[PPT] - Balanced Score Card Report Review of August 2017 Data Balanced PowerPoint Presentation

SLIDE 1

Balanced Score Card Report Review of August 2017 Data

SLIDE 2

Balanced Scorecard

Finance

Patient Access Quality & Safety Human Resource Management

Patient and Service User

SLIDE 3

Finance

SLIDE 4

Finance Report – August 2017

CUH Actual outturn YTD 2017 PAY and NONPAY

Gross pay & non pay budget €237.3m (2016 :€228.4m)
Actual pay & non pay €246.3m (2016: €235.0m)
Actual Deficit €8.9m (-3.8%) (2016 :€6.6m/-2.9%)

Less Adjustments €5.3m increase in Bad debts provision €2.4m PCRS Drugs €1m LRA Restoration unfunded €1.7m Living out allowance €231k

Adjusted Deficit €3.6m(-1.54%) (2016 :€3.0m/-1%)

NB: increase in % deficit is due mainly to retraction of Budgets for Bowel Screening & Diabetic Retinopathy screening €0.4m

SLIDE 5

CUH –Pay & Non pay Budget Surplus/(Deficit) %

SLIDE 6

CUH – Patient Income Budget Surplus/Deficit %

SLIDE 7

7

CUH AGENCY WTE 2014-7

Jul-14 Sep-14 Dec-14 Jan-15 Mar-15 Jun-15 Sep-15 Dec-15 Jun-16 Aug-16 Sep16 Oct 16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual

Radiotherapist

9.40 4.00 4.87 2.78 0.95 0.9

Radiographer

0.09 0.05 0.06

Labs

12.04 13.40 11.0 12.19 1.0

Cardiac Techs

3.80 3.80 1.0

Physio

1.60 1.50

Pharmacy

2.00 1.00

Admin

23.40 9.08 9.36 14.1 9.3

Nursing

46.20 33.0 34.7 37.8 40.0 30.4 28.6 26.1 31.6 28.7 27.6 29.6 31.5 25.5 33.3 33.3 32.7 31.7 34.3 37.3 44.8 41.3

HCA

34.80 16.2 22.7 23.2 24.4 29.8 30.8 38.2 38.4 52.1 52.1 56.9 32.1 17.7 26.1 25.3 34.5 34.5 33.9 36.6 41.6 35.7

House-Keeping 10.40 0.16 Physics

4.30 2.6 1.6 1.09 0.92 0.75 0.66 0.46 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.23

Catering

3.00 8.5 2.0 2.7 1.8 6.9 3.9 0.9 1.2

Social Work

1.00 0.5

Occ Therapy

1.00 0.37

Dietician

0.50 0.3 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Medical

11.00 5.27 4.77 4.4 6.35 5.86 7.97 15.73

Consult

0.25 4.44 0.38 1.62 0.6 0.34 2.9 3.94

NCHD

2.47 5.13 6.7 2.99 2.84 1.87 1.82 2.83 2.94 2.15 2.34 1.54 0.8 1.18 164.5 99.7 91.1 98.26 84.7 74.6 71.9 81.4 76.75 92.20 88.23 91.70 69.89 46.9 63.05 63.26 71.37 69.95 71.88 76.4 91.1 83.12

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CUH AGENCY COSTS €k 2015 - 2017

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Acute Nursing Agency WTE 2015 to 2017 Acute HCA Agency WTE 2015 to 2017

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CUH Average Nursing & HCA Agency WTE’s per Week 2015-17

10

CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2016-17

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CUH Nonpay-Budget v Actual YTD August 2017

Budget Actual Variance Actual YTD 2016 Diff 2017-16

Medicines 20,909 22,787

(1,878)

20,992

(1,795)

Medical & Surgical 19,723 20,324

(601)

19,069

(1,255)

Blood 3,298 3,687

(389)

3,502

(185)

Medical Gases 278 298

(20)

280

(18)

Medical equipment 2,990 3,289

(299)

3,085

(204)

Radiology 3,671 3,957

(286)

3,591

(366)

Provisions 1,369 1,408

(39)

1,330

(77)

Catering 328 302 26

330

28 Cleaning/Waste 2,534 2,810

(276)

2,545

(265)

Laundry 1,220 1,227

(7)

1,225

(2)

Energy 2,052 2,096

(44)

2,120

24 Bedding/ clothing 274 308

(34)

299

(9)

Furniture 122 165

(43)

193

28 Pathology 6,967 7,003

(36)

7,856

853 Maintenance /Grounds 487 602

(115)

557

(46)

Transport /staff travel 1,259 1,274

(14)

1,399

125 Office expenses 1,311 1,459

(147)

1,330

(128)

Telecommunications 312 318

(6)

270

(48)

Computer 790 706 85

778

73 Administrative expenses 4,963 7,779

(2,816)

5,024

(2,756)

Staff recruitment/training 494 457 37

475

17 Miscellaneous 1,083 828 256

1,114

286 TOTAL NON-PAY 76,435 83,084

(6,650)

77,363

(5,721)

Less Bad debts

855
3,073

2,218

848

2,225 NON-PAY excl Bad Debts 75,580 80,012

(4,432)

76,515

(3,496)

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CUH Actual Non-pay expenditure €k August 2017 v 2016

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CUH Bed Occupancy 2017 v 2016

147 145 139 151 128 130 120 123 125 124 115 111 114 120 126 118 121 102 111 110 115 113 111 114 110 111 107 117 100 110 120 130 140 150 160 Jan Feb Mar Apr May Jun Jul Aug Sep 12th Oct 19th Oct 26th Oct 2nd Nov 9th Nov 16th Nov 23rd Nov 30th Nov 7th Dec 14th Dec 21st Dec 2016 2017

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Patient Income 2015 –2017

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CUH Ot her Income Y TD August 2 0 17 Income Budget € k Act ual € k V ariance € k Rent al income 2 9 8 6 8 6 3 8 8 Bequest s/ Donat ions 10 4 13 9 3 5 Research grant s 2 0 3 156

( 4 7)

Carpark 1,54 1 2 ,0 0 4 4 6 3 Drug rebat es / PCRS 6 ,12 1 7,3 0 9 1,18 8 M isc 10 4 8 3

( 2 1)

8 ,3 71 10 ,3 77 2 ,0 0 6 CUH Recoupment s and Ref unds Y TD August 2 0 17 Income Budget € k Act ual € k V ariance € k Recoupment s Pay 6 12 759 14 7 Ref unds- Pay 116 8 9

( 2 7)

Ref unds- Ot her 16 1 8 5

( 76 )

Unclassif ied 13 6 14 2 5 1,0 2 5 1,0 74 4 9

SLIDE 16

CUH Debtor Days Consultant Claims

August 2017

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17

Cost Containment Initiatives update at 31/8/17

TARGET

JAN/FEB

MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

ACTUAL

1

Unrostered overtime-DIT 250 50 50 50 50 50

2

Reduction in Medical agency 300 30 30 30 30 30 30 30 30 30 30 153 99 53

43
45

117

24
4

3

Drug savings

4

Procurement (NDC) one-off & recurring (REVISED) 600 60 120 120 120 180

5

Reduce Waste costs 30 5 5 5 5 5 5

65
39
26

6

Reduce Energy costs 30 5 5 5 5 5 5 14 7 7

7

Reduce Bad debts

8

Blood science savings 1,000 100 100 100 100 100 100 100 100 100 100 763 74 70 165 162 40 100 152

9

Additional cafe income 330 140 110 10 10 10 10 10 10 10 10 247 4 9 38 170 20 7

10

Recode Clinical trials expenditure 100 100 100 100

11

Recode Donated funds expend 200 200 TOTAL-Target 2,840 270 240 140 240 150 260 320 320 320 580 TOTAL- Actual 1,212 177 132 160 117 327 164 136

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MGH - Finance Report – August 2017

Mallow YTD August 2017 outturn

Gross pay & non pay budget €13.47m (2016:€13.4m)
Actual pay & non pay €13.86m (2016:€13.5m)
Actual deficit €387k (-3%)

Less Adjustments €321k

increase in Bad debts provision €225k LRA Restoration unfunded €85k living out allowance €11k Adjusted deficit €66k (-0.5%) (2016:€87k/-0.7%) Mallow Income Outturn

Income budget €2.38m (2016:€2.57m)
Actual Income €2.54m(2016:€2.42m)
Actual surplus €157k (7%) (2016:Deficit €150k/-6%)

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BGH - Finance Report – August 2017

Bantry YTD August 2017 Outturn

Gross pay & non pay budget €13.84m
Actual pay & non pay €14.31m
Actual deficit €468k (-3.4%)

– Less Adjustments €317k – increase in Bad debts provision €77k –

St. Josephs ward €150k

– LRA Restoration unfunded €78k – Living out allowance €10k – Waiting list initiative €2k

Adjusted deficit €151k (-1.09%)

Bantry Income Outturn

Income budget €2.4m
Actual Income €2.3m
Actual deficit €99k (-4%)

SLIDE 21

Patient Access – Emergency Department

SLIDE 22

CUH 30 Day Moving Average 2016 - 2017 (September 2017)

SLIDE 23

30 Day Moving Average (18th September 2017)

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6 Hour PET & 8AM Trolley GAR per 100 ED Attends

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PET Monthly Comparison (Non Admitted)

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PET Monthly Comparison (Admitted)

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Patient Experience Time >24 Hours

50 100 150 200 250 300 350 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 up to 13 Sept

320 316 264 328 85 98 68 89 79

PET >24 hours

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>75 years >9 hour bed wait

50 100 150 200 250 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17

218 199 200 215 129 120 57 108 126 >75yrs Bed Wait >9 hrs (2017)

To 25th Sept

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>14 Day Target Reduction

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Project Flow Improving Patient’s Hospital Experience Project Flow 2017

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PF17 - Objectives Phase 1 - By 10th July 2017

Achieve 30% reduction 30 day moving average
No Patient >75yrs wait >9 hours for a bed
No patient >24 hour PET
Non Admitted PET to 85 %

Phase 2 - By 31st December 2017

Achieve 50% reduction 30 day moving average
No patient >75yrs wait >9 hours for a bed
No patient PET >18 hours
Non Admitted PET to 95 %

SLIDE 32

Improved Whiteboard Participation

Processes around whiteboard good generally
Engagement of Medical Staff (team by team)
Planned Date of Discharge capture variable
Weekend update of boards
Information leaflet
Data protection issue to be resolved – cost €10k

SLIDE 33

Weekend Demand/Capacity

Non Invasive Cardiology

Winter Plan Submission
Report average inpatient waiting time for echo / stress

Potential diagnostics as outpatient – for discussion with Radiology Communication of bi directional capacity – Bulk text message to Medical Staff – Whiteboard capture Delegated discharge responsibility (for action) Friday Specialty Handover (for action) ?? Weekend Discharge Registrar

SLIDE 34

Resource Dependant Initiatives

Transitional Care (50 Beds in

Community)

Acute Beds (Ward 2A)
Operational HUB
Flow Coordinators
Regularisation of extra unstaffed

beds

24/7 AMAU Service
ITU & HDU Capacity
Diagnostics
Point of Care (H1N1, Ketones,

Pregnancy testing)

CT Scanning
7 Day Echocardiograph
Bed Management & Acute Floor

Information Systems

Ambulatory Care Facilities /

Surgical & Cardiac Assessment

Health & Social Care

(Rehabilitation)

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SLIDE 35

Patient Access - Outpatient Waiting Lists

SLIDE 36

Total Medical Patients to be seen by 15 Month Target

(as of 22/09/2017) (202)

SLIDE 37

Total Surgical Patients to be seen by 15 Month Target

(as of 22/09/2017) (3109)

SLIDE 38

Patients Currently Waiting Longer Than 12 Months

(as of 22/09/2017) (4967)

SLIDE 39

Ophthalmology Waiting List Validation

Ophthalmology Return Waiting list validation Consultant G.O.Connor E.O. Connell S.Fenton A.Cullinane Z.Idrees Total Letters sent out 737 650 444 950 468 3249 Letters left to sent out 520 486 1006 Outcomes Yes to Stay on w/l 528 230 312 678 319 2067 Request removal 25 14 12 37 11 99 RIP 4 4 8 6 22 Attended TCI 1 1 2 Query 8 2 6 7 4 27 Return Post 2 3 3 2 1 11 Diabetic Screening 16 8 14 24 17 79 No response to date 25/9/17 154 388 97 194 109 942

SLIDE 40

Patient Access - Inpatient Waiting List

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Patients to be Treated by October 2017

Service Number to List by 13th October 2017 Number with TCI + Suspension Overall Total Cardiothoracic 5 5 General Surgery 86 4 82 Plastic Surgery 73 16 65 Urology 52 4 48 Vascular 13 13 Total 229 15 208

SLIDE 42

Urology Waiting List (48)

SLIDE 43

Plastic Surgery Waiting List (65)

SLIDE 44

General Surgery Waiting List (82)

SLIDE 45

Scope Waiting List (22/09/2017)

SLIDE 46

Quality & Safety

SLIDE 47

ALOS All Inpatients – July 2017

G

SLIDE 48

ALOS Medicine – July 2017

48

A

SLIDE 49

ALOS Surgery – July 2017

49

R

SLIDE 50

HIPE Coverage - Prior Month - % of cases entered into HIPE(A38)

G

SLIDE 51

Cancer KPI – Breast-Lung-Prostate

January – August 2017

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Risk Management – August KPI data

Serious Reportable Events reported CUH - 0

Serious Reportable Events reported MGH - 1

Medication Safety Incidents reported - 9
Complaints – 18 complaints raised in July with 6% closed

within 30 day timeframe

New claims notified to hospital – 7

Risk Register

Risk Register updated in June– one new risk added
Updated Risk Register submitted to the Group

SLIDE 53

Quality and Safety

Pressure Ulcer To Zero

Continue to roll out PUTZ initiative – ward 3B and ICU

SWARTZ Round

1st round held on12th September ( 2nd on 31st October)
Full Attendance
Very positive feedback

National Patient Satisfaction Survey

CUH – 53% response rate
Emerging theme is the Discharge Process
Workshop at Group level to review results of the survey

Staff Quality Survey Completed

Vision
Mission Statement

SLIDE 54

Quality and Safety

Purpose of Survey

Capture feedback from staff - what words best describe Quality? What are the Quality Priorities?

Results

268 Responses

Who Responded

31% Nursing, 26% Allied Health, 24% Administration 10% Clinicians

Words that describe Quality

Safe, Effective, Patient Centred

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SLIDE 55

Quality and Safety

Vision

Delivering Safe, Effective, Person- Centred care, Every time Mission Statement All CUH staff are committed to delivering the highest level of Quality Care achievable. We will work with you, our service users in enhancing services that are safe, clinically effective and delivered in a clean environment.

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5 top priorities 20 additional priorities

SLIDE 56

Human Resource Management

SLIDE 57

CUH Sick Leave 2016 v 2017- CHANGE

4.65 4.59 4.53 3.91 3.39 4.27 3.78 3.77 3.94 4.04 4.08 4.98 4.77 3.84 3.92 4.22 4.17 3.9 3.65 3.98

2 4 6

Jan Feb Mar April May June July August Sept Oct Nov Dec

%

CUH – Total % Sick Leave 2016 v 2017

2016% 2017% % Target

40.76 35.76 38.81 32.49 41.8 43.96 44.55 34.55 37.35 31.14 28.89 44.15 40.05

10 20 30 40 50

Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17

WTE’s

CUH Long Term Sick Leave – WTE’s

SLIDE 58

EWTD Compliance –January - August 2017

SLIDE 59

Capital Projects

Project Status Paediatric Unit Phase 1 - build programme completed Phase 2 – funding received – proceed to Design Stage Radiation Oncology Unit  Builder commenced on site on Monday 20th February Education and Training Centre Draft Statement of Need completed and discussion

ngoing with UCC

Meeting held with UCC Blood Sciences Project Design Team appointed Infrastructural works are near completion Oncology Service  Expansion of Day Unit – plan signed off – submitted for Philanthropic funding (ACT)  Refurbishment of Ward 2D – capital funding in place  Medical Oncology Centre – developing Statement of Need Ophthalmology Transfer – Phase 2  Project group in place  Application for planning permission submitted  Tender Pack being prepared Helipad Meeting held with the IAA Ground Level Helipad the agreed option

SLIDE 60

Key Issues

Implementation of SAP Structured Overtime Pay controls clearly working Need for change in accounting for PCRS funded drugs Bad Debts

PF17 working well Challenge with complex discharges Ophthalmology service risk CAMHS Pharmacy Review Quality Strategy National Quality Survey Unscheduled Care Process Day Surgery Unit

No outstanding third party hearings INMO relations working well Implementation of change programme in Catering/Housekeeping Sick Leave Focus HR recruitment workload Grading of staff must be addressed

Finance Patient Access Quality & Safety

Patient and Service User

Human Resource