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Oct 23 CAPHC CPDSN Symposium - Dr. Peter Fitzgerald


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Achieving System Improvement and Performance
CEO Perspective

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Oct 23 CAPHC CPDSN Symposium - Dr. Peter Fitzgerald

  2. 2. DATA ANALYTICS • We need to use data to first improve care and then to help contain costs • Clinical data, cost data and mixture of both • The amount of available data and reporting requirements are increasing every month – Internal, provincial, national, international – So be sure to pick your battles!
  3. 3. DATA ANALYTICS • Basic principles when using data – Patient safety and quality are top priorities – It takes a team to use the data properly – External benchmarking is often key to engagement of staff – Form follows function
  4. 4. • Critical Care LHIN Name Total Percent Hamilton Niagara Haldimand Brant 1428 68.5% Waterloo Wellington 457 21.9% N/A 75 3.6% Mississauga Halton 54 2.6% North East 13 0.6% South West 13 0.6% Central West 12 0.6% Central East 9 0.4% Central 8 0.4% North Simcoe Muskoka 6 0.3% Toronto Central 5 0.2% North West 3 0.1% Erie St. Clair 2 0.1% Total 2,085 100.0%
  5. 5. 68.5% 21.9% 3.6% 2.6% 0.6% 0.6% 0.6% 0.4% 0.4% 0.3% 0.2% 0.1% Critical Care Hamilton Niagara Haldimand Brant Waterloo Wellington N/A Mississauga Halton North East South West Central West Central East Central North Simcoe Muskoka Toronto Central North West
  6. 6. The SEC index includes Low SES and the Ontario Marginalization Index’s Instability and Ethnicity measures
  7. 7. DATA ANALYTICS • We need to use “big data” as we move more into population health initiatives – Taking an upstream approach to disease prevention and management – Assessing models of care delivery outside of our walls
  8. 8. MCH Approach to Reduce Admit Rate Challenge: Unsustainable increase in admission through the Pediatric Emergency Department. DATA: Admit Rate: Admits as a % of Visits - 10.1% (CIHI, 2015). Absolute Values: Admits increased from 3,327 to 4,878 (CIHI, 2013-15) 46.6% increase above 2013 baseline
  9. 9. MCH Approach to Reduce Admit Rate Goal: Determine what is the ideal admission rate for MCH utilizing CAPHC National Benchmarking? Background: Emergency Department Visit volume ranged from ~1,000 - 76,000 per ED (CIHI, 2015) Canadian Pediatric Hospitals Average Admit Rate through the Emergency Department – 8.1% of total visits (CIHI, 2015)
  10. 10. MCH Approach to Reduce Admit Rate Drilling Down: Hospitals with a similar range of ED visits (50,000/year) generated the following admit rates: BC Children’s Hospital – 7.4% Stollery Children’s – 9.7% Winnipeg Children’s – 7.2% McMaster Children’s – 10.3%
  11. 11. MCH Approach to Reduce Admit Rate Goal 8% Target (2016) 9.5% Action: Investigate alternatives to Admission to Reduce Admit Rate – upstream focus 1. Focused on 24hour admits and discharges a) Launched an expanded wait at home practice to include our Ronald McDonald House for patients that meet criteria but live outside of our City.
  12. 12. MCH Approach to Reduce Admit Rate 2. Partnered with our Ambulatory Sub- Speciality Teams to improve the ED physician’s knowledge of complex patient’s medical history on arrival to the ED – upstream focus a) Re-launched our patient alert card system I'm on your Sharepoint
  13. 13. MCH Approach to Reduce Admit Rate 3. Clustered long stay patients onto one Medical Unit to focus efforts on similar discharge barriers – downstream focus a) Strengthen partnerships with community and home care providers b) Explore the opportunity to expand care parameters in the community and/or home
  14. 14. Questions?