Balanced Score Card Review of April 2016 Data 1 Balanced Scorecard - - PowerPoint PPT Presentation

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Balanced Score Card Review of April 2016 Data 1 Balanced Scorecard - - PowerPoint PPT Presentation

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Balanced Score Card Review of April 2016 Data 1 Balanced Scorecard Patient Finance Access Patient and Service User Quality Human & Resource Management Safety 2 Finance 3 CUH Finance Report April 2016 Actual outturn Apr 2016-

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SLIDE 1

Balanced Score Card Review of April 2016 Data

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SLIDE 2

Balanced Scorecard

Finance

Patient Access Quality & Safety Human Resource Management

Patient and Service User

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SLIDE 3

Finance

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SLIDE 4

CUH Finance Report – April 2016

Actual outturn Apr 2016- CUH

  • Gross pay & non pay budget €112.5m (2015 :€108.3m)
  • Actual pay & non pay €115.2m (2015: €111.8m)
  • Actual Deficit €2.7m (-2.4%)
  • Less expenditure on transitional care €437k
  • Drug costs refunded by PCRS €1.15m.

Adjusted Deficit €1.1m (-1%) (2015 :€3.4m /3.2%)

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SLIDE 5

Income Outturn April 2016- CUH

  • Income budget €26.6m (2015 :€21.0m)
  • Actual Income €25.9m (2015 :€24.2m)
  • Actual Deficit €667k (-2.5%) (2015 Surplus :€3.2m/15%)
  • Less accelerated income target €1.14m
  • Adjusted Surplus €476k (1.8%) (2015 :€3.4m /3.2%)

Patient Income outturn April 2016- CUH

  • Income budget €21.5m (2015 :€17.5m)
  • Actual Income €22.1m (2015 :€20.0m)

Actual Surplus €547k (2.5%) (2015 Surplus :€2.5m/14%)

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SLIDE 6

CUH Group Summary – Budget v Actual Expenditure YTD April 2016

Pay €k Non-Pay €k Total Gross Income €k Net €k CUH (inc SMOH) -830

  • 1,894
  • 2,723
  • 667
  • 3,390

Less adj 1,589 1,589 1,143 2,732 CUH adj

  • 830
  • 304
  • 1,134

476

  • 658

Mallow 28

  • 74
  • 46

79 33 Total Group adj

  • 801
  • 378
  • 1,180

555

  • 625

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SLIDE 7

CUH –Pay & Nonpay Budget Surplus/(Deficit) %

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CUH – Patient Income Budget Surplus %

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CUH Budget v Actual - YTD

YTD 2016 Budget €k YTD 2016 Actual €k Aduustments €k Variance €k % Variance YTD Actual €k Pay 77,228 78,058

  • 830
  • 1.1%

75,757 Non Pay 35,268 37,162

  • 1,589
  • 304
  • 0.9%

36,025 Gross Spend 112,496 115,220

  • 1,589
  • 1,134
  • 1.0%

11,783 Income 26,607 25,940 1,143 476

  • 1.8%

24.17 Net 85,889 89,250

  • 2,732
  • 658
  • 0.8%

87,613

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SLIDE 10

CUH Budget v Actual Pay YTD April 2016

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Budget €k Actual €k Variance €k % Variance 2015 Actual €k Variance €k Medical/Dental 21,552 22,190

  • 638
  • 3%

21,377

  • 813

Nursing/Midwifery 29,636 29,446 190 1% 29,220

  • 225

Paramedical 10,778 11,068

  • 290
  • 3%

10,580

  • 488

Housekeeping 2,331 2,381

  • 49
  • 2%

2,133

  • 248

Care Assistants 2,331 2,315 16 1% 2,133

  • 183

Catering 1,415 1,393 21 2% 1,283

  • 110

Portering 1,947 2,018

  • 71
  • 4%

1,895

  • 123

Administration 6,184 6,131 54 1% 5,930

  • 201

Other Staff 1,053 1,116

  • 63
  • 6%

1,207 91 Total 77,228 78,058

  • 830
  • 1%

75,757

  • 2,301
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SLIDE 11

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CUH AGENCY WTE – 2016

Apr-14 Sep-14 Dec-14 Jan-15 Feb-15 Apr-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 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 2.0 0.95 0.95 0.95 0.9 0.95 0.24 Radiographer 0.09 0.05 0.06 Labs 12.04 13.40 11.0 12.19 3.0 1.0 0.95 1.0 Cardiac Techs 3.80 3.80 Physio 1.60 1.50 Pharmacy 2.00 1.00 Admin 23.40 9.08 9.36 14.1 14.0 9.3 3.0 0.93 Nursing 46.20 33.0 34.7 37.8 34.4 40.0 35.0 32.8 30.4 31.0 28.4 28.6 29.3 31.2 26.1 35.2 32.9 33.8

34.2

HCA 34.80 16.2 22.7 23.2 19.3 24.4 26.8 31.0 29.8 34.7 32.7 30.8 32.4 34.5 38.2 37.2 35.2 37.7

36.9

House-Keeping 10.40 0.16 Physics 4.30 2.6 1.6 1.09 1.0 0.92 0.87 0.92 0.75 0.59 0.62 0.66 0.25 0.5 0.46 0.46 0.47 0.47

0.47

Catering 3.00 8.5 2.0 2.7 1.8 1.8 2.6 2.7 6.9 8.4 8.4 3.9 1.2 1.1 0.9 1.2 1.2 1.2

1.4

Social Work 1.00 0.5 Occ Therapy 1.00 0.37 Dietician 0.50 0.3 Medical 11.00 5.27 4.77 4.4 3.92 6.35 4.7 5.1 5.86 3.39 5.79 7.97 14.34 10.35 15.73 9.0

Consultant

0.72 1.74 1.72

NCHD

10.28 8.53 6.08

164.5 99.7 91.1 98.26 79.4 84.7 74.9 75.4 74.6 79.0 76.2 71.9 77.5 77.7 81.4 83.1 80.8 83.4

80.8

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SLIDE 12

CUH AGENCY COSTS €k 2014-16

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SLIDE 13

CUH Average Nursing & HCA Agency WTE’s per Week 2014 -2016

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CUH Non Pay

NON-PAY -YTD 2016 Budget Actual Variance Actual YTD 15 Diff 2016-15 Medicines (see note)

8,289 9,786

  • (1,497)

8,004

  • (1,782)

Medical & Surgical

9,344 9,068

277 8,870

  • (198)

Blood

1,511 1,663

  • (152)

1,581

  • (82)

Medical Gases

140 142

  • (2)

123

  • (19)

Medical equipment

1,507 1,554

  • (48)

1,399

  • (155)

Radiology

1,742 1,681

60 1,797 116 Provisions

634 603

31 613 9 Catering

117 152

  • (36)

101

  • (52)

Cleaning/Waste

1,226 1,209

17 1,165

  • (44)

Laundry

617 632

  • (15)

631

  • (1)

Energy

1,128 1,143

  • (15)

1,305 162 Bedding/ clothing

127 159

  • (31)

119

  • (40)

Furniture

94 79

15 72

  • (7)

Pathology

3,736 3,733

3 3,577

  • (156)

Maintenance /Grounds

235 287

  • (53)

234

  • (53)

Transport /staff travel

612 679

  • (67)

587

  • (92)

Office expenses

705 694

11 725 31 Telecommunications

155 111

44 142 31 Computer

417 451

  • (34)

385

  • (66)

Admin expenses incl bad debts

2,196 2,578

  • (382)

3,724 1,146 Staff recruitment/training

281 229

52 355 126 Miscellaneous

454 529

  • (74)

518

  • (11)

TOTAL NON-PAY 35,268 37,162

  • (1,894)

36,024

  • (1,138)

Less PCRS drugs/ Ward 2A

  • 1,589

1,589

  • 1,111

478 TOTAL NON-PAY 35,268 35,573

  • (304)

34,913

  • (659)

Note :Bad debts in Admin exps 694 573 122 2,035 1,462 14

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CUH Actual Non-pay Expenditure April 2016 v 2015

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Patient Income 2014 –2016

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CUH Debtor days Consultant Claims - April 2016

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CUH Census Movement Multi Unit Report April 2016 In line with National Reports, Grads/Interns are no longer being excluded from the Census WTEs

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Finance Report - April 2016

Mallow Actual outturn ytd Apr 2016

  • Gross pay & non pay budget €6.63m
  • Actual pay & non pay €6.68m
  • Actual Deficit €46k (0.7%)

Mallow Income outturn ytd Apr 2016

  • Income budget €1.28m
  • Actual Income €1.35m
  • Actual Surplus €79k (6.2%)

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Patient Access

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Weekly INMO Trolley Report

Week ending 13th May 2016

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New ED Presentations

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ED – 6hr & 9hr Target – All Patients

(Quarter 4 2015 Jan – Apr 2016)

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 9hr PET 6hr PET

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ED – 6hr & 9hr Target – Admitted Patients

(Quarter 4 2015 Jan – Apr 2016)

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ED – 6hr & 9hr Target – Non admitted Patients (Quarter 4 2015 Jan – Apr 2016)

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New ED >75 years Presentations

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PET >24 hours 2016

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Ambulance Clinical Handover Performance

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Ambulance Distribution 2016

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Delayed Discharges Jan- May 17th 2016

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Outpatient Waiting Lists

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Patients to be seen by 15 Month Timeline

(end of current month April 2016)

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Total Medical Patients to be seen by 15 Month Target

End of May 2016 (projected)

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Total Surgical Patients to be seen by 15 Month Timeline

End of May 2016 (projected)

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Women and Children Patients to be seen by 15 Month Timeline

End of May 2016 (projected)

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Patients Currently Waiting Longer Than 12 Months

as of 04/05/2016 Waiting List

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New and Return DNA Rate in CUH

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Scope Waiting List

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Scopes Urgent – March 2016

G

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Scopes Routine - March 2016

R

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Inpatient Waiting List

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Total Inpatient & Day case Waiting List

(12th May 2016) Count

  • f id

Wait category hospital name wl type ACTIVE PREADMI T SUSPENSIO N Grand Total Cork University Hospital Adult 1680 341 50 2071 Child 72 30 1 103 GI Scope 150 174 18 342 Cork University Hospital Total 1902 545 69 2516 Grand Total 1902 545 69 2516

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18 month Breaches as of 12th May 2016 (50)

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15 month Breaches as of 12th May 2016 (143)

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Quality & Safety

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Surgical ALOS – March 2016

R

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Medical ALOS – February 2016

R

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ALO All Inpatients

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A

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Risk Management – April KPI data

  • Serious Reportable Events reported - 0
  • Medication Safety Incidents reported - 0
  • Complaints – 12 complaints raised in April with 33% closed

within 30 day timeframe

  • New claims notified to hospital – 7

Risk Register Risk Register updated in May - 10 new risks added

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Cancer KPI – Breast-Lung-Prostate January – April2016

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CIT Referrals – 15th May 2016

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Theatre Utilisation - 21st March 2016 to 8th May 2016

% Utilization Average Utilisation March 2016 to Present Average IOI Average Turn-Around in Minutes Start Time Average Finish Time Average Target 85% 0:45

  • 10 to +10

8:30 17:00 Theatre 1 Neurosurgery 92% 01:10

  • 1

08:28 18:05 Theatre 1A Orthopaedics 86% 01:07

  • 11

08:34 17:23 Theatre 2 Orthopaedics 78% 01:09

  • 6

08:51 16:25 Theatre 3 Emergency 45% 01:25 23 09:13 16:48 Theatre 4 Breast 88% 00:46 3 08:48 16:49 Theatre 5 General 71% 01:12 16 09:05 16:25 Theatre 6 General 76% 00:59 11 08:46 17:23 Theatre 7 General 85% 01:03 4 08:35 16:45 Theatre 8 General 84% 00:57 17 08:37 16:56 Theatre 9 Plastics 73% 00:49 15 08:58 16:53 Cardiac Theatre 1 Cardiac 89% 01:25

  • 19

08:19 17:04 Cardiac Theatre 2 Cardiac 71% 01:45 4 08:30 17:00 Hybrid Theatre Vascular 74% 01:00 8 08:54 16:08

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Quality and Safety

Serious Reportable Events(SRE’s) Audit of Serious Reportable Events completed – draft report received Housekeeping Services Project Group

  • Post of Health Care Assistant - Application being processed
  • Post of Health Care Assistant Facilitator signed off

Quality Improvement Programme for Outpatient services Commence development of CUH Quality Strategy NAS/Cork Hospital Interface Group

  • South West Dispatch/Operational Paramedical Personnel

Guideline implemented

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Audit of SRE’s – Draft Recommendations

1) Review the whole hospital process with regard to the identification, communication, escalation and reporting of SRE’s 2) Delegate responsibility to a senior member of staff within the CUH group to monitor the steps outlined in point 1. 3) Engage with the SSWHG to agree reporting responsibility when the death

  • f a patient (including mother infant) from another hospital occurs

following transfer to CUH/CUMH 4) Staff members relevant to a serious incident reported from CUH/CUMH to be invited to attend Serious Incident Management Team meeting 5) Amend and update all incident management policies to reflect the requirements of the Safety Incident Management Policy 6) Ensure all thematic risks identified in relation to SRE’s are reflected in the hospital Risk Register 7) Review current processes to ensure CUH/CUMH meet the timeline requirement of the Safety Incident Management Policy

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Human Resource Management

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Sick Leave – April 2015

4.01 3.79 3.74 3.16 3.07 3.86 3.75 3.91 3.72 3.81 4.08 4.32

4.65 4.59 4.53 3.91

2 4 6

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

%

CUH – Total % Sick Leave 2015 v 2016

2015% 2016% % Target

29.95 31.7 29.5 19.03 28.37 28 27.39 34.06 32.07 37.99 28.89 24.99 36.59 34.31 27.64

10 20 30 40

Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16

WTE’s

CUH Long Term Sick Leave – WTE’s

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Medical Sick Leave – April 2106

0.16 1.05 0.98 0.66 0.55 1.38 1.46 2.21 1.71 1.3 1.01 0.29 1.02 0.5 1 1.5 2 2.5 3 3.5 4 Oct '15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 Month % Consultants NCHD's Target

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SLIDE 58

EWTD Compliance –Jan - April 2016

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Capital Projects

Project Status Paediatric Unit Phase 1 - build programme to be completed by November 2016 Phase 2 – funding received to progress to Design stage Radiation Oncology Unit  Planning permission granted  Contractor appointed for enabling work  Funding received for Bracktherapy Equipment Education and Training Centre Statement of Need being developed Blood Sciences Project Design Team appointed Funding for interim infrastructural works approved Purchase of OLA approved 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

  • f Need

Ophthalmology Transfer – Phase 2  Project group in place  Application for planning permission submitted Helipad Interim helipad in place – contractor to be appointed in March 2016 Replacement Autoclaves & RO Project Commenced

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Key Issues

  • Retention of 30 inpatient beds (Transitional Care Unit)
  • Dependence on patient income
  • Potential loss of €300,000 income
  • Undergraduate Training costs - €6.5m per annum
  • Management of Unscheduled Care
  • Implementation of Change Programme Initiatives

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