Innovations in Provincial and Regional Cancer Services Delivery Planning in Ontario 2007 National Healthcare Leadership Conference Judy Burns, Director Regional Programs and Performance Management, Cancer Care Ontario June 12th, 2007
Agenda • Background • Priority Setting • Allocation • Contracts • Quarterly Review Process • Reallocation and Reconciliation • Target Setting
Cancer Care Ontario’s Vision and Mission • Working together to create the best cancer system in the world • We will improve the performance of the cancer system by driving quality, accountability and innovation in all cancer-related services
Who we are • An umbrella organization that steers and coordinates Ontario’s cancer services and prevention efforts so that fewer people get cancer, and patients receive the highest quality of care.
CCO: An Independent Government Agency • Chief advisor to the provincial government on cancer care • Legislative authority derived from Cancer Act, Personal Health Information Protection Act • Memorandum of Understanding with Ministry of Health and Long-Term Care • Contract with hospitals for cancer services
What we do • Direct $500M annually for cancer prevention, detection and care • Operate province-wide screening and prevention programs • Collect, monitor and report information about cancer and cancer system performance
What we do • Develop evidence-based standards and guidelines • Work with care providers to plan and continually improve cancer services at a provincial level and regionally
Ontario Cancer Plan • A roadmap for… – Cancer Care Ontario – The Ontario Government – Ontario’s Regional Cancer Programs • First comprehensive cancer control plan in Canada • Rolling 3-year plan • Supports provincial and local planning of cancer services
Ontario Cancer Plan Six priorities for action 1. Broaden development of provincial standards & guidelines 2. Implement Regional Cancer Programs 3. Close demand/capacity gap 4. Implement rapid access strategies 5. Invest in performance measurement & accountability 6. Advance coordination & focus of cancer research efforts in Ontario
Regional Cancer Programs • Virtual program to link service providers, patients and decision makers from the full spectrum of cancer care across a region – Led by RVP – Cancer service planning – Identification of strategies to meet local needs – Facilitation of consumer involvement – Fostering professional development – Responding to performance results (including re- alignment of services)
Pay for Performance • Use funding strategically to promote and reward quality and results • Pioneered by CCO in Ontario by tying quality conditions to funding we allocate to hospitals to reduce cancer surgery wait times • Goes beyond paying for volume or activity • Hospitals agree to participate in key quality initiatives
CCO Model for Driving Performance Improvement 1. Data/Information 2. Knowledge • incidence, mortality, survival • clinical guidelines • analysis • policy advice • Indicator development • synthesis • expert input • planning 4. Performance Management 3. Transfer • institutional agreements • publications • quarterly review • practice leaders engaged • quality - linked funding • policy advice • clinical accountability • public reporting
Priority Setting • Priorities are determined annually – Wait times – Evidence-based clinical priorities (e.g.: thoracic surgery guidelines, pathology reporting) – Provincial priorities (e.g.: colorectal cancer screening program) • These drive the annual process for contracts and performance management
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Target Setting • Set provincial benchmarks designed to improve performance and quality • monitor and report to the public, government, hospitals on performance • Identify and recommend action • Set annual targets for priority areas and report on progress
Allocation: Cancer Surgery Agreement • Identify what is a cancer surgery procedure – Index procedure list developed and reviewed annually • Establish baseline volume – what volume would be done without incremental funding • Calculation of funding rates – done in conjunction with the JPPC and based on actual 05/06 OCCI data
Volume Allocation • Principles developed – Address population based utilization through high level LHIN distribution – Allocate more lower intensity cases to community hosp and more higher intensity cases to academic centres – Proven ability to perform incremental cases – Critical mass – Minimum allocation to support real change – Consideration of wait times and capacity
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