Bed Management CapacityBed Management CapacityCANADIAN HOSPITALSCANADIAN HOSPITALS

The Other Side of The Other Side of the Cointhe Coin

Mr. Paul FaguyIntegrated Vice President, Clinical Support and Hospital ServicesHamilton Health Sciences & St. Josephs Healthcare Hamilton

The Canadian Healthcare SystemThe Canadian Healthcare System  Hamilton Health SciencesHamilton Health Sciences  The ChallengeThe Challenge  The ResponseThe Response  The ResultsThe Results    What Next What Next

A hospital bed is a parked taxi with the meter running.

Groucho MarxGroucho Marx

Defining Characteristics

Canada Health Act Federal Legislation – applied provincially Private (mostly) physician $ No national “pharmacy” standard Significantly unionized > 75% Enormous public sentiment Not really a “system” Focus on “single payer” = 80%

Healthcare

Canada Health Act Comprehensiveness: all medically necessary

health care services provided by physicians or in hospitals must be covered by provincial health care plans.

Universality: all residents of a province be entitled to insured services through uniform terms and conditions.

Portability: host-province rates apply to health care services provided elsewhere in Canada and establishes national standards for out-of-country benefits. It also requires the province-of-origin’s consent for the coverage of elective services provided to a resident outside of the province.

Canada Health Act

Accessibility: provincial health care plans must provide for insured health services through (uniform terms and conditions) and must not impede or prevent reasonable access to these services by any means.

Public Administration: the Canada Health Act describes the elements of public administration as: Administration of the insurance plan without profit; Run by a public authority appointed or designated by the

provincial government and responsible to government; Regular audits of the public authority.

Hospital Funding

Annual budget

Global 53% – priority 25% - private 22%

Inflation not or not adequately funded

Microscopically benchmarked

“Capitated must capitate”

“Hospitals in Ontario have a product that everyone

wants but no one wants to pay for.”

Efficiency & CostOntario hospitals

Hay Study 2001 & 2004

Little ability (right now) on top line

Our financial success is on bottom line

Our MissionTo provide excellent health care for the people and communities we serve and to advance health

care through education and research.

Our VisionLeaders in exemplary care, innovation and academic

excellence. Our Values

Respect - We will treat every person with dignity and courtesy.

Caring - We will act with concern for the well being of every person.

Innovation - We will be creative and open to new ideas and opportunities.

Accountability - We will create value and accept responsibility for our activities.

General McMaster University Medical Centre JCC Henderson Chedoke Children’s

General McMaster University Medical Centre JCC Henderson Chedoke Children’s

HHS Facts

Beds - 1036 Same Day Surgeries - 34,498 OR Cases - 25,444 Emergency Visits - 109,552 Outpatient Clinic Visits -510,125 Employees - 10,259 Volunteers - 1,107Research Dollars - $217,131,326 Operating Budget - $746,288,565

Customer Support ServicesServices We Provide…

•Environmental AidesEnvironmental Aides•PortersPorters•Logistics•Waste Management•Core Housekeeping•Telecommunications•Business Services

The Challenge

Improve service

Define and maintain quality

Achieve benchmark financial performance

The Response

Recentralization of clinical housekeeping and patient transport

Beginning the journey of bed management capacity

Service culture transformation Service response centre Technology implementation Strategic outsourcing of transactional

activities

There is nothing There is nothing more difficult more difficult to take in hand, to take in hand, more perilous more perilous to conduct, to conduct, or more uncertain or more uncertain in its success, in its success, than to take the lead than to take the lead in the introduction in the introduction of a new order of things.of a new order of things. Niccolo MachiavelliNiccolo Machiavelli

The ResultsServiceService

Standardized Highly satisfactory service levels Realistic expectations being met Rest being worked on

QualityQuality

“Best practices” recommendation through accreditation (JCOH)

FinancialFinancial

$2 million reduction on a base of $50 million 30% reduction in employee absenteeism

What Next?

Full system integration – clinical areas

Implement electronic bed board

Wi-fi, Blackberry, cellular, RFIDNetworkable patient bedside devices

880 devices installed880 devices installedFull web accessFull web access

Patient Infotainment firstPatient Infotainment firstBusiness applications within 6 monthsBusiness applications within 6 months

Clinical applications within 1 yearClinical applications within 1 year

Strategy without tactics is the slowest route to victory.

Tactics without strategy is the noise before defeat.

Sun Tzu