Hamilton Niagara Haldimand Brant (HNHB) Performance Update Niagara - PowerPoint PPT Presentation

Hamilton Niagara Haldimand Brant (HNHB) Performance Update Niagara Health System & Other LHIN Hospitals Presentation to the HNHB Local Health Integration Network (LHIN) Board of Directors October 26, 2010 1

Agenda Niagara Health System (NHS) • Summary of 2009-10 performance on select performance metrics • Contribution to Ministry-LHIN Performance Agreement (M-LPA) performance targets • Hospitals Performance Update September 2010 • Emergence Room (ER)- Alternate Level of Care (ALC) • Wait Times – Select Services • Quality – Select Metrics 2

NHS – Summary of 2009-10 Performance – Select Indicators Service HNHB Niagara Health System LHIN Year LHIN End Q1 Q2 Q3 Q4 • NHS wait times for cancer, cataract Performance Target (With and total joint replacement surgery Corridor) were consistently above the LHIN Cancer 50 70 53 55 61 58 target and showed little improvement Surgery Cataract 103 during the year. 134 125 135 128 104 Surgery Hip 182 • NHS wait times for MRI & CT were 223 293 258 235 177 Replacement lower than those reported by the Knee 182 377 376 284 405 201 majority of other HNHB hospitals. Replacement 51 69 78 88 106 MRI 87 38 44 45 44 48 CT 33 Source: Access to Care Cancer Care Ontario (ATC-CCO) 30.0% 25.2% P 22.7% 25.0% e 18.3% 20.0% 16.0% 16.0% • NHS decreased its acute ALC rate in r A 13.8% 15.0% c L 2009-10 from 25% in April 2009 to 16% by 10.0% e C March 2010, but remained higher than the n 5.0% LHIN target of 14%. t 0.0% Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-093 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Month HNHB CCAC-Hospital ALC Scorecard Data 3

Pay for Results (P4R) 2009-10 Year End Summary • NHS – St. Catharines General (SCG) site was one of two HNHB LHIN hospitals that received ER P4R funding to reduce wait times in 2008-09 and 2009-10. • Of the seven LHIN hospital sites that participated in ER P4R in 2009-10, NHS-SCG site was amongst the worst performers in Ontario. As a result NHS will have a portion of there P4R funding recovered. Indicator #2 Indicator #3 MOHL TC Indicator #1 Non-Ad mitted High Acuity ED Non-Ad mitted Low Acuity ED Asses sed Admitted ED LOS < 8hrs LOS < 8hrs CTAS I,II, < 6 hrs LOS < 4hrs perform ance. CTAS III % % % MOHLTC Baseline Year End Year End Baseline Year End Year 2 P4R Sites Improve- Baseline Improve- Improve- Weighted P4R Results Results Results ment ment ment Score Province (P4R sites) 28% 32% 4% 78% 80% 2% 78% 81% 2% 28% 33% 5% 78% 80% 2% 75% 76% 1% HNHB LHIN (P4R sites) Brant Community Healthcare 17% 0% 8% System (BCHS) -General Site 37% 54% 78% 78% 63% 71% 23 St. Joseph's Hospital Hamilton 5% 10% 7% (SJHH) 27% 32% 74% 84% 70% 77% 21 Hamilton Health Sciences Corp 6% 4% -6% (HHSC) McMaster Site 31% 38% 79% 83% 78% 72% 10 Joseph Brant Memorial 5% 3% 0% 23% 28% 82% 85% 89% 89% 8 HHSC General Site 2% 2% 3% 27% 29% 82% 83% 74% 76% 6 HHSC Juravinski Site 3% 0% -1% 20% 23% 83% 84% 78% 77% 4 Niagara Health System St. 2% -1% -4% Catharines General Site (SCG) 27% 30% 73% 72% 70% 66% 2 Green = Improvement met target of 10% 1) The MOHLTC assessed score was weighted whereby each Fiscal Quarter of 2009/10 Yellow = Above baseline and below 10% target was weighted higher than the previous quarter. The weighting was in a ratio of 1:3:6:9 . Red = Performance same or below baseline 2) A variable recovery rate was applied based on performance (ie score). Source: MOHLTC–Yr2 Performance summary – weighted 25 May 10 final. 4

NHS’s Contribution to LHIN MLPA Targets NHS Cataract Wait Time Trend 350 90th Percentile Wait Time (Days) NHS’s performance can substantially 300 impact the LHIN’s overall performance 250 based on the percentage of the LHIN’s 200 service volume they complete. 150 100 50 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 07 07 07 07 07 07 07 07 07 08 08 08 08 08 08 08 08 08 08 08 08 09 09 09 09 09 09 09 09 09 09 09 09 10 10 10 NIAGARA HEALTH SYSTEM 319314287205241240211206156159148153160165132139141135135121103117122129129143124104129128136141113134128123 Hamilton Niagara Haldimand Brant LHIN 16618514912013614813915210811311612713411510387 10610110710399 104110117114104 97 85 103100110107103101114109 15215513212814114114114111812012012613212511810811911812011310310710711110599 93 96 108114116114103110110113 Province 182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182 Priority 4 Access Target Source: ATC-CCO Adult Surgery and DI Hospital Trend Report Monthly March 2010 SJHH Catarct Wait Time Trend 200 90th Percentile Wait Time (Days) In 2009-10 NHS and SJHH each 180 160 completed 34% of the LHIN’s cataract 140 volume; NHS reported wait times 120 100 consistently higher than the LHIN target 80 (103 days), SJHH ‘s wait time was 60 40 consistently below the LHIN’s target. 20 0 Ma Au Ma Au Ma Au Apr Jun Jul Sep Oct Nov Dec Jan Feb Mar Apr Jun Jul Sep Oct Nov Dec Jan Feb Mar Apr Jun Jul Sep Oct Nov Dec Jan Feb Mar y g y g y g 07 07 07 07 07 07 07 08 08 08 08 08 08 08 08 08 08 09 09 09 09 09 09 09 09 09 09 10 10 10 07 07 08 08 09 09 12412811499 12710591 83 80 10410010796 88 81 78 91 88 93 10810110310911597 92 85 81 91 92 85 81 89 87 98 86 ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON 166185149120136148139 15210811311612713411510387 106101107 10399 10411011711410497 85 103100110 107103101114109 Hamilton Niagara Haldimand Brant LHIN Province 152155132128141141141 141118120120126132125118108119118120 11310310710711110599 93 96 108114116 114103110110113 5 Priority 4 Access Target 182182182182182182182 182182182182182182182182182182182182 182182182182182182182182182182182182 182182182182182 Source: ATC-CCO Adult Surgery and DI Hospital Trend Report Monthly March 2010

NHS’s Contribution to LHIN M-LPA Targets NHS Total Knee Replacement Surgery Wait Time Trend • In 2009-10 the LHIN was outside of its 800 performance corridor for total knee 90th Percentile Wait Time (Days) 700 replacement surgery by 0.8 days. 600 500 • NHS completed 28% of the LHIN’s volumes, 400 the second highest to HHSC at 34%. 300 200 • In 2009-10 NHS reported monthly wait 100 times consistently higher than the LHIN 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 07 07 07 07 07 07 07 07 07 08 08 08 08 08 08 08 08 08 08 08 08 09 09 09 09 09 09 09 09 09 09 09 09 10 10 10 target (182 days) ranging from 278-726 NIAGARA HEALTH SYSTEM 312 384 289 323 209 533 387 430 295 244 330 456 439 343 344 308 243 211 326 312 201 197 517 347 367 351 465 524 528 326 245 570 278 726 351 284 353 320 349 305 279 302 236 216 218 218 279 276 208 229 230 190 197 162 209 192 185 196 212 169 177 209 238 261 185 198 208 220 216 208 203 199 Hamilton Niagara Haldimand Brant LHIN days. Province 337 321 302 294 281 300 285 258 253 244 257 244 224 248 223 202 231 205 204 200 189 194 184 176 189 195 187 178 175 178 178 186 177 176 172 180 Priority 4 Access Target 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 Source: ATC-CCO Adult Surgery and DI Hospital Trend Report Monthly March 2010 HHSC Total Knee Replacement Surgery Wait Time Trend 90th Percentile Wait Time (Days) 400 In 2009-10 other wait time services where 350 NHS was a high volume contributor were: 300 • Total hip replacement surgery, 250 completing 24% of the LHIN volumes 200 150 • MRI services completing 30% of the 100 LHIN volumes 50 • CT services completing 38% of the LHIN 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar volumes. 07 07 07 07 07 07 07 07 07 08 08 08 08 08 08 08 08 08 08 08 08 09 09 09 09 09 09 09 09 09 09 09 09 10 10 10 HAMILTON HEALTH SCIENCES CORP 356236334248351312223219207219235271195229196193203174172168186176212154178236310227176227211208216203174199 Hamilton Niagara Haldimand Brant LHIN 353320349305279302236216218218279276208229230190197162209192185196212169177209238261185198208220216208203199 337321302294281300285258253244257244224248223202231205204200189194184176189195187178175178178186177176172180 Province 182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182182 Priority 4 Access Target Source: ATC-CCO Adult Surgery and DI Hospital Trend Report Monthly March 2010 6

2010-11 Performance Update – September 2010 Niagara Health System & HNHB LHIN Hospitals 7

ER & ALC 2010-11 • Pay for Results • 90th percentile ER length of stay (LOS) • Percent ALC days 8