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Achieving System Improvement
and Performance
Regional Perspective
Jennifer McCallum
1
Health System Funding Reform
Quality Based Procedure (QBP)
Southwestern Ontario health care partners and
patients working together to improve and sustain
system performance
Decision support collaboration models and access
to information
Regional Perspective
2
CH LHSC Academic Health Sciences Centre in SWO
 Regional referrals
 Providing specialized paediatric services
 Medical research
“Committed to providing family-centred care”
Southwestern Ontario Maternal, Newborn Child and
Youth Network (MNCYN)
Focused on:
 Quality Health Outcomes
 Systems Integration
 Asset Management
 Enhanced Learning and Growth
 Works in Partnership with Provincial Council for Maternal and Child Health
(PCMCH) to bring strategies, standards and best practices to communities
How we work together
3
How we work together
 LHSC Decision Support
 Key member on Data Working Groups, Local Health
Integration (LHIN) Decision Support networks.
 Many successes providing formal and informal
support.
 Share benchmarking information and opportunities
 Regionally, Provincially, Nationally
 Connects leaders with other system stakeholders,
departments, services and subject matter experts.
4
CoP and Decision Support Networks
Value & Impact
Right Care, at the Right Place,
at the Right Time
Collaboration
Improved
Patient Care
Benchmarking &
Evaluation
Feedback,
Best Practices
Integrate information
System and
Capacity
Electronic data sources
and reports
Improve data quality
and timeliness
5
Paediatric Asthma QBP cases
-in SWO facilities
6
Paediatric Asthma QBP cases
- SWO patient postal codes
7
Regional Integrated Decision Support
 Allows us to
understand
volume of
patients with
multiple visits.
 Observe where
variation
exists, informs
actions
8
1 2
3
4
Plan, Do,
Study/Check, Act
improvement
cycle
Indicator and
Case Costing
analysis
Clinical Handbook
and Pathway
review
Confirm processes,
pathway compliance,
regional dashboards
Internal and External Review
9
Accountability and Sustainability
 Teams continue executing improvement plans
 Internal monthly / quarterly performance monitoring
 Local Health Integration Network (LHIN) escalates external
reporting requirements, when performance is beyond target
corridors
 Performance metrics incorporated into Quality Improvement
Plans, Balanced Score Cards, Board Committee reports
 LHIN performance opportunities identified and followed up
through Decision Support Networks
 As provincial results improve, expectations are increased and
targets are compressed

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Oct 23 CAPHC CPDSN Symposium - Jennifer McCallum

  • 1. Achieving System Improvement and Performance Regional Perspective Jennifer McCallum
  • 2. 1 Health System Funding Reform Quality Based Procedure (QBP) Southwestern Ontario health care partners and patients working together to improve and sustain system performance Decision support collaboration models and access to information Regional Perspective
  • 3. 2 CH LHSC Academic Health Sciences Centre in SWO  Regional referrals  Providing specialized paediatric services  Medical research “Committed to providing family-centred care” Southwestern Ontario Maternal, Newborn Child and Youth Network (MNCYN) Focused on:  Quality Health Outcomes  Systems Integration  Asset Management  Enhanced Learning and Growth  Works in Partnership with Provincial Council for Maternal and Child Health (PCMCH) to bring strategies, standards and best practices to communities How we work together
  • 4. 3 How we work together  LHSC Decision Support  Key member on Data Working Groups, Local Health Integration (LHIN) Decision Support networks.  Many successes providing formal and informal support.  Share benchmarking information and opportunities  Regionally, Provincially, Nationally  Connects leaders with other system stakeholders, departments, services and subject matter experts.
  • 5. 4 CoP and Decision Support Networks Value & Impact Right Care, at the Right Place, at the Right Time Collaboration Improved Patient Care Benchmarking & Evaluation Feedback, Best Practices Integrate information System and Capacity Electronic data sources and reports Improve data quality and timeliness
  • 6. 5 Paediatric Asthma QBP cases -in SWO facilities
  • 7. 6 Paediatric Asthma QBP cases - SWO patient postal codes
  • 8. 7 Regional Integrated Decision Support  Allows us to understand volume of patients with multiple visits.  Observe where variation exists, informs actions
  • 9. 8 1 2 3 4 Plan, Do, Study/Check, Act improvement cycle Indicator and Case Costing analysis Clinical Handbook and Pathway review Confirm processes, pathway compliance, regional dashboards Internal and External Review
  • 10. 9 Accountability and Sustainability  Teams continue executing improvement plans  Internal monthly / quarterly performance monitoring  Local Health Integration Network (LHIN) escalates external reporting requirements, when performance is beyond target corridors  Performance metrics incorporated into Quality Improvement Plans, Balanced Score Cards, Board Committee reports  LHIN performance opportunities identified and followed up through Decision Support Networks  As provincial results improve, expectations are increased and targets are compressed

Editor's Notes

  1. Decision Support key to implementation, evaluation, and sustainability of QI and best practices - Must work together to achieve optimum results
  2. MNCYN Vision: Healthy partnerships for healthy families Mission: Promote healthy communities by developing and nurturing networks of relationships based on knowledge and trust. 2.0 Introduction The Ministry of Health and Long-Term Care (Ministry) established Health System Funding Reform (HSFR) in Ontario in 2012 with a goal to develop and implement a strategic funding system that promotes the delivery of quality health care services across the continuum of care, and is driven by evidence and efficiency. HSFR is based on the key principles of quality, sustainability, access, and integration, and aligns with the four core principles of the Excellent Care for All Act (ECFAA): Care is organized around the person to support their health; Quality and its continuous improvement is a critical goal across the health system; Quality of care is supported by the best evidence and standards of care; and Payment, policy, and planning support quality and efficient use of resources. Since its inception in April 2012, the Ministry has shifted much of Ontario’s health care system funding away from the current global funding allocation (currently representing a large portion of funding) towards a funding model that is founded on payments for health care based on best clinical evidence-informed practices. Principles of ECFAA have been further reinforced first by Ontario’s Action Plan for Healthcare in January 2012, and recently with Patients First: Action Plan for Healthcare in February 2015, which signals positive transformational activity which will require adaptive responses across sectors and organizational levels at a time of accelerated change. The Ministry’s commitment is to make Ontario the best healthcare system in the world. The 2012 Action Plan identified HSFR as a lever to advance quality and ensure that the right care gets provided at the right place and at the right time. HSFR focuses on delivering better quality care and maintaining the sustainability of Ontario’s universal public health care system. Ontario is shifting the focus of its health care system away from one that has primarily been health care provider-focused, to one that is patient-centred. The 2015 Action Plan continues to put patients at the heart of the health care system by being more transparent and more accountable to provide health care in a way that maximizes both quality and value. HSFR comprises 2 key components: Organizational-level funding, which will be allocated as base funding using the Health-Based Allocation Model (HBAM); and Quality-Based Procedure (QBP) funding, which will be allocated for targeted activities based on a “(price x volume) + quality” approach premised on evidence-based practices and clinical and administrative data. 2.1 ‘Money follows the patient’ Prior QBP Lever for change: input rationale about QBP selection
  3. Standardized electronic data sources and reports are valuable, ability to create special project fields. Aside from Intellihealth and IDS, majority of SWO facilities utilize Cerner HIS Impact: Data validity, improve DQ, timeliness, update reports as data becomes available Access to integrated data sets- in SWO, we use Intellihealth and IDS, have lHIN identifier that allows us to see how individual patients access care. Valuable when you see frequent users, outreach opportunities, or service level changes Benchmarking & Evaluation: Gather feedback, share best practices, CoP have mechanisms in place to connect. Relationships established with colleagues are invaluable. Collaboration: DS provides information required for clinicians and leaders, decisions contribute to improved outcomes.
  4. Explain catchment # facilities served by MNCYN Academic/ Community hospital split is 30%/70%
  5. Where LHIN 1 & 2 patients live Distance mncyn covers for outreach and support, proximity to AHSC
  6. Indicator performance, processes and var