Overview Who we are What are the pressures What we have done What - PDF document

i3<A&(~+ ~f'1iJ1 Eastern Health Volume 72 Page 001 CIHRT Exhibit P-0700 Page 1 rr"''''Ct'1:othlYVi 1=,'(€.: 'Zpa5-0e Pee, Itf - { "Excellence in Health Care" On behalf of the Board of Trustees, the staff and physicians of the Health Care Corporation of 81. John's, I would like to thank you for this opportunity to speak to you about our ongoing efforts to effectively utilize our resources to provide quality care to the people of this province. The Hea/th Care Corporation of 81. John's (HCC8J) appreciates the financial challenges facing Government and to that end, assures you of our continued commitment to work with you to seek out ways and means of providing appropriate/eve/s of service while keeping our costs to a minimum. 1

Eastern Health Volume 72 Page 002 CIHRT Exhibit P-0700 Page 2 Overview • Who we are • What are the pressures • What we have done • What does this mean • What we face • Where to from here During the next several minutes I want to highlight the aspects of our organization that make us unique in this province's health care system. I will describe some of the challenges we currently face and identify new pressures associated with offering care and treatment at a tertiary care level. I will also show you how we have successfully responded to those challenges while making our system more effective and efficient. In addition, I will outline for you the difficulties that we currently face and discuss implications of service reductions. 2

Eastern Health Volume 72 Page 003 CIHRT Exhibit P-0700 Page 3 Uniqueness in Service Delivery • One-of-a-kind services (tertiary) i.e. Cardiac, Neurosurgery, Vascular, High Risk Obstetrics, Nephrology, Haemolotogy, Oncology • Patient complexity • Technology • Staff skill sets • Patient flow • Supports to other centres • Size It is important to remember that the HCCSJ functions differently from other health organizations in the province. As an academic teaching hospital, a significant portion of the services we provide are one of a kind. Also we differ in the complexity of patients we care for. These elements significantly impact patient flow both into and out of our hospitals,.it affects the technology we required to diagnose and treat these patients, and the skill sets required from a variety of health professionals to deliver the necessary care. In addition, our role means that we interact with a variety of external partners in intricate and multifaceted ways. Within the HCCSJ are the provincial perinatal program, kidney program, genetics and the organ donor program. Our education service offers regional and provincial training in clinical and leadership areas. With MUN, we have a growing research portfolio which is offering new innovations to clinicians and the public. 4

Grenf~!!I-Board Eastern Health Volume 72 Page 004 CIHRT Exhibit P-0700 Page 4 Provincial Portion of all Inpatient and SDC Services Provided by HCCSJ • HCC 01 SL John's Avalon Board Peninsulas Board Cenlral East Board Cenlral West Board Western Board II Health Labrador The HCCSJ provides a substantial portion of the total services delivered to residents of other regions. This graph shows the provincial portion of all inpatient separations and SOC services provided by the HCCSJ in 2000-01, the most recent data available. Most notably we provide 55.2% of the total inpatient separations and SDC services used by the residents of the Avalon region .... And 47.4% for the residents of the Peninsulas Health region. As this map clearly indicates we also provide a significant portion of the total services to all of the other regions. Provincially, the HCCSJ provides almost one-half of the total inpatient separations and two-thirds of the SOC cases. National measures show that the HCCSJ has the highest net inflow of "out of region" patients in the country. 5

Eastern Health Volume 72 Page 005 CIHRT Exhibit P-0700 Page 5 What we have done- Operational Streamlined Administrative cost Improved efficiency - HR, Materiels Mgmt, Finance Site closures Investments in Staff - Recruitment, Employee Wellness, Labour Relations, Attrition, Stabilization Investments & New technology - e.g. Central Kitchen, CNS, Energy Efficiency, Renovations, PACS, Decision Support Tools Regional planning Since lhe regionalization in 1996, aggressive steps have been taken to consolidate and streamline our structure and administrative cost which has resulted in the reductiDn of 236 management positions. In addition we have closed 3 sites and financed the new Janeway Dut of these savings. The Drganization has participated in a number of external reviews that have helped us eliminate unnecessary overhead. Some of these reports included the HayGroup Operational Review ( Net Savings of $16.5M), Hewett Associates Review Df HR and the Atlantic Management Consultants review of Pharmacy. Many areas of the organization have found ways to improve the delivery of services. HR has shifted tD a service centre model, while Materials Management cDmbined inventory on two primary sites, and both fODd and laundry services have centralized their entire operations Dn off site centres. In addition, we ensured that these operations are scalable tD accDmmodate growth and additional volumes. We also invested in Dur staff by recognizing the importance of our unique training needs, increasing recDgnitiDn activities and enhancing our wellness strategies. We have made technolDgy investments, giving Dur staff better tools to work with and improving their decision-making capabilities. Human reSDurce initiatives and investments have improved staff attendance, decreased staff turnDver and increased pride amDngst our health care professionals. We have been active participants and catalysts in regiDnal and prDvincial planning We have reduced the level Df debt by Dver $5 million over the last three years. 6

~ ~ ~U ~ Eastern Health Volume 72 Page 006 CIHRT Exhibit P-0700 Page 6 ) Operational Efficiency - Corporate Services HCCSJ and Canadian Teaching Hospitals 7.00% o HCCSJ '" 6.00% <:: :;:; • National Benchmarks '" 5.00% Ql 0.- 4.00% o - 3.00% Z 2.00% 0 1.00% 0 0.00% All Depts Info Systems Mat Mgmt HAY Group Benchmarking Study 2001 & Operational Review National comparisons and operational reviews have confirmed that our corporate % of operating costs compares very favourably with national peers. From the Hay Benchmarking study and operational reviews we know that our administrative cost structure is lower then our peers. In 2001 our Corporate Departments cost 5.7 % of net operating cost compared to 6.7% average nationally. (This is 15% less) Since 2001 further improvements have been made by combining departments and reducing managers. For examples: Consolidation of Finance & Budgeting, Audiology, Quality Initiatives and Management Engineering. 7

~}'f."' ~9':: Eastern Health Volume 72 Page 007 CIHRT Exhibit P-0700 Page 7 Sick Leave Analysis Average Sick Leave Days /PTE --+- HCCSJ --- WHee -tr-Other lnst. Boards 22 . "".0' 20 /-"."' ..4" 18 / "" -->16.47 --o-rO,43 16 '.0" . ""- 14 ----. 11..1 12 10 , , 1997 1998 1999 2000 2001 2002 2003 2004 P Throughout the organization we have improved the management of our human resources. In the area of attendance management the organization has decreased the average sick leave days per FTE from 15.8 to 13.1 and targeting 12.3 days per FTE this year. This is all the more impressive given that the average usage for all Institutional Health Boards in the province has risen during the same period of time. This is an area where we have worked hard to achieve improvements and it is an area where our investments and creative solutions have shown a positive return. We believe that it is extremely important that we continue to focus on attendance management. While we also identify new initiatives in Employee Health and Wellness, Occupational Health and Safety and Employee and Family Assistance. The HCCSH has received international recognition for its Human Resource initiatives with our IPMA award in 2004. 8

~ ~ ~ Eastern Health Volume 72 Page 008 CIHRT Exhibit P-0700 Page 8 Turnover Rate Comparison 14.00% 11.90% 12.00% 10.00% 8.00'/, 8.00% ------...:::" • An'L 6.00% "n' 4.00% '- 2.00% 0.00% 2000-01 2001-02 2002·03 2003-04 2004-05 ytd In addition, the Turnover rate for our organization has declined from 11.9% in 2000-01 to 5.4% in 2003-04 . Nationally, in 2004 the weighted Turnover rate in the Health sector is 10.0%. 9