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Balanced Scorecard Quarterly Report September 2018

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Balanced Scorecard Quarterly Report

December 19

2018 Data updated to September 30, 2018


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Table of Contents

Page Strategy Map 2 Balanced Scorecard 3

Strategic Theme: Patient and Family Centred Care • Respond to Community Health Needs

➢ % of recommendations for Horizon from Community Health Needs Assessments that have been implemented 4

• Improve Patient and Community Engagement

➢ Number of primary health care spoke sites 5

➢ Repeat hospital stays for mental health and addictions patients 6

Strategic Theme: Best Care Experience

• Best Care Experience

➢ Patient Experience Survey Results (overall rating) 7 ➢ Patient Satisfaction Survey Score – receiving service in the language of choice 8

➢ Emergency Department wait time for triage level 3 9 ➢ % of patients who received elective hip or knee replacement surgery within targeted time 10

➢ Average length of stay for inpatients with COPD 11

• Improve Patient/Client Engagement

➢ % of Key Committees with Patient Experience Advisor involvement 12 • Strengthen Clinical Networks

➢ Research income received 13

➢ Clinical network maturity index 14

Strategic Theme: Focused Investments

• Manage within Available Resources

➢ Year to date Operating Surplus(Deficit) 15

➢ Average number of paid sick leave days 16

Strategic Theme: Smarter Healthcare • Standardize and Harmonize Practices

➢ Ratio of policies that are Horizon-wide versus local area specific 17

• Collaborate with Healthcare Partners

➢ Percentage of beds occupied by ALC patients in 5 regional hospitals 18

Enablers (Human Resources,Information Technology, Culture) • Employee and Physician Engagement

➢ Bravos! Sent by Leaders 19

➢ Rate of workplace violence incidents reported 20

• Information and Technology to Improve Delivery ➢ % of planned technology initiative milestones completed to improve patient services, and communication between

care giver and patient 21

Legend for Indicator Symbols:

Meets / exceeds stretch Exceeds target /

below stretch Meets target performance

Improved performance

(between base and target)

Below base performance

Not applicable

✓✓ ✓

Legend for Initiative Status Symbols:

Complete On Track Somewhat Off

Track Off Track On Hold Cancelled

Information

Required


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Strategy Map 2018–2019

Values: We show empathy, compassion and respect We strive for excellence We are all leaders, yet work as a team We act with integrity and are accountable


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Owner

Reporting

Frequency

(Q,SA,A)

Baseline

MeasureFull Year Target

Q2

Target

Reporting

Period

Actual

Indicator

Q1

Indicator

Q2

Respond to Community Health Needs% of recommendations for Horizon from Community Health Needs

Assessments that have been implementedJean D Q N/A 80% N/A

Number of primary health care spoke sites Jean D Q 17 2017

(FY18/19, Q2)

Repeat hospital stays for mental health and addictions patients Jean D Q 4.1% 9%3.4%

(FY18/19, Q1)

Patient Experience Survey Results (overall rating) Margaret M A 85.7% 85% N/A Patient Reported Satisfaction – Receiving Service in the Language of

ChoiceMargaret M A 47.2% 90% N/A

Emergency Department wait time for triage level 3 Geri G Q 90.3 78.397.1

(FY18/19, Q2) % of patients who received elective hip or knee replacement surgery

within targeted time Geri G Q 46.3% 65%

32.3%(FY18/19, Q2)

Average length of stay for inpatients with COPD Geri G Q 6.9 5.76.4

(FY18/19, Q1)

Improve Patient/ Client Engagement % of Key Committees with Patient Experience Advisor involvement Margaret M Q 86.7% 90%96.7%

(FY18/19, Q2) ✓✓

Research income received Edouard H Q $5,058,097 $4,800,000 $2,400,000$2,558,783(FY18/19, Q2)

Clinical network maturity index Geri G A N/A TBD N/A

Year-to-date Operating Surplus/ (Deficit) Dan K Q 99.97% 99.25%99.90%

(FY18/19.Q2) ✓✓ ✓✓

Average number of paid sick leave days Maura M Q 11.30 11.0010.72

(FY18/19, Q2)

Standardize and Harmonize Practices Ratio of policies that are Horizon-wide versus local area specific Margaret M Q 30% 34%33.3%

(FY18/19,Q2)

Collaborate with Healthcare Partners Percentage of beds occupied by ALC patients in 5 regional hospitals Geri G M 25.4% 24%26.3%

(FY18/19,Q2)

Bravos! Sent by Leaders Maura M Q 32.9% 35%33.5%

(FY18/19,Q2)

Rate of workplace violence incidents reported Maura M Q 0.77 0.680.68

(FY18/19, Q2) ✓ ✓ Information and Technology to

Improve Delivery

% of planned technology initiative milestones completed to improve

patient services, and communication between care giver and patientJennifer S Q 78% 80.0% 74.1%

(FY18/19, Q2)

Last Updated: December 19, 2018

Reporting Frequency: M = Monthly, Q = Quarterly, SA = Semi-Annual, A = Annual

Strengthen Clinical Networks

Horizon Health Network - Balanced Scorecard 2018-19 (Updated to September 30, 2018)

Strategic Theme: Healthy Populations

Enhance Primary Healthcare

Strategic Theme: Best Care Experience

Best care experience

Strategic Theme: Focused Investments

Manage Within Available Resources

Strategic Theme: Smarter Healthcare

Enablers (Human Resources, Information Technology, Culture)

Employee and Physician Engagement


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Table of Contents

Percent of Recommendations for Horizon from Community Health Needs Assessments that have been Implemented

Strategic Objective: Respond to Community Health Needs

Owner: Jean Daigle

Reporting Frequency: Quarterly

Definition: Priorities are identified through Community Health Needs Assessments for each of the 17 communities in Horizon. This indicator measures the percentage of initiatives from Community Health Needs Assessments priorities that are Horizon’s responsibility that have been completed this fiscal year.

Baseline Target Actual Indicator

N/A 80% N/A

Analysis Summary: This is a new measure for FY 2018/19. We are currently developing the measurement tracking and reporting process. Various initiatives are ongoing and will be included in future reports. Data will be available for reporting in Q3.

Priority Initiatives:

Priority Initiatives/Actions Status Comments

Action Community Health Needs Assessment Recommendations

✓ First report will be in Q3.


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Table of Contents

Number of Primary Health Care Spoke Sites

Analysis Summary: In response to priorities identified within the Community Health Needs Assessment, Horizon plans to expand primary healthcare services using the ‘hub and spoke’ model in fiscal 2018/19. The goal is to add three new satellite sites this year. The Charlotte County Collaborative Wellness Centre in St. Stephen is to act as the ‘hub’ for primary health care service delivery for the communities served within Western Charlotte County (includes Campobello Island, St. Andrews and St. Stephen). Key positions have been hired and space has been identified for service on a part time basis for the spoke site in Saint Andrews. Sexual Health Services are already being provided out of the community college at this time. The Moncton Primary Health Care Clinic is a new site that is being positioned to become a ‘hub’ for the Moncton Area. Key positions have been identified for Salisbury which will operate as a spoke site of Moncton. The sexual health clinic has successfully transitioned to the Chatham Health Centre, and is now operating as a spoke of the Miramichi Health Centre. Two Nurse Practitioners (NP) practice out of the centre daily. They continue to offer specialized sexual health services to the community, have begun rostering clients to their practice and have walk-in appointment available.



Charlotte County Collaborative Wellness Centre - St. Stephen

✓ Primary Health Care Manager have been hired and services are now being offered.

Moncton Primary Health Care Clinic - Moncton

✓ The Moncton Clinic is up and running. Salisbury site has been secured and final arrangements for tenancy are currently underway.

Miramichi Health Centre - Newcastle ✓ At the Chatham Clinic NP’s are rostering patients to their primary care services.

Strategic Objective: Enhance Primary Healthcare

Owner: Jean Daigle


Definition: Horizon is establishing primary health care sites in response to health care needs identified in various communities. This indicator tracks the number of Spoke sites in regard to Horizon’s Hub and Spoke model for Primary Health Care.


17 sites 20 sites 17 sites

(FY18/19, Q2)


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Table of Contents

Repeat Hospital Stays for Mental Health and Addictions Patients

4.1% 4.0% 3.9% 3.6% 3.4% 3.4% 4.2% 4.1% 3.4%

0%

10%

20%

30%

40%

50%

FY 16/17Q1

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

Repeat Hospital Stays for Mental Health and Addictions Patients

Horizon

Target

Analysis Summary: This indicator will be reported a quarter behind due to data availability. We continue to trend well below our target of 9% and the national average. This is expected to continue. One of the reasons that could be contributing to this positive trend is our operational guideline that stipulates that any patient transitioning from inpatient psychiatry will get a post discharge follow up call. Priority Initiatives:


Sustainability ✓ No further action. Team will continue to monitor these results.

Strategic Objective: Enhance Primary Healthcare

Owner: Jean Daigle


Definition: The percentage of individuals who had at least three episodes of care at the same facility for mental illness in a one-year period.


4.1% 9% 3.4% (FY18/19, Q1)


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Table of Contents

Patient Experience Survey Results (overall rating)

Analysis Summary: There will be no new Horizon survey results in fiscal year 2018-19. The New Brunswick Health Council will be conducting their Acute Care Patient Experience Survey during late 2018-2019 provincially. The results will hopefully be available in late 2019 for our review and action planning. The Strategic Plan for Patient Experience which was established for 2016 – 2020, has been recently refreshed with the following action plans:

1. The ONTRACC program implementation was recently started. This program was launched in Saint John and Fredericton Areas with further implementation planned in other areas.

2. The food quality steering committee has introduced a number of sub projects relating to food presentation, diet type revisions, for example. The work of this committee will be further profiled in future reports.

3. The Horizon Quality Consultants continue to work with specific networks and department teams toward initiatives to specifically address issues identified from the Horizon Experience Survey conducted in their facility.

4. In coordination with the strategy, a great deal of effort has been invested in recruiting and orienting Patient Experience Advisors (PEAs) to assist on Horizon committees and program teams to provide direct advise and involvement with program planning.

.



Food Service Quality ✓ This program includes 9 related projects within it.

Recruitment and Orientation of PEAS

✓ Ongoing

Strategic Objective: Best Care Experience

Owner: Margaret Melanson

Reporting Frequency: Annually

Definition: Patients who rated their hospital stay favourably (8, 9, or 10 out of 10) to the following question: • Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?


85.7% (Mar 2018)

85% N/A


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Patient Reported Satisfaction – Receiving Service in the Language of Choice

Analysis Summary: There will be no new survey results in fiscal year 2018/19. The Active Offer Every Day Dialogue Project is ongoing and is predicted to end in February 2019. Several projects stemming from the data collected have been produced. The Official Language intranet site will be built up to include a Learners’ Corner to provide staff with language tools that are easy to access. The Official Languages Website has been updated, some public and internal communications have also been produced (posters, Horizon Star articles, etc.) An updated official languages strategic plan will be introduced in January 2019. Other ongoing projects include:

• Languages testing

• Linguistic profiles

• Complaint process review



Active Offer Everyday Project ✓ Ongoing

Official Languages Strategic Plan ✓ Ongoing and communicated with action plans in winter 2019




Definition: This data reflects the patient experience as it is gathered through patient experience surveys completed by the New Brunswick Health Council (Acute Care Survey) every three years as well as the Horizon Patient Experience Survey conducted by the Horizon’s Quality team annually. The survey starts by identifying the patient’s language of choice. It then proceeds to ask how often the service was offered in their preferred language. The measure reported is the percentage of patients who responded that they always received services in their language of choice when French is indicated as the preferred language.


47.2% (March 2018)

90% N/A


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Table of Contents

Emergency Department Wait Time for Triage Level 3

91.481.7 85.4 86.5 84.2 86.9

104.0 97.1 97.1

0

20

40

60

80

100

120

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

ED wait time for triage level 3

Horizon

Target


Owner: Geri Geldart


Definition: The average time (in min) a triage 3 patient waits in ED from the time they are triaged/ registered to the time they are seen by a physician. Excludes those patients where no seen time was documented. The 5 regional hospitals (TMH, SJRH, DECRH, URVH, MRH) are included in this indicator. NOTE: Treatment may have been initiated by nursing staff prior to being seen by a physician.


90.3 min 78.3 min 97.1 min (FY18/19, Q2)

Analysis Summary: The wait time remains consistent for the first 2 Quarters of 2018/2019. The time waiting continues to exceed the Horizon target and the national benchmark set by the Canadian Triage and Acuity Scale of 30 minutes or less. The lowest average wait is at URVH with 39.5 minutes and the highest average wait is at TMH with 143.8 minutes for triage level 3 patients. Wait times in the emergency department are affected by multiple factors including the number of patients who are being seen in the department, the number of spaces to see patients, acuity of patients and the ability to transfer admitted patients to inpatient units. Each of the emergency departments continue to work on local initiatives in conjunction with the patient flow committees to reduce wait times. Priority Initiatives: None at this time.



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Table of Contents

Percent of Patients Who Received Elective Hip or Knee Replacement Surgery within Targeted Time

44.7% 49.8% 45.7% 45.5% 40.6%32.3%

0%

20%

40%

60%

80%

100%

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

% of patients receiving elective hip or knee replacement surgery within targeted time

Horizon

Target

Analysis Summary: We continue to struggle with long wait times for both hip and knee replacement surgeries. All areas except for Fredericton continue to experience a decrease in meeting this target. Factors that can impact the wait times include: • Limited OR time (scheduling, number of available OR’s) • Limited human resources (surgeons, anesthesia, nursing) • High volume of cases referred.

The Moncton Joint Initiative Project, targeting long-waiting hip and knee replacements with dedicated OR time, means most cases completed will already be outside of the target range. The number of procedures completed in Moncton has increased from 297 for the first half of FY 17 18 to 308 for first half of FY 18 19. As expected our percent completed within target timeframe for FY 2018/19 in Moncton saw a decrease from Q1- 29.9% to Q2 to 21.2%. The focus on those long-waiting cases also means fewer “quick turnover” cases are being completed, thus the percent complete within target timeframe is doubly impacted.

By addressing the long waits, we are seeing success with this initiative. Cases waiting within the targeted timeframe has improved for hip replacements (56% in Q1 to 59% in Q2) and for knee replacements (38% in Q1 to 42% in Q2).



Reduction of Hip & Knee wait times in Moncton

✓ Joint Initiative project started.


Owner: Geri Geldart


Definition: Percentage of Hip and Knee replacement cases that were completed within the target timeframe (182 days). Wait times are calculated from the date that the patient and physician agree to the surgery and the patient is ready to receive it to the date of the completion of surgery. These statistics do not include emergency surgeries. Timeframes during which the patient was not available to have surgery are excluded from the wait time calculations.


46.3% 65% 32.3% (FY18/19, Q2)


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Average Length of Stay for Inpatients with COPD

7.26.6 6.7 6.9 6.6 7.0 6.6

7.46.4

0

2

4

6

8

10

FY 16/17Q1

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

Average length of stay for inpatients with COPD

Horizon

Target

Analysis Summary: This indicator will be reported a quarter behind due to data availability. Although there was a decrease in the ALOS for COPD in Q1, Horizon continues to report higher lengths of stay for the COPD cases than CIHI’s expected length of stay (ELOS). The ELOS for Q1 in FY18/19 was 5.46. With the implementation of Inspired, there has been a drop in the number of admissions for COPD, however length of stay is affected due to sicker patients being admitted. Horizon is working on an in-depth analysis of COPD discharges to seek opportunities for improvement. Work is underway to revamp the current clinical order set (COS) for COPD. Priority Initiatives:


Implementation of a Clinical Order Set for COPD

✓Use of the COS for COPD is being monitored by Patient Flow. Changes to the COS is expected to help improve compliance.


Owner: Geri Geldart


Definition: Average length of stay in days for inpatients with Case Mix Group of Chronic Obstructive Pulmonary Disease (COPD). This indicator excludes those patients who expired and those who were transferred to an acute care facility.


6.9 days 5.7 days 6.4 days (FY18/19, Q1)


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Percentage of Key Committees with Patient Experience Advisor Involvement

Strategic Objective: Improve Patient and Community Engagement



Definition: The percent of 30 Horizon key committees with Patient Experience Advisor (PEA) involvement. Key committees include clinical networks and committees with focus on quality & safety. Involvement means inclusion in focused groups or as a standing committee member.


86.7% 90% 96.7% (FY18/19, Q2) ✓✓

Analysis Summary: Last year, a focused effort was made to identify committees where PEA involvement is appropriate and matching volunteers with the committees. The one remaining committee that does not have a PEA is currently in the recruitment phase. Recruitment is going well and it is expected this committee will have an active PEA by the end of the third quarter. PEAs have been successfully assigned to all clinical networks and are involved with quality and patient safety initiatives. We continue to strategically address patient engagement and work toward fully supporting our PEAs and our Horizon committees who interact with them. The PEA program has been integrated as a core program of the Volunteer Resources Department. Processes, tools and resources have been revised to reflect the current evolution of patient engagement within Horizon. This includes recruitment, the application, onboarding and evaluation processes.



Matching volunteers with committees requesting PEA

✓ On track to have PEA involvement on all identified committees.


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Table of Contents

Research Income Received

$1,701,289

$2,874,492

$3,955,515

$1,691,913

$2,772,119

$4,203,946

$5,058,097

$1,536,604

$2,558,783

$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

FYTD Research income received

Horizon

Target

Strategic Objective: Create Centres of Expertise

Owner: Edouard Hendriks


Definition: This metric captures all income research funds received from external sources (i.e. outside of our departmental budget) and represents income received from pharmaceutical companies, granting agencies, and other sponsors of research.

Baseline Target Q2 Target Actual Indicator

$5,058,097 $4,800,000 $2,400,000 $2,558,783 (FY18/19, Q2)

Analysis Summary: The total income received for end of Q2 for 2018/19 ($1,022,179) fell approximately 15% below our target of $1,200,000. This reduction is partly due to a number of clinical trials that have recently been initiated but have not yet enrolled patients, which is one mechanism through which clinical trial income is derived. However, the total income received for Q1 and Q2 ($2,558,783) is approximately 7% higher than the total combined target for Q1 and Q2 ($2,400,000) which means the Research Income received is on track to meet or exceed the target by end of Q4. In addition to the research income reported, other institutions within New Brunswick (e.g. UNB) have received significant income related to health research through their strategic partnerships with Horizon.



Implement actions from the Research Services Strategic Plan

✓

Research Services is implementing a new service delivery model that will increase the support we can provide to clinician researchers engaged in both clinical trials and Investigator Initiated Research initiatives. We expect this to increase the level of external funding we receive. We have also partnered with University New Brunswick, Dalhousie Medical School NB, and New Brunswick Community College to develop a proposal for a Health Research Institute. This has been reviewed by government and is under consideration.


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Clinical Network Maturity Index

Strategic Objective: Strengthen Clinical Networks

Owner: Geri Geldart


Definition: To be determined


N/A TBD N/A

Analysis Summary: This is a new measure for FY 2018/19.

Horizon needs to strengthen all its clinical networks before they can move successfully to centres of expertise. The

networks are in various stages of development. A Clinical Network Maturity Index will help the clinical networks

assess their strengths and identify opportunities for development to systematically move the program areas

forward. A framework and measurement process is being developed to gauge progress for each network.



Develop Clinical Network Maturity Framework

✓ Ongoing


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Table of Contents

Year to date Operating Surplus(Deficit)

99.88% 99.90% 99.94% 99.77% 99.83% 99.83% 99.97% 99.71% 99.90%

0%

20%

40%

60%

80%

100%

120%

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

Ratio of Actual Expenditures to Revenue

Horizon

Target

Analysis Summary: Over the period, Horizon has been able to maintain spending within our available resources. Year to date expenses of $572,731,385 were offset by revenues of $ 573,320,432 resulting in a YTD surplus of $589,047. The second quarter resulted in a small surplus of revenues to expenses. This is typical for the second quarter where new initiatives are beginning to be operational and projects that had been delayed have started. Spending can fluctuate due to extraordinary events but are normally offset by increased revenues as in the case of contract settlements. During the second quarter there were no significant events. We are operating on budget in most areas. We have a few areas showing cost overruns (Oncology Drugs and Clinical Staffing) but these are either offset from Department of Health or by surpluses in other area’s.

Priority Initiatives: None at this time.


✓

Strategic Objective: Manage within Available Resources

Owner: Dan Keenan


Definition: Ratio of Hospital Operations Actual Expenses (Including Medicare and excluding amortization and sick pay obligation) to actual revenues (Excluding Capital Grant Funding).


99.97% 99.25% 99.90%

(FY18/19, Q2) ✓✓


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Table of Contents

Average Number of Paid Sick Leave Days

10.98 11.23 11.6310.68 10.42 10.89 11.30 11.24 10.72

0

2

4

6

8

10

12

14

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

Average number of paid sick days

Horizon

Target

Analysis Summary: Historically Q2 paid sick trends better than Q3 and Q4. Q2 2018/19 resulted in a 3% increase from Q2 2017/18. Q2 is peak vacation season and due to staff shortages in some areas, it is anticipated that employees who were not approved to take vacation may have used paid sick leave. Managers are encouraged to act proactively with employees who are trending toward attendance issues and to address employees who have exceeded the Horizon attendance trigger. We will continue to use the Attendance Management tools to manage and monitor attendance. The HR team will continue to educate and support its use by managers. Human Resources Strategic plans include initiatives to identify opportunities for improvement.



Human Resource Strategic Plan Attendance Management Pilot

✓ The goal of the pilot is to reduce the rate of absenteeism by one day per eligible employee in the pilot site. Planning to start in Q3.

Strategic Objective: Manage within Available Resources

Owner: Maura McKinnon


Definition: This measure is an annualized average number of paid sick days per employee eligible to receive the benefit.


11.3 days 11.0 days 10.72 days (FY18/19, Q2)


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Ratio of Policies that are Horizon-wide versus Local Area Specific

26.5% 27.5% 28.5% 30.7% 31.9% 33.3%

0%

20%

40%

60%

80%

100%

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

% of Policies that are Horizon-wide

Horizon

Target

Strategic Objective: Standardize and Harmonize Practices



Definition: This indicator reports the percentage of total policies that are Horizon-wide, measuring the progress toward the Regionalization of our policies to encourage consistency in practice throughout Horizon.


30% 34% 33.3% (FY18/19, Q2)

Analysis Summary: To encourage regionalization Horizon requires that all policies be Regional unless they must be Area policies. The positive trend of this indicator is attributed to the number of Regional policies increasing while the number of Area policies has decreased. This is mainly due to 2 factors:

1) regionalization of policies; where a regional policy replaces existing area policies; and 2) the deletion of policies that are out of date; which are disproportionally area policies.

Following the initial review and deletion of out of date policies the percentage of regional policies continues to grow. It is expected that the rate of improvement will slow. Priority Initiatives:


Identify out of date policies and ownership of all policies

All out of date policies have been identified. Ownership has been identified on 96% on the policies.


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Percent of Beds Occupied by ALC Patients in 5 Regional Hospitals

24% 26% 25% 27% 27% 26% 27% 26% 27% 26% 26% 26% 26% 28% 27%

0%

10%

20%

30%

40%

50%

Jul2017

Aug2017

Sep2017

Oct2017

Nov2017

Dec2017

Jan2018

Feb2018

Mar2018

Apr2018

May2018

Jun2018

Jul2018

Aug2018

Sep2018

% of beds occupied by ALC patients

Horizon

Target

Strategic Objective: Collaborate with Healthcare Partners

Owner: Geri Geldart

Reporting Frequency: Monthly

Definition: The percentage of beds occupied by Alternative Level of Care (ALC) patients. Includes ALC patients in all beds, regardless of bed classification, and is based on the MIS Nursing Unit functional centres. The measure includes only the five regional hospitals (TMH, SJRH, DECRH, URVH, MRH).


25.4% 24% 26.3% (FY18/19, Q2)

Analysis Summary: ALC remains a significant cause of hospital congestion. This is a complex problem with no simple solution. 24% of our ALC patients are dependent on Department of Social Development (DSD) processes, mostly waiting for assessment. 72% are waiting for outside services (ex. Nursing Home). 4% are waiting internal services (ex. rehab). In Quarter 2 of FY 18-19 we are seeing an increase of ALC patients overall in Horizon; the largest increase in ALC numbers are at TMH and in the smaller community facilities. Horizon is collaborating with Vitalité, Department of Social Development and Department of Health to develop actions to help reduce the number of inpatients waiting for community services. We hope to see a positive impact with the various Home First initiatives. Expanded long term care capacity will be an important part of the solution. Priority Initiatives:


Home First ✓ Ongoing


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Bravos! Sent by Leaders

23.8%18.8%

38.0%32.9% 31.2% 33.5%

0%

20%

40%

60%

80%

100%

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

Bravos! Sent by Leaders

Horizon

Target

Analysis Summary: Of the 460 Leaders that have direct reports, 154 sent at least one Bravo in the reporting period. A total of 2304 Bravos! were submitted in Q2; 791 were submitted by Leaders. Human Resources is currently implementing an initiative to provide Leaders with support and education of the impact recognition has on engagement and how to increase employee recognition. Priority Initiatives:


Accreditation Worklife Pulse area of opportunity – ‘I receive recognition for good work’.

✓ The project charter is approved. Implementation is beginning in Q3.

Strategic Objective: Improved Employee and Physician Engagement



Definition: Percentage of Leaders who sent at least one Bravo! In the reporting period.


32.9% 35% 33.5%

(FY18/19, Q2)


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Rate of Workplace Violence Incidents Reported

0.730.61

0.710.83 0.78

0.890.77

0.68 0.68

0.00

0.20

0.40

0.60

0.80

1.00

FY 16/17Q2

FY 16/17Q3

FY 16/17Q4

FY 17/18Q1

FY 17/18Q2

FY 17/18Q3

FY 17/18Q4

FY 18/19Q1

FY 18/19Q2

Rate of workplace violence incidents reported

Horizon

Target

Analysis Summary: Our overall objective is to reduce workplace injuries through reduction of incidents of workplace violence.

The rate of reported workplace violence incidents from Q1 to Q2 2018-19 remains flat and Q2 2018-19 reflects a 14.7% decrease from Q2 of the previous year.

Use of the incident tracking system is providing useful data to identify trends or most likely causes of incidents, which enables targeted responses.

Based on feedback from staff, one area of high incidents of workplace violence is the Emergency Departments. The customized pilot project in the Emergency Department has been completed and staff feedback is being evaluated to determine if a broader rollout will occur.



Workplace Violence Prevention Program Implementation Phase 2 Project

✓

Significant progress in various project elements Example: Education - Code White and non-violent crisis intervention training, development of a comprehensive communication plan to relaunch and re-educate staff on tools and resources available. Working sub committees have been established and respective projects plans are in development.

Strategic Objective: Improved Employee and Physician Engagement



Definition: The number of recordable Workplace Violence incidents per 100 full time employees. To accurately reflect trending, this indicator is calculated on a rolling year. Recordable: includes Parklane Incident Reporting System recorded incidents of Health Care and Lost Time (Health Care: MD seen, treatment received, no lost-time; Lost Time: MD seen, treatment received, lost time). Includes Salaried Physicians but does not include Nursing Home personnel.


0.77 Per 100 employees

0.68 Per 100 employees

0.68 per 100 employees (FY18/19, Q2) ✓


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Table of Contents

Percent of Planned Technology Initiatives Completed to Improve Patient Services and Communication between Caregiver and Patient

The following table represents the planned milestones for each initiative by quarter:

Initiatives Q1 Q2 Q3 Q4 Total

Allscripts eDoc Expansion to St. Joseph's Hospital 1 5 6

Anesthesia Information Management System 5 1 2 8

Corporate Email on Physicians Personal Devices (Horizon) 2 3 5

Electronic Operating Room Documentation (Moncton) 2 2 4

Horizon IT Strategic Plan 2 3 1 3 9

Mobile Access to Kronos Workforce Management for Staff (Horizon) 5 2 2 9

Provincial Incident Management Platform 1 2 3 8 14

Secure Communication & Collaboration Platform (Horizon) 1 2 5 8

Surgical Patient Tracking Tool (Moncton) 3 5 8

Total 10 17 16 28 71

Milestones Achieved in Quarter 7 13

% Milestones in Expected Quarter Achieved 70% 76%

Analysis Summary: Six out of the seven outstanding milestones from Q1 and Q2 will be completed in Q3.

Corporate email access of physician personal devices was completed in the quarter and made generally available to physicians.

The provincial incident management system continues with analysis and design over the summer months.

The enablement of staff to provide shift availability through a mobile app (Kronos Mobile) had 5 deliverables. 3 missed deliverables (18%) were primarily attributed to a lack of a security resources to complete the Threat Risk Assessment, partial infrastructure redesign, and the delay to the foundational Kronos upgrade (enabled the use of the mobile app).

Organ and Tissue system was put on hold due to limitation of available solutions (RFP response).

SOMIA Initiatives:


Development of an IT Strategy for Horizon

✓ Preliminary draft has been completed and under revision with the IT Strategic Steering Committee.

Strategic Objective: Available Information and technology to improve delivery

Owner: Jennifer Sheils

Reporting Frequency: Quarter

Definition: A list of Information and Technology projects has been identified for completion, or progress, in this fiscal year, with target milestones. This measure will track the percent of the milestones that were met.


78% 80% 74.1% (FY18/19, Q2)

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