How are we doing? Analyzing our Metrics SWRCP Strategy Session Brenda Fleming & Nicole Van Dyke January 23,2013 1
Objectives Highlight selected metrics that have shown significant improvements in the last year Discuss areas of focus for performance improvement in 2013/14 2
Looking Back.2012/13 Successful Quality Improvement Initiatives 3
Cancer Surgery Wait Time Improvement Project Initiated in response to the SW LHIN reporting the longest wait times for cancer surgery in the province Quality Improvement Activities : Monthly reports were distributed to key stakeholders to target queuing improvements Education and processes were created to support the proper entry and use of data to the Wait Time Information System 4
Cancer Surgery LHIN v Province Trend: Solutions Impact 90 th Percentile Wait Time, closed cases (days) 5
Days Cancer Surgery Wait Time Trend for South West Sites with Cancer Surgery Agreements (90P, closed cases) 120 100 80 60 40 20 HPHA, 73 TARGET 70 LHSC, 68 LHIN Total, 57 SJHC, 43 GBHS, 33 0 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 6 SJHC LHSC SW LHIN target GBHS HPHA
Percent Ontario Breast Screening Program Wait Times 100% 90% 80% 70% 60% 50% OBSP - Percentage of Abnormal Screens Diagnosed within Target Wait Time, 2011/12 to 2012/13 57% 93% 74% 40% 30% 20% 10% 44% Without Biopsy (Target = 5 wks) With Biopsy (Target=7 wks) 0% Q1 Q2 Q3 Q4 Q1 Q2 Q3 2011/12 2012/13 Process improvements between the breast assessment sites and the OBSP satellite sites has helped to improve the wait times to final diagnosis. An expert panel review was conducted in November of 2012 and recommendations for further improvements are pending 7
Percent Multidisciplinary Cancer Conferences SW LHIN cancer care facilities and specialists are multi-sited and regional partners are geographically distant In 2010, less than 40% of MCCs in the SW LHIN, that treated 35+ patients within a disease site, reported meeting the minimum standards criteria 80 Adherence to standards criteria of reported MCCs, by LHIN 2010/11 to 2012/13 70 60 50 40 30 20 10 Q1 2010/11 Q1 2011/12 Q1 2012/13 0 8 Source: MCC Provincial Report
Multidisciplinary Case Conferences Quality Improvement Activities: Technology Organization Documentation Adherence to standards criteria of reported MCCs Q1 2012 Q1 2011 Q1 2010 59% 48% 37% Source: CSQI, 2012 9
Looking Forward 2013/14 Potential Areas for Quality Improvement Initiatives 10
Performance indicators at or above the target in the South West Multidisciplinary Cancer Conference (MCC) Colonoscopy Wait Time for +FOBT Colonoscopy Wait Time for Family History Nursing Program- Canadian Certification CON (C) Satellite Sites Nursing Program-Canadian Hospital Palliative Care Association certification (CHPCA) for Dedicated Palliative Care Clinic locations 11
Performance indicators below target but Increasing Ontario Breast Screening Program Wait Times Cancer Surgery Wait Times Radiation Treatment Wait Times Referral to Consult, Ready to Treat to Treatment 12
Performance indicators below target with no improvement Symptom Management ESAS Systemic Treatment Wait Times Referral to Consult, Consult to Treatment Patient Experience/Emotional Support Nursing Program CON(C ) RSTP Level 1 & 2 (LRCP and GBHS) 13
Systemic Treatment Wait Times Referral to Consult, Oct 2011 to Sept 2012 Consult to Treatment, Oct 2011 to Sept 2012 100% 80% 60% 40% 20% 0% Systemic Treatment - Percentage of Patients Seen Within Target, LRCP, Oct 2010 to Sept 2012 Referral to Consult (Target=67%) Consult to Treatment (Target=85%) Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept 14 2010/11 2011/12 2012/13
Systemic Treatment Wait Times Consult to Treatment (non-rcc) 15
Systemic Treatment Wait Times Current QI Activities (2012/13) Future QI Activities (2013/14) Chemotherapy Closer to Home Regional OPIS Roll-out LWHA Oncology IT Project Audits/Reports: Weekly Wait Time Report Weekly Out of Target Report Weekly Date Issues Audit 16
Symptom Assessment and Management - ESAS 17
Symptom Assessment and Management - ESAS Current QI Activities (2012/13) Future QI Activities (2013/14) Volunteer Recruitment Visual prompts for patients and volunteers Reinforce documentation of functional status in the EPR to clinic nurses as a critical decision support tool Roll-out of symptom management guidelines 18
Patient Experience Emotional Support: Percentage of patients who reported being put in touch with other providers to help with their anxieties and fears in the last six months Region 2010 2011 2012 Apr - Jun 2012/13 Target % Variance from target South West 33.9% 34.6% 37.1% 50% -25.8% Information, Communication & Education: Percentage of patients who reported that they wanted but did not receive information on the below services. Region Services 2012 Apr - Jun 2012/13 Target % Variance from target (25%)* South West Dietician 7.6% 25% or less 69.6% Counseling/Support 4.7% 25% or less 81.2% Support Groups 8.2% 25% or less 67.2% Palliative Care 1.8% 25% or less 92.8% 19
Patient Experience Current QI Activities (2012/13) Future QI Activities (2013/14) Patient Navigation Binders Community Advisory Council Experienced based design approach to process improvement On-line virtual orientation for patients 20
Thank You Questions? 21