Hospital Service Accountability Agreements: Schedules & Indicators Fiscal

Hospital Service Accountability Agreements: Schedules & Indicators Fiscal

Hospital Service Accountability Agreements: Schedules & Indicators Fiscal 2017/18 Presented in Fall 2016 Agenda 1. 2. Context HSAA Organizational Structure 3. 4. 5. 6. 7. 8. Changes to HSAA Schedules for 2017-18 HSAA Indicator Work Group Provincial HSAA Indicator Slate Next Steps Questions Appendix A: HSAA Indicator Work Group Membership 9.

Appendix B: HSAA Planning & Schedules Work Group Membership 2 Context HSAA Schedules and Indicators The HSAA Template Agreement is envisioned to be a multi-year agreement established through consultative stakeholder meetings between the LHINs, hospitals, the OHA and MOHLTC. The Schedules content will be negotiated annually. It is intended that the current HSAA will be extended an additional year, with an expiration date of March 31, 2018. This presentation will focus on the status of the schedules and provincial indicators for 2017/18. 3 HSAA Organizational Structure

Creating an ownership framework 4 Creating an ownership framework The HSAA Indicators Work Group is co-led by Eric Partington, Senior Director, Champlain LHIN, and Imtiaz Daniel, Director, Financial Analytics and System Performance, Ontario Hospital Association. The HSAA Planning & Schedules Work Group is co-led by Jeff Kwan, Director, Financial Health & Accountability, North Simcoe Muskoka LHIN, and May Chang, Executive Vice President and Chief Administrative Officer, Markham Stouffville Hospital. 5 Changes to HSAA Schedules for 2017-18 Schedule A (Funding) Under Wait Time Strategy Service (Section 3), incremental funding has been removed to reflect the current approach, which reflects allocation through base funding only.

Under Quality Based Procedures (Section 2), the list of QBPs has been updated to reflect the refined list of QBPs noted in the HAPS Guidelines. 6 HSAA Indicator Work Group The HSAA Indicators Work Group (IWG) is comprised of representation from involved hospital, LHIN and MOHLTC leaders with backgrounds in program delivery, performance improvement and finance (see Appendix A for membership list). The core deliverables of the HSAA Indicators Work Group were to: Review current indicators to ensure continued alignment with pan-LHIN system imperatives Update technical specifications and target setting guidelines as required Develop other communication and education materials as needed 7 Provincial HSAA Indicator Slate

With the tabled proposed legislation (the Patients First Act) in the Legislative Assembly as of the fall, the LHINs have agreed to maintain the 2016/17 SAA provincial indicator slates for 2017/18. However, LHINs will reserve the right to amend LHIN-specific (i.e., local) indicators / obligations and/or to make any changes as required by law, policy, statute or Ministry direction. As such, no changes will be introduced to the provincial HSAA indicator slate for 2017/18. 8 Performance Indicators Performance indicators will remain as:

90th Percentile Emergency Department (ED) Length of Stay for Complex Patients 90th Percentile ED Length of Stay for Minor/Uncomplicated Patients Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Hip Replacements Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Knee Replacements Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for MRI Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for CT scans Rate of Hospital Acquired Cases of Clostridium Difficile Infections Readmissions to Own Facility Within 30 Days for Selected HBAM Inpatient Grouper (HIG) Conditions Current Ratio Total Margin (all sector) ALC Rate 9 Explanatory Indicators Explanatory indicators will remain as: Percent of Stroke/TIA Patients Admitted to a Stroke Unit During Their Inpatient Stay

Hospital Standardized Mortality Ratio Rate of Ventilator-Associated Pneumonia Rate of Central Line Infection Rate of Hospital Acquired Cases of Methicillin Resistant Staphylococcus Aureus Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cancer Surgery Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cardiac By-Pass Surgery Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cataract Surgery Total Margin (Hospital Sector Only) Adjusted Working Funds / Total Revenue % 10 Explanatory Indicators (contd) Percentage of ALC Days Repeat Unscheduled Emergency Visits within 30 days for Mental Health Conditions Repeat Unscheduled Emergency Visits within 30 days for Substance Abuse Conditions 11 Next Steps

The HSAA IWG will: Liaise with external stakeholder groups as necessary to enhance understanding of, and continually improve upon, proposed and existing indicators for next cycle Assess indicator set to ensure ideal alignment of hospital performance and accountabilities to system outcomes, as well as to other key work streams like Quality Improvement Plans The HSAA P&S WG will: Discuss members feedback about the HAPS and schedules materials and processes, and discuss any improvements for the following year 12 Questions? Please contact your local LHIN. 13 Appendix A: Indicator Work Group

Membership Sector Organization Individual, Title LHIN Champlain LHIN Eric Partington, Senior Director (Co-Chair) OHA Ontario Hospital Association Imtiaz Daniel, Director (Co-Chair) Hospital Grey Bruce Health Services Martin Mazza, CFO Hospital Joseph Brant Hospital

Cheryl Williams, VP Patient Care Services and Chief Nurse Executive Hospital Markham Stouffville Hospital May Chang, Executive Vice President and Chief Administrative Officer Hospital Sunnybrook Health Sciences Centre Darren Gerson, Senior Director, Decision Support Hospital St. Josephs Healthcare Hamilton Jane Loncke, Director MOHLTC Ministry of Health and Long-Term Care Nam Bains, Manager

MOHLTC Ministry of Health and Long-Term Care Lauren Churcher, Senior Health Analyst MOHLTC Ministry of Health and Long-Term Care Thomas Custers, Manager MOHLTC Ministry of Health and Long-Term Care Domenic Della Ventura, Team Lead 14 Indicator Work Group Membership (contd) Sector Organization Individual, Title

HQO Health Quality Ontario Gail Dobell, Director LHIN Central East LHIN Marilee Suter, Lead, Decision Support LHIN Champlain LHIN Paul Caines, Senior Accountability Specialist LHIN Hamilton Niagara Haldimand Brant LHIN Iwona Bielska, Advisor LHIN Toronto Central LHIN

Erin Scholl, Senior Consultant LHIN Toronto Central LHIN Ranjeeta Wadhwani, Analyst 15 Appendix B: HSAA Planning & Schedules Work Group Membership Sector Organization Individual, Title LHIN North Simcoe Muskoka LHIN Jeff Kwan, Director, Financial Health & Accountability (Co-Chair) Hospital

Markham Stouffville Hospital May Chang, Executive Vice President and Chief Administrative Officer (Co-Chair) Hospital Collingwood General & Marine Hospital Michael Lacroix, Vice President, Corporate Services & CFO Hospital North York General Hospital Deepak Sharma, Director, Decision Support Hospital St Michaels Hospital Tomi Nieminen, Director, Decision Support Services Hospital Trillium Health Partners

Carol Vinette-Hancharyk, Director, Financial Strategy & Deputy Chief Financial Officer MOHLTC Ministry of Health and Long-Term Care Maria van Dyk, Team Lead Ontario Hospital Association Imtiaz Daniel, Director, Financial Analytics and System Performance OHA Planning & Schedules Work Group Membership (contd) Sector Organization Individual, Title LHIN Central LHIN Jennifer Chiarcossi, Senior Business Analyst

LHIN Central LHIN Kelvin Luk, Business Analyst LHIN South West LHIN Scott Chambers, Team Lead LHIN Mississauga Halton LHIN Carrie Parkinson, Senior Lead LHIN Mississauga Halton LHIN Andrew Wahab, Senior Lead of Funding and Allocation LHIN North East LHIN

Marc Demers, Controller / Corporate Services Manager LHIN North West LHIN Kevin Holder, Senior Consultant LHIN Toronto Central LHIN Erin Scholl, Senior Consultant

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