Balanced Score Card Report Review of August 2017 Data
Balanced Scorecard Patient Finance Access Patient and Service User Quality Human & Resource Management Safety
Finance
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
CUH – Pay & Non pay Budget Surplus/(Deficit) %
CUH – Patient Income Budget Surplus/Deficit %
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 A ctual A ctual Actual A ctual A ctual Actual Actual Actual Actual Actual Actual Actual A ctual 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 0.25 4.44 0 0.38 1.62 0.6 0.34 2.9 3.94 Consult 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 NCHD 7 164.5 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
CUH AGENCY COSTS € k 2015 - 2017
Acute Nursing Agency WTE 2015 to 2017 Acute HCA Agency WTE 2015 to 2017
CUH Average Nursing & HCA Agency WTE’s per Week 2015 -17 CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2016 -17 10
CUH Nonpay-Budget v Actual YTD August 2017 Budget Actual Variance Actual YTD 2016 Diff 2017-16 Medicines 20,909 22,787 -(1,878) -(1,795) 20,992 Medical & Surgical 19,723 20,324 -(601) -(1,255) 19,069 Blood 3,298 3,687 -(389) -(185) 3,502 Medical Gases 278 298 -(20) -(18) 280 Medical equipment 2,990 3,289 -(299) -(204) 3,085 Radiology 3,671 3,957 -(286) -(366) 3,591 Provisions 1,369 1,408 -(39) -(77) 1,330 Catering 328 302 26 28 330 Cleaning/Waste 2,534 2,810 -(276) -(265) 2,545 Laundry 1,220 1,227 -(7) -(2) 1,225 Energy 2,052 2,096 -(44) 24 2,120 Bedding/ clothing 274 308 -(34) -(9) 299 Furniture 122 165 -(43) 28 193 Pathology 6,967 7,003 -(36) 853 7,856 Maintenance /Grounds 487 602 -(115) -(46) 557 Transport /staff travel 1,259 1,274 -(14) 125 1,399 Office expenses 1,311 1,459 -(147) -(128) 1,330 Telecommunications 312 318 -(6) -(48) 270 Computer 790 706 85 73 778 Administrative expenses 4,963 7,779 -(2,816) -(2,756) 5,024 Staff recruitment/training 494 457 37 17 475 Miscellaneous 1,083 828 256 286 1,114 TOTAL NON-PAY 76,435 83,084 -(6,650) -(5,721) 77,363 Less Bad debts -855 -3,073 2,218 2,225 -848 NON-PAY excl Bad Debts 75,580 80,012 -(4,432) -(3,496) 76,515 11
CUH Actual Non-pay expenditure € k August 2017 v 2016
CUH Bed Occupancy 2017 v 2016 160 151 150 147 145 140 139 130 130 2016 128 2017 126 125 124 123 121 120 120 120 118 117 115 115 114 114 113 111 111 111 111 110 110 110 107 102 100 Jan Feb Mar Apr May Jun Jul Aug Sep 12th 19th 26th 2nd 9th 16th 23rd 30th 7th 14th 21st Oct Oct Oct Nov Nov Nov Nov Nov Dec Dec Dec
Patient Income 2015 – 2017
CUH Ot her Income Y TD August 2 0 17 Budget € k Act ual € k V ariance € k Income 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 Budget € k Act ual € k V ariance € k Income 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 15 1,0 2 5 1,0 74 4 9
CUH Debtor Days Consultant Claims August 2017
TARGET Cost Containment Initiatives update at 31/8/17 MAR APR MAY JUN JUL AUG SEP OCT NOV DEC ACTUAL JAN/FEB 250 50 50 50 50 50 Unrostered overtime-DIT 1 300 30 30 30 30 30 30 30 30 30 30 Reduction in Medical agency 2 153 99 53 -43 -45 117 -24 -4 0 Drug savings 3 600 60 120 120 120 180 Procurement (NDC) one-off & recurring 4 (REVISED) 30 5 5 5 5 5 5 Reduce Waste costs 5 -65 -39 -26 30 5 5 5 5 5 5 Reduce Energy costs 6 14 7 7 0 Reduce Bad debts 7 1,000 100 100 100 100 100 100 100 100 100 100 8 Blood science savings 763 74 70 165 162 40 100 152 330 140 110 10 10 10 10 10 10 10 10 Additional cafe income 9 247 4 9 38 0 170 20 7 100 100 Recode Clinical trials expenditure 10 100 100 200 200 Recode Donated funds expend 11 TOTAL-Target 2,840 270 240 140 240 150 260 320 320 320 580 17 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%)
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%)
Patient Access – Emergency Department
CUH 30 Day Moving Average 2016 - 2017 (September 2017)
30 Day Moving Average (18 th September 2017)
6 Hour PET & 8AM Trolley GAR per 100 ED Attends
PET Monthly Comparison (Non Admitted)
PET Monthly Comparison (Admitted)
Patient Experience Time >24 Hours PET >24 hours 350 300 320 250 328 316 264 200 150 100 98 85 89 68 50 79 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 up to 13 Sept
>75 years >9 hour bed wait >75yrs Bed Wait >9 hrs (2017) 250 200 To 25 th Sept 150 218 215 200 199 100 129 126 120 108 50 57 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17
>14 Day Target Reduction
Project Flow Improving Patient’s Hospital Experience Project Flow 2017
PF17 - Objectives Phase 1 - By 10 th 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 31 st 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 %
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
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
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