Performance Management Andrew Crow Manager Rehabilitation and - - PDF document

Performance Management

Andrew Crow Manager Rehabilitation and Hospital at Home

Presentation Outline

Performance Management

• What are we all trying to achieve?
• The levels at which it occurs
• Activity targets and other areas we are monitoring
• Processes

Performance management

What is performance management?

• includes activities which ensure that goals are

consistently being met in an effective and efficient manner

• can focus on the performance on an organisation,

a program or even the processes to build a product or service, are well as many other areas

Why performance manage?

• Improve knowledge around what is occurring
• Ensure quality of services
• Accountability for funding (significant tax payer $)
• Transition to ABF & monitoring maintenance of effort

Equity

• A key reason for performance management
• Fair playing field
• All in this together and want the same outcomes-the

best for clients

• Aim for equity in terms of access to services (quantity)

and quality of services

Department’s Performance management tools & mechanisms

• Policy and Funding Guidelines
• Equitable processes
• Reports
• Frameworks
• Opportunities
• Recall
• Monitoring maintenance of effort
• Activity targets
• Networking
• Calculating & monitoring National Weighted Activity Unit (NWAU)
• Excellence

Victorian health policy and funding guidelines Victorian health policy and funding guidelines Policy and funding guidelines (P&FG)

• Main document that outlines department’s expectations
• Outlines the parameters that health services are expected to work to and

within

• Strengthened for subacute in 2013-14 - greater focus on policy
• Performance requirements at a health service level and at a program level

Annual Statement of Priorities (SoP)

• Sets out policy priorities of government, health service specific priorities and

expected levels of performance in key areas for financial year

• Signed off by CEO and Chair of the board with the minister
• For Pall care NGO’s this is usually a SAMS agreement

2013-14 performance management framework

Health Service performance monitoring

• The goal of this level is to monitor overall health service

budget, activity against target and quality measures

• Tools used – PRISM and Monitor reports
• Who-Quarterly meetings with CEO and Performance area of

DH

2013-14 performance management framework

Program Monitoring The goal of this level of monitoring is to be more specific and allow:

– a comparison of the current year and previous year(s) activity using historical units of measure. – benchmarking model of care and comparison with peers for patient characteristics. – Inform services of their progress towards the national model units of count.

• Tool used – subacute / program stream benchmark reports
• Who- Subacute exec and managers in health services and

Continuing Care section of DH

13-14 Activity targets

Admitted

• Weighted beddays
• Public and private
• DVA

Non admitted

• Service events & monitoring of existing units

Maintenance of effort

• Monitoring existing units
• Non admitted – also monitoring effort against any

growth for HIP

• Calculating and monitoring National Weighted Activity

Units (NWAU)

• Other measures including quality measures

2013-14 Subacute Wrap & Funding Recall Policy

• Admitted: Consider activity across a number of admitted

subacute inpatient funding streams (GEM, Rehab and pall care, private and public) when deciding to apply funding recall or to provide additional funding. This process is referred to as the ‘subacute wrap’

• Same percentages this year (over and under)
• Simplified process in weighted bed days

Admitted recall example

$9,617,421 $33,779 20,000 100% 18,800 $9,583,642 20,000 Total $448,781 ‐$448,781 1,000 5% 940 $897,562 2,000 $449 Subacute Private (rehabilitation, GEM and Pall Care private combined ) $9,168,640 $482,560 19,000 95% 17,860 $8,686,080 18,000 $483 Subacute Public (Rehabilitation, GEM and Pall Care public combined) Revised Funding For Health Service Cash Flow Adjustment To Health Service Revised Private/Public Targets based

• n percentage

private /public actual % of activity Health Service Actual Weighted Bedday Activity Budget For Health Service Health Service Weighted Bedday Targets Weighted bedday price (TBC) Subacute Service Step 4 Step 3 Step 2 Step 1

Recall example continued

Step 6 ‐6.0% PROPORTION OF FUNDING FOR RECALL ‐$577,045 ‐1,200 20,000 18,800 Total ‐$26,927 ‐60 1,000 940 Subacute Private ‐$550,118 ‐1,140 19,000 17,860 Subacute Public Difference $ Amount For Revised Targets Difference Activity To Revised Targets Revised Private/Public Targets based on percentage private /public actual Actual Weighted Bedday Activity Subacute Service Step 5 part 2 Step 5 part 1

Recall example

‐$300,907 Total financial adjustment for health service $33,779 Cash flow adjustment based

• n revised targets

‐$334,686 Total recall as per above Step 8 ‐$334,686 ‐$577,045 Total ‐$96,174 100% ‐$96,174 >5% ‐$126,950 66% ‐$192,348 3‐5% ‐$48,087 50% ‐$96,174 2‐3% ‐$63,475 33% ‐$192,348 0‐2% Marginal Recall Variance Margin Therefore Step 7

2013-14 Subacute Wrap & Funding Recall Policy

• Non admitted: Funding recall will not be automatically
• applied. When determining whether recall applies, the

department will consider maintenance of effort in relation to service events and pre-existing units as well as utilisation of any growth funds for the Health Independence Program. It is expected consistent recall policy will apply in 2014-15

• Non acute care will not be recalled in 2013-14
• TCP state based component will be subject to recall

(more than 5% variance)

• Equity

Reports

• Getting the data back to health services
• PRISM used by CEO and Executive to monitor activity

2013-14 subacute program reports:

• Subacute admitted and streams reports (Rehab, GEM,

Palliative Care)

• Non admitted – Health Independence Program report

(& stream reports), Community Palliative Care, Family Choice, VRSS

• Reports will be modified to include changes related to

classifications and funding models

Frameworks

• Subacute capability and access

planning framework

• Palliative care service delivery

framework

• 7 components
• service description & mix
• Catchment
• clinical staff mix
• networking & integration
• quality standards/clinical guidelines
• equipment & supporting services
• teaching & research
• Performance is not just activity
• Quality expectations
• National definitions of care
• Focus mapping current service

provision; identifying service gaps and what health services need to address

• Health service requirements

articulated in the 2013-14 P&FG

Opportunities

• New system
• New focus
• To transition
• To learn and build

Networking

• Through frameworks in regions
• Through forums focusing on benchmarks and model of

care

Key Messages

• Performance management is an important aspect to

ensuring our goals are met and there is a level playing field

• Lets work together
• Read the policy and funding guidelines
• Data is important- VAED, VINAH, AIMS (and cost data)
• Not just activity! Systems are changing so quality of

service very important and using resources in best interest of patients