Community and Hospital Profile

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2 Community and Hospital Profile Scope of Services ACUTE CARE Emergency Department (~33,000 visits) Intensive Care Unit (Level 2: 6 beds) Medicine/Surgical Inpatient (40 beds) Surgical Services (3 ORs; 5,000 cases) Maternal Child Care (6 beds; ~600 births) Diagnostic Imaging Radiology, CT, MRI, Ultrasound, Mammography, Nuclear Medicine, Bone Mineral Densitometry POST ACUTE CARE Palliative Care (6 beds) Restorative Care (16 beds) Interim Long Term Care (11 beds) Inpatient Rehabilitation (18 beds) OUTPATIENT Dia nosti Ima in Diagnostic Imaging Ambulatory Care Satellite Chemotherapy Clinic Satellite Dialysis Clinic Community Mental Health 2

3 Geographic profile: NHH catchment South East corner of the Central East LHIN Serves approximately 60, residents in the Town of Cobourg, Municipality of Port Hope, and the townships of Hamilton, Alnwick/ Haldimand d and Cramahe Notably older population Males Population Pyramids, 2006 Females 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% Source: Statistics Canada 2006 Census NHH catchment considerably older than Central East LHIN and Ontario NHH Catchment Northumberland Central East LHIN Ontario 6 3

4 Notably older population Males Population Pyramids, 2006 Females 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% NHH Catchment Northumberland Cobourg Peterborough Source: Statistics Canada 2006 Census Projected population growth by age cohort (Relative vs. Absolute Change), Northumberland County, % 50.0% 40.0% Relative Change 52.4% 41.2% 4.% 6,000 5,000 4,000 Absolute Change 5,000 4, % 20.0% 20.4% 27.5% 3,000 2,000 1, % 1, % % 20.0% 9.1% 2.9% ,000, 2, , Current or shorter term growth ( ) demonstrates significant growth of older population Source: Ministry of Finance Population Projections 4

5 Retrospective Review 5

6 Strategic Plan Building a sustainable future Patients first Our Mission: Exceptional patient care. Every time. Collaborative networks Operational excellence Our team, our strength Our Shared Vision: Leaders and partners creating health care excellence. In 2010 We Said We will balance our operating budget Operational Patients excellence first We will maintain i low administrative and management costs We will implement a hospital wide program for continuous quality improvement We will continue to pursue additional regional shared services to help reduce operating costs 6

7 Health Based Allocation Methodology (HBAM) Performance Indicator Actual Unit Cost HBAM Expected Unit Cost Difference Acute Inpatient & Day Surgery $4,659 $4,980 $321 or 6.4% better Emergency $5,152 $5,229 $77 or 1.5% better Inpatient Rehabilitation (note: improvement from 2008/09 performance of $1,962 or 13.4%) $12,705 $12,061 $644 or 5.3% improvement required 7

8 LEAN: Our commitment to continuous quality improvement 2010/2011 Emergency Department Fast Track / Blue Zone New Restorative Care Program 2011/2012 Inpatient Rehabilitation hbl Diagnostic Imaging Just In Time Inventory Management 12.0% 10.0% 0% 8.0% 6.0% 4.0% 2.0% 00% 0.0% Maintained low Administrative Costs 7.6% 7.5% NHH 2009/2010 NHH 2010/ % CE LHIN 89% 8.9% Large Community Hospitals 8

9 And low Management Costs of Total Expenditures Improving the financial health of NHH $0.50 Net Operating Surplus (Deficits) Millions $ $0.50 $1.00 $1.50 $2.00$ $2.50 $ / / / /11 9

10 In 2010 We Said We will enable all of our health professionals to practice to their full potential We will add new health professionals to our team to bring expertise that we Our team, our strength currently do not have We will invest in our team to keep pace with advances in medicine and technology Interprofessional Practice = Quality NHH Framework Quality Practice Patient Centered Care Clinical Leadership & Innovation Interprofessional Collaboration 10

11 New Expertise and Additional Supports = Improved Quality of Care Geriatric Specialist Clinical Nurse Specialist, Gerontology Recreational Therapist Weekend Therapy coverage ED Mental Health Crisis Worker Access and Patient Flow Specialist Decision Support Specialist Porters Near future Nurse Practitioner x 2 Practice Leaders Patient Care Manager Flow Nurse In 2010 We Said We will establish new partnerships to improve local access to specialized services and expertise We will address the Alternative Level of Care (ALC) issue head on so we don t compromise our acute care services Patients first Collaborative networks 11

12 Improving access to Community Mental Health Services Direct Service (Clinical Interactions) / % overall increase since integration with Ontario Shores 2009/ /11 0 Counselling & Treatment Case Management Crisis Early Psychosis ACT Team Supportive Housing 12

13 INTEGRATED SERVICES SUPPORTING ELDERLY PATIENTS RETURN TO COMMUNITY Elderly Patient In the Community Emergency Department GEM Nurse Pay for Results >Community access crisis initiative >virtual Clinical Decision Unit >Process Improvement t(pip) Acute Care H.E.L.P. including CNS Gerontology Hospital to Home Restorative Care Program 16 Beds Nurse practitioner Additional therapy coverage Recreational therapist Inpatient Rehabilitation DISCHARGE BACK TO THE COMMUNITY CCAC Home First Community Care Home at Last Hospitals Geriatric Assessment & Intervention Network Clinics (GAIN) 26 13

14 Securing and sustaining our Acute Care Services 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Apr Jun 2009 Jul Sep 2009 % Acute Patient Days Designated Alternate Level of Care (ALC) Oct Dec 2009 Jan Mar Apr Jun Jul Sep Oct Dec Jan Mar Apr 2011 May 2011 June 16, 2011 ALC Patients in Acute Care Beds 14

15 In 2010 We Said We will create a safer hospital providing improved outcomes and patient satisfaction We will create an elder friendly environment Patients first We will reduce wait times for emergency e care, diagnostic services and cancer care NHH Quality and Safety Framework QUALITY ATTRIBUTES Patient Centered Appropriately Resourced Population Focused Accessible Effective Equitable Efficient Integrated SAFETY Safe Environment Safe Practices Infection Control Emergency Preparedness PERFORMANCE MONITORING Strategic Use of Indicators Quality Scorecard Action planning Accountability RISK MANAGEMENT Prevention Preparation Protection 15

16 NHH patients experience shorter wait times in the Emergency Department Patients with Complex Conditions 5 hours less than provincial average Patients with Minor/ Uncomplicated Conditions 0.2 hours less than provincial average Difference Between NHH and Provincial Wait Times (Hours) 2010/11 16

17 Performance bonus for reduced Emergency Department wait times NHH patients wait fewer days for diagnostic scans and surgery MRI Scans 78 days less than provincial average 4 th shortest wait time for MRI in province* 21 days less CT Scans than provincial Cataract Surgery average Difference Between NHH and Provincial Wait Times (Days) 2010/11 * Based on most recently reported (Feb Apr 2011) data 17

18 NHH patients wait fewer days for diagnostic scans and surgery MRI Scans General Surgery* * Measured via Gallbladder surgeries 49 days less than provincial average 2 nd shortest wait timefor Gallbladder Surgery in province* 85 days less Cataract Surgery than provincial average 2 nd shortest wait time for Cataract Surgery in province* Difference Between NHH and Provincial Wait Times (Days) 2010/11 * Based on most recently reported (Feb Apr 2011) data Improving local access to services through good performance Cataract Surgeries New 1000 Cataract Cases 800 Funded Wait Time Volume Base Volume / /

19 NHH patients receive safe care MRSA Infections VRE Infections CENTRAL LINE Infections VENTILLATOR ASSOCIATED PNEUMONIA Infections NHH patients receive safe care C Difficile Infections Per 1,000 Patient Days / / /

20 NHH staff provide safe care Care Provider Hand Hygiene Compliance Rates 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Before Patient/Environment Contact 2008/ / /11 After Patient/Environment Contact High patient satisfaction for NHH Medical/Surgical Inpatients 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Apr Jun 2009 % Patients Rating Overall Experience as Positive Jul Sep 2009 Oct Dec 2009 Jan Mar 2010 Apr Jun 2010 Jul Sep

21 In Summary Stronger financial position Reduced patient wait times Improved patient access Improved patient safety B Building a sustainable future 21

22 Immediate Challenge Family Physicians relinquishing hospital privileges iil Increased pressure on remaining GPs for covering orphan patients New Northumberland Family Health Team requires medical office building 22

23 Underutilized capacity and potential NHH has exceptionally good wait time performance NHH has capacity to expand: MRI, CT, Cataract Surgeries, Cancer Surgeries, General Surgeries NHH cost performance provides the CE LHIN and province Value for Money NHH can be leveraged to address LHIN wide pressures! Sign up for our enewsletter: In Touch 23

24 Exceptional patient care. Every time. 24