian before they're born.
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Early in her pregnancy, Romeila's unborn child was diagnosed with myelomeningocele, a form of spina bifida where the spinal column fails to close early in fetal development. At only 25 weeks gestation, an expert team from SickKids and Mount Sinai Hospital performed the first-in-Canada in-utero surgery to significantly reduce the risk of permanent damage to the spinal cord and nervous system and improve the child's chance of walking independently.
Romeila recovered well from the surgery, and baby Eiko was born at 36 weeks gestation. Since her birth, Eiko has been healthy and needed no further intervention for what is typically a debilitating condition. This is the first case in Canada where the mother has not had to travel to the United States for this life-changing surgery.
Like Eiko, baby Sebastian also had surgery before he was born – surgery that likely saved his life. He was diagnosed prenatally with a severe form of a congenital heart defect called Transposition of the Great Arteries (TGA), which can be surgically repaired after birth. But, Sebastian had another complication: the walls of his heart were closed shut. Without in-utero intervention, Sebastian would have required emergency intervention within minutes of his birth to avoid brain damage, stroke, or death.
To spare Sebastian and his mom a traumatic delivery, the surgical team from SickKids and Mount Sinai Hospital inserted a balloon into Sebastian's heart five days before he was born. It is believed that this is the first time in the world that this procedure – a balloon atrial septoplasty – has been performed before birth to treat this particular condition. Then, at a week old, Sebastian was able to undergo a successful surgery at SickKids to fix his TGA.
Together, Mount Sinai and SickKids perform more than 100 in-utero fetal surgeries and procedures every year. This work will be further supported by Government of Ontario funding for the provincial Ontario Fetal Centre, a collaboration between Mount Sinai and SickKids and the only centre of its kind in Canada. Eiko and her family were at the announcement to celebrate and to support the bright future of fetal care at SickKids.
Partners in Mental Health
To meet Ontario's surging demand for child and youth mental health care, we're going to need all our friends – and make new ones.
From birthdays to first steps, SickKids is often the backdrop to our patients' and families' lives. In this section, we celebrate the everyday moments – big and small – of the children, families, staff and volunteers who make up the fabric of life at SickKids.
Follow us on Facebook and Instagram to catch more of our everyday moments as they happen!
By The Numbers
Total Staff and Volunteers: 11,237
|2,429||Management and support|
|375**||Project Investigators and Team Investigators|
|792||Research staff (primarily grant funded)|
|232||Research Operations staff|
|162||Core Facilities research staff|
** Staff who spend less than 50% of time on research activities are also counted within hospital Operations and Clinical Care numbers.
|513||Research graduate students|
|369||Research summer students|
|986||Medical Affairs residents and fellows|
|570||All other clinical and corporate trainees|
|267||Women's Auxiliary Volunteers (WAV)|
|294||Average number of beds occupied daily|
|6.26||Average length of stay (in days)|
|235,542||Total clinic visits|
|316,021||Total ambulatory visits|
|6,949||Inpatient and same-day admit cases|
|12,529||Total OR cases|
Our Quality Improvement Plan (QIP), which outlines our quality and safety priorities, represents our commitment to ensuring the care and services we provide are accessible, effective, safe, patient-centred, and promote an integrated health system. In accordance with the Excellent Care for All Act, we post our QIP publicly and submit it to the provincial government so they can improve care across the health system. Data reported is based on calendar year (January to December 2017). To see the 2017-18 progress report, visit www.sickkids.ca/qip.
|Effective: Percentage of eligible nurses who have completed the Sepsis Education Bundle|
|Efficient: Average Length of Stay for the lowest 99% of inpatient stays|
|Timely: Percentage of patients admitted from the ED that exceed the 12-hour service standard|
|Safe: Serious Safety Event Rate (Rate per 10,000 adjusted patient days)|
|Safe: Central Line Associated Blood Stream Infections (CLABSI) - for PICU, CCCU, NICU, 4D, 6AE, 8AE rate per 1,000 central line days|
|Patient-centred: Inpatient communication survey (Completed by guardian) (Survey focused on satisfaction around communication with emphasis on patient safety)|
Hospital financial highlights for the year ended March 31, 2018
SickKids is committed to operational efficiency, transparency and accountability. We support evidence-based decisions to enhance our financial health, conduct business under the principle of fiscal prudence and act with integrity and good judgment when allocating resources.
The hospital continues to maintain its financial health. Excess of revenues over expenses contribute positively to the hospital's net assets, which are then reserved for specific purposes or reinvested into operations and capital investments aligned with the hospital's strategic priorities.
Financial highlights for the year ended March 31, 2018
SickKids Foundation is committed to the highest standards of accountability and transparency. We were among the first nationally-accredited charities under Imagine Canada's Standards Program.
|Gross fundraising program revenue and net lottery revenue||$147.8 million|
|Total grants and charitable activity||$141.4 million|
|Fundraising and administrative expenses||$48.5 million|
Investment Asset Growth Summary Since 1995 (IN MILLIONS)
|Opening Market Value, March 31, 1995||148|
|Net Contribution (Withdrawal)||(80)|
|Investment returns, Realized gains, and Unrealized appreciation||1,132|
|Cumulative Return from Investments||1,132|
|Ending Market Value, March 31, 2017||1,200|
Unrestricted giving creates impact where it's needed most now, and where it's headed next.
We can plan for the future, but we can't predict it.
That's why SickKids needs unrestricted giving: donations without any constraints on how they're allocated. This gives the hospital the flexibility to deploy funds in the areas of greatest need to deliver the greatest impact, now and in the future.
Unrestricted giving is the bedrock of big ideas and breakthroughs.
It's what powers the Centre for Genetic Medicine, which uses tools like genomic sequencing to better understand and diagnose rare diseases. It's what funds social worker scientist Dr. Samantha Anthony, who's working to improve paediatric transplant patients' quality of life. And it's what supports Head of Neurosciences and Mental Health Dr. Donald Mabbott, who's using neuroimaging and psychological testing to learn how tumours, surgeries, and chemotherapy affect the way patients think, learn, and feel.
Unrestricted giving helps ensure that kids get the right drugs at the right time. It's what allowed the hospital to fund Program Dose, a multi-year tech transformation program to improve the safety and efficiency of drug distribution at SickKids. Unrestricted giving is what helps fund the Centre for Brain & Mental Health, whose interdisciplinary teams work together to treat everything from severe epilepsy to obsessive compulsive disorder.
From conference sponsorships to community conference grants, unrestricted giving funds information sharing between health professionals, community groups, and families. And for early-career researchers, unrestricted giving funds the New Investigators Research Grant Program, which supports the next generation of rising stars in children's health.
We would like to recognize the following individuals whose cumulative contributions have reached or exceeded $25,000, and those corporations, foundations, associations and community events that have generously contributed $50,000 or more, between April 1, 1993 and March 31, 2018. We are profoundly grateful for your support. We also wish to thank those donors who have chosen to remain anonymous.