2016/17 Emergency Department Pay-for-Results Program (Year 9)

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1 2016/17 Emergency Department Pay-for-Results Program (Year 9) Central East LHIN Board of Directors May 25, 2016 Presented By: Brian Laundry, Senior Director, System Design and Integration

2 Overview Background for 2016/17 Pay-for-Results Program (Year 9) New Items for 2016/17 Pay-for-Results (Year 9) 2016/17 P4R Indicators, Methodology, and Hospital Sites 2016/17 P4R Consolidated Action Plan Development 2016/17 P4R Preliminary Allocations 2016/17 P4R Shared Initiatives 2016/17 P4R Timelines Next Steps Board Motion 2

3 Background for 2016/17 Pay-for-Results Program (Year 9) 2016/17 represents Year 9 of the Pay-for-Results (P4R) Program in Ontario P4R is a Ministry of Health and Long-Term Care (MOHLTC) program funding one-time initiatives to support the reduction of Length of Stay (LOS) and improved patient experience in Emergency Departments (ED) Hospitals with at least 30,000 annual ED visits for two consecutive years are eligible to participate in the P4R Program (n=73) Each year, the Central East LHIN works with its hospitals to develop a consolidated P4R Action Plan 3

4 New Items for 2016/17 Pay-for-Results (Year 9) Changes to the funding streams, performance metrics, and targets since the P4R Program started in 2008 Funding methodology for 2016/17 P4R Program included the Ambulance Offload Time (AOT) as the sixth performance indicator Period used to determine performance rankings and resulting preliminary allocations for 2016/17 is the 2015 calendar year (January-December 2015) Two new requirements for P4R hospitals to participate in the following: 1. Health Quality Ontario s (HQO) ED Return Visit Quality Program; and 2. Ontario Hospital Association s (OHA) new ED Patient Experience of Care (EDPEC) Survey 4

5 2016/17 P4R Indicators Provincially, preliminary allocations are determined based on hospital performance in the following six indicators: 1. ED Length of Stay for admitted patients 2. ED Length of Stay for non-admitted complex patients (CTAS I-III) 3. ED Length of Stay for non-admitted non-complex patients (CTAS IV-V) 4. Time to Physician Initial Assessment 5. Time to Inpatient Bed (for admitted patients) 6. Ambulance Offload Time (AOT) 5

6 2016/17 P4R Methodology As initiated in Year 5, hospitals no longer have specific performance targets Hospitals are measured based on their relative performance amongst all 73 provincially designated P4R hospitals Current performance (70%), performance improvement from initial P4R year (30%), and slight adjustment for ED volume Total provincial P4R preliminary allocation of $90M has decreased by 4.8% in 2016/17 In Central East LHIN, our P4R preliminary allocation has decreased by 4.5% from $11,657,200 to $11,135,200 An average 12.1% of the provincial preliminary allocation for Central East 6

2016/17 P4R Hospital Sites The Scarborough Hospital - Birchmount The Scarborough Hospital - General Rouge Valley Health System - Centenary Rouge Valley Health

7 2016/17 P4R Hospital Sites The Scarborough Hospital - Birchmount The Scarborough Hospital - General Rouge Valley Health System - Centenary Rouge Valley Health System - Ajax/Pickering Lakeridge Health Oshawa Lakeridge Health Bowmanville Peterborough Regional Health Centre Northumberland Hills Hospital Ross Memorial Hospital 7

8 2016/17 P4R Consolidated Action Plan Development The Central East LHIN process (January April 2016): - Conducted preliminary internal review of P4R historical performance - Held kick-off meeting and planning webinar with hospitals - Performed year-over-year review, evaluation, and scoring of 2015/16 initiatives - Ministry announced preliminary allocations for P4R on March 4, Each hospital completed their own Action Plan template (Ministry provided) with a list of proposed initiatives - 42 proposed initiatives were received by the Central East LHIN on March 30, 2016 A Working Group, including the ED Physician Lead and three hospital representatives, used Expert Choice to evaluate the initiatives 8

9 2016/17 P4R Consolidated Action Plan Development (cont d) Initiatives were assessed based on their intended impact on: - MLAA performance indicators (ED LOS for Complex and Non-Complex Patients) - Alignment with advancing integrated systems of care (IHSP ) DRAFT P4R Action Plan was submitted to the MOHLTC on April 25, 2016 to meet MOHLTC timelines Final P4R Action Plan presented for Board decision on May 25, 2016 Emergency Care Steering Committee, to consist of ED Chiefs and hospital representatives, will provide oversight to the P4R program and ensure funding and initiatives are aligned to achieve the best results for patients within individual EDs and across the Central East LHIN The Central East LHIN will be releasing the approved 2016/17 P4R funding allocations to the hospitals in two separate installments. This staged funding process (75% installment up front and 25% installment in Q4) will allow redistribution between projects within a hospital. Criteria to be established by the Emergency Care Steering Committee. 9

10 2016/17 P4R Preliminary Allocations Hospital Site MOHLTC Preliminary Allocation % MOHLTC Preliminary Allocation Allocation After Shared Project Allocation Peterborough Regional Health Centre $1,970, % $1,748,414 Scarborough Hospital - Birchmount Campus $1,516, % $1,345,138 Scarborough Hospital - General Campus $1,456, % $1,292,344 Lakeridge Health - Oshawa $1,338, % $1,187,200 Lakeridge Health - Bowmanville $835, % $741,601 Ross Memorial Hospital $1,174, % $1,042,393 Rouge Valley Health System - Ajax & Pickering $1,096, % $972,918 Rouge Valley Health System - Centenary $1,070, % $949,494 Northumberland Hills Hospital $677, % $600,698 Shared Initiatives $0 0.0% $1,255,000 Total $11,135, % $11,135,200 10

11 2016/17 P4R Shared Initiatives Initiatives to support system improvement and ED performance across the Central East LHIN Shared Project Hospital Allocation % Allocation Non P4R Small Hospital Campbellford Memorial Hospital $125, % Non P4R Small Hospital Central East LHIN-Wide ED Conference Haliburton Highland Health Services Peterborough Regional Health Centre $125, % $5, % Other Shared Initiatives TBD $1,000, % Total $1,255, % 11

12 2016/17 P4R Timelines Activity Central East LHIN Letter to Hospitals informing of P4R Process Date May 2016 Central East LHIN Board Decision P4R Action Plan May 25, 2016 Planning Letters to Hospital CEOs June 2016 Ministry Funding Letter to Central East LHIN June 2016 (expected) Emergency Care Steering Committee Established with Meetings Planned Funding Letter (Installment 1) to Hospitals May/June 2016 July 2016 (pending MOH letter) Emergency Care Steering Committee Review of Project Performance October 2016 Funding Letter (Installment 2) to Hospitals November

13 Next Steps Central East LHIN Board of Directors consider for decision the proposed Central East LHIN Consolidated Action Plan Establish an Emergency Care Steering Committee to oversee, monitor, and evaluate the 2016/17 P4R Program - Develop process and determine criteria for selecting shared initiatives and reviewing funded initiatives 13

14 Questions/Discussion Board Motion 14

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