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Presentation to North Okanagan Columbia Shuswap Regional Hospital District Board March 28, 2017 Richard Harding - Health Service Administrator North Okanagan Dan Goughnour - Director Business Support 1) Enhance access to appropriate primary


  1. Presentation to North Okanagan Columbia Shuswap Regional Hospital District Board March 28, 2017 Richard Harding - Health Service Administrator North Okanagan Dan Goughnour - Director Business Support

  2. 1) Enhance access to appropriate primary health care 2) Improve primary & community care delivery and outcomes for frail seniors living with complex chronic conditions 3) Improve primary and community care delivery and outcomes for mental health and substance use clients 4) Improve timely access to elective surgery 5) Implement a renewed system of care for rural B.C. 2

  3. STRATEGY 1 Enhance access to appropriate primary health care 3

  4. Shuswap North Okanagan Collaborative Service Committee (SNO CSC) Partnership with Division of Family Practice to support the Integration of Primary Care and Community Care • Summer 2016: Established introductions • September 2016: Interdivisional Strategic Council • October 2016: Preplanning meeting • November 2016: Facilitation-based CSC meeting • Primary Care Home overview • Integrated Care Teams • Vernon Downtown Primary Care Clinic • Geriatric Seniors Response Team Proposal • January 2017: Data and Discussion of Proof of Concept

  5. STRATEGY 2 Improve primary and community care delivery and outcomes for frail seniors living with complex chronic conditions 5

  6. NEW: VJH Quick Response T eam (QRT) • Community Led Initiative: Team based in the VJH Emergency Department to “bridge” the gap between discharge and initiation of community care to ensure patients do not return to hospital shortly after discharge, prevent initial admissions and un-needed utilization of ED. • QRT Quick Response Community RN and Allied Health Team (Social Worker and Rehabilitation Assistant) 7 days per week QRT RN Statistics - Trial to Support Winter Surge: December 2015-March 2016  Managed 93 patients of which 62% were known to Home Health  Managed 424 Consults (Home visits, Telephone consults, Acute care) 6

  7. MoH News Release – March 9, 2017 The Province is investing $500 million over the next four years as part of the MoH action plan to improve care for seniors across the system, including increasing direct care hours for seniors in residential care.

  8. Update on Vernon Residential Care Beds The Hamlets at Vernon will include 85 publicly- funded beds and 15 private pay residential complex care beds, as well as 53 private pay assisted living beds. Will open in July, with phased opening and will be fully operational by September 2017

  9. Regional Residential Care Initiatives • Working with Divisions of Family Practice as part of the GPSC Residential Care Initiative help achieve provincial best practice expectations • Reducing inappropriate transfers to the emergency room • Reducing the inappropriate use of antipsychotics • Embedding a palliative approach across our homes – focusing on comfort and quality of life vs. cure • Enhancing the role of the Nurse Practitioner in residential Care • Improving our ability to manage people with responsive behaviors including participation in the Specialty Services Committee Project – Enhancing Access to Pscyhogeratrics care in the residential care setting.

  10. STRATEGY 3 Improve primary and community care outcomes and delivery for mental health and substance use clients 10

  11. STRATEGY 4 Improve timely access to elective surgery 11

  12. On Target to Achieve 40 Week Waitlist Target

  13. STRATEGY 5 Implement a renewed system of care across rural The West Chilcotin Health Centre in Tatla Lake has benefited from a $50,000 grant from the Province for specialized medical equipment. and remote communities & for Aboriginal partners 13

  14. Continuing to Build our Aboriginal Health Partnerships at VJH Supporting equitable access to care for our aboriginal clients

  15. VJH Key Indicators PERIOD 1217 PERIOD 1216 Change 15/16 Percentage Statistic YTD 16/17 YTD 15/16 to 16/17 Change Acute Admissions 9,546 8,473 1,073 12.66% Acute Patient Days 58,398 53,214 5,184 9.74% Occupancy Percentage 107.58% 106.34% 1.24% 1.17% Acute ALC-P Days 8,216 8,050 166 2.06% Acute ALC-N Days 5,618 6,351 (733) -11.54% Acute ALC Days Total 13,834 14,401 567) -3.94% % ALC Days / Acute Days 23.69% 27.06% -3.37% -12.46% Avg Length of Stay 6.29 6.33 (0.04) -0.63% ALC-N Avg Length of Stay 21.76 24.07 (2.31) -9.60% Emergency Visits 43,195 39,327 3,868 9.84% Ambulatory Care Visits 27,002 28,823 (1,821) -6.32% Visits - Surgical Inpatient 3,593 3,088 505 16.35% Visits - Surgical Day Case 10,210 10,628 (418) -3.93% % DC of Total Surgical Visits 73.97% 77.49% -3.52% -4.54% Hips/Knees 611 568 43 7.57% Cataracts 2,090 2,074 16 0.77%

  16. Capital Budget Update

  17. Polson T ower Project – Cash Flow Update March 2017 Polson Tower - Additional Two Projected 2013 2014 2015 2016 2017 2018 Total Inpatient Floors Surplus ($ 000s) ADJUSTED (to account for NOCSRHD Shelled Floors Contribution) Ministry of Health RCG - 100% $ 683 $ 6,269 $ 8,798 $ - $ - $15,750 Ministry of Health RCG - - 814 1,919 237 - 2,818 5,788 NOCSRHD - - 1,166 1,940 200 - 2,219 5,525 VJH Foundation - - 1,000 990 - - 510 2,500 Total Project Capital Funding $ 683 $ 6,269 $ 11,778 $ 4,849 $ 437 $ - $ 5,547 $29,563 • We anticipate the full financial close will occur in 2017 • The projected surplus is still subject to change, but IH is quite confident in the overall $5.5M amount • Increase of $500K since October update • RHD portion of surplus $2.2M

  18. 2017/18 Capital Funding Letter

  19. Highlights for 2017/18 Letter • Total funding request - $1.9M • Prior year $2.6M • Less costly equipment being replaced • Increase in IMIT spending • Heliport – partnership with Revelstoke District Health Foundation • IMIT Corporate Projects • New ask for RHD’s • Total IH cost for projects distributed across all RHD’s based on catchment population • NOCSRHD share is 17% • Primary Care

  20. Vernon Jubilee Hospital MRI • Provincial announcement for additional MRI’s across British Columbia • VJH is one of the sites identified • Working through details on funding support from VJH Foundation • Cannot make specific funding ask of RHD at this time • Will send formal funding request letter separate from the current letter • Planning underway for overall IH MRI strategy • MRI’s going to PRH and EKRH in additional to Vernon • MoH setting new MRI volume targets • Details on anticipated volume and opening date for VJH MRI will be available once IH strategy confirmed

  21. Vernon Jubilee Hospital MRI Location

  22. MRI Equipment Across Interior Health • Installed units at Kelowna and Kamloops (one each) • Mobile MRI shared between Penticton, Cranbrook and Trail • Installed unit at Cranbrook expected to open Spring 2018. • Installed unit at Penticton expected to open Spring 2019. • Installed unit at Vernon, opening date to be determined.

  23. MRI Patient Utilization • Data from 2015/16 – Annual # Exams per 1000 population • Average for all of IHA: 23.39 • Average for Okanagan: 23.66 • North Okanagan Columbia Shuswap Region • Vernon: 18.93 • Enderby: 18.62 • Armstrong – Spallumcheen: 13.21 • Salmon Arm: 18.58 • Revelstoke: 16.09 • Utilization will be rebalanced with new MRI’s coming on line

  24. QUESTIONS?

  25. Thank you for your continued support

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