BREAKFAST OF CHAMPI ONS Septem ber 1 6 2 0 1 0 CONSOLIDATION OF - - PowerPoint PPT Presentation

BREAKFAST OF CHAMPI ONS Septem ber 1 6 2 0 1 0

CONSOLIDATION OF OPHTHALMOLOGY SURGICAL SERVICES

Sparks, Tinder and Flam e

The Sparks

 Ontario Wait Time Strategy – Funded Incremental Cataract Volumes Available  Formation of the LHINs – Regionalization arrives  Anesthesia Care Team Demonstration Projects  Study confirms relationship between Volume and Quality Outcomes for Cataract Surgery

2

The Tinder

 CLHIN declares plan to develop High Volume Centre(s)  Hospitals potential benefit – equipment and OR space  Physicians potential for increased volumes and efficiency  Patients likely to experience better access to care  Accountability and Quality are easier to manage in a two centre vs. a seven centre model  Virtually all of the planned surgery is ambulatory  Consolidated – the ophthalmology community could “Dream Big”

3

The (Wet) Tinder

 Change is Hard  Small hospital consequences (Stevenson)  Ophthalmology Services in communities without surgery  Maintaining Ophthalmologists in their home communities  Patients would need to travel

4

The Flame

 April 2007: Ophthalmologists and Hospital reps meet and create an Ophthalmology Working Group  Support from hospital CEOs and CLHIN  2 teams Governance/ Administration Clinical Care Model make recommendations  Sept 2008: CLHIN Eye Centre Implementation Task Force is formalized  April 2009: Project Manager funding provided by CLHIN  April 2010: Approved by CLHIN Board of Directors

5

Eye Care Vision

 Original vision was to consolidate cataracts, however it became apparent that by consolidating cataracts alone there would be some major issues:

 Maintenance of equipment and team expertise for very low volume scheduled non cataract surgery  Loss of current services due to focus on cataracts  Non cataract surgical ophthalmology will ultimately not be sustainable at hospitals if they are not performing cataract surgery  Exception of pediatric strabismus surgery  Maintaining Ophthalmologists in home communities

 Conclusion: Consolidation of all eye surgeries is more feasible than just cataracts alone.  The surgical consolidation and creation of the two centres, lays the framework to a better integrated approach to delivering the entire spectrum of eye care services.

6

Our Planning Model

 Creation of 2 sites:

 North at Southlake Regional Health Centre  South at Branson site of North York General Hospital

 Emergency care to be provided across CLHIN  Maintenance of ophthalmologists in their home communities  Continuation of the current on-call system  Improved access to and repatriation of tertiary services (where that makes sense).  Efficient and cost effective operational model can enable further decreases in already low wait times  Maintenance of the high standard of patient care  Patient friendly processes

7

The Results

 JVA &MOU agreements and HSIP for cataracts completed  Communication plan developed and executed  Chiefs of Staff reviewed and developed an understanding

• f physician privileges to support a consolidated model

 Patient satisfaction surveys confirm success

8

Hospital within Central LHIN 2006-2007 2007-2008 2008-2009 2009-2010

NYGH 2611 6183 5,982 6980 Stevenson Memorial 326 638 276 215 York Central 632 1,127 498 Southlake Regional 1334 1,983 3,045 3749 Markham Stouffville 519 1,492 1,305 740 Humber River 440 1,982 1,993 1366

Cataract Completed Cases

Cataract Com pleted Cases 2 0 0 6 -2 0 1 0

1000 2000 3000 4000 5000 6000 7000 8000 2006-2007 2007-2008 2008-2009 2009-2010 Cataract Completed Cases Volum e NYGH Stevenson Memorial York Central Southlake Regional Markham Stouffville Humber River

Hospital within Central LHIN 2006-2007 2007-2008 2008-2009 2009-2010

NYGH 142 76 76 89 Stevenson Memorial 42 72 104 49 York Central 104 78 72 Southlake Regional 154 156 93 118 Markham Stouffville 91 59 57 64 Humber River 338 190 85 85

Cataract Wait Times (90th Percentile) 2006 to 2010

Cataract Wait Times 2006 to 2010

50 100 150 200 250 300 350 400 2006-2007 2007-2008 2008-2009 2009-2010 Fiscal Year NYGH Stevenson Memorial York Central Southlake Regional Markham Stouffville Humber River

Provincial Target 1 8 2 days CLHI N Target 1 0 2 days

Cataract Centre

Day of Surgery

3rd Floor

Patient Flow for Cataract Patient Flow for Cataract Surgery Surgery

Patient Satisfaction

Patient Satisfaction Survey Results (n= 105):  100% would recommend the centre to their friends and family  93% -100% excellent courtesy shown by staff members  93% -100% excellent care received

• verall from admitting to discharge

Ophthalmologist Perspectives

 Pros  Opportunities  Challenges

Conclusion – The Future

 First consolidation and integration of a Clinical Service in the CLHIN  Eye Care Committee established to advise on development and functioning of integrated eye care program for CLHIN area  Representatives from all signatories to JVA – clinical and administrative plus interested observers  Currently setting an agenda for the next 2 years: Fiscal – Clinical – Quality - Other

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Regional Eye Care Centre of Excellence

invites you to an open house at the Branson site

“Sharing our vision: An insight into cataract surgery”

Please join us in celebrating this integration initiative . Light refreshments will be served.

Wednesday, September 22, 2010 4 – 6:30 p.m.

Cataract Centre North York General Hospital – Branson Site 555 Finch Avenue West, 3rd Floor, Toronto For more information, contact Marcela Tutay at 416‐633‐9420 ext.1‐6625 marcela.tutay@nygh.on.ca