2009 CEO ForumKananaskis, Alberta

Alan R. Hudson, OC, FRCSC

February 16, 2009

Cataract Surgery Wait Time Trend

0

50

100

150

200

250

300

350

Aug

-Sep

05

Oct

-Nov

05

Dec

-Jan

06

Feb

-Mar

06

Apr

-May

06

Jun-

Jul 0

6

Aug

-Sep

06

Oct

-Nov

06

Dec

-Jan

07

Feb

-Mar

07

Apr

-May

07

Jun-

Jul 0

7

Aug

07

Sep

07

Oct

07

Nov

07

Dec

07

Jan

08

Feb

08

Mar

08

Apr

il 08

May

08

Jun

08

Jul 0

8

Aug

08

Sep

t 08

Oct

08

Nov

08

Dec

08

Wai

t D

ays

trendline

Priority 4 Target - 182 days

Benchmark

vs.

Targets

Hip Replacement Surgery Wait Time Trend

0

50

100

150

200

250

300

350

400

Aug

-Sep

05

Oct

-Nov

05

Dec

-Jan

06

Feb

-Mar

06

Apr

-May

06

Jun-

Jul 0

6

Aug

-Sep

06

Oct

-Nov

06

Dec

-Jan

07

Feb

-Mar

07

Apr

-May

07

Jun-

Jul 0

7

Aug

07

Sep

07

Oct

07

Nov

07

Dec

07

Jan

08

Feb

08

Mar

08

Apr

08

May

08

Jun

08

Jul 0

8

Aug

08

Sep

t 08

Oct

08

Nov

08

Dec

08

Wa

it D

ay

s

trendline

Priority 4 Target - 182 days

v

Cataract Surgery Wait Times – LHIN Variation

Note: Based on priority level 4 targets.

Current State (December 2008) - % of cases completed within target

43%

89%92%

98%

100%

97%

86%

0%

100%

Cancer Surgery

Bypass Surgery

Cataract Surgery

Hip ReplacementKnee Replacement

MRI

CT

Target Actual

June 2007

Cardiac

Cancer

Hip and Knee Replacements

Cataract

MRI and CT Scans

March 2008

Ophthalmic Surgery

Orthopaedic Surgery

General Surgery

Paediatric Surgery PilotPaediatric Surgery Pilot

2008/09

Neurosurgery

Vascular Surgery

Otolaryngic Surgery

Ob/Gyn Surgery

Thoracic Surgery

Urologic Surgery

Plastics/Reconstruction

Oral Surgery

Paediatric SurgeryPaediatric Surgery

WTIS Phase 1-3

• 81 WT funded hospitals

• Surgeons: 1,700

• Total cases 2006/07: 1,301,069

• Total MRI and CT scans (2006/07): 1.2 million

WTIS Adult Group 2 Expansion

• ~74 WT funded hospitals (surgery only)

• Cumulative surgeons: ~3,350

• Total cumulative cases 2008/09: ~2,225,000

IMPLEMENTED

IMPLEMENTED

WTIS Adult Group 1 Expansion

• 74 WT funded hospitals (surgery only)

• Cumulative surgeons: 2,600

• Total cumulative cases 2007/08: 1,610,000

Paediatric (Pilot)

• London Health Sciences Centre and St. Joseph’s Health Care (London)

• All paediatric surgical procedures

Progress Developing Ontario’s Wait Time Information System

Progress to Date

Principles

1. Accountability

2. Transparency – D.C.C. – public reporting

3. I.T.

4. Expert panels

5. Political will

6. Pay for performance

(money, data and embarrassment)

Pay for Performance

P 4 P

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Unintended Consequences

• I.C.E.S.

• CIHI

• General Surgery

The infrastructure and resources to reduce demand and increase supply cannot be put in place overnight, therefore, efforts must start early and will take time to show results

The ER Strategy calls for System-wide Improvements

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Increasing Supply of ServicesImproving Processes within the ERReducing Demand for Services

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HomeHome

RehabilitationRehabilitation

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Long Term Care

Long Term Care

‚

Alternate Levels of Care

HomeCommunityand home-based services

RehabilitationRehabilitation‚

Long Term Care

Long TermCare

‚

Alternate Levels of Care

Complex and Continuing

Care ‚

Reducing ER Wait Times and Improving Public Satisfaction can only be achieved by making improvements across the entire system

Therefore, accountability for improvement must rest with Hospital Boards and CEOs, LHIN Boards and CEOs and community partners such as

CCACs

• Aging at Home• Family Health Care for All• Chronic Disease Prevention and

Management (Diabetes)• Mental Health and Addiction

• Aging at Home (ALC)• High Growth Hospital Funding

• Emergency Room Strategy• HHR - Emergency Department

Coverage

Future

eHealth Ontario $2.4• Diabetes• ePrescribing• E.H.R.• LHIN accountability for program integration

tracked and managed quarterly• Emphasis now on transparent reporting of

RESULTS, e.g. post op improvement and QUALITY results tracked over time

• Customer satisfaction• R.O.I. = results + quality

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