Environmental Services Business Case Development. Presentation to CHICA Saskatchewan Mark Heller

Transcription

1 Environmental Services Business Case Development Presentation to CHICA Saskatchewan Mark Heller September 20 th, 2013

2 My Background Sector Experience 25 years of healthcare experience Led environmental hygiene programs in over 570 healthcare facilities Trained with 100 s of operations managers Coast to coast and multi-national experience Career Executive leader of North America s largest (in-house) environmental services portfolio National leader of Canada s largest private sector (contracted) environmental services provider North American healthcare leader for a leading hygiene supply logistics leader Today, I consult with leading private and public operators in the areas of environmental hygiene and service operations Mark Heller, MBA Project Lead, Environmental Services 3sHealth (Share Services Saskatchewan) Memberships Association for Professionals in Infection Control and Epidemiology (APIC) 10 years Association for the Healthcare Environment (AHE) Healthcare Financial Management Association (HFMA) Community and Hospital Infection Control Association (CHICA) Canada The Society for Healthcare Epidemiology of America (SHEA) Chair Environmental Hygiene Interest Group, CHICA - Canada 2

3 Understanding 3sHealth

4 Creating 3sHealth Patient First Provides a mandate for Shared Services Shared Services Office (SSO) established by Council of CEOs Joined national group purchasing organization (HealthPRO) Joint purchasing accelerated Two major quality and savings improvement projects were started: Provincial Linen Services Project Gateway Online (Improved HR processes) 2012: SAHO Inc. Collective Bargaining and Labour Relations 3sHealth: Health Shared Services Saskatchewan Shared Service Office, Payroll, Benefits, Procurement 4

5 3sHealth: Health Shared Services Saskatchewan Vision: Province-wide services that better support a high performing, sustainable patient-centered health system. Mission: Health Shared Services Saskatchewan (3sHealth) provides efficient, customer focused, quality province-wide common services to the Saskatchewan Health Sector. Goals: 1. Improving Service Quality 2. Lowering the Cost Curve 3. Creating Enhanced Value to the System 5

6 6 Who are our Customers?

7 3sHealth Strategic Advantage Leverage Economies of Skill and Scale Standardization with Best Practice Focus Leverage Competition where appropriate Stage-gated decision making process Active Participation / Engagement Model Lean Management System expertise Dedicated Change Management Capacity 3sHealth Board 7

8 Millions Health System Savings (by month, projected trajectory to target comparison) $8.3m (see YTD achievements) Target $7m Current Projection Past Projection

9 3sHealth Strategy 2012/ / /14 Build Trust & Confidence Establish Mandate Creating Winning Conditions Defining Opportunities Business Cases & Quick Wins Capturing the Value for Patients and Families (Quality + Savings) Yesterday Today Tomorrow 9

10 10 Engagement

11 11 Telling the Story

12 Establishing Mandate June 13 September 13 October 9 October 31 November 6-7 November 14 November 15 CEOs review potential shared services and a stage gated decision making process CEOs Rate Opportunities Strategic approaches and draft 3 Year Plan presented to CEOs BD&SR Committee briefed on engagement & the draft 3 Year Plan Level 1 Hoshin Kanri & IT/IM license approved CEOs suggest revisions & provide support for 3 Year Plan 3sHealth Board approves 3 Year Plan February CEOs/CFOs/ADM Budget Planning Meeting (Accelerate and Quick Wins) March 1, 2013 Governing Council Meeting approves 3 Year Plan 12

13 Shared Services Business Case Development Phase 1 Supply Chain Services Laboratory Services Phase 2 Pharmacy Services (CEO s requested move to phase 2) Phase 3 Diagnostic Imaging Services (CEO s requested move to phase 1) Environmental Services Capital Projects (CEO s requested move to phase 1) Enterprise Risk Management Transcription Services (CEO s requested add to phase 1) IT/IS Services (Approved in Prov. Hoshin Kanri) Facility Services * * Facility Services = Facilities Maintenance and Engineering; Biomedical Equipment Maintenance; Real Estate; Protective Services and Parking Internal Audit Food Services Business Intelligence Services 13 Blue boxes approved by 3sHealth Board on November 15, 2012

14 Timeline June 1/13 Jan 1/14 June. 31/14 Sep 30/15 6 months 6 months 18 months Business Case Development Transformation Implement Improvement Projects DECISION: Go / No Go Capturing Value 14

15 Business Case Development Phasing April May June July Aug Sept Oct Nov Dec Jan Feb Mar Laboratory Services Diagnostic Imaging Supply Chain Environmental Services Transcription Services IT/IM Capital ERM 15

16 Building a Business Case Defining the Opportunity and Creating Winning Conditions Vision or Future State Business Case Detail Recommendation and Approvals Best Practice Future State Quick wins Data collection and validation Develop Options Analysis and Review Implementation plans to create winning conditions CEOs 3sHealth Governing Council Ministry of Health 16

17 Building a Business Case Business Case Detail Options Development VP - Operations - Finance - Human Resources - Communications Patient Advisors, Others Data collection and validation Detailed Financial, Labour Relations, and Operating analysis (according to Business Case Template) Transition Plan, Business Continuity Plan, Stakeholder Analysis, Risks and Sensitivities, Iterative process looking for system leaders to participate 17

18 The Value Proposition of Environmental Services

19 Saves Lives! Environmental Services made in Saskatchewan solution! We clean and disinfect surfaces to break the chain of infection and reduce opportunities for cross contamination! We are on the frontline of patient care; our employees clean without disrupting medical treatment and clinical care! We create an environment that is ready for care; the right service, at the right time! We perform our cleaning in a safe manner, protecting the health our employees, patients and visitors! 19 copyright 2013 Mark Heller Consulting Inc.

20 Define the Patient Experience! Environmental Services made in Saskatchewan solution! We spend more time with the patient and visitors than almost any other employee; our employees interact directly with patients in a private & personal way! We create an environment that instills trust and confidence; our services set the first impression of patient satisfaction! We know more about the day-to-day activities on the patient care unit than almost any other employee! We set the tone of morale for the facility; our services impact the attitudes and behaviors of every member of the patient care team! 20 copyright 2013 Mark Heller Consulting Inc.

21 Maintain the trust of Saskatchewan! We are the second largest workforce (after Nursing) in the healthcare system; our staff are highly integrated into the fabric of the local community! We set the first impression of every visitor to our facilities; thereby every Saskatchewan resident! We create the environment for efficient medical and clinical care; our work ensures a sustainable health system! We contribute to a healthy province through sustainable cleaning practices and responsible waste management! We maintain our facilities like they were our home; preserving the most-valued built environment in our community! 21 copyright 2013 Mark Heller Consulting Inc.

22 Environmental Hygiene Program it s a small world that is, until you have to clean it! 210 Facilities Urban, Rural, Remote Locations Acute, Long Term Care, Specialty & Community Health Large, Medium, Small Sizes One Province, One Patient, One Goal! 22 copyright 2013 Mark Heller Consulting Inc.

23 23 The emerging Value Proposition of Environmental Hygiene, represents a paradigm shift for Healthcare and cleaning service providers, and is a potential threat or an opportunity the outcome is up to you!

24 The Environmental Services Project Visioning Day June 19, 2013

25 We defined our collective focus To enhance patient safety through infection prevention and control Increase patient and public confidence through patient satisfaction in facility cleanliness Current State of Environmental Services Improve access to care through better patient flow Savings are an outcome of quality and efficient service 25

26 We articulated our desired attributes of the future state Patient/Residents/Family Experience Observe a clean and tidy facility Interact with employees who are motivated, positive and competent Service that is consistent throughout their stay Receive timely access to care with the right services at the right time Employees Engaged as a component of the patient care team Empowered to stop the line Be provided with the right equipment and supplies to do the job Well trained, certified, and competent 26

27 We articulated our desired attributes of the future state (cont d) Province Wide Consistency Evidence-Based Standard Work Consistent methodology for workload assessment Uniform operating and quality standards, performance metrics, and outcomes Roles, responsibilities, and accountabilities clearly communicated 27

28 28 We defined the opportunities we d like to see in the future state

29 The Environmental Services Project Current State

30 Environmental Services Current State Provincial ES Services Portfolio 72 million sq. ft of facilities cleaned 2,387 employees $ 66 million annual spend 78% hourly labor 8% management 7% cleaning supplies 4% waste management 3% other Predominantly an in-house provided service; outsourced cleaning exists at administrative, ambulatory care and support facilities Leadership is motivated on the need to improve services that add value Consensus on the contribution environmental services can make to support organizational goals of Patient Safety, Access to Care, Confidence/Satisfaction. Operations team are (generally) well equipped with the tools for staff to perform their work While not universally implemented, that are excellent examples of Daily Visual Management (DVM) impacting the performance of ES team and driving positive service outcomes 30

31 Environmental Services - Opportunities Establish a provincial mechanism to measure and report on environmental hygiene performance Standardized audit program will avoid duplication of effort (tools development) Provincial balance dashboard will improve accountability, transparency and (smart) comparisons Align environmental hygiene with clinical outcomes and returns on financial investments Standardized routine cleaning practices of clinical environments (critical and emergency care departments, surgical suites, inpatient units, resident home units) Improve patient safety through infection prevention Address critical gaps in cleaning practice Improve the predictability of resourcing (based on standard work engineering) Improve employee performance and ease of resource sharing 31 Standardized terminal bed cleaning processes and systems Improve patient safety through infection prevention Improve predictability of resourcing (based on clinical volumes) Improve patient throughput through standard work, comparable and measureable performance data

32 Environmental Services - Opportunities Standardized routine cleaning practices of non-environments (administrative, public, support and ancillary spaces) Improve patient confidence and community satisfaction Improve workplace safety and employee morale Improve the predictability of resourcing (based on standard work engineering) Improve employee performance and ease of resource sharing Standardize employee recruitment, on-boarding and training process Improve the ability to source and develop high caliber applicants Reduce employee (new hire) turnover Increase quality and productive of new hires Improve efficiency of the onboarding process Avoid duplication of effort (tools development) Standardize waste management practices across the province Improve health sector performance as a leader in sustainable practices at the community and provincial level Reduce organizational risk from incidents of improper waste handing and disposal Improve cost efficiency by leveraging provincial waste volumes to drive new opportunities (and markets) for recycling 32

33 Opportunities for Provincial Standard Work - Enhance safety through infection prevention & control - Improve access through better patient flow - Increase patient and public confidence - Savings through quality and efficiency 1.0 Protocol quality standards 2.0 Products & Equipment 3.0 People (staffing) 4.0 Processes (Daily Work) 5.0 Performance Reporting and Improvement Rural + Urban + Acute Care + Long Term Care Pilots = Provincial Standard Work = Sustain = Replicate = Automate 33 Standard Exists Research/Replication is Next Step Standard Can Be Finalized without RPIW RPIW Needed to Develop Standard Work

34 Environmental Services - Successes Broad and enthusiastic engagement at the ES visioning day Provincial consensus on the business-case evaluation frameworks for Quality, Risk and Economics Visit of representational facilities from every RHA and SCA Patient representation and input into the process Regular engagement of provincial Lead and Operations committees; all RHAs are represented on both bodies IPC participation in the process The population of a provincial statistical profile and database, representing 92% of healthcare facilities. 34

35 Questions? Thank You!