2016-17 Q1 Report on Strategic Plan June 28, 2016 Housekeeping - - PowerPoint PPT Presentation

2016-17 Q1 Report on Strategic Plan June 28, 2016

Housekeeping

• Washrooms located on the left wall
• WiFi connectivity is limited
• Documents are available on USB at

registration

Strategic Reporting

• Q1 Report on

Strategic Plan

• Current year

course correct

Q1

• Q2 Report on

Strategic Plan

• Review inputs

into next year plan

Q2

• Q3 Report on

Strategic Plan

• Finalize next year

plan

Q3

• Year end report

(annual report)

• Celebrate

successes

Q4

Provincial Outcomes & Targets Clinical Best Practice Budget

Risks/Gaps/Challenges

Other E-Scan Data

Accred. Standards

CIHI Data

Patient, Staff, and Physician Feedback

Strategic Planning Inputs 

We are here

Objectiv Objectives es of Q1 Report

• f Q1 Reporting

ing Day Day

• Q1 Report on Strategic Plan
• Current year course correct
• Key Initiative discussion
• Learning Opportunity: Examples of Daily Visual

Management (DVM) using effective communication

CEO Introduction

Mike Higgins for Keith Dewar

Welcome and Introductions

Welcome

– Patient Representatives, Board of Directors, Senior Leadership Team, Department Head Council, Executive Directors, Directors, Managers, Affiliates, and Provincial Colleagues

Our Purpose

Why we are here

Strategic Hierarchy Government of Saskatchewan Ministry of Health Regina Qu’Appelle Health Region Provincial Health System

Patient, Staff and Physician Input

Patients, Clients, Residents and Families Patients, Clients, Residents and Families

Provincial Strategic Plan

Provincial Hoshin

• To improve access for patients and

reduce ED waits by 60%, necessary improvements in key areas (primary health care, specialist consults, diagnostics, mental health & addictions, long term care, home care, and acute care) will be achieved by 2019.

• ED Waits and Patient Flow
• Appropriateness
• Access to Specialist and

Diagnostics

• Mental Heath and Addictions
• Primary Health Care
• Seniors
• Culture of Safety
• Bending the Cost Curve

RQHR Strategic and Business Plan

The Strategic Plan summarizes the direction from the Regina Qu’Appelle Regional Health Authority (the Board). The Business Plan is the Region’s

• ne‐year operational work plan that

guides us towards achieving the goals and targets that have been

• utlined in the Strategic Plan.

Cascading Plans are worked on by the teams who can contribute to the success of the initiative.

RQHR Strategic Areas of Focus

Quality and Safety

• Everyone has a right to expect safe, quality health.

Access/Patient Flow

• Access to the right care, in the right place, at the right time, by

the right provider is a cornerstone of high quality care.

System Sustainability

• Using our people, infrastructure, and financial resources

responsibly to build a strong health care foundation now, and into the future.

2016-17 Operating Budget Allocation

RQHR 2016-17 operating budget is approx. $1.05 billion.

• RQHR’s MoH funded base operating grant increased by 3.5 per

cent to $936 million this year.

• New funding highlights:
• $17.8M compensation funding to address collective bargaining

increases

• $9.247M inflation funding
• $4.7M for amounts previously received as special payments now

included in our base operating grant.

• New targeted funding of $20M provincially to increase surgeries and

decrease wait times (RQHR portion unknown at this time).

• Commitment to maintain the targeted funding for reducing ED waits.
• Other targeted funding for specific programs still to come

2016-17 Capital Budget Allocation

Capital funding highlights

• MoH - $2.8M for capital equipment, which represents no change

from last year

• MoH - $6.1M to begin electrical renewal projects at the Regina

General and Pasqua Hospitals

• MoH - $7.9M for life safety and emergency infrastructure

funding which is an increase of $2.6M from last year

• MoH - $1.0M Tertiary capital grant
• HRF - $6.0M equipment, research and education funding

2016-17 Budget Challenges

• Continued fiscal mandate to balance our budget
• Delay in release of provincial budget resulting

in final RQHR departmental operating budgets not being finalized until late July

• Despite increases in capital funding this year,

still have significant needs unmet in infrastructure (facilities, equipment and information technology)

• Budget direction to reduce RHA administration

expenses and re-invest savings

• RQHR allocation is $1.464M
• Special Commissioner to be appointed to lead

recommendation development on transformational change opportunities for the provincial health system

Quality and Safety

David McCutcheon & SLT

Key Message

• Quality and Safety is everyone’s
• responsibility. Our goal is to ensure the

safety of all those who use our services and provide care within it.

Quality and Safety Multi-year Outcome

Multi-year Outcome

• To achieve a culture of safety, by 2020,

there will be no harm to patients, clients, residents, staff or physicians (Provincial Outcome)

2016-17 Board Measures and Targets

• Surgical Site Infection Rate of 6 Procedures
• Coverage rate for diphtheria-pertussis-tetanus

(DPT) for two-year olds residing in RQHR, Regina, and Rural

• Coverage rate for measles-mumps-rubella

(MMR) for two-year olds residing in RQHR, Regina, and Rural

• # of Falls resulting in harm (code 3 and 4)
• Hand Hygiene Audit Regional Compliance

Rate

• # of Workers' Compensation Board Claims

(WCB) per 100 FTE

No Audit in Q1

2016-17 Interim RQHR Business Plan Quality & Safety ITL

Hard copies on tables

Planning Implementation

Quality & Safety

Legend:

Planning Implementation Initiative Lead

27 25 29 26 31 28 26 30 27 27

Implement Region Wide Stop-the-Line Program Higgins Develop and Implement Comprehensive Medical Quality Plan McCutcheon / Garratt Develop Medication Reconciliation Program on Admission, Discharge and Transitions Besse / McCutcheon Implement Antimicrobial Stewardship Program McCutcheon Improving the Appropriateness of Care in RQHR McCutcheon Personal Protective Equipment Initiatives - Horizontal Infection Prevention and Control Strategy McCutcheon Implement Open Family Presence Policy Dewar/Higgins Implement Violence Prevention Policy Higgins Launch Computerized Provider Order Entry using SunRise Clinical Manager (SCM) Order Management Klassen Feb-17 Mar-17 Jun-16 Oct-16 Nov-16 Dec-16 Jan-17 Jul-16 Aug-16 Sep-16

2016-17 Quality & Safety Initiatives

Implement Region Wide Stop-the-Line Program

SLT Lead: M. Higgins

• Official rollout began in April
• Implementation will continue throughout this
• year. Asking leaders in all areas to:

– Educate your team – Lead by example – Help create a culture of safety

• Goal: Embed STL into daily practice.

2016-17 Quality & Safety Initiatives

Implement Violence Prevention Policy

SLT Lead: M. Higgins

• Policy rolled out since Sept. 2015
• Policy calls for training programs which is also

identified by Accreditation Canada and by the Ministry of Labour Relations and Workplace Safety.

• Target: 75% employees oriented by March 31,

2017

2016-17 Quality & Safety Initiatives

Develop and Implement Comprehensive Medical Quality Plan

SLT Lead: D. McCutcheon

• Milestone Chart in place
• Data Management
• Symbiosis with Culture of Accountability

2016-17 Quality & Safety Initiatives

Improve the Appropriateness of Care in RQHR

SLT Lead: D. McCutcheon

• Progresses:
• Challenges:

2016-17 Quality & Safety Initiatives

PPE Initiatives – Horizontal Infection Prevention and Control Strategy

SLT Lead: D. McCutcheon

• Education
• Maintenance of Competence
• Accountability for Hand Washing

2016-17 Quality & Safety Initiatives

Develop Medication Reconciliation Program on Admission, Discharge and Transitions

SLT Lead: J. Besse/ D. McCutcheon

• Progresses:
• Challenges:

2016-17 Quality & Safety Initiatives

Implement Open Family Presence Policy

SLT Lead: K. Dewar

• Provincial initiative that supports PFCC
• Once fully implemented family will be

welcome in our facilities 24/7

• RQHR support team is in place
• Audit measures in place provincially

Questions/Discussion

Lunch Break

LUNCH BREAK We will resume at 1300 SHARP!

Access/ Patient Flow

John Ash & SLT

Key Message

• Enabling the patient to get access to the

right care, in the right place, at the right time, by the right provider is a cornerstone of high quality care.

Multi-year Outcome

• To improve access for patients and reduce ED

waits by 60%, necessary improvements in key areas (primary healthcare, specialist consults, diagnostics, mental health & addictions, long term care, home care, and acute care) will be achieved by 2019 (Provincial Hoshin)

2016-17 Board Measures and Targets

• ED LOS at 90th Percentile – All Patients
• Seniors Plan current state, future state and

gap analysis

2016-17 Interim RQHR Business Plan Access/Patient Flow ITL

Hard copies on tables

Planning Implementation

Access / Patient Flow

Legend:

Planning Implementation Initiative Lead

27 25 29 26 31 28 26 30 27 27

Evaluate Accountable Care Unit Pilot and Further Replication Decision McCutcheon/Dewar Improve Transition Points for Clients Earnshaw Establish Community COPD Pathway Earnshaw Implement Centralized Referral Management for Mental Health & Addictions Redenbach Implement Electronic Clinical Documentation for Mental Health & Addictions Redenbach Complete a Senior's Strategy Gap Analysis Redenbach Reduce Inpatient Wait for Surgery Garratt Establish Early Pregnancy Assessment Clinic (EPAC) Garratt Implement a Standardized Medicine Inpatient Nursing Program McCutcheon Reassess the alignment of Emergency Department (ED) Physician and Nursing Resources to meet ED Demand McCutcheon Reassess the alignment of Diagnostic Imaging/Lab/Porters/Unit Support Workers/ Environmental Services Workers to meet ED Demand Besse/Carlson Implement New Model for General Internal Medicine Physician Service McCutcheon Enhance Medicine Bed Capacity Redenbach/McCutcheon Dec-16 Jan-17 Feb-17 Mar-17 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16

2016-17 Access/ Patient Flow Initiatives

Evaluate Accountable Care Unit and Further Replication Decision

SLT Lead: D. McCutcheon

• 4A & MSU staff concern
• Data to date
• Massive transformation

2016-17 Access/ Patient Flow Initiatives

Reassess the Alignment of ED Physician and Nursing Resources to Meet Demand

SLT Lead: D. McCutcheon ED Over Crowding:

• Place: too small
• Resources: too few
• Flow: Admit no Bed

2016-17 Access/ Patient Flow Initiatives

Enhance Medicine Bed Capacity

SLT Lead: M. Redenbach/ D. McCutcheon

• Clearly identified need for additional Medicine

beds – even if all of the other patient flow improvements are successful.

• Primary solution will be converting Unit 5D at

Pasqua Hospital to a Medicine Unit.

• Will continue to look at other opportunities to

create Medicine capacity in the system.

2016-17 Access/ Patient Flow Initiatives

Improve Transition Points for Patients

SLT Lead: K. Earnshaw

• Central intake for community based PHC services
• Demand and capacity analysis/optimization of

public health services

• Model of care and master roster realignment

2016-17 Access/ Patient Flow Initiatives

Establish Community COPD Pathway

SLT Lead: K. Earnshaw

• Pooled referrals for community spirometry testing

( PHC/ Respiratory services)

• COPD Clinical Pathway from inpatient to

community

Questions/Discussion

• RURAL LTC DVM

From wallpaper to an effective management tool steering you and your teams to success

In Sharon Garratt’s IHS Portfolio

Assessment of the current state Identify challenges and barriers

• there is no good time, we are too busy
• too much work to maintain the vis walls
• amount of information is overwhelming

What do we need to do differently?

• make it a priority
• pick the ‘best’ time
• keep it short 5-10 min
• choose metrics wisely

*What are the regions

goals?

*How will the service

line contribute to the success of the region meeting those goals?

*Id unit specific goals

Step One:

Connecting the dots

Drafted by SKOT (NL)

• Daily metrics that address
• Access and flow(Demand/capacity)
• Performance indicators
• Quality and Safety
• System Sustainability
• Improvement idea boards

Let’s create a new “Daily Work Board”

*Set expectations *Standard work for huddles *Lead by example, make

huddles/boards a priority

Huddles: Back to Basics

*

Director/EX . Director Vice President Final Response

*

Drafted

*

*

Lorie Kinneberg Manager Pediatrics RGH

Purpose of Session

Purpose of this Session is to:

• Create awareness of existing opportunities to

communicate strategic information and engage your teams/colleagues/families in the discussion

• Use the collective knowledge within the room to

Identify additional opportunities to build on existing channels and make our collective strategic information communications

Current Opportunities for Sharing Information & Engaging Staff

• Strategic, Business & Budget Plan(s)

– http://rqhshrpntwebprd:4604/sites/DocShare/SitePages/Home.aspx

• Quarterly Report-Outs
• Quarterly Special Edition elink – under review
• Wall Walks

– Quality & Safety Wall RGH – Access & Flow Wall(s) RGH – System Sustainability Wall RGH – Portfolio Walls – Department Walls

• Team Meetings
• Interaction with teams/colleagues/families

Current Opportunities for Sharing Information & Engaging Staff and Stakeholders

• Publications:

– e-link (weekly)

– The Physician (monthly) – Health News (twice per year) – Annual Community Report – Annual Legislative Report

• On-Line

– www.rqhealth.ca – Facebook – Twitter

• Media

– News releases – Interview Opportunities

We know that Daily Visual Management and embedding opportunities for regular conversation with staff and others is crucial to success. You have seen the various supports in place to support leaders to be successful…

…so we would like your support and ask that each person complete a short survey to answer the following three questions:

• What support do you need to communicate general

strategic information to your teams/colleagues/families?

• What support do you need to communicate Quarterly

Report information to your teams/colleagues/families?

• Which corporate communication channels do you access

to share our successes with your team/colleagues/families?

Follow up

The Strategy portfolio will assess the information you provide and:

– Will share the results of the survey in the coming weeks. – Identify opportunities to build on existing channels, cease channels that are not effective, and create new channels as/if appropriate.

Complete Survey

15 Minutes to complete survey If you need more time, complete and return to the Communications Department at Wascana Rehab by June 30th. Thank You

Short Break

SHORTBREAK We will resume at 1505 SHARP!

System Sustainability

Robbie Peters & SLT

Key Message

• We will achieve sustainability through

accountability, stewardship and commitment, and ensuring that key foundational structures are in place in order to support the people we serve.

Multi-year Outcome

• Ongoing, RQHR will achieve a balanced or

surplus budget (Provincial Outcome)

2016-17 Board Measures and Targets

• Define characteristics of culture of

accountability and develop an action plan for staff and physicians

• RQHR Operating Surplus / Deficit
• # of Surgical cases waited greater than three

months

2016-17 Interim RQHR Business Plan System Sustainability ITL

Hard copies on tables

Planning Implementation

System Sustainability

Legend:

Planning Implementation Initiative Lead

27 25 29 26 31 28 26 30 27 27

Develop Human Resource Plan Higgins Develop Physician Resource Plan McCutcheon Develop Infrastructure Capital Asset Management Plan Peters Develop Equipment Plan Klassen Higgins McCutcheon Implement an Integrated Risk Management (IRM) Framework Peters Expand Research / Academic Capacity Klassen Replace Admission, Discharge and Transfer System Klassen Create Conditions for Front Line Manager Success Garratt / Higgins Optimizing Use of Our "People Resources" (initiative under Financial Strategic Oversight Committee, formerly ETI) Higgins/Garratt Mar-17 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Define Characteristics of Culture of Accountability and Develop an Action Plan for:

• Staff
• Physicians

Dec-16 Jan-17 Feb-17 Implement Procurement / Supplies Efficiency Strategies:

• Product Standardization
• Psuite implementation
• Inventory clean up and direct order management

Peters

2016-17 System Sustainability Initiatives

Define Characteristics of Culture of Accountability and Develop an Action Plan for Physicians

SLT Lead: D. McCutcheon

• Leadership Development
• Rules & Discipline
• Trust and Engagement

2016-17 System Sustainability Initiatives

Define Characteristics of Culture of Accountability and Develop an Action Plan for Staff

SLT Lead: M. Higgins

• Define characteristics of an accountability culture
• Identify actions
• Foster personal accountability and drive
• rganizational performance
• Establish conditions to ensure success

2016-17 System Sustainability Initiatives

Optimizing Use of People Resource

SLT Lead: S. Garratt / M. Higgins

Work will focus on three primary drivers of

• ptimal use of people resources

– Human resource capacity matches service demand – Work units are managed effectively (creating conditions for manager success) – Leader (VP/ED/D) work standards in place

2016-17 System Sustainability Initiatives

Create Conditions for Front Line Manager Success

SLT Lead: S. Garratt / M. Higgins

Activities in next quarter include:

– Workforce Planning exploring alignment of demand and capacity for manager roles – PDCA framework by applying it to the financial management functions (expectations, plans to achieve, information/supports/resources required, performance monitoring and response to outcomes) – Complete Kaizen events required to implement agreed to future state, PDCA

2016-17 System Sustainability Initiatives

Implement Procurement/ Supplies Efficiency Strategies

SLT Lead: R. Peters

• Stores inventory clean up and direct order

management

• Psuite implementation
• Product Standardization
• 3sHealth and RHAs provincial procurement

2016-17 System Sustainability Initiatives

Develop Infrastructure Capital Asset Management Plan

SLT Lead: R. Peters

• Develop Maintenance Service Plans based on risk and

service priorities

• Continue to roll out Space Change Request process
• Initiate key capital and space priority projects including

Immediate Acute Bed Capacity project

• Develop charter for 3 year Strategic Facility Plan

development

• Define a 3 year Real Estate and Leasing plan
• Roll out LTC renewal plan for replacement of priority LCT

sites including Regina Pioneer Village

2016-17 System Sustainability Initiatives

Integrated Risk Management Framework Development

SLT Lead: R. Peters

• Integrated Risk Management working group -

formed Dec 2015

• Draft Policy and Framework have been developed
• pending approval Sept 2016
• Population of Risk Register
• HIROC Risk Checklist
• Embed in 2017-18 strategic, business and budget

planning cycles

Questions/Discussion

Closing Remarks

Closing Remarks from our President and CEO Mike Higgins, for Keith Dewar

Closing Remarks

Closing Remarks from our clients TBD

Closing Remarks

Closing Remarks from our Board of Directors Dick Carter, Board Chairman