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Microsoft PowerPoint - Appendix 14 Wait Times Strategy

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Microsoft PowerPoint - Appendix 14 Wait Times Strategy Powered By Docstoc
					Ontario Wait Time Strategy

     Visit to Central LHIN

      January 14, 2008


               Alan R. Hudson, OC, FRCSC
                                         Progress to Date
Provincial Trend 90th Percentile Analysis - November 07 Wait Times Data
      Service Area                                              90% Completed Within
                                                             Priority Level 4 % completed
                              Baseline          Current                                               Current vs. Baseline
      Service Area                                            (PL4) access     within PL4
                                                              target (days) access target
                            (Aug/ Sept05)       (Nov 07)                                          Net change           % change
Cancer surgery                   81               63                84              95%               -18                -22.2

Angiography                      56               21                -                -                -35                -62.5
Angioplasty                      28               13                -                -                -15                -53.6
Bypass surgery                   49               51               182             100%                2                  4.1

Cataract surgery                311               141              182              95%              -170                -54.7

Hip replacement                 351               202              182              86%              -149                -42.5
Knee replacement                440               258              182              80%              -182                -41.4

MRI                             120               124               28              45%                4                  3.3
CT                              81                55                28              77%               -26                -32.1

Paediatric surgery*             273               238              182              82%               -35                -12.8
*Apr/May06 data used as baseline for paediatric surgery; **bypass surgery wait time includes elective referrals only
           Current State (November 2007) - % of cases
                     completed within target
                                                                Cancer Surgery
                                                            100%


                                                                       95%



                                 CT                                                                   Bypass Surgery


                                              77%                                              100%




                                                                 0%
                                                    45%

                                                                                                      95%

                       MRI                                                                                    Cataract Surgery




                                                          80%                    86%




                                 Knee Replacement                                      Hip Replacement


              Target    Actual




Note: Based on priority level 4 targets.
                                DETAILED VIEW
                        Indicator:           Cataract Surgery Wait Time
                        Objective:           Improve surgical wait times
                        Time Period:         February/March 2007
Definition:                                        Trend
 Number of days at which point 90% of
 patients have had surgery. Wait time is             3 50
 calculated from decision to treat date to
                                                     300
 surgery date.
                                                     2 50
Results:
                                                     200
  Benchmark/     Baseline     Current    Status                 18 2
  Target                      Period                  15 0
                                                      10 0
     182           311         159
                                                       50

Analysis:                                                  0

Wait time has decreased by 49% since
Aug/Sep’05 and 93% of cases are completed
within 6 months.


Action Plan:

The indicator exceeds the benchmark. No action plan is required at this time.
Cataract Surgery Wait Times – LHIN Variation
Central LHIN Wait Time Trend Analysis - Nov 2007 Data
              Central LHIN Monthly Trend


Cataract
Surgery




Hip
Replacement




Knee
Replacement
Central LHIN Hospital Performance – November 2007 data
Central LHIN Priority Analysis – November 2007 data
                                Central LHIN - Hospital Implementation Activities by Quarter
                                Wherever possible, we are using the emerging LHIN PMOs to coordinate
                                these activities and leverage resources across the LHIN
Implementation Activities




                                                                                                    EDRS Beta Sites                    EDRS


                                                                                                    WTIS–CCN                           WTIS–CCN                          EDRS                        EDRS

                                                                                                    WTIS – Expansion                   WTIS – Expansion                  WTIS – Expansion             WTIS – Expansion
                                                                                                    Group 1                            Group 2, All Paed Sites           Group 2, All Paed Sites      Group 2, All Paed Sites

                                                                 WTIS – Expansion                                                      SET Program Phase 2
                                SET Program Phase 1                                                 SET Program Phase 2                                                  SET Program                  SET Program
                                                                 Group 1

                                CCIS Roll-out to all             CCIS Roll-out to all               CCIS Phase 3:                      CCIS Phase 3:                     CCIS Phase 3:                CCIS Phase 3:
                                MSICUs                           MSICUs                             Specialty ICUs                     Specialty ICUs                    Specialty ICUs               Specialty ICUs

                                           Q2 (07/08)                       Q3 (07/08)                        Q4 (07/08)                        Q1 (08/09)                      Q2 (08/09)                  Q3 (08/09)
                                                                                                   EDRS Beta Sites
                                                                                                    Southlake Regional Hospital
                               Implementation Activities                                           WTIS-CCN
                               By Hospital in LHIN #8                                               Southlake Regional Hospital
                                                                                                   WTIS-Expansion
                                                                                                    Humber River Regional Hospital   EDRS
                                                                                                    Markham Stouffville Hospital      TBD
                                                                                                    North York General Hospital      WTIS-CCN
                                                                                                    Southlake Regional Hospital       Southlake Regional Hospital
                                                                                                    Stevenson Memorial Hospital      WTIS-Expansion
                                                                 WTIS-Expansion                     York Central Hospital             TBD
                               SETP Phase 1                       Humber River Regional Hospital   SETP Phase 2                      SETP Phase 2
                                Humber River Regional Hospital    Markham Stouffville Hospital      Humber River Regional Hospital    Humber River Regional Hospital   EDRS
                                North York General Hospital       North York General Hospital       Markham Stouffville Hospital      Markham Stouffville Hospital      TBD
                                Southlake Regional Hospital       Southlake Regional Hospital       North York General Hospital       North York General Hospital      WTIS-Expansion              WTIS-Expansion
                                Stevenson Memorial Hospital       Stevenson Memorial Hospital       Southlake Regional Hospital       Southlake Regional Hospital       TBD                         TBD
                                York Central Hospital             York Central Hospital             Stevenson Memorial Hospital       Stevenson Memorial Hospital      SETP                        SETP
                               CCIS Roll-out                     CCIS Roll-out                      York Central Hospital             York Central Hospital             TBD                         TBD
                                Markham Stouffville Hospital      Markham Stouffville Hospital     CCIS Roll-out                     CCIS Roll-out                     CCIS Roll-out               CCIS Roll-out
                                Southlake Regional Hospital       Southlake Regional Hospital       TBD                               TBD                               TBD                         TBD

                                        Q2 (07/08)                       Q3 (07/08)                         Q4 (07/08)                        Q1 (08/09)                      Q2 (08/09)                  Q3 (08/09)
                            *slide specific to Central LHIN hospitals
        ER

Who is the customer?
                 ER Wait Time
Demand Control          •   CDM
                        •   Mental Health
                        •   FHT
                        •   Streaming


ER                      •   WT – Public Reporting
                        •   CS – Consumerism
                        •   Tool Kits
                        •   HR

Exit                    • ALC
                        • Community Services
ALC
        Hospital Board/CEO
• Authority
• Responsibility
• Accountability

             Patient Flow
•   Imaging and other Diagnostics
•   GIM
•   Intensive Care
•   Operating Room
•   Chiefs of Services
         LHIN Board/CEO
• LHIN ER Plan
• Competition intra-LHIN
• Competition inter-LHIN
Implementation of EDRS across Ontario
     Technical
    Development
                      Beta Site
                      Testing
                       Hospital
                       Training                                       All Hospitals submitting
                                                                      data to EDRS
                                  Provincial Implementation


                                                    Public Reporting of ED Wait Times



                                           ED Wait Time data informing decision making


Q2 07/08   Q3 07/08     Q4 07/08        Q1 08/09        Q2 08/09          Q3 08/09


 Approximately 80 hospitals will be participating
 EDs volumes >20,000 will be a priority in implementation
Proposed Beta Sites for EDRS


                   Grey Bruce Health Services
                   Hotel-Dieu Grace Hospital
                   Mount Sinai Hospital
                   Northumberland Hills
                   Hospital
                   Sault Area Hospital
                   Southlake Regional Hospital
                         Proposed EDRS Indicators
                                                                             Ambulance Off-load Time

                                                                                 Time to Physician
                                                                                   Assessment

   EDRS indicators are currently                                                Time to Admission
   being refined, in consultation
                                                                                 ED Length of Stay
   with the EDRS Advisory
   Committee
                                                                                     ALC Census

                                                                                     ED Census



      Patient              Triage           Physician                                Disposition/
                                                                 Patient                                    Patient
      Arrival            Registration      Assessment                                  Admit/
                                                              Intervention                                leaves ED
                                                                                     Discharge


Ambulance Offload Time         Time to Physician Assessment

                                                                              ED Time to Admission

                                                                                                     ED LOS
Expansion of IM/IT is underway to improve access to care . . .


                                               EDRS

                                              Emergency
                                  ER Wait       Room



Screening
                                                  Other
                                           Specialized Services
                                            (Systemic; Radiation)          CCIS
                                                                                   ICU
                  WTIS – Wait 1
                                           WTIS –all surgery
                      pilot                                                                 After Care
            Primary
                              Specialist                             OR                     (i.e. Rehab,
            Provider                                                                        Home Care)


                                                                                  Nursing
                                                                    SETP           Unit

                                                MRI/CT



                                               Other
                                             Diagnostic
                                             Procedures


                                   Provincial Client Registry
Over time, access to care will be improved through information
across the spectrum of care


                                                 EDRS
                                                                                   Neurosurgery
                                                        Emergency
                                            ER Wait       Room


                       Disease
Screening Management
                                                            Other
                                                     Specialized Services
      Family Docs IT




                                                      (Systemic; Radiation)
                                                                                           ICU
                        WTIS – Wait 1
                                                WTIS –all surgery
             Primary                                                                               After Care
                                        Specialist                            OR                   (i.e. Rehab,
             Provider                                                                              Home Care)


                                                                                         Nursing
                                                                                          Unit

                                                          MRI/CT



                                                         Other
                                                       Diagnostic
                                                       Procedures


                          Provincial Registries (Client, Provider, Facility)
           Quality and Safety

•   Dr. Michael Baker
•   Dr. Ross Baker
•   Mortality Rates
•   April 1, 2008 -- Conditionality
  From Deference to
          Data
to Direct Management
www.ontariowaittimes.com

				
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