Improvement Targets and Initiatives

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4 9/17/2013 QIP III Improvement Targets and Initiatives Deep River and District Hospital AIM MEASURE CHANGE Quality dimension Objective Measure/Indicator Safety implement electronic pharmacy system by March 31, 2014 fully functional computer physician order entry and electronic medication record Current Target for performanc 2013/14 e Target justification Priority level Planned improvement initiatives (Change Ideas) Methods and process measures 0% 100% 1 CPOE & emar in all physicians and staff trained and utilizing the system - further analysis of reduction in medication incidents to occur post implementation Goal for change ideas (2013/14) total use of new electronic system Comments Effectiveness Improve organizational financial health Total Margin (consolidated): Percent by which total corporate (consolidated) revenues exceed or fall short of total corporate (consolidated) expense, excluding the impact of facility amortization, in a given year. Q3 2012/13, OHRS balanced balanced Maintain 2 identify all opportunities 1) work with foundation and auxiliary for funding for capital expenses 2) continue to focus on revenue generation 3) continue to examine all operational efficiencies Access Patient-centred understand current state of employee satisfaction Improve access to tele-medicine services Increase access to smoking cessation programs fir standardized, benchmarkable survey conducted winter results that not are available will be analyzed and an action plan created to ensure change previously occurs done increase access to TM services 350 patients in improve smoking cessation counselling for admitted patients q3 2012/13 = 44% full analysis of results new process implemented 2 full analysis of results completed 1) work with NRC Picker to extract reports based on the survey completed 2) create an action plan where deficiencies identified 3) report quarterly to QPS committee the results of changes made 400 patients 14% increase 1 implement new clinics/specialists access as need identified understanding of current state of employee satisfaction 1) work with local partners to identify need and improved access to TM implement added resources 2) identify needs of patients services for local clients and advocate with regional group to get new clinics in 80% 3 ensure all identified smokers have 1) work with the Ottawa Heart Institute (OHI) smoking smoking cessation consult completed cessation program to improve practices 2) increase training for staff 3) review of screening practices embed into current practice the completion of the required documents for the success of the program implement bedside point-of-care patient satisfaction implement senior leadership rounds at the bedside in order to identify real time patient satisfaction data 0% 100% monthly rounds conducted 2 full implementation of program 1) prepare standard script 2) educate staff on how this impacts them 3) report to QPS committee quarterly the results of the feedback full implementation so that real time feedback can be incorporated with other standardized patient satisfaction tools already in Integrated Implementation of electronic health record on in-patient unit full implementation of EHR in partnership with other CLHIN small hospitals as part of Transformation funding HIMSS scale 1.2 HIMSS scale % improvement 1 full use of EHR on in-patient unit 1) work with vendor and steering committee to share resources 2) complete training for all staff fully functional EHR on inpatient unit

5 DRDH Executive Incentive Plan Linkages to Quality Improvement Plan Quality Dimension Objective Target for 2012/13 Weighting Percentage of Available Incentive Final Report 0% < 10% <20% <50% 100% 120% April, 2014 implement electronic pharmacy systems SAFETY 80 to 100% of achievables in for new electronic pharmacy sytems 40% 80% in fully implement ed ACCESS Improve access to telemedicine services 15% increase in usage over % 450 clients seen 500 patients seen INTEGRATION inplementation of electronic health record on in-patient unit 80 to 100% of achievables in for new electronic patient record 40% 80% in fully implement ed 100% Executive Risk Note: Total incentive available cannot exceed the %'s of base pay identified below for any single individual. CEO 5% base salary CNO 2.5% base salary CFO 2.5% base salary 2.5% of annual Chief of Staff stipend