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Finance
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Balanced Score CardReview of December 2015 Data
Balanced Scorecard
Patient and Service User
Finance
Finance Report – December 2015
Provisional outturn - 2015
• Group budget €286.1m (2014 €284.9m)• Group actual expenditure (net) €285.9m (2014 €284.1m)• Group actual surplus €0.3m ( 2014 surplus: €0.7m)
• CUH Budget €268.8m (2014:€265.1m)• CUH /SMOH actual expenditure €269.2m (2014 €265.3m)• CUH /SMOH actual deficit (€0.3m) (2014 €0.2m)
• Mallow Budget €17.3m (2014:€17.5m)• Mallow actual expenditure €16.7m (2014 €16.8m)• Mallow actual surplus €0.6m (2014 surplus: €0.8m )
CUH Group –Surplus / (Deficit) percentage % (December)
CUH Group Summary – Budget v Actual Expenditure YTD 2015
Pay €k Non-Pay €k Income €k Total
CUH -3,983 -7,071 10,803 -251
SMOH 0 -68 -10 -78
CUH-SMOH -3,983 -7,139 10,793 -329
Mallow -1 -685 1,278 592
Total -3,984 -7,824 12,071 263
CUH Budget v Actual Pay YTD 2015
2015 Budget €k
2015 Actual €k
Variance €k
% Variance
2014 Actual €k
v 2014 Variance €k
Medical/Dental 64435 65,975 -1,540 -2% 63,637 2,338Nursing/Midwifery 87,139 87,646 -507, -1% 87,579 -67
Paramedical 32,088 32,583 -495 -2% 32,207 -376
Housekeeping 6,567 6,927 -360 -5% 6,392 535
Care Assistants 5,967 6,656 -689 -12% 6,392 264
Catering 3,976 4,080 -104 -3% 4,133 53
Portering 5,800 5,785 16 0% 5,934 149
Administration 17,875 18,175 -299 -2% 17,699 506
Other Staff 3,501 3,504 -3 0% 3,524 20
Total 227,349 23,133 -3,983 -2% 227,467 3,864
CUH Actual Non-pay Expenditure €k YTD 2015
CUH AGENCY COSTS €k 2013 – YTD 2015
CUH AGENCY WTE – YTD 2015
CUH Average Nursing & HCA Agency WTE’s per Week 2013-15
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2014-15
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2014-15
Patient Income 2013 – YTD 2015
CUH Debtor Days –YTD 2015
Mallow Budget v Actual YTD 2015
Budget
€k Actual €k Variance €k %Variance
Pay 15,161 15,162 -1 0.00%
Non - Pay 4,373 5,058 -685 15.70%
19,534 20,220 -685 3.50%
Income -2,244 -3,522 1,278 57.00%
Total 17,290 16,698 593 3.40%
Patient Access
INMO Trolley ReportAnnual data for 2015 and comparative data for 2014
CUH Weekly INMO Trolley ReportWeek ending 15th January 2015
ED – 6hr & 9hr Target – All Patients (January – December)
R
ED – 6hr & 9hr Target – Admitted Patients (January – December)
ED – 6hr & 9hr Target – Non Admitted Patients
Times of Ambulance Presentations Week Ending 10th January 2016
Ambulance Distribution Monthly
Improvement Initiatives
• More options for Ambulance Crews
• Decision making on destination hospital
• ED visibility of incoming ambulances
• NAS visibility of ED Status
• Ambulance Management assistance with clinical handover when required
• Separate Ambulance Triage Nurse
Delayed Discharges YTD 2015
Outpatient Waiting Lists
Patients to be seen by 31st January to meet maximum 15 - Month Wait Timeline
Patients with no Appointment before End of January 2016 and Patients with an Appointment post January 2016 by Specialty
Medical Patients to be seen by 31st January, 2016 to meet maximum 15-Month Wait Timeline
Surgical patients to be seen by 31st January, 2016 to meet maximum 15 - Month Wait Timeline
Women and Children Patients to be seen by 31st January, 2016 to meet maximum 15 - Month Wait Timeline
Current Waiting List 13/01/2016
Scope Waiting List
Scopes Urgent – November G
Scopes Routine - November R
Medical ALOS - November G
Quality & Safety
Day Surgery Admission Rate - November G
Surgery – Length of Stay - November G
ALOS – Excluding LOS over 30 days - November G
ALOS for all inpatients- November G
Emergency Re admission – Medicine - November
Emergency Re admission – Surgery - November G
Day Case Rate – Elective Cholecystectomy - November G
ALOS for all inpatients- November G
Emergency Hip Fracture Rate – November G
ALOS for all inpatients- November G
NEWS Full Implementation G
IMEWS Implementation for pregnant patients G
Reducing Healthcare Acquired Infection (MRSA)November
R
Reducing Healthcare Acquired Infection- C diff(October Dashboard)
R
Antibiotic Consumption Rate(October Dashboard)
G
Cancer KPI – Breast-Lung-ProstateJanuary – December
CUH OPAT Referrals 2015
CUH - OPAT Bed Days Saved 2015
CIT Referrals – January 2016(01/01/2016 – 12/01/2016)
CIT Referral Source - January 2016(01/01/2016 – 12/01/2016)
Quality and Safety Appointment of Clinical Director for Women and Children Directorate
Appointment of Lead for Clinical Audit
External Expert for Radiology Review identified
Improvement Programme on Complaints Management
Housekeeping Services Project Group – Principals agreed
Pilot project on risk assessment , risk escalation and risk register using module on Q Pulse (medium term plan is an electronic system)
Quality Improvement Programme for Outpatient services
Interviews for post of Risk Manager, Quality Assurance Manager and Quality Improvement Manager completed – In place 1st Quarter 2016
Risk Management December KPI data• Serious Reportable Events (x2) -Fractures (incidents happened in
November but not reported until December)
• Reportable events (Safety Incident Reporting) – 67 (*timelag in reporting due to manual system, electronic reporting 2016 at ward level)
• Medication Safety Incidents reported - 0 (*)
• Complaints – 24 complaints raised in December on average 41% closed within 30 day timeframe
• Claims - 3 new claims notified to hospital (one claim previously reported as incident)
• 1 risk escalated in November
•
Human Resource Management
Sick Leave – November 2015
Staffing & Costs November YTD 2015
EWTD Compliance 2015
Capital ProjectsProject Status
MRI Unit Completed and operational
Paediatric Unit Phase 1 - build programme commenced in JulyPhase 2 – submitted for capital funding
Mental Health Unit Completed and operational
Acute Medical Assessment Unit – Phase 3 & Endoscopy Unit Completed and operational
Radiation Oncology Unit Planning permission granted Enabling works to commence in January 2016
Cystic Fibrosis/ Respiratory Ward Completed and operational
Education and Training Centre Statement of Need being developed
Blood Sciences Project Design Team appointed – request for managed service approved
Oncology Service Expansion of Day Unit – plan signed off – submitted for Philanthropic funding (ACT)
Refurbishment of Ward 2D – capital funding in place Medical Oncology Centre – developing Statement of Need
Ophthalmology Transfer – Phase 2 Project group in place
Helipad Interim helipad in place - final solution being assessed by CAA.
Interim Transitional Care Unit Completed
Key Issues
• Reopening of 30 inpatient beds (Transitional Care Unit)
• Recognition of Budgetary performance
• Dependency on patient income
• 2016 Budget / Estimates
• Undergraduate Training costs - €6.5m per annum
• Management of Unscheduled Care
• Implementation of Change Programme Initiatives