December 3, 2014 Mark Brintnell, Scott Chambers, Jennifer McCullough, Betty Wang 1
• Opening comments • Milestones • Hospital Accountability Planning Submission (HAPS) o HAPS, HAPS supplementary o Narrative o * NEW Board/Executive Balanced Scorecard or Dashboard o Performance Improvement Plan • Assumptions • H-SAA Indicators • Questions & Additional Resources 2
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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 4
• 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 5
• HAPS narrative template posted to LHIN web site • Brief narrative (2-3 pages) mandatory for 2015/16 o Review of Hospital Narrative Template 6
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 7
• 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 o Review of PIP Template 8
• 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 9
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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). 11
• 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 12
• 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 of 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. 13
• 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. 14
• 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 15
• 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 16
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 p erformance & targets in the Ministry-LHIN Performance Agreement (MLPA) + H-SAA Target & Corridor Setting Guidelines 17
• The LHIN will communicate proposed targets in early February to allow time to include more current baseline data …discussions & negotiations to follow Baseline Q2, Q3, & Q4 frames: Q4 2013/14 and time- 2013/14 and Q1 Q1, Q2, & Q3 2014/15 2014/15 *15/16 QIP baseline = • ER LOS (admitted*, non-adm complex, non-adm minor) Q4 13/14 to Q3 14/15 Performance Indicator: • % of PIV cases completed within priority access • target (cancer, cardiac by-pass, cataract, hip, knee, MRI, MH/SA repeat **15/16 QIP CT) baseline = unscheduled Q4 13/14 to visits to ED Q3 14/15 • C. Diff** (London Local (avail Feb) Indicator) • ALC*** rate ***15/16 QIP (NOTE: QIP is % ALC Days) baseline = X Q3 13/14 to Q2 14/15 In finalizing targets, the LHIN will consider adjustments to timeframes if: • Inclusion of more current data results in material change in baseline • 18 There has been/will be a significant change in operating environment and/or services (planning assumptions)
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Coming Soon • 2015-16 H-SAA Technical Specifications • 20 2015-16 HSAA Target Setting Guidelines
Hospitals LHINs (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 H-SAA Indicators Work Group Work Group Co-Chair: Mark Brintnell, SW LHIN Co-Chair: Sherry Kennedy, SE LHIN Co-Chair: Imtiaz Daniel, OHA Co-Chair: May Chang, MSH 21
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• Finance: o (South) Scott Chambers – scott.chambers@LHINS.on.ca (519)-640-2578 o (Central & North) Betty Wang – betty.wang@LHINS.on.ca (519)-640-2601 • Performance: o Jennifer McCullough – jennifer.mccullough@LHINS.on.ca (519)-640-2575 23
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