Steering us Toward Excellence


          Peel Regional Cancer Centre

         35         39             42
         May ...
Outline

• Outline the drivers of change
• Discuss how planning reduces uncertainty and
  will help us achieve our goals
•...
Oncology Program Steering Committee
                                Terms of Reference

Purpose: To oversee and monitor th...
Current Context
Our concerns?
1. Increase in health care costs vs current and future demand.
2. Patients are living longer...
The Future



             Certainty?

       The only certainty is
      that nothing is certain.
                       ...
Planning for Excellence

•   Face uncertainty squarely and preparedly.
•   Harness the best possible management tools.
•  ...
What is Quality?

Quality: Meeting or exceeding our customer’s requirements
in a cost effective way, the first time and ev...
Enhancing Quality and Value
We are all in this together!


   Economic                            The Quality Sphere      ...
What is value?


• The quest to provide value in service is one that
  ensures that patients receive the best possible car...
Getting there Involves Focus on Our Processes
Provider System Processes
       • Timely access to the right treatment
    ...
Performance Management Framework


Linking Strategy, Performance Measurement for Excellence

   Policies                 T...
Oncology Program Plan 2009-2010

1. Strengthen accountability in care across the
   trajectory.
2. Actively manage program...
Value Domains and Performance Dimensions
In summary the domains or people, operations and
locations where value resides ar...
Need a Strategy

“Strategy fundamentally reflects a statement about what
you are doing and what you hope to achieve.”
    ...
Strategy Map and Goals

                  Strategic Direction   Performance Goals




Michelle Goulbourne June 2009
Need Performance Measurement


You can’t manage processes and outcomes for
improvement if you don’t measure them.
PRCC Measurement Framework




                        Michelle Goulbourne – Template - December 2008
Performance Measurement Framework

                                            PRCC key performance indicators (KPIs)
Stra...
Cascading PM Frameworks



                                            Hospital
                             Corporate Str...
Contact

Michelle Goulbourne
Sr. Consultant
Diamind Health
mgoulbourne@diamindhealth.com
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Oncology Steering Bi Strategy Implementation Presentation M Goulbourne Jun09

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2009 - Strategic Performance Management Implementation - Oncology Example

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Oncology Steering Bi Strategy Implementation Presentation M Goulbourne Jun09

  1. 1. Steering us Toward Excellence Peel Regional Cancer Centre 35 39 42 May Current Goal % IMRT June 2009 Michelle Goulbourne June 2009
  2. 2. Outline • Outline the drivers of change • Discuss how planning reduces uncertainty and will help us achieve our goals • Describe the rationale for program-wide strategic planning and performance measurement • Describe the current oncology program strategic plan and scorecard • Describe the performance management vision • Outline next steps for the committee as we prepare for 2009-2010 Michelle Goulbourne June 2009
  3. 3. Oncology Program Steering Committee Terms of Reference Purpose: To oversee and monitor the Cancer Centre performance, planning and service delivery to ensure our patients and families have access to high quality, integrated evidence-based cancer care across the continuum. Objectives: 1. To establish and review the Oncology Programme’s strategic goals and performance. 2. To monitor progress towards our strategic goals and performance (clinical and business) as they reside within each of the five dimensions of the Oncology Programme’s Strategic Plan: Patient Experience and Satisfaction, Utilization and Clinical Outcomes, Financial, Worklife and System, Integration and Change. 3. Provide direction for important action items and issues as they pertain to achieving strategic goals and performance within each of the five dimensions. 4. Develop a communication strategy to share our progress and performance across all oncology programme stakeholders.
  4. 4. Current Context Our concerns? 1. Increase in health care costs vs current and future demand. 2. Patients are living longer. 3. Variations in outcomes reflect spatial and sociocultural factors. 4. Access issues such as wait times and variation in utilization rates remain. 5. Aging of baby boomers and concerns about the burden of care weigh heavily on all stakeholders. 6. Patient evaluations of care. 7. Data quality issues hindering efficient management. 8. Limited systematic technology integration within and across the region. Michelle Goulbourne June 2009
  5. 5. The Future Certainty? The only certainty is that nothing is certain. Pliny the Elder
  6. 6. Planning for Excellence • Face uncertainty squarely and preparedly. • Harness the best possible management tools. • Develop collaborative and long-term knowledge building relationships between the oncology program and other programs, health care stakeholders, government and academia. • Create principled strategies for dealing with competing healthcare priorities that include decisions about health care operations and clinical practice. • Maintain the focus on quality, safety and value. Michelle Goulbourne June 2009
  7. 7. What is Quality? Quality: Meeting or exceeding our customer’s requirements in a cost effective way, the first time and every time. Quality Gap: The difference between where you are and where you want to be in order to meet or exceed your customer’s requirements. When quality gaps exist time is spent searching, checking, re-doing and/or waiting. Domains where quality is created? 1. Customers: Patients and families 2. People: Clinical and administrative staff, physicians, volunteers, donors, community partners & stakeholders 3. Processes: Clinical and business operations The quality sphere…we’re all in this together! Michelle Goulbourne June 2009
  8. 8. Enhancing Quality and Value We are all in this together! Economic The Quality Sphere Socio-cultural Community Ambulatory Hospitals Support Inpatient Services Long-Term Care Patients and Mental Staff Current Families Health Community Addictions Care Access Future Previous Children’s Centres Treatment Donors Centres Community Community Suppliers Partners Government Service Providers Environmental Political Michelle Goulbourne June 2009
  9. 9. What is value? • The quest to provide value in service is one that ensures that patients receive the best possible care in the most cost effective manner. • “…should occur in the prevention, diagnosis, and treatment of individual health conditions. It is at this level that true value is created – or destroyed – disease by disease and patient by patient. It is here where huge differences in cost and quality persist.” Porter and Olmsted Teisberg 2004 Michelle Goulbourne June 2009
  10. 10. Getting there Involves Focus on Our Processes Provider System Processes • Timely access to the right treatment • Accurate patient assessment, treatment and follow-up Patient Level Processes • Patient and family satisfaction and quality of experience along the trajectory of care to end of life Medical Care Process Factors • Guideline based clinical care paths at point of care • Standardization of patient care Organizational Processes • Resource utilization, efficiency and cost effectiveness • Managed costs Technological Processes • Accurate data for clinical and business decision making • Integrated clinical system supporting the trajectory of care Michelle Goulbourne June 2009
  11. 11. Performance Management Framework Linking Strategy, Performance Measurement for Excellence Policies Tools Structure Levels of Operation 1. CVH / CCO CVH and CCO Strategic Balanced Score Innovation for Goals and Priorities Card Sustainability 2. PRCC - Systemic Formalized policy Performance Creation of programs, framework that measurement and operational - Radiation informs: system that consists processes that - Palliative 1. evidence based of health care and enhance our ability to planning and quality indicators achieve our goals and - Surgical 2. accountability whose measures may sustain them over processes. be tracked and space and time. compared over time. *Revised Strategy Diagram – Original in Veillard, J., Ardal, S. and Gilbart, E. 2006. Michelle Goulbourne June 2009
  12. 12. Oncology Program Plan 2009-2010 1. Strengthen accountability in care across the trajectory. 2. Actively manage program performance. 3. Target better clinical and operational processes and outcomes for the program and its stakeholders. Towards this end a strategy map and performance management framework have been established with agreed upon performance indicators associated with each dimension. Michelle Goulbourne June 2009
  13. 13. Value Domains and Performance Dimensions In summary the domains or people, operations and locations where value resides are: These are grouped into dimensions – those perspectives we need to consider as we plan for achieving our goals. 1. Patient Experience and Satisfaction 2. Utilization and Clinical Outcomes 3. Financial 4. Worklife 5. System Integration and Change Michelle Goulbourne June 2009
  14. 14. Need a Strategy “Strategy fundamentally reflects a statement about what you are doing and what you hope to achieve.” Veillard, J., Ardal, S. and Gilbart, E. 2006.
  15. 15. Strategy Map and Goals Strategic Direction Performance Goals Michelle Goulbourne June 2009
  16. 16. Need Performance Measurement You can’t manage processes and outcomes for improvement if you don’t measure them.
  17. 17. PRCC Measurement Framework Michelle Goulbourne – Template - December 2008
  18. 18. Performance Measurement Framework PRCC key performance indicators (KPIs) Strategic goals are linked to performance are linked to the corporate KPIs in the management framework indicators BSC Michelle Goulbourne June 2009
  19. 19. Cascading PM Frameworks Hospital Corporate Strategic Goals and Indicators Oncology Program Strategic Goals and Indicators Medical Oncology Radiation Oncology Surgical Oncology Palliative Care Goals Goals and Indicators Goals and Indicators Goals and Indicators and Indicators Michelle Goulbourne June 2009
  20. 20. Contact Michelle Goulbourne Sr. Consultant Diamind Health mgoulbourne@diamindhealth.com

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