December 3, 2014 Mark Brintnell, Scott Chambers, Jennifer - - PowerPoint PPT Presentation

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December 3, 2014 Mark Brintnell, Scott Chambers, Jennifer McCullough, Betty Wang

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• Opening comments
• Milestones
• Hospital Accountability Planning Submission (HAPS)
• HAPS, HAPS supplementary
• Narrative
• *NEW Board/Executive Balanced Scorecard or Dashboard
• Performance Improvement Plan
• Assumptions
• H-SAA Indicators
• Questions & Additional Resources

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• Window for HAPS upload to SRI December 19 –

January 16

• New H-SAA legal agreement template shared (date

TBD)

• Proposed Schedule C-1 performance targets and local

conditions and indicators sent to hospitals February 2

• H-SAAs sent to hospitals February 9
• Hospitals confirm intention to approve H-SAAs March 9
• LHIN Board considers H-SAA approval March 17

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• HAPS template available on SRI
• Detail and comments in the Assumptions tab very

helpful!

• No need to complete working capital detail information
• HAPS supplemental worksheet will be posted to the

LHIN web site early December (captures HSAA schedule data not in the HAPS)

• No need to add Schedule C-1 performance targets to the

HAPS supplemental worksheet – LHIN will provide proposed targets early February

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• HAPS narrative template posted to LHIN web site
• Brief narrative (2-3 pages) mandatory for 2015/16
• Review of Hospital Narrative Template

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Addition to HAPS Submission: Please submit a recent copy of a Board/ Executive Level Balanced Scorecard or Dashboard to SWLHINReporting@lhins.on.ca

• Eg. Quality Committee of the Board Report
• Not QIP

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• The goal: balanced budget
• In the event that a budget margin waiver is necessary,

the hospital will be required to complete a Performance Improvement Plan (PIP)

• The PIP must accompany the HAPS submission,

although this is no guarantee that the LHIN will provide a balanced budget waiver

• Review of PIP Template

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• Large (HSFR) hospitals – make allowance for revenue

changes that can be projected from the 2014/15 impact spreadsheets

• Small hospitals – assume zero increase for 2015/16
• Assume 2015/16 funded QBP volumes match 2014/15

levels for elective QBPs, for non-elective QBPs the 2015/16 funded volumes will most likely be set to the 2014/15 actual level

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• “ALC Rate – Acute” was transferred from an explanatory

classification to a performance classification, while “Percentage of ALC Days” was transferred from a performance classification to an explanatory classification.

• “Rate of Hospital Acquired Cases of Clostridium Difficile Infections”

was identified as a key patient safety indicator and retained its performance classification. All other patient safety indicators were transferred to the explanatory classification (see next slide).

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• The following patient safety indicators were transferred to the

explanatory classification:

• Rate of Central Line Infection
• Rate of Hospital Acquired Cases of Methicillin Resistant

Staphylococcus Aureus

• Rate of Ventilator-Associated Pneumonia
• Rate of Hospital Acquired Cases of Vancomycin Resistant

Enterococcus

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• ALC indicators (non-acute): ALC rates for CCC, Rehab and Mental

Health were removed. Should individual LHINs/hospitals be interested in these rates, it was suggested that they be added on a local basis.

• Stroke indicators: The group engaged the Ontario Stroke Network

to advise on a single key indicator, resulting in the identification of “Percent of stroke/TIA patients admitted to stroke unit during their inpatient stay”. This will maintain its explanatory classification.

• Remaining stroke indicators were removed: 30-Day Readmission
• f Patients with Stroke or Transient Ischemic Attack (TIA) to Acute

Care for All Diagnoses, and Percent of Stroke Patients Discharged to Inpatient Rehabilitation Following an Acute Stroke Hospitalization.

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• Working Funds indicators: The group engaged

MOHLTC to advise on a single key indicator, resulting in the identification of “Adjusted Working Funds as a Percentage of Total Revenue”. This will maintain its explanatory classification.

• Adjusted Working Funds was removed.

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• New indicators proposed by Senior Friendly Hospitals were added

as developmental indicators:

• Rate of Hospital Acquired Delirium
• Rate of ADL Function Assessment at Admission and Discharge

(Acute Care)

• Rate of No Decline in ADL Function (Acute Care)
• Rate of Baseline Delirium Screening

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• New indicators proposed by BORN were added as developmental

indicators:

• Proportion of Women with a Cesarean Section Performed from Greater

than or equal 37 to Less than 39 weeks' Gestation among Low-Risk Women having a Repeat Cesarean Section at Term, by Hospital of Birth and Comparator Groups

• Proportion of Women Induced With an Indication of Post-Dates Who are

Less than 41 Weeks Gestation at Delivery

• Proportion of Newborn Screening Samples that are Unsatisfactory for

Testing

• Proportion of Labouring Women Delivering at Term Who had GBS

Screening at 35-37 Weeks Gestation

• Rate of Episiotomy in Women having a Spontaneous Vaginal Birth
• Rate of Formula Supplementation in Healthy Term Infants Whose Mothers

Intended to Breastfeed

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General Considerations:

• Recent performance trend (last four quarters)
• Anticipated impact of performance improvement

initiatives, e.g. ED Knowledge Transfer, Home First

• Quality Improvement Plan (QIP) targets
• The LHIN’s performance & targets in the Ministry-LHIN

Performance Agreement (MLPA) + H-SAA Target & Corridor Setting Guidelines

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• The LHIN will communicate proposed targets in early February to allow

time to include more current baseline data …discussions & negotiations to follow

Baseline time- frames:

Q2, Q3, & Q4 2013/14 and Q1 2014/15 Q4 2013/14 and Q1, Q2, & Q3 2014/15 Performance Indicator:

• MH/SA repeat

unscheduled visits to ED (London Local Indicator)

• ER LOS (admitted*, non-adm complex, non-adm minor)
• % of PIV cases completed within priority access

target (cancer, cardiac by-pass, cataract, hip, knee, MRI,

CT)

• C. Diff**
• ALC*** rate

(NOTE: QIP is % ALC Days)

In finalizing targets, the LHIN will consider adjustments to timeframes if:

• Inclusion of more current data results in material change in baseline
• There has been/will be a significant change in operating environment and/or services

(planning assumptions)

**15/16 QIP baseline = Q4 13/14 to Q3 14/15 (avail Feb) *15/16 QIP baseline = Q4 13/14 to Q3 14/15 ***15/16 QIP baseline = Q3 13/14 to Q2 14/15

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Coming Soon

• 2015-16 H-SAA Technical Specifications
• 2015-16 HSAA Target Setting Guidelines

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Hospitals (OHA)

H-SAA Steering Committee Co-Chairs: Paul Huras, CEO SE LHIN Bill MacLeod, CEO MH LHIN Marian Walsh, CEO Bridgepoint H-SAA Planning & Schedules Work Group

Co-Chair: Sherry Kennedy, SE LHIN Co-Chair: May Chang, MSH

H-SAA Indicators Work Group

Co-Chair: Mark Brintnell, SW LHIN Co-Chair: Imtiaz Daniel, OHA

LHINs

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• Finance:
• (South) Scott Chambers –

scott.chambers@LHINS.on.ca (519)-640-2578

• (Central & North) Betty Wang –

betty.wang@LHINS.on.ca (519)-640-2601

• Performance:
• Jennifer McCullough –

jennifer.mccullough@LHINS.on.ca (519)-640-2575

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