Osler town hall april 2014

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  • MATT: MUST SAYS:Since we last met... We have implemented:CTAS 2 Redesign – at BCHMedical Model of Care- first phase with the Hospitalists and GIMsWhat are the next big things coming your way...well I wanted to highlight a few areas where we will spending a lot of our energy.... Ambulatory Care – leveraging our ethical resource allocation methodology and in alignment with the need to increase our focus on scheduled care, we are currently developing a framework to assess our current complement of ambulatory services. This, to ensure that we are meeting the needs of our patients, that our outpatient services are aligned to the CPP, and that we are optimizing partnerships with the community. Bed optimization strategies – we will be optimizing our current set of resources (beds) to align with the direction of the CPP, the need to focus on shifting the health system, and being purposeful about where we choose to allocate our resources. Why Optimize our Beds:Aligning capacity with demand and needs supports a sustainable health care systemOptimize clinical adjacencies, interdependencies, efficiencies Optimize models of carePrepare for our upcoming redevelopment activities Changes to highlight: Cohorting patients with similar needs: Nephrology; StrokeAligning bed compliment to utilization, as well as shifting resource to the outpatient setting: MHA; Paeds; PalliativeLeveraging synergies/alignment opportunities: Rehab (STAR); Palliative & OncologySite-specific programming: Rehab
  • Matt: Welcome everyoneProvide overview of the agenda:Matt to province an overview of the 2013-14 and 2014-15Jo to provide update us on the clinical priorities plan
  • MATT:Context setting re: 5 year plan.Talk about how majority of folks will be directly involved in Strategic Direction 1 and 2 – - really the day to day work of the organization (the most important work): delivery of patient care only some in Strategic Direction 3 and 4
  • MATT:How did we end the year – pretty goodGo over the numbersWhile we have some red – that means we are pushing ourselves to improve
  • MATT:We had a lot going on last year – some of the highlights included…..
  • MATT:We are big…and growing and we need to continue to do this with the same or less funding… One of the largest areas of growth is unscheduled visits in the emergency department – where we continue to see more visits year over year And, scheduled visits in our outpatient areasAT THE SAME TIME – the government has said that hospitals will continue at zero percent increase to the budget Close the gap on efficient spending (CPWC)Find more efficient ways to deliver front line and back office services Like any other year we will have to find some efficiency savings throughout the organizationBecoming more difficult as some areas are incredibly efficient – ie ED
  • MATT: (Note after this slide you will be handing it over to Jo)Where are we going to focus this year (we are about a week into the 2014-15 fiscal year)3 Areas of significant corporate focus: Redevelopment, Partnerships, meeting or exceeding LOS for clinicalRedevelopment: at all 3 sites - explainPartnerships:We willwork more closely with our partners to transform the systemThe CW LHINCCACs, Headwaters, Peel Region Primary Care PhysiciansBuilding on our plans to align our internal programs and services – we now must focus on external partners to move our agenda forwardThis year we will focus on four key priorities:Primary Care Planning Table – ramp up our efforts to engage them with Osler Ambulatory Care - extend our outreach to all primary care physicians throughout the Central West LHIN to help inform our Ambulatory Care Review process to provide insight into the needs of the patients.LHIN Health and Social Services Planning Table – to help develop and support new partnerships with community care providers. With Neil’s leadership and vision, Osler will be well-served in advancing innovative partnerships.Joint Planning Committee/Strategic Partnership Committee with our Board co-leads – Jane and Beck in place that we can together with members from the Central West CCAC and Headwaters promote collaboration, cooperation and shared governance between the organizations in support of strategic integration opportunities. Focus on improving LOS to meet or exceed provincial benchmarks while continuing to achieve same patient outcomes
  • 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:Our efforts in 2013-14 really centered around:Creating our new CPPAligning our resources to support our strategic agenda and set us up for successImproving access to care for patientsAnd we began working in new ways with partners including creating shared accountabilities and scorecards.These changes support innovative delivery models, improved quality and increased efficiency within the local health care system. This means we are moving some things around to:Provide capacity to treat more patientsQuality improvementOpportunity for specialization New and leading patient care programsHelp to attract and recruitIncrease efficiencyTouch on some of the new programs introduced: MSK/Stroke/Vascular/Breast Program/Trauma.
  • Why Optimize our Bed Map? Aligning capacity with demand and needs supports a sustainable health care systemOptimize clinical adjacencies, interdependencies, efficiencies Optimize models of carePrepare for our upcoming redevelopment activities There are four (4) components of the Bed Optimization Strategy: Service AlignmentService Utilization and LOS OptimizationSite-specific programmingIncreased capacity for increased Access & FlowChanges to highlight: Cohorting patients with similar needs: Nephrology; StrokeAligning bed compliment to utilization, as well as shifting resource to the outpatient setting: MHA; Paeds; PalliativeLeveraging synergies/alignment opportunities: Rehab (STAR); Palliative & OncologySite-specific programming: RehabThere are NO additional layoffs associated with these changes Nephrology changes will be implemented in February. ACE and Dialysis conversations have begunPalliative and Oncology discussions will begin this week (palliative changes are in line with the Palliative Review Recommendations – moving from 41 beds to 28 beds in line with utilization, still focusing on outpatient clinic and inpatient consultation) The others will commence in March for completion by April SIMCU requires some capital funding and renovations. The plan is to implement in FY 2014/15
  • The Clinical Priorities Plan and the Redevelopment Project will bring additional specialized services to Etobicoke:Enhancements related to CPP:Click 1: Additional Trauma OR TimeWe have already added a 3rd day for Trauma to support fractured hip workClick 2: Enhanced Triage Assessment Area in the EDClick 3: Specialized Geriatric Services for The STAR (Short Term Asses & Restore) unit is moving to Etobicoke 16 (PASSU) Satellite Geriatric Clinic under development in the community to enhance seniors accessClick 4: Specialized Mental Health ServicesAdding Adolescent and Geriatric Mental Health outpatient clinicsClick 5: Decanting Cataracts (mentioned that we may have to move services more than once)All cataract procedures are moving to EGH…renovations will begin soonClick 6: Specialized surgical proceduresNew Breast Program and moving upper MSK to EGHClick 7: Satellite Dialysis CentrePlan is to add 36 dialysis stations for patients in Etobicoke. The current strategy is to place these in the ASB…portable interim options under consideration to advance the access to this service closer to home.Enhancements related to Redevelopment and completion of the new WingClick 8: Increased ED Capacity & Critical CareNew expanded ER to address volume pressures for emergency care and brand new critical care unitsClick 9: Increased Obstetrical Capacity (up to 4000 births)New Labour and Delivery with Tie-in to existing departmentNew C-sec rooms (2), Special Care NurseryAlso renovating the Pharmacy area as additional example of ongoing investment in EGH
  • Note: Want to provide time horizons for services but emphasize can’t do everything simultaneously. BCH is both a great GENERAL hospital and a specialized centre that provides tertiary/quaternary care. In order to do this we need to shift services and programs not only among Osler sites but also with key partners.The Clinical Priorities Plan and the Redevelopment Project will bring additional specialized services to Brampton:Enhancements related to CPP:Click1: TelehomecareHost for the CWLHIN Telehomecare program. Also expanded telemedicine programs and introduced tele-psychiatryClick 2: CTAS 2 RedesignProcess redesigned the CTAS 2 flow with introduction of SAZClick 3: Health LinksCo-lead for two Health Links in Brampton and Bramalea and participating in the Etobicoke link as well. Host to the Secretariat to support all 5 Health Links in the LHINClick 4: Introduced Medical Model of CareFirst phase with the Hospitalists and GIMs – Specialist care next phaseClick 5: Additional ORPlan to open an additional OR by the beginning of fiscal 14/15Click 6: MSKFocus on creation of centre of excellence…Pradeep to provide an overview in a few minutesClick 7: Stroke ProgramPlans to introduce a formal stroke program and neurosciences programClick 8: Enhanced Vascular & EVARPlanning will begin next year and will take approximately a year to complete recruitment and training. Support the vascular needs of our communityClick 9: Extensive preparations for the opening of PeelClick 10: BCH GrowthOnce we have moved identified services to PMC we will need to backfill Brampton with the required and/or expanded programs/services to meet growth demands
  • MATT:Health Quality Ontario has changed the QIP requirements for 2014-15This year there are 7 mandatory metrics recommended in an effort to standardize and compare hospitals across the province. These metrics are ranked as maintain or improveThese are measured based on a calendar versus fiscal year (which all hospitals use to measure progress) This creates inherent timing differences between Osler’s performance metrics and those measured through the QIP. The Health Services Committee is recommending that a letter be sent to HQO on behalf of the Board stating their concerns regarding the timing differencesRemember the QIP is only one small component of Osler’s quality plan
  • MATT:These are important questions and we look forward to hearing from you on other things that are important to you and on your mind…..Make sure to point out that all Lunch with the President reports are listed on Oslernet and available to everyone….
  • MATT:Before we get to some of the pre-circulated questions – this is just a reminder that if you have questions please submit them on line now as there is a bit of delay in receiving them....To ask a question please send it to town.halls@williamoslerhs.ca – thank you!
  • Osler town hall april 2014

    1. 1. 1 APRIL TOWN HALL April 8, 2014
    2. 2. 2 Submit now online at town.halls@williamoslerhs .ca
    3. 3. OUR VISION 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
    4. 4. 4 • Welcome • 2013-14 Review • 2014-15 Strategic Focus • Clinical Priorities Plan update • Questions & Suggestions AGENDA
    5. 5. 5 OUR FIVE YEAR ROAD MAP: Strategic Plan
    6. 6. 6 2013-14 SCORECARD 15 8 6 1 Our Corporate Scorecard Indicators 3R1 G
    7. 7. 7 GREAT PROGRESS AND TRANSFORMATION • Strategic Plan Public Launch • EGH facility upgrades • Peel Proponent Named • Canada’s Best Diversity Employer • GTA Top Employer • First Student App Contest • Foundation gala raises $650,000 …and much more!
    8. 8. 8 2014-15: WHAT WE KNOW • Continued demand for key services • 200,000+ ED visits • 400,000+ outpatient visits • Essentially flat-lined operational funding • More efficient and effective service delivery • Some areas highly efficient, room for improvement in others
    9. 9. 9 • Significant energy on three key strategies: • Redevelopment program • EGH • BCH • Peel Memorial • Strategic partnerships • Length of Stay 2014-15 STRATEGIC FOCUS
    10. 10. 10 Clinical Service s Update
    11. 11. 11 CLINICAL SERVICES UPDATE • New Clinical Priorities Plan • Aligning Resources • Improving Access to Care • Enhancing Site Specific programming • Shared Accountabilities with partners
    12. 12. 12 BED OPTIMIZATION • Nephrology/Renal • Palliative Care • SIMCU Service Alignment • Mental Health • Paediatrics • Medicine • Critical Care Service Utilization & LOS Optimization • Rehabilitation/Reactivation/C CC Site-specific Programming • Post-Acute Short Stay Unit (PASSU)Increased Capacity
    13. 13. 13 ENHANCED SERVICES: ETOBICOKE GENERAL EnhancedTriage AreainED AdditionalTrauma ORTime Specialize d Geriatric Services SpecializedMental HealthServices Decanting Cataract Surgery Specialized Surgical Procedures Satellite Dialysis Centre (Interim) MoreEDCapacity &CriticalCare Increased Obstetrical Capacity 2013/14 2014/15 New Wing Centreof Excellence MSK(Upper)
    14. 14. 14 ENHANCED SERVICES: BRAMPTON CIVIC AND PEEL Established HealthLinks Redesigned CTAS2 ProcessinED Introduced Medical ModelofCare 2013/14 2014/15 2015/16 Planning BCHgrowth Prepfor PMCopening Enhanced Vascular Specialized Medical Services Open ORatBCH Introduced Telehomecare Centreof Excellence MSK(Lower)
    15. 15. 15 2014-15 QUALITY IMPROVEMENT PLAN • CDI - Maintain • Med Rec - Improve • Total Margin - Maintain • ED LOS - Improve • Would you recommend? - Improve • ALC - Maintain • Readmission - Maintain
    16. 16. 16 FOLLOW-UP…QUESTIONS ON YOUR MIND • What is Osler doing to be ‘green’?
    17. 17. 17 Submit now online at town.halls@williamoslerhs.ca
    18. 18. 18 Please fill out the evaluation form and leave it on your chair or complete survey monkey online! THANK YOU!
    19. 19. OUR VISION 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 19

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