Capio S:t Gorans Hospital Sofia Palmquist
Capio S:t Göran s Hospital # 4 of 6 emergency hospitals in Stockholm - 15 % market-share Service-area 330,000 patients 310 beds ~1,800 employees Private but publicly financed Capio contract to 2022 EMERGENCY VISITS PLANNED VISITS 80,000 emergency visits: 30% by ambulance 31% admitted 141,000 consultancies CARE EPISODES OPERATION 29,000 inpatients AVLOS: Acute: 3.4 dygn Planned: 2.1 dygn 9,300 operations: 43% acute or semiacute
Clear goals for new contract period Improved quality and patient safety Improved access, acute and planned care Improve productivity with good work environment Develop CStG to future plan In addition we have national and county goals and participate in all relevant quality registers and
Capio S:t Görans business strategy Continuous improvement Patient-flow We deliver the care to the patient needs What s needed When needed As needed We make improvements based on patient needs Show respect for the individual Everything we do create value from a patient point of view Quality Correct the first time completed ASAP We solve the problems and address the underlying cause Multi professional teams and standardisation Methods and tools Values 4 2015-04-13
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Improving quality outcomes O U T C O M E QPI CROM PROM PREM Quality report P R O C E S S Follow up - Activities done? - Process targets met? Quality Plan - Activities to improve process - Responsibilities - Resources - Targets for activities and processes - Time line 7
Structured protocols enable visualization of quality data 8 4/13/2015
Somatisk specialistvård Result based quality indicators for Stockholm Acute Hospitals 2009 2010 2011 2012 2013 CStG 96 % 95% 96% 99% 98% DS 88 % 97% 95% 94% 90% SÖS 87% 88% 92% 92% 87% K 85% 88% 90% 91% 92% STS 88 % 93 % 93% 93% 97% NTS 89 % 88 % 95% 93% 96%
CStG reach acute access targets Share of ER patients with door-to-door time under 4h CStG 78 SLL average 68 85 Other SLL hospitals 67 69 75 59 0 20 40 60 80 100 10
CStG reach access targets for planned care Vårdgaranti Mottagning Number of patients meeting waiting targets for consult >30 days 100,0% 90,0% 80,0% 70,0% 60,0% jan14 feb14 mar14 apr14 maj14 jun14 jul14 aug14 sep14 okt14 nov14 dec14 50,0% CStG DS SöS K Vårdgaranti Behandling Number of patients meeting waiting targets for planned surgery/treatment >90 days 100,0% 90,0% 80,0% 70,0% 60,0% jan14 feb14 mar14 apr14 maj14 jun14 jul14 aug14 sep14 okt14 nov14 dec14 50,0% CStG DS SöS K 11
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Cooperation across organizational boundaries Emergency patient flow Before During hospital visit After AE Rad Ward
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Continuous improvement from a patient perspective We systematically improve the quality in the patient flow We focus on patient value when eliminating waste in the flow Waste Value Managers lead and coach employees in our continuous improvement work All employees are responsible for increasing patient quality 15
Involved patients active participants in their own care and in developing care Patient involvement in their own care Patient information Online quality publication MVK (National patient portal) Online national patient record Online patient booking Online health-declaration Information across the care-chain e-referrals National e-prescription Patient involved in developing our care Patient feedback and visualization of feedback Patient participating in development workgroups Patient involved in analysis of risks and negative events
Online patient tools My care Online booking of appointments Online medical records
Patient perceived quality 2014 100 80 82 81 80 80 77 78 60 40 20 0 Outpatient Inpatient Capio S:t Gorans Hospital Stockholm Nation Source: Swedish Institute for Quality Indicators, spring 2014
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Engaged employees and decentralized leadership 20
Decentralized leadership a success factor Education based on business need according to the Capio model Clear responsibility and authority First line managers with clear responsibility for the business Employees Management training for all managers, and key personnel Basic Step I All managers Six modules 12 days in total Intermediate Step II For selected competent and future leaders An integrated leadership program 7 days Finance Operations Advanced Step III Individual program for advanced and competent leaders 21
Roles and responsibilities Manager Employee Introduce, lead and follow up on continuous improvement work Coach and motivate employees Be present on the floor Two jobs to give care and to continuously improve quality for the patient Participate when trying out new, improved ways of working Correct the first time around completed ASAP
Continued high employee satisfaction Employee satisfaction 80 Capio S:t Görans Sjukhus Other hospitals in Stockholm County (SLL) 79 CStG 78 77 76 75 74 73 72 71 70 Days sick 14 15 16 17 18 19 20 21 22 23 Source: Information from hospitals 2014 23 4/13/2015
Focus areas 2015 Businessplan 2015 Continuous improvements Goals: Improved quality and patient safety Access for acute and cancer patients Access for patients with planned care Develop CStG to future plan Improved productivity with good work environment 1. Improve working methods for improved quality 2. Cooperation across organizational boundaries 3. Involve patients 4. Engaged employees 5. Develop IT, premises and other infrastructure
Steering through structured approach and follow-ups Participants Objective Daily Multi professional care teams First line management Daily team meetings Feedback, divergence from standard and risks Weekly CEO, CFO Department heads and first line management Cross-functional coordination of resource utilization and production Monthly CEO, CFO, PD Department heads and controller Follow-up of production, productivity and economic result Quarterly CEO, CFO, CMO, HR, MD, Dep. CEO, PD Department Head, First-line management, quality controller, business controller 25 Follow-up of business plan, HR, Patient safety, quality and satisfaction, LEAN, Productivity and business, Department specific initiatives
Steering through a structured approach and follow-up Focus shifted towards real-time automatic information Historic information Real-time information Quality data Warnings Future information Automated data New BI economic reporting New quality report Statistics from ER on the intranet Clinical decision support Ward utilization overview Improvement boards Manual data Daily team meetings
Rubrik Text Text Text Text 27
County hospital quality benchmark shows that CStG has good results on all dimensions Quality Patient satisfaction Employee satisfaction Access to care Productivity and we continue to use all available input to continuously improve our hospital
Future Capio S:t Görans Hospital - 2018
Thank you Sofia Palmquist Capio S:t Goran s Hospital Sofia.palmquist@capiostgoran.se