Excellence – every moment, every day

Performance Improvement PlanCE LHIN Board Meeting (November)

Lakeridge Health

Excellence – every moment, every day

Our journey to quality

PCOP+ Buildings

PIP

2008/09 2009/10 2010/11 2011/12

QIP

Financial recovery

MAC Quality Priorities

Regeneration

Oldest MRI in province

TP4

No LHW

Rising debt

Interim Balanced Scorecard

Balanced Scorecard

Slide 2

Strategic Plan

Excellence – every moment, every day

Performance improvement plan

Slide 3

CE LHIN & LAKERIDGE HEALTH CONCERNS:

• Emergency and ALC wait times

• Long-term care capacity

• Home First implementation

• Administration and physician engagement

• ED PIP a challenge with consultants

Long-s tand ing p ressures o f g rowthand sys tem capac i t y con t r i bu te

to the p rob lem

Excellence – every moment, every day

Setting targets & developing strategies

Measuring and monitoring progress

Achievements and next improvement opportunities

Performance Improvement Plan

Our road to excelling in performance

Slide 4

Excellence – every moment, every day

Performance improvement plan

Slide 5

OUR STRATEGIES:

• Operate within a quality framework

• Investment in Quality, Safety & Patient Experience Departments

• Improve physician engagement

• Rebuild patient flow as transition management team

• Implement meetings in addition to daily bed/flow meetings

• Reinforce principles of Regeneration the organizational transformation journey

• Delegate to program-specific leadership

• Open the right type of BEDS

Excellence – every moment, every day

Our targets (PIP)

Slide 6

ALTERNATE LEVEL OF CARE:

EMERGENCY DEPARTMENT:

• Learning from ED PIP

• Increasing physician hours

• Improving patient access with seven-day model of care

• Target 10% improvement over 90 days (~ 68 hours)

• Working aggressively with CCAC to reduce # waiting

• Establish approval forum for each new LTC case

• Improvement target for ALC-LTC

• LTC: 120 in August; 90 in October; target is 60

Excellence – every moment, every day

ED & ALC Targeted Improvements

Slide 7

*ALC-LTC volume (Corporate) target reduction is based on the current ALC-LTC volume and does not include new ALC designations that occur after Q1 (That is we aim to reduce the Q1 ALC-LTC patients by 2 per month. This will not reflect if new ALC designations are present).

Excellence – every moment, every day

Setting targets & developing strategies

Measuring and monitoring progress

Achievements and next improvement opportunities

Performance Improvement Plan

Our road to excelling in performance

Slide 8

Excellence – every moment, every day

Outcomes and Action Plan

Slide 9

Excellence – every moment, every day

Outcomes

6.9 2.6 90.8

7.3 3.0 104.3

OCTOBER

Slide 10

79

80.9

AUGUST

Time to Initial Physician

Assessment

ALC-LTC average daily open cases

ED Non-Admitted High Acuity Patients

ED Admitted Patients

1.9 0.4 0.4 13.5

4.5

5.1

ED Non-Admitted Low Acuity Patients

0.6

Excellence – every moment, every day

90th Percentile ED LOS Admittance

Slide 11

Excellence – every moment, every day

ALC – LTC

Slide 12

A v e r a g e D a i l y O p e n A L C - L T C ( b y M o n t h )

JULY AUGUST SEPT. OCTOBER YTD

LH Corporate 110 104 99 90 100

Excellence – every moment, every day

Commitment to Home First

Slide 13

COMPLIANCE ISSUE(process not followed)

NO ISSUE (ALC designation only appropriate option for patient)

4OCTOBER

15OCTOBER

7SEPTEMBER

2SEPTEMBER

11AUGUST

3AUGUST

Excellence – every moment, every day

Excellence – every moment, every day

Setting targets & developing strategies

Measuring and monitoring progress

Achievements and improvement opportunities

Performance Improvement Plan

Our road to excelling in performance

Slide 14

Excellence – every moment, every day

Achievements – ED LOS

90th Percentile ED LOS Admitted

Opening Short Stay Unit (LHO)

24/7 Crisis Intervention Team

Draft development of COPD care pathway

Slide 15

Excellence – every moment, every day

Achievements – ED PIP

Slide 16

• See and Treat (LHO and LHB)

• Bed readiness process improvement strategy

• Transfer of Accountability Faxed Report ED to Medicine

• Discharge Checklist

• Rapid Assessment Zone model (LHO – starting November)

IMPLEMENTED

PILOTED

Excellence – every moment, every day

Achievements - ALC

Recruitment of ED Social Worker

Development of ALC Long Stay Working Group and subcommittees

LH Transition Management Team

Appointed Leader of Transition Management

Conduct consults, support meetings, feedback

Slide 17

Excellence – every moment, every day

Interim Conclusion

• Process improvements

• Capacity

• Positive impact of ED PIP, Home First and GAIN

• Various projects (i.e. See and Treat) in progress

Benefits of targeted improvements & strategies are in view

Slide 18

Excellence – every moment, every day

Excellence – every moment, every day

Lakeridge Health