Rotary Club of Bracebridge

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Jacob Price
5 years ago
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1 A presentation for Rotary Club of Bracebridge Natalie Bubela, CEO January 9, 2015 Outstanding Care ~ People Focused

2 Who Are We? Multi-site health care organization created in 2005 through the amalgamation of: South Muskoka Memorial Hospital Bracebridge Algonquin Health Services Huntsville Today MAHC includes: Huntsville District Memorial Hospital Site South Muskoka Memorial Hospital Site Also supported by outpatient programs at Almaguin Highlands Health Centre in Burk s Falls, two Diabetes Education Programs (Huntsville & Bracebridge), and SASOT (Seniors Assessment & Support Outreach Team) 2

What Happens at MAHC Bed Types: Acute Complex Continuing Care South Muskoka Memorial Hospital

43,600 Surgeries 7,655 Births 268 Chemotherapy Clinic Visits 2,903 Dialysis Treatments 3,111

Ultrasounds 18,842 Employees 645 Active Physicians 85 Volunteers 355 Total Operating Budget $75

3 What Happens at MAHC Bed Types: Acute Complex Continuing Care South Muskoka Memorial Hospital Huntsville District Memorial Hospital 32 0 Admitted Patients 4,400 Emergency Visits 43,600 Surgeries 7,655 Births 268 Chemotherapy Clinic Visits 2,903 Dialysis Treatments 3,111 Diabetes Visits 1,535 Radiology Exams 36,939 Mammography Exams 4,285 CT Scans 16,791 Ultrasounds 18,842 Employees 645 Active Physicians 85 Volunteers 355 Total Operating Budget $75 million Capital Needs ~$13 million 4 Bargaining Units 2 Foundations Note: the above activity data is data 3

4 Budget Update Four consecutive balanced budgets since Health System Funding Reform introduced in 2011 Two components: Health Based Allocation Model (HBAM) and Quality-Based Procedures (QBP) HBAM and QBP funded at pre-determined best practice rates and based on the volume of procedures performed Quality patient outcomes are key component Working toward a balanced budget for Working with NSM LHIN, MoHLTC to resolve $2.4 million funding shortfall 4

5 MAHC s Performance Our Report Card A Patient Satisfaction Consistently Above Ontario Community Hospital Average A CT Wait Times Better than provincial targets and averages A Balanced Budget Four balanced budgets in a row A Emergency Room Wait Times Better than provincial targets and averages A Patient Safety Improvements recognized by OHA, CHICA, APIC A Infection Prevention & Control Improvements recognized by OHA, CHICA, APIC 5

6 Success Stories/Initiatives we have introduced Seniors Assessment & Support Outreach Team Gynaecological Surgery Ear Nose Throat (ENT) Surgery 6

Success Stories/Initiatives we are working toward Accreditation Survey Nov. 24-28; Dec.

7 Success Stories/Initiatives we are working toward Accreditation Survey Nov ; Dec Quality/Safety Initiatives LEAN Training another 25 Yellow Belts Balanced budget in

8 Improving Care Through Upgrades Medical Device Reprocessing Department renovation SMMH Site August 2013 Dialysis renovation HDMH Site May

9 Improving Care Through Upgrades New CT Scan Suite HDMH Site May 2014 Chemotherapy/Infusion Clinic HDMH Site June

10 Capital Equipment Needs Hospitals responsible for 100% of cost of new and replacement equipment (depreciation to fund replacement) one exception: Hospital Infrastructure Renewal Fund (HIRF) for minor capital projects that extend the useful life, or improve functionality of hospital facilities, e.g. roof replacement Information Management/Technology significant IT needs key to MAHC achieving quality care, sustainable future and supporting clinical practice. Estimated cost of $5 million General capital equipment needs - $13 million 10

- $3 million investment to improve energy efficiency and reduce carbon

11 Improvements Underway Master Program/ Master Plan - visioning future clinical services and facility space needs Energy Project (both sites) - $3 million investment to improve energy efficiency and reduce carbon footprint - Green Hospital Scorecard Bronze Seal two consecutive years 11

12 Planning for the Future Facilities don t meet current standards; existing space is challenged Changes in practices require new / different space; Community share = 24% Better position MAHC to provide safe, quality care now and in the future 12

13 Health Capital Planning Process Planning Grants: 3 possible approval milestones: proposal development, functional program, design development Construction Grant *WE ARE HERE Pre-Capital (Part A & B) Stage 1 Proposal (Part A & B) Stage 2 Functional Program (Part A & B) Stage 3 Preliminary Design Or Output Specifications Stage 4 Working Drawings Or Output Specifications Stage 5 Implementation Review and support of Pre-Capital Submission Review and approval of Stage 1 Submission Requires Government approval to plan Review and approval of Stage 2 Functional Program Requires Government approval to plan Review and approval of blocks and sketch plans; approval to proceed to working drawings OR blocks/output specifications Requires Government approval to construct Review and approval to tender & implement/ issue RFP OR approval to award construction contract/ Project Agreement 13

14 Master Program & Master Plan MASTER PROGRAM: present and future service role within the community Inventories programs, services & resources, challenges re: quality, accessibility and capacity Analyzes current practices and processes relative to national standards of care MASTER PLAN: the condition and potential use of existing buildings, sites and systems Guides capital investments over the next 20+ years Develops new Service Delivery Models including operational options for siting of programs and services 14

15 Engagement in Planning Board Ad-Hoc Steering Committee 8 MDs, Board members, Foundation reps, community member, admin Master Program 4 meetings 16 Planning Teams comprising ~150 individuals Community Information Sessions Huntsville/Bracebridge/Gravenhurst May ; August Master Plan 3 Workshops ~40 people Steering Committee review of models Creation of Hybrid Model Working Group 32 participants (16 MDs) 2 meetings (Nov/Dec) 15

16 Role of Data in Planning Analysis and projection of future hospital bed numbers and visit volumes is based on: Past 3 years of workload data Catchment area Market share Population growth Provincial averages Planning / Building / Infection Control standards Travel distances to access services 16

17 Master Plan Guiding Principles Create an environment of wellness Establish strong community connections Design for flexibility and future change Create a positive work environment Operational efficiency 17

18 MAHC s Current State 18

19 Site - SMMH 19

20 Site - HDMH 20

21 Technical Assessment of Existing Sites Evaluation, site layout/circulation, zoning, parking, watercourses, vehicle access, etc. for both sites Assessment of existing conditions: Mechanical review of all building systems e.g., cooling, heating, plumbing, medical gas, fire protection, building automation Electrical assessment including electrical/ emergency distribution, fire alarm, nurse call, etc. Future expansion capability 21

22 Options Models MASTER PROGRAM OUTLINED THREE DEVELOPMENT MODELS: One Site Model (Master Plan Option 1) Ambulatory Site/Acute Site Model (Master Plan Options 2 & 3) Two Acute Sites Model (Master Plan Option 4) 22

23 Evaluation Tool CRITERIA Patient- and Family- Centered Care Design Construction Financial Approvals Community Support -Quality of space; -Efficient use of space; -Flow of public, patients & staff SUB-CRITERIA -Ability to accommodate future growth & changes -Community connection -Site & building utilization -Construction phasing and ease of implementation -Impact on ongoing operations -Duration of construction -Capital cost building & site -Operational cost initial & ongoing -Fundraising capability capital needs & redevelopment needs -Alignment with MoHLTC / LHIN priorities -Municipal support -District of Muskoka support -Community feedback -Travel times -Market share -Recruitment & retention of staff/physicians/volunteers 23

Legend 75 Highest 70 65 60 55 50 45 40 35 30 25 20 15 10

24 Legend 75 Highest Lowest MAHC Option Evaluation, October 30, 2014 Page 1

25 Model Evaluation One Acute Care Site in the middle is not viable Single Site scored best for Patient- and Family- Centered Care, Design, Construction, MoHLTC/LHIN Support, and Cost Two Acute Care Site Model scored best for Community Support, Fundraising and Municipal/District Support. It also scored well in Design and Patient- and Family-Centered Care Most expensive models not likely to be approved Is there a model that combines benefits of all model strengths, minimizes weaknesses? 25

26 Next Steps Steering Committee directed: Creation of a working group to look at Hybrid Master Program Model (November/Dec) Results of Hybrid Master Program to Stantec for analysis model development and costing (Dec/Jan 2015) Workgroup to consider: Closing the costing gap between the most and least expensive model Considering the impact of MoHLTC funding reform on operating costs Focusing on centers of excellence and specialty, resulting in reduced duplication A model that could be phased in affordably 26

27 Keep Up-To-Date with MAHC Subscribe for the Latest News on our website! 27

28 Questions? All of MAHC s great work would not be possible without the generous support of our communities. Thank you! 28

Hospital Care for Future Generations

Hospital Care for Future Generations May 26 Huntsville; May 27 Bracebridge; May 28 - Gravenhurst Outstanding Care ~ People Focused Purpose & Desired Outcomes Provide an overview of the required planning