Osler Town Halls September 2013


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  • Matt: Must Says:Welcome everyone Hope you had time to enjoy it and have some time away from work this summerThere has been a lot going on here at OslerWhen I picked the music for the opening montage (Ain’t no mountain high enough)...Speaks to the commitment of people at Osler to deliver high quality health care everydayAlso it resonated with me with regards to how we are reorganizing and changing what we do to better serve patients and families in our communitiesHow we are going beyond what is “the norm” at other hospitals to really push thinking about health care delivery to get services to patients While they are with usin the community and In their home – virtually....
  • Matt: Must Says:Our plan for the next five years is bold, it is exciting and it will mean change in how we deliver care and interact with our patients, our partners and our community - it will be at times challenging – we know through our work (remind them that the plan is based on research and data) it will lead to system improvements and support sustainabilityWe have made deliberate choices about what we will do to achieve our strategy over the next five years.The future of sustainable healthcare lies in our ability to shift the proportion of unscheduled visits downward and the proportion of scheduled visits upward, to focus more on health and prevention to reduce avoidable visits in the ED and inpatient visits and for those patients who require inpatient admission to provide care in the most effective manner so they have the same great outcome and a shorter stay…We’ve made considerable progress on all aspects of our Strategic Directions this year. Here’s a closer look....
  • Matt: Must Says:Strategy #1 is focused on creating health services with an unwavering commitment to patient inspired care – this is about the softer side of our services, how we treat folks when they are with us, and how we communicate with them before, during and after their visit.Call Centre:This has been a terrific way to not only ask what patients tell us but take action:Questionnaire expanded from 3 to 10 questions to probe deeper on specific drivers of “Would You Recommend” Started calling Geriatric Outreach Program In August we received 2 Best Practice Awards – Accreditation Canada and The Beryl InstituteOther hospital (Trillium) have reached out to us to learn what we are doing and replicating it at their siteFrontline Heroes:Through the Inpatient Surveys patients often recognize staff/physicians and volunteers by name for the care they recievedThis summer we launched “FH” on OslerNet where we recognize the names of those Oslerfolks who patients have noted for going beyond Patient Summit:A forum where the voice of the patient is loud and clear Planned for mid-October (October 23 TBD)Key Objective: help us design-solution:  what meaningful communication is prior to scheduled outpatient visits and upon discharge.Staff and Physician SatisfactionAll areas have received their results and should be working on their action plans to continue working on enhancing satisfaction and engagement.Next survey: February 2014Website/social mediaTo better connect with the community beyond our walls we’ve enhanced and expanded our social media platform in the last few months!Launched new website in June; as well as Twitter, Youtube, LinkedIn, Facebook and Matt’s blog on Wordpress.It would be great to get more folks to “like us on facebook’ – make some sort of joke here ....
  • Matt: Must Says:Strategic Direction 2 – Continue to deliver exemplary care in the eyes of our patients and peersOur 2013-16 Clinical Priorities Plan which Jo will be speaking about shortly really is the operational plan to achieve this strategy
  • Matt: Must Says:Strategic Direction #3 is all about transforming the way we work not just within but outside our walls. Looking to working more with our partners with a focus on primary care to deliver services to the community.Great examples5 Health Links ( 2 Osler led approved!)Brampton and Bramalea Health Links, Created Central West Health Links SecretariatOther partnerships:Established Primary Care Planning Table, a group of local primary care physicians that will meet twice annually to advise us and guide the implementation of initiatives focused on improving access and transitions Held second Tele-Town Hall with partners; third one is being planned for this fall.
  • Matt must says:Strategic Direction #4 is all about creating impact through education and innovationOn the research side:This year we’ve set a goal to develop a formal applied research strategy. We have a population that is rich in diversity that we can learn from and then share with peers so that others can benefit from our knowledge.Dr. Ron Heslegravejoined Osler last week – from UHN where he is Ron will be helping us map out our plan around research and I am sure we will be hearing a lot about it over the coming weeks and months.Ethics PilotWorking on an ethics quality improvement project that reduces common mistakes in the consent process that contributes to transfers of senior patients from LTC homes to our EDs that patients do not want or cannot benefit from. The pilot is currently in field and will run until March 2014.On the education side:Expanding Academic PartnershipsTrain the next generation of nursing and medical students so Osler’s innovative patient-inspired practices will benefit patients beyond our communities.This year we’ve added metrics to our Corporate Scorecard around the number of nursing and professional practice staff acting as preceptors and we are currently tracking on target.Student App ContestIn the next few weeks, Osler is going to be launching its first ever mobile app contest. Entitled “Kiss My App”, it will be open to all students across Canada.This contest will position us as a forerunner in technology and keeps us top of mind when students look for career opportunities.It’s just one of the new and different ways we’re connecting with others in the community and beyond.
  • Matt Must Says:Challenge ourselves to find savings If we want to do new things we need to find investment from existing budgetsBased on our assumptions for this year – we are still on trackTodeliver on our overall Strategic Plan and at the same time meet our funding obligations to the government we have to challenge ourselves to find transformative new ways to deliver exemplary care more efficiently and effectively.In today’s provincial economic climate and with a shift in Ministry funding mechanisms – if we want to invest in new things we have to find some of the money within our existing budgets. Finding savings allows us to continue with our capital program – equipment replacement, renovations and upgrades of our buildings but also priorities like our research program...This will allow us to reinvest our dollars to ensure Osler stays at the forefront of innovation and outstanding care delivery.To meet our budget for the current year (2013-2014) we reviewed services and practices across the organization for cost saving strategiesAs a result of this work:There were no service reductions;We had some staffing changes and about 20 people were affected with a few leaving the organizations while others were redeployed and reassignedBasically based on what we know today we are continuing with our Annual Business Plan priorities as planned – so full steam ahead....
  • So – when we were at our last Town Hall I also said we were planning for 2014-15 earlier than usual because we see it as a more challenging yearSo based on what we know today and this may change in the coming months (our plan for next year is based on assumptions – but Dave and the entire finance team have a great track record with their budget planning and assumptions)we again have looked for cost savings across the organizationorder of magnitude of about 3% to balance our budget for the year aheadWhat does this mean:We are refocusing some clinical areas to support community needs (investment to increase outpatient volumes)We are going to move towards to delivering the service levels we are funded for – as an example in DI we deliver far more volumes than the government funds us for – we will work towards delivering volumes closer to what we are funded for.We will shift and close a handful of beds in areas where occupancy is low based on our census – and we will reinvest in these same areas in outpatients because we have high ambulatory volumes because it is a better way to serve the patient populationAs a result of these changes and reshaping our programs, some people will be affected across the organization About the same magnitude as last Spring – in the neighbourhood of 20 peopleOn the nursing side – we expect no involuntary separations of any nurses who are willing to be retrained or redeployed to another area ...There will be some disruption as we make these changesIf you have questions – please speak to your managerIt is early days yet and as we finalize things, some areas will shift slightly but we think we have a solid plan in place to continue to delivery exemplary care, to serve patients and families and to meet our financial obligations.We wanted to share this with you now as we start to finalize our plans so that you have an idea of the magnitude of the changes that we are talking about.
  • Are there any questions based on what you just heard? Now we can take questions from the floor and those of you watching online can submit your questions to us live at “town.halls@williamoslerhs.ca”A heads up: there is a 2 minute delay from when you submit your question to when we get it.Added bonus: those that ask a question will get an Osler t-shirt sporting our new look!If you’re sending via email please include your full name and location so we can send you your shirt.
  • The main focus of the CPP is to deliver on Strategic Direction 2 in order to continue to deliver exemplary care in the eyes of our patients and peers...We want to identify and declare what are the areas that we will be leaders/community differentiators.We have achieved numerous accomplishments with the previous CPP and its important to remember that as a high performing organization we will recalibrate again to move the organization forward
  • Jo Must SaysAs a reminder ..... Over the last 9 monthswe engaged inside and outside the organizationFramework based on the proven Strategic Planning ProcessYou were likely involved in department meetings, huddles, strategic wallpaper etc.Collected a lot of information, advice and suggestions on how to reorganize ourselves and refocus our efforts to achieve our plans over the next 3 years.Last Wednesday it was approved by the Board of Directors – Today I am thrilled to share it with youAlso important to point out that this really is the beginning of the work – and we will be connecting with clinical teams in various ways over the coming months as we begin work on implementation throughout the organizationGuiding Principles of the plan include:Align to the corporate Strategic Directions.Support: Integration and Flow; Access and Equity; Quality and Safety; Health Status; and Workplace Environment (Clinical Services Resource Allocation - Ethical Framework).Strategically consider the role of each site, including site-specific programming and redevelopment.Purposefully consider supports/services offered in the community and/or with partnerships.Be driven by data and evidence.Support Osler’s fiscal sustainability.
  • Jo Must Says:Philosophy of care encompasses exemplary and high quality care (i.e. providing the right care by the right provider in the right time) – the bread and butter of acute care.EXPLAIN THE TWO SIDES OF THE STORYGIVE AN EXAMPLE
  • Jo Must Says:This is an administrative way to manage our health care servicesNo resource allocation differences between Program and ServicesEasier for public, our partners and in some ways internal audiences to understandComprehensive list
  • Jo Must Says:PICK up to 5 – most appropriate for each site.....
  • Jo Must Says:LET’S REMEMBER WHY WE ARE DOING THIS....Spend time telling Fred’s story (more than 1 minute for sure)
  • Here are some of the more frequent questions people ask across Osler.(go through each)Don’t forget, those of you watching online can submit your questions to town.halls@williamoslerhs.ca
  • Matt: ask people to fill out evaluation form found on chair (for those in the live audience) or for those web-streaming download it from the Osler Live page and email it to the town hall mailbox.
  • Osler Town Halls September 2013

    2. 2. OUR VISION 2 PAT I E N T- I N S P I R E D H E A LT H C A R E W I T H O U T B O U N D A R I E S
    3. 3. 3 • Welcome • Strategic Plan Update • 2013-14 & 2014-15 Budget Update • 2013-16 Clinical Priorities Plan • Questions & Suggestions AGENDA
    5. 5. 5  Call centre enhancements & recognition  Launched “Frontline Heroes”  Patient Summit – October  Staff/physician satisfaction: results shared & action plans underway  New website and social media platform STRATEGIC PLAN – PROGRESS REPORT
    6. 6. 6  New 2013-16 Clinical Priorities Plan! STRATEGIC PLAN – PROGRESS REPORT
    7. 7. 7 Health Links  CW Health Links Secretariat established Critical Partnerships  Primary Care Planning Table established  2nd Tele-Town Hall with CW CCAC, Region of Peel, Headwaters Health Care STRATEGIC PLAN – PROGRESS REPORT
    8. 8. 8  Chief Research Officer  Ethics LTC pilot in field  New preceptor targets  National student app contest STRATEGIC PLAN – PROGRESS REPORT
    9. 9. 9 2013-14 BUDGET UPDATE 2013-14 budget tracking as expected – No service reductions – Minimal staffing changes – Full revenues not confirmed – Capital released in phases based on organizational performance – Continue on track with our ABP and Year 1 priorities
    10. 10. 10 THE YEAR AHEAD • Strategically refocus some clinical areas to support community needs • Move towards volume funding in a few areas • Reassign or close a small number of underutilized beds to invest in for new care models (i.e. outpatients services) • Additional short-term funding allows for 18-month transition • Some staffing changes expected: – Some involuntary separations – No involuntary nursing exits
    11. 11. 11 QUESTIONS ON YOUR MIND Submit online at town.halls@williamoslerhs.ca QUESTIONS?
    12. 12. 12CONFIDENTIAL – For Discussion Purposes ONLY Paving Osler’s future towards operational leadership and community differentiation
    13. 13. 13CONFIDENTIAL – For Discussion Purposes ONLY OUR CLINICAL PRIORITIES PLANNING PROCESS Completed: • Validation of Clinical Services aspirations; Several stakeholder engagement sessions and consultations. • Drafting and validation of the Clinical Priorities Plan Current State: • Continued engagement with partners; Refinement of the Clinical Priorities Plan; Board approval: • Last week we received the go ahead from the Board on the plan • Now we will work on sharing it internally • Launch is planned for November Today
    14. 14. 14CONFIDENTIAL – For Discussion Purposes ONLY KEY ASSUMPTION Initiating a shift in the model of care within the health system to: Increase Scheduled Outpatient Activity Reduce Unscheduled/ Avoidable Emergency Visits & Inpatient Admissions
    15. 15. 15CONFIDENTIAL – For Discussion Purposes ONLY OVERARCHING THEMES A system designed to support timely access to appropriate care, across the continuum of care. Effort to prevent onset and/or exacerbation of chronic diseases, such as diabetes, COPD and CHF.
    16. 16. 16CONFIDENTIAL – For Discussion Purposes ONLY Programs • Cardiovascular * • Medicine • Mental Health and Addictions * • Musculoskeletal • Oncology * • Palliative Care • Renal / Chronic Kidney Disease • Seniors * • Women and Children * Services • Ambulatory Care • Critical Care • Diagnostic Imaging • Emergency Care • Laboratory • Pharmacy • Rehabilitation and Complex Continuing Care • Support • Surgery Practice • Academic Partnerships • Ethics • Family Medicine • Infection Prevention and Control • Interprofessional Practice • Quality • Research • Spiritual Care OSLER’S CLINICAL SERVICES PORTFOLIO * Represents previous Health System designation
    17. 17. 17CONFIDENTIAL – For Discussion Purposes ONLY THE HIGHLIGHTS... • Contemporary Vascular Program • Health Links • Specialized EGH Services • CTAS 2 Redesign/Level IV Trauma • Integrated & Virtual Mental Health & Addictions • Stroke Strategy/Neurosciences • MSK Program • Peel Memorial - Centres of Excellence • Model of Care
    18. 18. 18CONFIDENTIAL – For Discussion Purposes ONLY Fred Today: • 71-year-old male, living independently, without a family physician • Diagnosed with vascular disease, high blood pressure and depression • Suffers a stroke, is admitted to a hospital without a stroke program • Transferred to a rehab facility outside of the LHIN • Discharged without follow up • Has multiple encounters with hospital EDs and walk in clinics • Readmitted several times for mental health and vascular issues
    19. 19. 19CONFIDENTIAL – For Discussion Purposes ONLY Fred in Three Years: • Receives life saving Endovascular Aneurysm Repair • Lives independently with regular vascular health follow up using telemedicine • Regularly visits on-site psychiatric services at his Family Health Team • Visited the Urgent Care Centre for an infection • After a hip fracture is quickly admitted to the Musculoskeletal Program for surgery and rehab • Receives follow up at a Seniors outpatient clinic • Participates in the True North Project to share his experiences directly with staff
    20. 20. 20 QUESTIONS ON YOUR MIND Submit online at town.halls@williamoslerhs.ca OTHER QUESTIONS? • What is the status of the staffing and scheduling project review? • What is the status of redevelopment at Peel? • If you could name your top two priorities for the balance of this calendar year, what would they be? • I would love to spend more time with the senior leadership at Osler. Can you help make that happen?
    21. 21. 21 THANK YOU! Please fill out the evaluation form on your chair or fill out the online evaluation through survey monkey
    22. 22. OUR VISION 22 PAT I E N T- I N S P I R E D H E A LT H C A R E W I T H O U T B O U N D A R I E S
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