Balanced Score Card Report Review of May 2018 Data Balanced - - PowerPoint PPT Presentation
Balanced Score Card Report Review of May 2018 Data Balanced - - PowerPoint PPT Presentation
Balanced Score Card Report Review of May 2018 Data Balanced Scorecard Quality Patient & Access Safety Patient and Service User Human Resource Finance Management Patient Access Emergency Department CUH 30 Day Moving Average 2017
Balanced Scorecard
Patient Access
Quality & Safety Human Resource Management Finance
Patient and Service User
Patient Access – Emergency Department
CUH 30 Day Moving Average 2017 v 2018
4
6 Hour PET & 8AM TrolleyGAR per 100 ED Attends
PET Greater than 24 Hours
Non Admit PET Year to date Comparison
0% 10% 20% 30% 40% 50% 60% 70% 80% 2014 2015 2016 2017 2018
67% 71% 75% 79% 70%
Annual Non Admit PET 2014 - 2017
>75yrs Bed Wait >9hrs
50 100 150 200 250 Jan-18 Feb-18 Mar-18 Apr-18 May-18 248 232 249 190 203
>75yrs Bed Wait >9 hrs (2018)
Targeted >14 Day Occupancy
100 120 140 160 180 200 220 4000 5000 6000 7000 8000 9000 10000 01/09/2017 01/10/2017 01/11/2017 01/12/2017 01/01/2018 01/02/2018 01/03/2018 01/04/2018 01/05/2018 01/06/2018
>14 Day Patients and >14 Day Occupancy
Bed Days Patients >14 Days
>100 Day Occupancy
2 4 6 8 10 12 14 16 18 20 500 1000 1500 2000 2500 3000 3500 4000 01/09/2017 01/10/2017 01/11/2017 01/12/2017 01/01/2018 01/02/2018 01/03/2018 01/04/2018 01/05/2018 01/06/2018
>100 Days Patients & Bed Days
Bed Days Patients
AMAU Activity May2018
20 40 60 80 100 120 140 160 180 ED Surge ED GP Planned Repeat OPD Other Referrals
171 114 154 87 13 4
AMAU Boarders at 8:00am - May 2018
12 12 11 12 10 10 8 8 7 10 10 12 12 9 10 10 12 8 8 8 12 12 12 2 4 6 8 10 12 14
Project Flow Improving Patient’s Hospital Experience
Project Flow 2018
Project Flow Objectives
- Bed Capacity Review
- Implement the SAFER Patient Flow Bundle in 2018 on all inpatient wards.
- 90% of patient notes should have a Planned Date of Discharge (PDD).
- Achieve a 25% increase in weekend discharges by September 2018.
- Achieve monthly 80% either green or amber (40% green) at 8am on TrolleyGAR
- Achieve a 10% reduction in bed days used by patients >14 days.
- No patient should spend >24 hours in any area of the Acute Floor
- 95% of non-admitted patients should achieve a patient experience time (PET) <6 hrs on
the Acute Floor
- 75% of all patients should achieve a PET <6 hours
- 100% of patients needing medical (excluding patients requiring care in the Resuscitation
Room) will be reviewed in the Acute Medical Assessment Unit (AMAU)
Project Flow Initiatives
Initiative
- SAFER Implementation
- Weekend Discharges
- >75 Year Old Patient Flow Improvement
- >14 Day Process Improvement
- Patient Experience Time Improvement
- Acute Ambulatory Care / Discharge to
Assess Pathways
- Acute Floor Implementation
- Communication & Education
- Diagnostic Flow needs to be reviewed
- Bi-Directional Flow Improvement
Nominated Lead
- Ms. Olivia Wall
- Ms. Deirdre Feehely
- Dr. Mike O’Connor
- Ms. Noreen Galvin
- To be Confirmed
- To be Confirmed
- To be Confirmed
- To be Confirmed
- To be Confirmed
- Ms. Lorraine Kearney
Patient Access - Outpatient Waiting Lists
Total Medical Patients to be seen by 15 Month Target
(241) (June)
Total Surgical Patients to be seen by 15 Month Target
(5062) (June)
Patients Currently Waiting Longer Than 12 Months
(5062) (May)
Patients to be seen by 15 Month Target
June 2018
3739 Urgent and Routine Patients who need to be seen in relation to the 15 month deadline by month end June 2018 Count of Patients % No of Patients with an Appointment before or on End of Month 122 3.26% Number of Patients with an Appointment Post End of Month 155 4.15% Number of Patients with No Appointment 3462 92.59%
Patient Access - Inpatient Waiting List
Total Inpatient & Day case Waiting List (12/06/2018)
wl type ACTIVE PREADMIT SUSPENSION Grand Total Adult 1190 304 40 1,534 Child 85 32 5 122 GI Scope 136 211 8 355 Grand Total 1411 547 53 2,011
Perspective Adult Pivot - to be Treated by October 2018 (433)
General Surgery Waiting List (141)
Plastic Surgery Waiting List (90)
Urology Waiting List (76)
Quality & Safety
Scope Breaches (June 2018)
Cancer KPI – Breast-Lung-Prostate
October 2017 – May 2018
Radiotherapy Patients In/Out of Target - May 2018
IN TARGET, 48, 51% OUT OF TARGET, 46, 49%
94 Patients
Consultants In/Out of Target May 2018
5 10 15 20 25 Dr Faisal Jamaluddin (Locum RO)
- Dr. Aileen
Flavin (RO)
- Dr. Bolanle Ofi
(Locum RO)
- Dr. Carol
McGibney (RO)
- Dr. Kathy Rock
(RO)
- Dr. Frederik
Vernimmen (RO)
- Dr. Paul Kelly
(RO) Total 16 16 16 17 3 4 22 In Target 9 10 6 5 2 2 14 Out of Target 7 6 10 12 1 2 8
Reasons for Out of Target – May 2018
5 10 15 20 25 30 35 40 45 Personal choice Medical Capacity Data Missing Other Total 2 1 42 1
Chemotherapy Patients In/Out of Target – May 2018
In Target, 39, 83% Outside Target, 8, 17%
Consultants In/Out of Target May 2018
2 4 6 8 10 12 14 16
Dr Deirdre O'Mahony Dr Derek Power Dr Dearbhaile Collins Dr Derville O'Shea Prof Mary Cahill Dr Richard Bambury Dr Vitaliy Mykytiv Prof Seamus O'Reilly Total 10 4 4 3 2 16 1 7 In Target 8 3 4 3 1 14 1 5 Out of Target 2 1 1 2 2
Reasons for Out of Target – May 2018
1 2 3 4 5 6 Personal Medicinal Capacity Total 1 1 6
Risk Management – April KPI data DRAFT
- Serious Reportable Events reported CUH - 3 communicated in April
- Medication Safety Incidents reported - 36
- Complaints – 4 with 0% closed within the 30 day timeframe.
- New claims notified to hospital - 3
Risk Register CUH3, CUH4, CUH49, CUH64 updated Updated Risk Register submitted to the SSWHG
Human Resource Management
Total Sick Leave
4.77 3.84 3.92 4.22 4.17 3.9 3.65 3.98 3.89 3.84 4.15 4.35 4.42 3.8 4.01
3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.5
2 4 6
Jan Feb Mar April May June July August Sept Oct Nov Dec
%
CUH – Total % Sick Leave 2017 v 2018
2017% 2018% % Target
44.55 34.55 37.35 31.14 34.88 44.15 40.05 31.32 29.2 26.8 28.89 26.11 31 24
10 20 30 40 50
Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18
WTE’s
CUH Long Term Sick Leave – WTE’s
EWTD Compliance - October 2017 – May 2018
Finance
Finance Report –May 2018
Actual outturn ytd 2018 CUH -PAY & NONPAY
- Gross pay & non pay budget €137.85m
- Actual pay & non pay €143.49m
- Actual Deficit €5.63m (-3.6%)
Less adjustments €3.22m
- Bad debts provision €1.5m
- PCRS €665k
- Surge/Storm Emma/CPE €723k
- Outsourced Mater €248k
- GDP Adj -12th ICU bed €93k
Adjusted Deficit €2.41m (-1.75%)
CUMH DIRECT PAY & NONPAY
- Gross Direct pay & non pay budget €17.1m
- Actual direct pay & non pay €18.17m
- Actual Deficit €1.06m (-6%)
CUH/CUM PAY & NONPAY
- Gross pay & non pay budget €154.95m (2017 :€147m)
- Actual pay & non pay €161.67m (2017: €151.2m)
- Actual Deficit €6.72m (-4.3%) (2017 :€4.2m/-3%)
Less adjustments €3.22m (2017 :€3.2m) Adjusted Deficit €3.5m(-2.26%) (2017 :€1.06m/-0.7%)
CUH /CUMH SUMMARY FINANCIAL POSITION AS AT MAY 2018
May €k % Apr € %
YTD Gross Expenditure 161,654 128,163 YTD Gross MEL 158,264 125,772 YTD April Deficit 3,390 2.1% 2,391 1.9% Less Bad Debt Increase 1,496 974 YTD Deficit after Bad Debt 1,894 1.2% 1,416 1.1% Storm Emma Costs 82 82 CPE Costs 34 34 12th ICU Bed not included in GDP Allocation (opened April) 93 49 YTD Deficit after Bad Debt, Storm Emma, CPE & 12TH ICU Bed 1,685 1.1% 1,251 1.0% PCRS Increase YTD April 665 458 YTD Deficit after Bad Debt, Storm Emma, CPE, 12TH ICU Bed & PCRS 1,020 0.6% 793 0.6% Surge Costs CUH additional beds 606 573 Outsourced Patients to Mater Private re Surge 248 154 YTD Deficit after Bad Debt, Storm Emma, CPE, 12th ICU Bed ,PCRS & Surge 166 0.1% 66 0.1%
Finance Report – May 2018
CUH/CUMH Other Income outturn
- Income budget €7.17m (2017 :€6.82m)
- Actual Income €8.58m (2016 :€8.34m)
- Actual Surplus €1.41m (20%) (2016 :€1.51m/22%)
CUH Other Income
- Other Income budget €6.84m
- Actual Income €8.31m
- Actual Surplus €1.47m (21%)
CUMH Other Income
- Other Income budget €332k
- Actual Income €268k
- Actual Deficit €64k (-19%)
CUH Actual Non-pay Expenditure €k YTD 2018 v 2017
CUH/CUMH Income outturn
- Income budget €33.39m (2017 :€33.0m)
- Actual Income €32.07m (2016 :€32.3m)
- Actual Deficit €1.3m (-4%) (2016 :-€0.7/-2%)
CUH
- Income budget €28.28m
- Actual Income €27.77m
- Actual Deficit €513k (-1.8%)
CUMH
- Income budget €5.11m
- Actual Income €4.3m
- Actual Deficit €813k (-16%)
Finance Report –May 2018
CUH –Pay & Non pay Budget Surplus/(Deficit) %
- 2.19%
- 1.38%
- 1.40%
- 1.46%
- 1.75%
- 5.57%
- 3.45%
- 2.92%
- 3.58%
- 4.09%
- 10.0%
- 8.0%
- 6.0%
- 4.0%
- 2.0%
0.0% Jan Feb Mar April May June July Aug Sept Oct Nov Dec
2018(adj) 2018
CUH Budget v Actual Pay ytd 2018
B udget € k A ct ual € k
Va r i a n c e €k Va r %
C U M H D I R E C T A c t 2 0 1 8 C U H / C U M H 2 0 1 8 A c t C U H / C U M H 2 0 1 7 A c t
Medical/Dental 28,315 27,391
9 2 4 3 %
3 , 6 7 4
3 1,0 6 5 28,342
Nursing/Midwifery
30,317 31,016
- ( 70 0 )
- 2 %
10 , 0 0 7
4 1,0 2 3 37,930
Paramedical
14,993 15,147
- ( 154 )
- 1%
7
15,154 1 4,263
Housekeeping
2,349 2,837
- ( 4 8 8 )
- 2 1%
4 9 5
3 ,3 3 2 2,966
Care Assistants
3,244 3,937 - ( 6 9 3 )
- 2 1%
3 ,9 3 7 3,1 30
Catering
1,912 2,033
- ( 12 1)
- 6 %
2 ,0 3 3 1 ,91 5
Portering 2,687 2,767
- ( 8 1)
- 3 %
2 ,76 7 2,652
Administration 7,669 7,528
14 2 2 %
8 6 3
8 ,3 9 0 8,092
Other Staff 1,451 1,295
156 11% 1,2 9 5 1 ,429
Total Pay 92,937 93,953
- (1
,01 6)
- 1
% 15 , 0 4 5 10 8 ,9 9 8
100,719
47
CUH AGENCY WTE 2014-2018
Jul-14 Sep-14 Dec-14 Jan-15 Jun-15 Sep-15 Dec-15 Jun-16 Sep16 Dec-16 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 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 0.9
Radiographer
0.09 0.05 0.06
Labs
12.04 13.40 11.0 12.19
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
Nursing
46.20 33.0 34.7 37.8 30.4
28.6 26.1 31.6 27.6 25.5 37.3 44.8 41.3 42.0 41.3 35.4 42.3 48.4 41.5 41.5 39.3
38.0
HCA
34.80 16.2 22.7 23.2 29.8
30.8 38.2 38.4 52.1 17.7 36.6 41.6 35.7 39.4 40.8 39.2 47.4 54.7 51.4 60.9 48.5
45.7
House-Keeping
10.40 0.16
Physics
4.30 2.6 1.6 1.09 0.75
0.66 0.46 0.83 0.83 0.83
Catering
3.00 8.5 2.0 2.7 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
2
Medical
11.00 5.27 4.77 4.4 5.86
7.97 15.73 Consult 0.25 2.9 3.94 1 0NCHD 2.47 6.7 1.87 1.54 0.8 1.18 3.04 1.51 2.85 2.98 2.09 3.12 0.97 0.73 2.15
164.5 99.7 91.1 98.26 74.6
71.9 81.4 76.75 88.23 46.9 76.4 91.1 83.12 85.44 85.61 78.45 93.68 106.2 97.0 104.37 89.53 87.85
CUH AGENCY COSTS €k 2016 - 2018
Acute Nursing Agency WTE 2016 to 2018 Acute HCA Agency WTE 2016 to 2018
49
42.8 35.9 38.2 34.0 30.7
31.4 31.3 30.7 29.8 30.8 33.8 37.7 36.7 37.8 37.1 38.8 38.2
34.2 31.7 32.6 31.1 30.5 30.4 30.5 27.8 25.2 27.6 29.5 23.8
10 20 30 40 50
Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2018 2017 2016
54.7 51.4 60.9 48.5 45.7
26.1 25.3 34.5 34.5 33.9 36.6 41.6 35.7 39.5 40.8 45.6 47.4 37.2 35.2 37.7 36.9 41.1 38.4 45.7 52.1 52.1 56.9 32.1 17.7
10 20 30 40 50 60 70
Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2018 2017 2016
CUH Average Nursing & HCA Agency WTE’s per Week 2016 - 2018 CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2016- 2018
97.5 87.3 99.1 82.5 76.3
57.4 56.6 65.2 64.2 64.6 70.4 79.3 72.5 77.3 77.9 84.4 85.6
71.4 66.9 70.4 68 71.6 68.8 76.2 79.9 77.3 84.5 61.6 41.5
10 20 30 40 50 60 70 80 90 100 110
Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2018 2017 2016
53.8 48.5 59.5 45.9 43.8
28.5 27.6 31.9 33.7 34.1 33.7 37.8 34.9 35.5 41.2 45.4 56.6
43.7 38.7 39.6 36.6 32.6
29 28.9 33.3 30.6 30.5 36.7 41.5 37.6 41.9 36.8 37 29 10 20 30 40 50 60 70 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Specials 2018 Specials 2017 Other 2018 Other 2017
97.5 87.3 99.1 82.5 76.3
57.4 56.6 65.2 64.2 64.6 70.4 79.3 72.5 77.3 77.9 84.4 85.6
71.4 66.9 70.4 68 71.6 68.8 76.2 79.9 77.3 84.5 61.6 41.5
10 20 30 40 50 60 70 80 90 100 110
Jan Feb Mar April May June July Aug Sept Oct Nov Dec
2018 2017 2016 53.8 48.5 59.5 45.9 43.8
28.5 27.6 31.9 33.7 34.1 33.7 37.8 34.9 35.5 41.2 45.4 56.6 10 20 30 40 50 60 70 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Specials 2018 Specials 2017
CUH Average Specials Nursing & HCA Agency WTE’s per Week 2017-18
43.7 38.7 39.6 36.6 32.6
29 28.9 33.3 30.6 30.5 36.7 41.5 37.6 41.9 36.8 37 29 10 20 30 40 50 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Other 2018 Other 2017
CUH Average Other Nursing & HCA Agency WTE’s per Week 2017-18
CUH Average Nursing & HCA Agency WTE’s per Week 2016-18
52
CUH Nonpay-Budget v Actual ytd 2018
NON-PAY
Budget Actual Variance
C U M H A c t C U H / C U M H A c t
2017 Act
Medicines 13,093 13,357
- (263)
28 13,384
13,542
Medical & Surgical 11,314 11,921
- (608)
1,294 13,215
12,127
Blood 2,061 2,157
- (96)
4 2,161
2,136
Medical Gases 173 220
- (47)
220
185
Medical equipment 1,566 2,097
- (531)
335 2,432
2,138
Radiology 2,283 2,713
- (429)
4 2,717
2,467
Provisions 808 846
- (38)
47 893
842
Catering 196 177 19 7 184
187
Cleaning/Waste 1,109 1,216
- (108)
562 1,778
1,660
Laundry 754 839
- (86)
840
766
Energy 1,275 1,332
- (57)
1,332
1,333
Bedding/ clothing 149 229
- (80)
39 267
165
Furniture 69 76
- (8)
17 93
81
Pathology 4,158 4,493
- (334)
87 4,579
4,364
Maintenance /Grounds 295 345
- (51)
37 382
412
Transport /staff travel 760 786
- (27)
38 825
782
Office expenses 792 915
- (123)
55 970
882
Telecommunications 190 203
- (13)
6 209
178
Computer 479 394 85 25 419
444
Administrative expenses 2,465 3,982
- (1,517)
371 4,353
4,958
Staff recruitment/training 286 343
- (57)
73 416
283
Miscellaneous 640 891
- (251)
95 986
572
TOTAL NON-PAY 44,914 49,533
- (4,619)
3,123 52,656
50,504
Less Bad debts
- 486
- 1,782
1,296
- 147
- 1,928
- 2,132
NON-PAY excl Bad Debts 44,428 47,751
- (3,323)
2,977 50,728 48,372
Patient Income 2016 –2018
- 1,000
2,000 3,000 4,000 5,000 6,000 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2018 5,080 4,421 4,807 4,638 4,541 2017 4,258 4,261 5,072 4,934 5,474 4,727 4,843 4,105 5,509 5,050 4,738 5,296 2016 5,633 5,504 5,288 5,629 5,699 4,844 5,179 5,496 5,326 4,671 5,697 4,506
CUH /CUMH Patient Income 2016/8
C U H / C U M H Ot her Income yt d 2 0 18 Income
B u d g e t € k A c t u a l € k V a r i a n c e € k
R ent al income & Licence f ees 2 2 9 3 2 1 9 2 B equest s/ D onat ions 6 5 8 7 2 2 R esearch grant s 12 6 52
- ( 74 )
C arpark 9 58 1,0 71 114 D rug rebat es / PC R S 3 ,9 0 7 5,0 75 1,16 8 Insurance claims / M isc 2 1 9
- ( 12 )
5,3 0 5 6 ,6 15 1,3 10 C U H / C U M H R ecoupment s and R ef unds yt d 2 0 18 Income B udget € k A ct ual € k V ariance € k R ecoupment s General 3 8 0 4 6 5 8 5 R ef unds- Pay 72 3
- ( 6 9 )
R ef unds- Ot her 10 0 3 0
- ( 71)
Post age rebat e 14 5 14 5 U nclassif ied 8 5 10 3 19 6 3 7 74 6 110
55
Cost Containment Initiatives update at 31/5/18 Q1 APR MAY JUN JUL AUG SEP OCT NOV DEC ACTUAL 1 Reduce Medical overtime 100 10 10 10 10 15 15 15 15 2 Reduce Nursing overtime 150 25 25 25 25 25 25 4 4 3 Reduce/Convert Support agency 100 10 15 15 15 15 15 15 4 Defer filling of posts 100 10 10 10 10 15 15 15 15 5 Cessation of Managed Services agreement 300 50 50 50 50 50 50 6 Savings on Drugs and Medicine spend 500 100 43 44 44 44 45 45 45 45 45 187 100 43 44 7 Medical and Surgical appliances –reduce issues by 10% Q4 /other 150 60 60 30 8 Reduce stock/nonstock issues –final week 450 450 9 Reduce Cleaning and waste expenditure 100 10 15 15 15 15 15 15 10 Reduce Pathology spend 100 11 11 11 11 11 11 11 11 12 11 Postage rebate /reduce volume 300 75 25 25 25 25 25 25 25 25 25 144 68
- 1
77 12 Reduce IT spend ILAB Support 63 7 8 8 8 8 8 8 8 7 7 13 Use of donated funds for specified projects 200 100 100 14 Misc/other 62 5 5 5 5 5 5 10 10 12 TOTAL-Target CUH 2675 175 84 112 233 218 219 229 294 294 817 TOTAL- Actual CUH 342 168 42 132 CUMH 331 5 16 25 25 25 30 50 50 105
MGH - Finance Report – May 2018
Mallow YTD 2018 outturn
- Gross pay & non pay budget €8.67m (2017:€8.37m)
- Actual pay & non pay €8.92m (2017:€8.63m)
- Actual deficit €255k (-2.9%) (2017:€268k)
- Less adjustments €80k
- -Bad debts provision €43k
- -Storm Emma/CPE€36K
- Adjusted deficit €175k(-2.02%) (2017:-€51k (-0.6%))
Mallow Income outturn YTD 2018
- Income budget €1.48m (2017:€1.48m)
- Actual Income €1.46m (2017:€1.82m)
- Actual deficit €22k (-1.5%) (2017:Surplus €345k/23%)
BGH - Finance Report – May 2018
Capital Projects
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 ongoing 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 Refurbishment of Ward 2D – capital funding in place Medical Oncology Centre – developing Statement of Need Funding received for replacement Mammography Units Ophthalmology Transfer – Phase 2
- OPD & Day Care – Tender documents ready to issue in
January ‘18
- Theatre Accommodation tender documents being
prepared for early ’18 Helipad Approval received from the IAA