CEO INTRODUCTION

Keith Dewar, President & CEO

Our Purpose

Why we are here

Strategic Hierarchy

Government of Saskatchewan

Ministry of Health

Regina Qu’Appelle Health Region

Provincial Health System

Patient, Staff and Physician

Input

Planning And Reporting Flow Chart

ClinicalBest

Practice

• Initiatives and projects cascaded down from the strategic plan and one-year business plan• Other important work identified to mitigate risks, fill gaps, and improve performances

Budge

Risks/Gaps/Challenges

Other E-Scan Data

Accred. Standards

CIHI Data

• Q1 Report on Strategic Plan

• Current year course correct

Q1

• Q2 Report on Strategic Plan

• Review inputs into next year plan

Q2• Q3 Report on

Strategic Plan• Finalize next

year plan

Q3

• Year end report (annual report)

• Celebrate successes

Q4

Feedback/ challenges/gapsbrought back to

the MOH and PLT tables.

Initiatives and projects

cascading downto service lines

and departments where they are

able to contribute to achievement

of strategic outcomes and

targets.

• Includes high priority, cross functional initiatives, measures, and targets that require regular monitoring by the Senior Leadership Team

• Identifies the annual priority areas of focus for the region

Portfolio, Service Line,

Department Multi-Year Plans

Key Support: SPBIU/KPO/KOTs

Use Lean tools to support implementation of operational plans wherever applicable: RPIW, 5S, Kanban, Standard Work, Replication, etc. Ongoing review of operationalization of Lean tools and training on the use of Lean tools will take place throughout the year rather than

ProvincialOutcomes &

Targets

Patient, Staff, and Physician Feedback

Strategic Planning Inputs

Strategic PlanningOutput 1:

Strategic Planning Output 2:

CascadingPlans

RQHR Multi-Year Strategic Plan

Key Supportt: SPBIU

RQHR One-YearBusiness Plan

Key Support: SPBIU

• Daily work of service delivery• Current year initiatives and projects cascaded down from service line/department multi-year plans

Service Line, Department, Unit

One-Year Operational Plans

Key Support: KPO/KOTs

DRAFT RQHR Planning and Reporting Input/Output

Kaizen Plans/Integrated

TimelinesKey Support: KPO/KOTs

Hard copies are on your table to see the details

• Quarterly Report on Strategic Plan: – VP Lead of multi-year plans report on outcome

measures and progress towards targets

RQHR Strategic Plan Reporting Mechanism

STRATEGIC MULTI-YEAR PLANNING & REPORTING

RQHR Strategic Plan

• RQHR Multi-year Strategic Plan includes:• Provincial Strategies

• ED Waits and Patient Flow (prov. Hoshin)• Mental Health and Addictions (prov. Hoshin) • Seniors• Infrastructure• Primary Health Care• Wait 1/GP to Specialist• Appropriateness• Financial Sustainability• Culture of Safety

• RQHR Internally Identified Strategies • Patient Family Centred Care• Engagement• Academics and Research

RQHR Strategic Plan – Cont’d

• We are confident in the strategic direction we are taking as a province and organization

• Each strategy is led by a Vice President (VP) who is accountable for achieving the outcome

• Each strategy is supported by a multi-year plan• Each strategy is being monitored and reported out

quarterly• Funding restraint will slow the progress of multi-year

plans and delay achievements and could potentially result in a deterioration in our gains to date

• We have significant capital and infrastructure deficiencies (facilities, equipment and information technology systems) that could impede our ability to meet strategic, business plan and operating budget targets

2015/16THE CURRENT YEAR

BUSINESS PLAN

2015-16 RQHR Business Plan

• 2015/16 RQHR Business Plan (One-year Regional

priorities):

– Continues to focus on:oQuality and SafetyoPatient Flow (also a 15/16 provincial Hoshin)oPrimary Health Care

– Added one more focused area:oMental Health & Addictions (also a 15/16 provincial

Hoshin)

Link RQHR Strategic & Business Plan

• RQHR Multi-year Strategic Plan includes:

• Provincial Outcomes • ED Waits and Patient Flow (prov.

Hoshin)• Mental Health and Addictions

(prov. Hoshin) • Seniors• Infrastructure• Primary Health Care• Wait 1/GP to Specialist• Appropriateness• Financial Sustainability• Culture of Safety

• RQHR Internally Identified Strategies • Patient Family Centred Care• Engagement• Academics and Research

• RQHR 2015-16 Business Plan has 4 Focused Areas:

o Quality and Safetyo Patient Flow (also a 15-16

provincial Hoshin)o Primary Health Careo Mental Health & Addictions

(also a 15-16 provincial Hoshin)

• Focuses on the work of the Senior Leadership Team (SLT)– It includes regional work that SLT has to lead, monitor,

and report

• Supports alignment across the RQHR – It is supported by work plans at the portfolio, service

line and unit level

• Focuses SLT support for daily management – Quality care, safe care, and financial sustainability

• Business plan can and will change during the year– When targets are met, initiatives can be replaced by

other work appropriate for SLT

2015-16 RQHR Business Plan – Cont’d

2015/16 WHAT HAS CHANGED SINCE OUR BUSINESS PLAN WAS APPROVED

2015/16 Preliminary Operating Budget

14

Regina Qu'Appelle Health Region

2015-16 Operating Budget

In $000's

2014-15 2015-16 Budget $ Change % Change

RevenueMinistry of Health Funding - Base 863,515 901,502 37,987 4.40%Ministry of Health Funding - Other 67,382 31,044 (36,338) -53.93%Other Gov't & Agency Revenue 25,830 25,513 (317) -1.23%Patient & Service Fees 24,745 24,108 (637) -2.57%Other Revenue 32,485 30,527 (1,958) -6.03%Total Revenue $1,013,957 $1,012,694 (1,263) -0.12%

ExpensesSalaries & Benefits 664,424 684,107 19,683 2.96%Medical Remuneration 86,930 86,763 (167) -0.19%Operating Grants 68,175 69,111 936 1.37%Medical Supplies 94,529 97,173 2,644 2.80%Infrastructure 48,768 48,504 (264) -0.54%Clinical & Operational Supports 52,588 50,561 (2,027) -3.85%Admin & Other 14,689 14,744 55 0.37%Total Expenses $1,030,103 $1,050,963 $20,860 2.03%

Preliminary Deficit ($16,146) ($38,269) ($22,123) 137.02%

Service Volume Changes Has an Impact on Costs

15

Hospital Care Utilization

  2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

Admissions 34,123

34,549

35,281

36,595

38,282 12.19%

Average Daily Census 642.40

655.60

645.70

650.67

650.01 1.18%

Average Lenth of Stay (Days)

6.90

7.0

6.70

6.30

6.30 -8.70%

Births/Newborn Admissions

3,771

3,954

4,087

4,234

4,253 12.78%

Emergency Visits 106,755

108,900

110,000

107,033

113,805 6.60%

Surgeries 21,683

22,774

23,232

26,615

26,216 20.91%

Diagnostic Imaging Procedures 274,490

272,759

305,956

312,977

257,129 -6.32%

Laboratory Tests Performed

3,555,074

3,662,535

3,783,155

3,952,096

3,952,096 11.17%

Home Care Service Workload Units 168,106

334,791

361,498

357,718

360,000 114.15%

Emergency Medical Services Calls 23,598

23,764

24,870

24,811

25,028 6.06%

# of Influenza Immunizations provided by Public Health

34,487

33,076

35,447

52,346 n/a 51.78%

Ambulatory Care & Medical Outpatient Procedures

86,056

99,906

108,445

112,025

118,899 38.16%

# of Long Term Care Beds n/a

1,989

1,961

1,963

1,963 -1.31%

Primary Driver – Paid Hours

16

Regional Focus to a Balanced Budget

Regina Qu'Appelle Health Region

2015-16 Operating Budget

In $000's

2014-15 2015-16 Budget $ Change % ChangeTotal Revenue $1,013,957 $1,012,694 (1,263) -0.12%Total Expenses $1,030,103 $1,050,963 $20,860 2.03%

Preliminary Deficit ($16,146) ($38,269) ($22,123) 137.02%

Regional Focus to Reducing Long-Term Cost Structure VP Responsible3sHealth and Other Contracts 2,500 PetersCost Savings from Reduced Surgical Volumes 8,000 GarrattReduction of VAC Beds if No Funding for Alternative use 1,300 RedenbachClinical Appropriateness 1,000 McCutcheonQuality & Safety Initiatives 1,000 SmaduPatient Flow / 95% Occupancy 1,000 NevilleImprove on Ambulatory Care Sensitive Condition Indicators 3,000 EarnshawReduce Orientation Costs by 20% * 1,300 HigginsReduce Sick Costs by 15% * 2,500 HigginsReduce Overtime Premiums by 33% * 3,929 PetersWorkforce Optimization - 152 FTEs at average salary of $85,000 ** 12,740 All

Revised Surplus (Deficit) $0

* Expected payback from daily management initiatives** Done through attrition, does not contemplate layoffs

ACCREDITATION

Accreditation Items before Sept. 17, 2015

Standard SetDue Date

June 15-19

June 22-26

June 29-July

3July 6-

10July 13-

17July 20-

24July 27-

31 Aug 3- 7Aug 10

- 14Aug

17-21Aug

24-28Aug 31- Sept 4

Sept 7-11

Dr. McCutcheon

Emergency Department Sep-15

Emergency Medical Services Sep-15

Medicine Services Sep-15

Cancer Care and Oncology Sep-15

Critical Care Sep-15

Michael Redenbach

Mental Health Sep-15

Population Health and Wellness

Sep-15

Long-Term Care Sep-15

Sharron Garratt

Ambulatory Sep-15

Obstetrics Sep-15

Perioperative Sep-15

Accreditation Items before Sept. 17, 2015Cont’d

Karen Earnshaw

Hospice, Palliative, and End-of-Life

Sep-15

Home care Sep-15

Public Health Sep-15

Rural (Imbedded in other CQI Teams)

Emergency Department

Ambulatory

IPAC

Reprocessing

Medication Management

Perioperative

Long -Term Care

Keith Dewar

Leadership: Medication Reconciliation

Sep-15

Leadership: Workplace Violence Prevention

Sep-15

Accreditation Items before Sept. 17, 2015Cont’d

Dawn Calder

Reprocessing Sep-15

Rehabilitation Sep-15

Medication Management Sep-15

Medication Reconciliation

Antimicrobial Stewardship Program

Concentrated Electrolytes

High- Alert Medications

Heparin

Narcotics

Infusion Pump Training

Marlene Smadu

IPAC Sep-15

PATIENT FLOW VISIONING SESSION

Current Year Course Correction

• Listen and take notes throughout the day • Note changes to things that will influence your

area and your plan, e.g. budget restriction. • Dedicate time after the session to work in your

teams and look at your plans to see what needs to be adjusted for this year and the following years

• Who will you need to talk to/link in with to connect your work?

Portfolio Planning & Deployment

ClinicalBest

Practice

• Initiatives and projects cascaded down from the strategic plan and one-year business plan• Other important work identified to mitigate risks, fill gaps, and improve performances

Budge

Risks/Gaps/Challenges

Other E-Scan Data

Accred. Standards

CIHI Data

• Q1 Report on Strategic Plan

• Current year course correct

Q1

• Q2 Report on Strategic Plan

• Review inputs into next year plan

Q2• Q3 Report on

Strategic Plan• Finalize next

year plan

Q3

• Year end report (annual report)

• Celebrate successes

Q4

Feedback/ challenges/gapsbrought back to

the MOH and PLT tables.

Initiatives and projects

cascading downto service lines

and departments where they are

able to contribute to achievement

of strategic outcomes and

targets.

• Includes high priority, cross functional initiatives, measures, and targets that require regular monitoring by the Senior Leadership Team

• Identifies the annual priority areas of focus for the region

Portfolio, Service Line,

Department Multi-Year Plans

Key Support: SPBIU/KPO/KOTs

Use Lean tools to support implementation of operational plans wherever applicable: RPIW, 5S, Kanban, Standard Work, Replication, etc. Ongoing review of operationalization of Lean tools and training on the use of Lean tools will take place throughout the year rather than

ProvincialOutcomes &

Targets

Patient, Staff, and Physician Feedback

Strategic Planning Inputs

Strategic PlanningOutput 1:

Strategic Planning Output 2:

CascadingPlans

RQHR Multi-Year Strategic Plan

Key Supportt: SPBIU

RQHR One-YearBusiness Plan

Key Support: SPBIU

• Daily work of service delivery• Current year initiatives and projects cascaded down from service line/department multi-year plans

Service Line, Department, Unit

One-Year Operational Plans

Key Support: KPO/KOTs

DRAFT RQHR Planning and Reporting Input/Output

Kaizen Plans/Integrated

TimelinesKey Support: KPO/KOTs