2016-17 Q3 Report on Strategies January 31, 2017 Welcome and - - PowerPoint PPT Presentation

2016-17 Q3 Report on Strategies January 31, 2017

Welcome and Introductions

Welcome

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

Housekeeping

• Washrooms
• WiFi Password: qcc201603
• Handouts

Objectiv Objectives es of the Day

• f the Day
• 2016-17 Q3 Report on Strategic Plan
• 2017-18 Review of Business Plan Initiatives
• Understand regional challenges and opportunities

CEO Update Provincial Transformation

Keith Dewar President and CEO

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

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.

Transition to one Provincial Health Authority

• Advisory Panel Recommendations

– Consolidate 12 RHAs into a single Provincial Health Authority

• Supported by one Board that is accountable to the Minister of

Health

• Four service integration areas
• Direction to fully implement the PHC Framework
• Engage with Indigenous people and communities

– Pursue opportunities for consolidation of clinical support services and standardization of health system support

services

– One set of standards and reporting expectations for all

• Including affiliates and other third party delivery agents

Transition to one Provincial Health Authority

• Transition Team

– Lead Beth Vachon – Work Streams

• Governance, Legislation and Organizational Design

– Suann Laurent, CEO Sunrise Health Region

• Budget, Administration, Risk and Corporate Governance

– Robbie Peters, CFO, Regina Qu’Appelle Health Region

• Human Resources, Labour Relations and Change Management

– Mike Northcott, Saskatoon Health Region

• Clinical Health Services

– Scott Livingstone, President and CEO of Saskatchewan Cancer Agency

Transition to one Provincial Health Authority

• RQHR response

– The RQHRA (Board) supports the recommendations in the Advisory Panel Report and will work as part of the provincial health system to ensure the successful implementation of these recommendations

• Direction for 2017-18 planning and budgeting
• Direction to management and staff

– Continue to provide the safest, highest quality care we can to the people of this province – Business as usual unless otherwise directed

• Communication/change management

Transition to one Provincial Health Authority

Question and Answer Session

President and CEO, Keith Dewar

Setting the Context: Strategic Priority Areas

Keith Dewar President and CEO

Multi-year Outcome

• Quality and Safety Multi-year Outcome:

– To achieve a culture of safety, by 2020, there will be no harm to patient, clients, residents, staff and professional practitioners.

harm

Multi-year Outcome

• Access/Patient Flow Multi-year Outcome:

– To improve access for patients and reduce Emergency Department waits by 60%, necessary improvements in key areas will be achieved by 2019.

Waits

Multi-year Outcome

• System Sustainability Multi-year Outcome:

– Ongoing, RQHR will achieve a balanced or surplus budget.

Deficit

RQHR Q3 Strategic Indicators: Quality and Safety

Coverage Rate for DPT for Two-year Olds Residing in RQHR

• Dr. Tania Diener on behalf of

Karen Earnshaw, VP Integrated Health Services

Qualit Quality y & & Saf Safety ety Indica Indicator tors s – Diphtheria Diphtheria-Per ertuss tussis is-Tetanus etanus (DP (DPT) T)

Coverage rate for DPT for two-year olds residing in RQHR (Regina & Rural)

Corrective Action Plan

Measure: Coverage rate for diphtheria-pertussis-tetanus (DPT) for two year olds residing in RQHR, Regina and Rural HOW ARE WE DOING?

• We have not met the target of 80% in RQHR. However, Q3 resulted in 77.5%

coverage which is slightly better than the Q2 results of 76.6% for DPT.

WHAT ACTIONS ARE WE TAKING?

• Child health clinics have as of October 31, 2016 enhanced access by two

evenings a week and all Saturdays in each network. Low SES families receive in home support for immunization. Evening access to child immunization appointments have been enhanced in some rural neighborhoods. The Networks are monitoring these rates closely and have developed corrective action plans and creative ways to connect with families (i.e, school family clinic).

• Reminder phone calls are being made to clients who already have an

appointment booked. Focused interventions for neighbourhoods with lowest rates and imbedding immunization into other services where possible.

Coverage Rate for MMR for Two-year Olds Residing in RQHR

• Dr. Tania Diener on behalf of

Karen Earnshaw, VP Integrated Health Services

Qualit Quality y & & Saf Safety ety Indica Indicator tors s – Meas Measles les-Mumps Mumps-Rubella ubella (MM (MMR) )

Coverage rate for MMR for two-year olds residing in RQHR (Regina & Rural)

Corrective Action Plan

Measure: Coverage rate for measles-mumps-rubella (MMR) for two year olds residing in RQHR, Regina and Rural HOW ARE WE DOING?

• We have never met the target of 80% in RQHR. However, Q3 resulted in

77.6% coverage rate which is slightly better than the Q2 results of 75.9% for MMR.

WHAT ACTIONS ARE WE TAKING?

• Child health clinics have as of October 31, 2016 enhanced access by two

evenings a week and all Saturdays in each network. Low SES families receive in home support for immunization. Evening access to child immunization appointments have been enhanced in some rural neighborhoods.

• Reminder phone calls are being made to clients who already have an

appointment booked. Focused interventions for neighbourhoods with lowest rates and imbedding immunization into other services where possible.

Hand Hygiene Audit Regional Compliance Rate

• Dr. David McCutcheon, VP

Physician Services & Integrated Health Services

Qualit Quality y & & Saf Safety ety Indica Indicator tors s – Hand Hand Hygien Hygiene e

Source: RQHR IPAC Date: Jan 23, 2017

Corrective Action Plan

• Update hand hygiene policy and

rollout/reintroduce policy to the Region.

• Implement monthly auditing to all RQHR

units.

• Update the Hand Hygiene IT application to

allow for corporate/administrative areas to enter data.

• Create a tracking system in Gateway online

for the training within industry method for hand hygiene.

# of Workers' Compensation Board Claims per 100 FTE

Brent Kitchen on behalf of Michele Vogt, VP People & Safety

Reduce Number of Workers' Compensation Board Claims (Lost Time Claims) per 100 FTEs Quality & Safety Indicators – Reduce WCB LTCs

Reduce Number of Workers' Compensation Board Claims (Lost Time Claims) per 100 FTE

0.4 0.6 0.5 0.4 0.4 0.3 0.5 0.6 0.5

0.34 0.34

0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

RQHR INJURY RATE

Quality & Safety Indicators – WCB LTCs

Quality & safety Indicators – WCB LTCs

Action Who Date Implement monthly audits on all units where TLR and SMART have been implemented VPs Feb 17 – June 17 Perform inspections all units where TLR and SMART have been implemented EH&S Sept - Dec Continue PDSA in areas where injuries are not reducing EH&S Sept - March Integrate TLR/SMART audits with DVM and use of safety huddles EH&S Sept - March

Quality & safety Indicators – WCB LTCs

Proposed Action items for ‘17-’18

Surgical Site Infection Surveillance

Sandy Euteneier on behalf of Sharon Garratt, VP Integrated Health Services

Quality & Safety Indicator – SSI Rate

0.0% 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% 3.5% 4.0% Q3 Q4 Q1 Q2

SSI Rate, targeted procedures, RQHR, 2015-16, 2015-17

SSI Rate (%) Target

Corrective Action Plan

• SSI Prevention Working Group

– review the new housekeeping work standards

• New OR Case report that includes SSI

bundle components

• Address non-compliant results of the OR

Infection Control Audit

Falls Resulting in Harm (Code 3 and 4)

Executive Sponsors: Michael Redenbach and Karen Earnshaw VPs of Integrated Health Services

Qualit Quality y & & Saf Safety ety Indica Indicator tors s – Falls Falls

Q1 & Q2 2015 (April - September) Q1 & Q2 2016 (April - September) 67 64 7 7

Falls - Code 3 & 4 Q1 & Q2 2015 & 2016

Code 3 Code 4

Qualit Quality y & & Saf Safety ety Indica Indicator tors s - Falls Falls

Reduce Falls Resulting in Harm by 50% (Code 3 and 4 falls)

Corrective Action Plan

• Move towards including ALL falls
• We have all of the necessary preventative measures,

and response measures in place, but we need to focus

• n consistent use and embedding proper practice
• Move from a steering committee to an operational

group

• Planning an improvement event for May, with focus
• n key principles, and standardization of practice
• Ensure audit and monitoring plan is in place

RQHR Q3 Strategic Indicators: Access/Patient Flow

Seniors Current State Analysis

Michael Redenbach, VP Integrated Health Services

Access/Patient Flow Indicator – Seniors Current State Analysis

Current State Analysis is now complete, but had been significantly delayed. To be presented to RQHR Board and then available for wider circulation. Mostly statistical overview, with some inter-jurisdictional comparisons where possible

Next Steps

• RQHR unlikely to have a ‘seniors strategy’ for

2017/2018

• Current State Analysis is intended to assist each

service line and program area to assess their own work in seniors care

• More ambitious seniors strategy will need to wait for

provincial commitment, health region reorganization, and – to some extent – financial commitment

• Upcoming year will be devoted to further collaboration

with Ministry and RHA partners on seniors-specific initiatives

# of Surgical Cases Waiting Greater than Three Months

Sandy Euteneier on behalf of Sharon Garratt, VP Integrated Health Services

Access/Patient Flow Indicator – Su Surgica gical Cases l Cases Waiting >3 aiting >3mon months ths

Corrective Action Plan

• Finalize 2016-17 volume and funding with MoH
• We will perform our funded volume of surgeries
• Allocate available operating room time to meet

funded volume; adjusting inpatient and outpatient mix to equalize wait times

• Bi-weekly meetings to address long waiters
• Planning sessions for 2017-18 are under way

ED LOS at 90th Percentile

(all patients)

John Ash, Executive Director Quality and Strategy Management Office

Access/Patient Flow Indicator – ED LOS at 90 Percentile

Corrective Action Plan

• Improving access and coordination of primary

health care, and community mental health and addictions services.

• Reducing patient care delays in the emergency

department and inpatient units while improving bed capacity through supporting team based care and bedside rounds.

• Improving the sharing of information between the

emergency department, inpatient units and community services to reduce delays in waiting for non-acute services.

RQHR Q3 Strategic Indicators: System Sustainability

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

Brent Kitchen on behalf of Michele Vogt, VP People & Safety

System Sustainability Indicator - Culture of Accountability (staff)

In January the Human Resource Committee of the Board:

• Requested more information on the application of the Region’s Corrective

Discipline Policy

• Confirmed support for the existing Corrective Discipline Policy
• Directed the People and Safety portfolio to prioritize the foundational work
• f the ‘Culture of Accountability’ Framework

Next Steps:

• Consult with stakeholders.
• Develop a framework for a culture of accountability.
• The elements within that framework will include:
• Clear expectations aligned with organizational values
• Effective onboarding/ orientation processes
• Engaged and empowered employees
• Strengthened performance/leadership development processes
• Effective real-time performance feedback and application of corrective

discipline processes

People & Safety - Small Wins

Patient Safety:

• Increasing use of Stop the Line
• Advancement of Falls Reduction Strategy
• eCOR roll out

Employee Injuries:

• Dramatic improvement in the rate of TLR Lost time Claims
• Monthly monitoring and targets for LTCs for Depts. available.
• Monthly audits (just 2) tracking/reporting application ready for “Go

Live”. Culture of Accountability:

• Improved ‘New OOS Manager’ onboarding experience
• Measuring employee engagement- pulse survey developed
• Clarity on the work required to develop the framework.

*Patient & Employee Safety Integration

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

(Merging into Clinical Quality Plan)

• Dr. David McCutcheon, VP

Physician Services & Integrated Health Services

System Sustainability Indicator - Culture of Accountability (physicians) MQP

Small Wins

• Physician Engagement – Communication Plan
• Department Head Recruitment
• 4 New/12
• Leadership Development
• PLI, SLP, CQIP, SACI
• DHC Retreat
• GIM Reform
• ACU – Physician Relationship Building
• Making things Visual and Meaningful
• Driver Diagram – Physician Report Card
• Lumbar Spine MRI Checklist
• Transfusion Safety – Drs Ledingham and Lett

Operating Surplus/Deficit

Darlene Rorbeck on behalf of Robbie Peters, VP Financial Services

System Sustainability Indicator - Operating Surplus/Deficit

• 3011
• 4755
• 8165
• 5128
• 4678
• 6629
• 3517
• 4667
• 3291
• 16500
• 11500
• 6500
• 1500

3500 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar $'000's

Financial Sustainability Strategy Surplus / Deficit as of December 31, 2016

Actual (Year to Date) 2015-16 Actual (Year to Date) 2016-17 2016-17 Target

($9,369)

Projection

Date Prepared: January 12, 2016 Report Contact: Darlene Rorbeck Source: Finance Refresh Cycle: Monthly Operational Definition: Total operating revenues less total operating expenditures at the end of a specified time period.

• Diligent daily management
• Optimizing People Resources - matching capacity with demand (correct

staffing models, benchmarking and staffing standards, reduce variations in service), effective management of work units and consistent standards for leaders

• Reduce sick time, overtime and avoidable orientation costs
• Participating in 3sHealth initiatives to reduce costs
• Internal procurement and inventory management strategies
• Preparing and reporting on monthly corrective actions plans for each service

line/portfolio not meeting its budget target.

• Reduce salary costs by reviewing all job postings to ensure only essential

positions are filled, as per Ministry hiring freeze directive

• Deferring infrastructure upgrades and projects to the extent possible without

creating safety risks or impeding service delivery

Corrective Action Plan

Lunch Break

Please return at 1:00pm sharp

Setting the Context: Planning Inputs and Considerations

John Ash, Executive Director Quality and Strategy Management Office

Recap From Last Quarter: Strategic Planning Inputs

Major Data Drivers: Quality and Safety

Major Data Drivers: Quality and Safety

Major Data Drivers: Access/Patient Flow

Major Data Drivers: Access/Patient Flow

Major Data Drivers: System Sustainability

Major Data Drivers: System Sustainability

2017-2018 Planning

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.

2017-2018 Business Plan

RQHR 2017-18 Business Plan: Initiatives by VP

2017-18 Draft Business Plan

Carol Klassen, VP Knowledge and Technology Services

Portfolio Overview

Knowledge & Technology Services

– Academic Health Sciences – Research & Health Information Services – Patient Point of Care IT Services – Corporate and Clinical Support IT Services – Clinical Engineering and IT Infrastructure Services

Planning for 2017-18

Regina General & Pasqua Hospitals - 140,000 patients hospitalized and Emerg Dept visits annually (75% inpatients RQHR) Orders (2015/16):

• 210,000 medical images (575/day)
• 1,197,151 Laboratory orders (3,279 orders per day with

11,690 test results)

• Plus drugs, nutrition & food services, therapy, ….

2017-18 Initiatives

• Quality and Safety

– Deploy SunRise Clinical Manager (SCM) – Order Management (by June 2018)

Support Other Business Plan Initiatives Support Health System IT consolidation plans Support Portfolio Specific Plans

Steps for Implementation

KTS Business Initiative:

• Work with Saskatoon/eHealth/others to finalize

governance, project charter & milestone chart for SCM Order Management Project and begin work/engagement (RQHR -IM/IT Steering Committee) KTS Support for other Business Initiatives:

• Support Quality Care Transitions with expanded

SCM electronic clinical documents (Emerg, PHC, MH&A)

• Clinical Quality Plan: Analysis, tools, reports, &

clinical e-document support services

Steps for Implementation

Other Key Work

• Work with eHealth/stakeholders to

coordinate IT services for transition to single provincial health authority

• Identify & develop plan for portfolio

specific needs

2017-18 Draft Business Plan

David McCutcheon, VP Medicine Service Line and Physician Services

Portfolio Overview

Medicine Service Line

– Emergency Department/EMS – Critical Care & Cardioscience Units – Medicine Inpatient Units – Regional Infection Prevention & Control – Transfusion Safety – Antimicrobial Stewardship Program

Physician Services

– Practitioner Staff Affairs – Department Heads

Planning for 2017-18

• Review ITL
• Review Driver Diagram
• ACU Pilot Outcomes
• Provincial Catchball Document
• Integrated Risk Assessment
• Pt Flow Data ALOS/ELOS
• Financial Data
• RQHR Business Plan 2016-2017

– Appropriateness of Care – Comprehensive Medical Quality Plan – Physician Culture of Accountability

2017-18 Initiatives

• Antimicrobial Stewardship Program
• Horizontal Infection Prevention & Control

Strategy

• Improving Appropriateness of Care, Physician

Culture of Accountability, and Comprehensive Medical Quality Plan – 3 merged into Clinical Quality Plan – more info later

• ELOS=ALOS
• ED - Human, Space and IT Infrastructure
• Accountable Care Unit Replication

Steps for Implementation

• Antimicrobial Stewardship Program

– Recruitment of ID Specialist: Closing- Start Time, Contract

• Horizontal Infection Prevention & Control Strategy

– Update hand hygiene policy and rollout/reintroduce policy to the Region. – Implement monthly auditing to all RQHR units.

• Improving Appropriateness of Care, Physician Culture
• f Accountability, and Comprehensive Medical Quality

Plan – 3 merged into Clinical Quality Plan

Steps for Implementation

• Clinical Quality Plan

– Data analyst recruitment – Physician Report Card Pilot – Physician leadership development – Physician onboarding – Engagement of Program VPs, EDs, Directors

• ED - Human, Space and IT Infrastructure

– IT support for data gathering – Synergy Tool – HQC partnership - Modeling – Identified as Portfolio’s area of highest risk

Steps for Implementation

• Accountable Care Unit Replication

– Ministry submission – 3D identified as the next unit – 1Unit partnership – MSU and 4B – Standardize to Alpha Unit (4A) – Physician Model and compensation

• High Quality Care Transition (HQCT)
• partnering with PHC, HQC and MSL
• ELOS=ALOS

– RCA – Interportfolio Teams – Oversight and Operations – A3; Milestone Charts

2017-18 Draft Business Plan

Jan Besse and Terri Carlson, Acting VP’s Clinical Support Service Line

Portfolio Overview

Clinical Support Service Line

– Medical Imaging – Lab Services – Pharmacy Services – Rehabilitation – Spiritual Care – Native Health Services – Respiratory Services – Support Services

Planning for 2017-18

• Inputs:

– 2016-2017 ITL, regulations/legislation, other service line business plans, accountability document, operational pressures, patient flow data, CAP, accreditation, IRM, advisory panel recommendations, and budget information.

• Activities/Outcomes:

– Employee/Physician engagement, Med Rec, seniors

• utcomes, SMS, Horizontal IPAC, 3rd party contracts,

antimicrobial stewardship, capacity plan, 3S Health transcription project, recruitment and retention strategies, and patient and family centered care.

2017-18 Initiatives

Business plan initiatives we are leading

Medication Reconciliation – implementation

Business plan initiatives we support

• Horizontal IPAC – Hand Hygiene
• Building Manager Capacity
• Accountable Care Replication
• Patient Flow

– ELOS=ALOS

• Employee Injury Reduction

– TLR/SMART Audits – WHMIS

• Improving Appropriateness of Care

– Lab - Business Intelligence – Medical Imaging

Steps for Implementation

• Med Rec

– Implementation will begin in February with Units 1D, 3F and 4B. Ongoing roll-out will occur until all units are live.

• Accountable Care Replication

– Each September and April another Medicine Inpatient Unit is scheduled to transition to an ACU model and that replication will require workflow changes to a number of CSS areas.

• ELOS=ALOS

– Optimum length of stay while desirable impacts the work of all CSS areas. More throughput of patients requires increased workload and business processes will be adjusted to accommodate

Steps for Implementation

• Improving Appropriateness of Care

– Lab Business Intelligence software to be selected and

• installed. Data gathering and action plans related to findings

will be critical to the success of this work – Medical Imaging

2017-18 Draft Business Plan

Karen Earnshaw, VP Integrated Health Services

Portfolio Overview

Primary Health Care Service Line

 Urban Networks (North, South, Central, East)  Rural Networks (Touchwood, Twin Valleys, Prairie East)  Home Care/SWADD  Palliative Care  Population & Public Health  Eagle Moon Health Office  Saskatchewan Health Line

Planning for 2017-18

 Large provincial expenditures but poor health

• utcomes

 High rate of hospitalization for ACSC  Increase in demand and complexity of care  System complex and difficult to navigate  Barriers to shared care with family physicians  Little focus on prevention and health promotion

2017-18 Initiatives

Accountable Community Care Initiative

• Expand Response Team service to support care at the

community level

• Implement the community COPD pathway
• Increase coverage rate for Diphtheria-Pertussis-Tetanus

(DPT) & Measles-Mumps- Rubella (MMR) for two year

• lds residing in Rural & Urban RQHR
• Work with stakeholders to improve intake, referral and

coordination of PHC services

Steps for Implementation

 Expand response team service to support care at the community level

 Imbed response service into PHC networks  Improve after hour urgent care and diagnostics in the community  Focus on high quality transitions between stakeholders

 Implement the community COPD pathway

 Initiative COPD prevention activities  Develop a central referral process for COPD services  Improve access to COPD diagnostics and rehabilitation services

Steps for Implementation

 Increase Coverage rate for Diphtheria-Pertussis-Tetanus (DPT) & Measles-Mumps-Rubella (MMR) for two year

• lds resident in RQHR, Regina and Rural

 Establish timely access for immunization services that is client

centered.

 Develop an immunization marketing and communication strategy  Establish network websites

 Work with stakeholders to improve intake, referral and coordination of PHC services

 To be determined

2017-18 Draft Business Plan

Michael Redenbach, VP Integrated Health Services

Portfolio Overview

Integrated Health Services

– Long-term Care – Mental Health & Addiction Services

Planning for 2017-18

Assisted Living/Subsidized Housing Initiative

• Using an assessment tool (DASH Algorithm) LTC

residents have been identified as possibly no longer needing institutional-based care

• In-depth, individual assessments of targetted

residents will occur

• Aim will be to transfer residents – as appropriate –

to an assisted living setting

2017-18 Initiatives

Assisted Living/Subsidized Housing Initiative

• Significant partnership required from Home Care

and/or other community-based services – while not requiring institutional long-term care, clients will still require some care and support

• Initiative will free space within long-term care

facilities in Regina for alternate uses, and over time reduce need for additional LTC beds

• Will be accompanied by a process to minimize

any unnecessary admissions to LTC

2017-18 Initiatives

Mental Health and Addictions – Length of Stay

• Part of Region’s overall commitment to

addressing this issue

• Likely to include some or all of following:
• Electronic Health Record Phase II
• Centralized Referral Management Phase II
• Level of Care Utilization System (LOCUS)
• Partners for Change Outcome Management

System (PCOMS)

2017-18 Draft Business Plan

Brent Kitchen on behalf of Michele Vogt, VP People and Safety

Portfolio Overview

People and Safety

– Legal Counsel – Privacy – Patient & Employee Safety – HR Operations & Volunteers – Workforce Planning & Development

Planning for 2017-18

Information That Informed Planning:

– Eliminate Harm to Patients - Patient Safety

• Confidential Occurrence Reporting :

– 33% Falls – 25% Medication Errors – 11% Assault/Altercation (Violence)

• Critical Incident Reporting – Common Themes:

– Communication between providers (individuals or groups). I.e. Upon transfer, shift to shift handoff, change in provider – Improve Assessments

– Employee Safety

• Employee Incident Reporting :

– 25% Acts of Violence (now #1) – 16% TLR related

• Lost Time Claims – 54% TLR related

– Human Resources/Workforce Planning

• Sick hours per FTE/OT per FTE/Internal Movement Rate/ Retirement Eligibility

rate/Staff mix/Engagement survey results………..

2017-18 Initiatives RQHR ‘17-’18 Business Plan - Patient & Safety Portfolio Initiatives

Strategic Initiatives: Strategic Priority Implement Region Wide Stop the Line Program Quality & Safety Implement Violence Prevention Program Quality & Safety Reduce Patient Falls Quality & Safety Reduce Employee Injuries Quality & Safety Ongoing Portfolio Work: Develop Health Human Resource Plan System Sustainability Characteristics of Culture of Accountability System Sustainability Optimizing Use of Our People Resources - Teams 1 & 3 A3’s System Sustainability “On the Radar”: WHMIS training Quality & Safety Essential Services Planning System Sustainability

Steps for Implementation

• Stop The Line Education: additional training sessions &

improving roll out to frontline.

• Continued roll out of eCORs
• Falls Reduction Strategy event(s)
• TLT/SMART audits tracking and reporting process
• Finalize the Culture of Accountability framework
• Consultation for better alignment of Indigenous health

services

• Essential Services Planning required
• WHMIS training required
• Participate in the transformation agenda

2017-18 Draft Business Plan

Darlene Rorbeck on behalf of Robbie Peters, CFO and VP Financial Services

Portfolio Overview

Financial Services

– Accounting – Payroll & Benefits – Decision Support – Materials Management – Facilities Management – Security & Parking Services

Planning for 2017-18

• Sources

– 2016-17 Strategic/Business Plans, Portfolio Driver Diagram and Multi-Year Plans, A3s (Strategic and Project), Department Planning Sessions, Risk Assessments

• Considerations

– Portfolio vs. cross functional work – Work that transcends structure and department – Work that is required and common across all sources (MoH, Accreditation, Board, etc.) – Work that needs to continue from last year – Focus on ONE year or less deliverables

2017-18 Initiatives

• Financial Management - All areas will

monitor and manage the following to contribute to financial sustainability target

• f balancing to budget:

– Budget Surplus/Deficit – Paid Hours

• Optimizing Use of Our People Resources:

– Aligning Demand and Capacity

Steps for Implementation

• Financial Management - All areas will

monitor and manage the following to contribute to financial sustainability target

• f balancing to budget:

– Budget Surplus/Deficit – Paid Hours

• Continuation of last year’s work, DVM, Action

Plans, did the Action Plan have the intended

• utcome?

Steps for Implementation

• Optimizing Use of Our People Resources:

– Aligning Demand and Capacity

• Inpatient hospital units initially (AnalysisWorks

project)

• All areas however could be subject to demand and

capacity reviews, benchmarking initiatives etc.

2017-18 Draft Business Plan

Sandy Euteneier on behalf of Sharon Garratt, VP, IHS

Portfolio Overview

Integrated Health Services

– Clinical Quality & Professional Practice – Specialized Ambulatory Care – Integrated Renal Program – Women’s & Children’s Health – Surgical Services

Planning for 2017-18

• Analysis identified surgical bed efficiency
• pportunities related to pre-op and ALOS

reductions.

 Identified we had a 2.7 beds per day of opportunity for preoperative patients

• New technology (less invasive procedures that

result in decreased ALOS)

• We have annually funded inpatient/outpatient

volumes we must meet

 Ensure the most appropriate beds and resources are aligned to meet volumes and maintain fiscal responsibility

2017-18 Initiatives

• Reduce Surgical LOS

– Continue with the foundational pre-op LOS work which includes the ‘After Hours Booking Rules’ – Establish a process and align resources to support the flow of patients thru day surgery seven days/week – Develop and implement an Anterior Hip Pathway to encompass the patients’ journey from pre-operative thru to completion of post-operative therapy

Steps for Implementation

• Reduce Surgical LOS

– Establish a pilot project to trial the move of Orthopedic Trauma to RGH – Continue to monitor and evaluate our 18 month Trauma pilot

*Linkage with decreasing ED LOS

Afternoon Break

Please return at 3pm sharp

Facilitated Open Discussion

with the Senior Leadership Team

Closing Remarks Sean Quinlan

Board of Directors (RQRHA)