CENTRAL EAST LHIN MLPA PERFORMANCE INDICATOR DASHBOARD Performance effective as of August 2011

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1 LHIN Starting LHIN Indicator Provincial Point or Actual LHIN Current LHIN Reporting PI No. Performance Indicator (PI) FY211/12 Trend Data Source Type Target Baseline Performance Status Ranking Period Target 11/12 1 9th Percentile Wait Times for Cancer Surgery 1 Access 84 days WTIO, CCO Aug th Percentile Wait Times for Cataract Surgery 1 Access 182 days WTIO, CCO Aug th Percentile Wait Times for Hip Replacement 1 Access 182 days WTIO, CCO Aug th Percentile Wait Times for Knee Replacement 1 Access 182 days WTIO, CCO Aug th Percentile Wait Times for Diagnostic MRI Scan 1 Access 28 days WTIO, CCO Aug th Percentile Wait Times for Diagnostic CT Scan 1 Access 28 days WTIO, CCO Aug Percentage of Alternate Level of Care (ALC) Days - By LHIN of Institution 4 Integration 9.46% 2.22% 14.8% 18.39% 12 DAD 21/11Q4 8 9th Percentile ER Length of Stay for Admitted Patients 2 Access 25 hours ERNI Aug th Percentile ER Length of Stay for Non-Admitted Complex (CTAS I-III) Patients 2 Access 7 hours ERNI Aug 211 9th Percentile ER Length of Stay for Non-Admitted Minor Uncomplicated 1 (CTAS IV-V) Patients 2 Access 4 hours ERNI Aug NOTES: Repeat Unplanned Emergency Visits within 3 Days for Mental Health Conditions 5 Access TBD 17.5% 16.6% 17.7% 7 NACRS 21/11Q3 Repeat Unplanned Emergency Visits within 3 Days for Substance Abuse Conditions 5 Access TBD 19.6% 19.% 21.% 9 NACRS 21/11Q3 9th Percentile Wait Time for CCAC In-Home Services - Application from Community Setting to first CCAC Service (excluding case management) 4, 6 Access TBD HCD 21/11Q4 Readmission within 3 Days for Selected CMGs 5 Q3 21/11 data (October, Novemeber, Decemeber 21) *Trend analysis comparison to prior reporting period No established Target, monitoring indicator only CENTRAL EAST LHIN MLPA PERFORMANCE INDICATOR DASHBOARD Performance effective as of August 211 Efficiency (Quality) Data sources may vary depending on the availability of data sources (e.g. WTIO vs CE LHIN WTSWG monthly survey) Data Source: WTIS = This month/quarter's data source via the Wait Times Information Office (WTIO), Cancer Care Ontario (CCO). *Hospital-specific waitlists for MRI & CT are a combination of either Hospital-submitted data and/or CCO. ALC = CIHI Inpatient Discharge Abstract Database (DAD), Intellihealth. Note: Jan, Feb, Mar source data is considered 'interim' until final data cut by ministry. ERNI = National Ambulatory Care Administrative Database (NACRS, CIHI) via Ontario s ER NACRS Initiative (ERNI-Level 1). NACRS = National Ambulatory Care Reporting System (NACRS). HCD = Home Care Database (HCD), OACCAC, Health Data Branch SAS EG Server. CE LHIN WTSWG = Central East LHIN's Wait Time Strategy Working Group monthly survey. *Trend analysis comparison to prior month and/or established baseline (where applicable) of current reporting period LHIN Ranking (1 = shortest, 14 = longest) indicates how the LHIN s current value compares against all other LHINs in the province. Q3 21/11 data Most recent available data TBD 14.77% 14.5% 15.8% 9 DAD 21/11Q3

2 9 9th Percentile Wait Times for Cancer + Waitlist (# of Patients Waiting) 1,5 8 1,25 7 1, Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN Cancer Wait Times (9th percentile) is 49 days, vs the 211/12 negotiated target = 48 days. Funding/Allocations: In 21/11, LHC & NHH were the only 2 CE LHIN hospitals that received one-time incremental funding from CCO. For 211/12, we have not yet received details of this funding. Action/Strategy: 1) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 2) Engagement sessions with Hospital Physicians/Surgeons are in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 3) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 4) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator are held as needed. * Where applicable, wait time is approximated as the average of the last 3 months, when wait time is not reported.

3 28 9th Percentile Wait Times for Cataract + Waitlist (# of Patients Waiting) 7, 24 6, 2 5, 16 4, 12 3, 8 2, 4 1, Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN Cataract Wait Times (9th percentile) is 121 days, vs the 211/12 negotiated target = 14 days. Hospital-Specific Issues/Best Practice: In Aug 211, all CE LHIN hospitals were below the CE LHIN target except TSH. But as the Q4 LHIN funded additional volume exausted, many CE LHIN hospitals are seeing wait times increasing. In TSH, # of patients on wait list is rising since April 211, mainly driven by the high demand.they perform approximately 1/3 of CE volume and have indicated a risk in meeting target. Action/Strategy: 1) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 2) Engagement sessions with Hospital Physicians/Surgeons are in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 3) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 4) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator are held as needed. 5) A meeting with TSH was held to discuss the impact of the identified and consider solution. TSH will resubmit their business plan to seek support including funds for data cleaning and additional volume. 6) Capacity survey was conducted and the LHIN is looking into volumes reallocation among hospitals to achieve the best wait times outcome. Other hospitals are also suggested to look into above mentioned two areas to improve wait times. * Where applicable, wait time is approximated as the average of the last 3 months, when wait time is not reported.

4 4 9th Percentile Wait Times for Hip + Waitlist (# of Patients Waiting) Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN Hip Replacement Wait Times (9th percentile) is 17 days, vs the 211/12 negotiated target = 179 days. Funding/Allocations: Comparing to 21/11, RVHS' funded incremental volume for hips & knees revision dropped to zero from 5, and TSH also experienced a significant reduction of funded incremental volumes for Hip & Knee revision from 38 to 6, in 211/12. Hospital-Specific Issues/Best Practice: In Aug 211, all hospitals remained below or equal to the 211/12 CE LHIN target except RVHS (which is a result of their staffing issues, which have been resolved and RMH (staffing issues). RVHS's wait times are improving from last month) and PRHC ( Wait Times have been improved to be below CE target in September) Action/Strategy: 1) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 2) Engagement sessions with Hospital Physicians/Surgeons are in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 3) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 4) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator are held as needed. 5) Capacity survey was conducted and the LHIN is looking into volumes reallocation among hospitals to achieve the best wait times outcome. * Where applicable, wait time is approximated as the average of the last 3 months, when wait time is not reported.

5 th Percentile Wait Times for Knee + Waitlist (# of Patients Waiting) Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN Knee Replacement Wait Times (9th percentile) is 159 days, vs the 211/12 negotiated target = 179 days. Funding/Allocations: Comparing to 21/11, RVHS' funded incremental volume for hips & knees revision dropped to zero from 5, and TSH also experienced a significant reduction of funded incremental volumes for Hip & Knee revision from 38 to 6, in 211/12. Hospital-Specific Issues/Best Practice: In August 211, all CE LHIN hospitals WT are below CE LHIN target except RVHS and RMH due to their staffing issues. Action/Strategy: 1) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 2) Engagement sessions with Hospital Physicians/Surgeons are in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 3) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 4) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator are held as needed. 5) Capacity survey was conducted and the LHIN is looking into volumes reallocation among hospitals to achieve the best wait times outcome. * Where applicable, wait time is approximated as the average of the last 3 months, when wait time is not reported.

6 9th Percentile Wait Times for CT + Waitlist (# of Patients Waiting) 7 6, 6 5, , 3, 2, 1 1, Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN CT Wait Times (9th percentile) is 23 days, vs the 211/12 negotiated target = 28 days. Hospital-Specific Issues/Best Practice: In Aug 211, as a result of wait time improvement initiatives regarding data quality and in-house education by end of the fiscal year, all CE LHIN hospitals are below the CE LHIN target except PRHC, which requested more additional volume to lower the Wait Times.. Action/Strategy: 1) Business proposals for new CT machines that are more efficient has been endorsed by the CE LHIN Board of Directors with letter of approval sent to the Ministry. 2) CE LHIN DI Group monthly meetings including action on Data Improvement Initiative. 3) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 4) Engagement sessions with Hospital Physicians/Surgeons are in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 5) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 6) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator are held as needed. Note: Request to Hospitals to begin tracking monthly waitlists. Prior history from CCO is only estimates and only up to April 21. Data is dependent on how hospitals report data to WTIS (data is used as submitted).

7 9th Percentile Wait Times for MRI + Waitlist (# of Patients Waiting) 16 12, 14 1, , 8 6, 6 4, 4 2 2, Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 PRHC Waitlist LHC Waitlist RVHS Waitlist RMH Waitlist NHH Waitlist TSH Waitlist PRHC LHC RVHS RMH NHH TSH CE LHIN Target Provincial Target CE LHIN ACTUALS PROVINCIAL ACTUALS As of Aug 211, CE LHIN MRI Wait Times (9th percentile) is 9 days, vs the negotiated target = 63 days. Funding/Allocations: Comparing to 21/11, both of RVHS and TSH's funded volumes reduced by 166 (7%), in 211/12 initial allocation. LHC's funded base hours were adjusted to 5,2 instead of 6,24, due to an adjustment for a MOH error. But considering the extra volumes due to delays in opening, all hospitals' funded volume increased ranging from 11% to 43% from 21/11 to 211/12. Hospital-Specific Issues/Best Practices: In Aug 211, all CE LHIN hospitals are below CE LHIN target except LHC (due to increasing demand resulting from a replacement machine installed in August andtsh (driven by high demand). 1) RVHS (ajax site) has received their new MRI on August 29th, 211, and expect to start operational on September 27th. 2) TSH & RVHS, Ministry initiative MRI PIP completed to assist in the reduction of MRI wait times & managing wait lists in 21/11. 2nd MRI machine for both will be operational as of early fall 211 (including base funding). In all, six CE LHIN hospitals will be participating in this initiative for this fiscal year in various waves (e.g. phases), starting with PRHC, including LHC and NHH (best practice) and RMH, RVHS and TSH. 3) PRHC, two staff have completed their exams successfully which will allow an increase in the number of scans that will be completed. Action/Strategy: 1) Hospitals & CE LHIN implemented a one-time Task Force for Data Quality Improvement Initiatives with specific key strategies underway (e.g. Lunch & Learn sessions at each hospital, chart audits, etc.). 2) Engagement sessions with Hospital Physicians/Surgeons is in development (e.g. Medical Advisory Councils, Chief of Staff/Surgery). 3) Wait Time Performance Indicators have been incorporated into the Hospital Service Accountability Agreement with Hospital-specific Negotiated Targets. 4) One-on-One meetings with each hospital including CFO, Chief of Surgery, CE LHIN WTS Working Group member & WTIS Coordinator have been conducted. 5) With the late start date of RVHS and TSH's new MRI machines in 211/12, volumes are being allocated pending a review of their Q2 performance. The funding may have to be reallocated to other hospitals if RVHS and TSH are unable to deliver planned volumes. 6) In 211/12, the Ontario Ministry of Health and Long-Term Care introduced Ontario Breast Screen Program, which will have an impact on wait times. Detailed impact are unavailable at this moment. 7) In July 211, CE LHIN Board approved approximately 1 scans valued $285, to assist wait times. 8) Capacity survey was conducted and the LHIN is looking into volumes reallocation among hospitals to achieve the best wait times outcome. CE LHIN has met with LHC and TSH individually to identify drivers and explore solutions. 9) CE LHIN has informed the ministry that residents are seeking local MRI services with installation of new machines (repatriation) which is negatively affecting MRI performance.

8 % Repeat Visits Number of Repeat Visits Repeat Emergency Visits Within 3 Days for Mental Health Conditions + Number of Repeat Visits by Site /1 Q2 29/1 Q3 29/1 Q4 21/11 Q1 21/11 Q2 21/11 Q3 TSH - GEN # OF REPEAT VISITS TSH - BIRCH # OF REPEAT VISITS PRHC # OF REPEAT VISITS CMH # OF REPEAT VISITS RVHS - CEN # OF REPEAT VISITS RVHS - AJAX # OF REPEAT VISITS LHC - BOW # OF REPEAT VISITS LHC - OSHAWA # OF REPEAT VISITS LHC - PP # OF REPEAT VISITS RMH # OF REPEAT VISITS NHH # OF REPEAT VISITS HHHS - HAL # OF REPEAT VISITS HHHS - MINDEN # OF REPEAT VISITS CMH % VISITS RVHS - CEN.% VISITS RVHS - AJAX.% VISITS LHC - BOW.% VISITS LHC - OSHAWA.% VISITS LHC - PP.% VISITS RMH % VISITS HHHS - MINDEN.% VISITS NHH % VISITS HHHS - HAL.% VISITS TSH - GEN. % VISITS TSH - BIRCH.% VISITS PRHC % VISITS CE LHIN TARGET CE LHIN ACTUALS Provincial Actuals Central East LHIN performance has remainded unchanged from last quarter (17.7%). The Provincial Target = 16.6%. The methodolgy for calculating this indicator has been revised to account for changes in the data source. The methodology more precisely measures the days between 2 consecutive ER visits. The impact to this indicator increases the rate by 8% for Ontario for all LHINs. Past (Q3 9/1-Q3 1/11): Initiatives have performed as expectd. This is attributable to the increased integration of the system and the improved working relationships amongst Health Service Providers that have been created as a result of Integration activities. Current (Q3 1/11): CSI Integration will make Peer Support more accessible throughout the Central East LHIN area, particularly in the Durham and Northeast Clusters. Integration planning activites continued with Health Service Providers. The Central East LHIN performance rate is about average in terms of the return rate. In considerting the GTA as a unit, CE LHIN has a much lower retrun rate than Toronto Central and is approximately 2 points lower than Central LHIN which has a more urban/rural mix. Future (Q4 1/11): Community Crisis beds are used to prevent In-Patient admissions where appropriate. They also ensure that clients are engaged with community providers who can intervene earlier, thus preventing the client's presentation at the local emergency department. Increased access to Community/Peer/CSI supports provides for improved client supports in the community, thus preventing ED use. Increased resources to the MHSu provide for an increased response time, and additional follow-up services, thus preventing ED use.

9 % Repeat Visits Number of Repeat Visits Repeat Emergency Visits Within 3 Days for Substance Abuse Conditions + Number of Repeat Visits by Site /1 Q2 29/1 Q3 29/1 Q4 21/11 Q1 21/11 Q2 21/11 Q3 TSH - GEN # OF REPEAT VISITS TSH - BIRCH # OF REPEAT VISITS PRHC # OF REPEAT VISITS CMH # OF REPEAT VISITS RVHS - CEN # OF REPEAT VISITS RVHS - AJAX # OF REPEAT VISITS LHC - BOW # OF REPEAT VISITS LHC - OSHAWA # OF REPEAT VISITS LHC - PP # OF REPEAT VISITS RMH # OF REPEAT VISITS NHH # OF REPEAT VISITS HHHS - HAL # OF REPEAT VISITS HHHS - MINDEN # OF REPEAT VISITS CMH % VISITS RVHS - CEN.% VISITS RVHS - AJAX.% VISITS LHC - BOW.% VISITS LHC - OSHAWA.% VISITS LHC - PP.% VISITS RMH % VISITS HHHS - MINDEN.% VISITS NHH % VISITS HHHS - HAL.% VISITS TSH - GEN. % VISITS TSH - BIRCH.% VISITS PRHC % VISITS CE LHIN TARGET CE LHIN ACTUALS Provincial Actuals As of 21/11Q3, Central East LHIN performance is 21.% vs the CE LHIN negotiated target = 17.5%. The methodolgy for calculating this indicator has been revised to account for changes in the data source. The methodology more precisely measures the days between 2 consecutive ER visits. The impact to this indicator increases the rate by 3% for Ontario for all LHINs. Past (Q3 9/1-Q2 1/11): Initiatives have performed as expected. Substance Abuse Resources are limited in the Central East LHIN and Health Service Providers are performing to capacity. The Central East LHIN has conducted an Addictions Environmental Scan that highlighted system access gaps and that the system is currently at maximal capacity. Current (Q3 1/11): In considering the GTA as a whole, the Central East LHIN has the lowest unscheduled return visit rate in the GTA. The Central East return rate was 2.2 pts below that of the Central LHIN. The Substance Abuse Health Service Provider system is extremely well integrated both on a LHIN and on a Provincial level. Future (Q4 1/11-Q1 11/11): The implementation of the new additions to Supportive Housing beds in all three quarters of the LHIN is anticipated to have an impact on the rate of unscheduled return visits for substance abuse within the Central East LHIN. Currently, there are sixteen beds each for the Scarborough and Durham Clusters, and 8 for the Northeast Cluster. A process to more effectively integrate the Addictions Health Service Providers in the Central East LHIN was begun during this period.

10 Hours 9th Percentile EDLOS Admitted Patients 1. 5, 4,5 8. 4, 3,5 6. 3, 2,5 4. 2, 1,5 2. 1, 5. Aug 1 Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 CMH(Volume) LHB (Volume) LHO (Volume) LHPP (Volume) NHH (Volume) PRHC (Volume) RMH (Volume) RVAP (Volume) RVC (Volume) TSB (Volume) TSG (Volume) CMH (9th) LHB (9th) LHO (9th) LHPP (9th) NHH (9th) PRHC (9th) RMH (9th) RVAP (9th) RVC (9th) TSB (9th) TSG (9th) CE LHIN Target (9th) Provincial Target (9th) CE LHIN Actuals (9th) Provincial Actuals (9th) In August of FY211, Central East LHIN performance at the 9th percentile in length of stay in the Emergency Department for Admitted patients was 41.8 hours Two facilities are performing longer than the FY211 MLPA target of 39 hours in this indicator: LHO and RVAP In August 211, NHH was the top performer in this indicator at 11.5 hours. This performance, while better than the provincial interim target of 25 hours, still remains above the provincial standard of 8 hours

11 Hours 1. 9th Percentile EDLOS Non-Admitted Low Acuity Patients 2, 9. 18, 16, 8. 14, 7. 12, 1, 6. 8, 5. 6, 4, 4. 2, 3. Aug 1 Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 CMH(Volume) LHB (Volume) LHO (Volume) LHPP (Volume) NHH (Volume) PRHC (Volume) RMH (Volume) RVAP (Volume) RVC (Volume) TSB (Volume) TSG (Volume) CMH (9th) LHB (9th) LHO (9th) LHPP (9th) NHH (9th) PRHC (9th) RMH (9th) RVAP (9th) RVC (9th) TSB (9th) TSG (9th) CE LHIN Target (9th) Provincial Target (9th) CE LHIN Actuals (9th) Provincial Actuals (9th) In August of FY211, Central East LHIN performance at the 9th percentile in length of stay in the Emergency Department for non-admitted low acuity patients was 4.3 hours In February 211, all LHC sites had data quality issues with this indicator (all sites reporting longer stays than actual) In August 211, CMH, LHPP, LHB and RVAP were the only facilities meeting the LHIN target of 4. hours In August 211, LHB was the top performer in this indicator, at 3.4 hours

12 Hours Trend lines that dip down to are an indication that the hospital's outcomes have been FOI'd due to small case counts and/or no data available for that reporting period th Percentile EDLOS Non-Admitted High Acuity Patients 14, , 1. 1, 8, 8. 6, 6. 4, 4. 2, 2. Aug 1 Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 CMH(Volume) LHB (Volume) LHO (Volume) LHPP (Volume) NHH (Volume) PRHC (Volume) RMH (Volume) RVAP (Volume) RVC (Volume) TSB (Volume) TSG (Volume) CMH (9th) LHB (9th) LHO (9th) LHPP (9th) NHH (9th) PRHC (9th) RVAP (9th) RVC (9th) TSB (9th) TSG (9th) CE LHIN Target (9th) Provincial Target (9th) CE LHIN Actuals (9th) Provincial Actuals (9th) RMH (9th) In August 211, Central East LHIN performance at the 9th percentile in length of stay in the Emergency Department for non-admitted high acuity patients was 6.9 hours, lower than the Central East LHIN FY21 MLPA target of 7. hours In August 211, LHO,PRHC, RMH and TSG were performing longer than the target In August 211, LHB was the top performer at 5.4 for this indicator

13 Readmission Rate Number of Readmission within 3 days 24.% 3 Day Readmission Rate - Select CMGs 5 22.% 2.% 4 18.% 3 16.% 14.% 2 12.% 1 1.% 8.% Q1 29/1 Q2 29/1 Q3 29/1 Q429/1 Q1 21/11 Q2 21/11 Q3 21/11 CMH RMH PRHC HHHS LHC NHH RVHS TSH CMH RMH PRHC HHHS LHC NHH RVHS TSH Central East Actuals An increase in Q has occurred - this increase is beyond that experienced previously between quarters. Q3 represents the beginning of the annual system surge (Oct-March). Given that CHF and COPD/Bronchitis/Asthma, Pneumonia are significant drivers in our LHIN and influenced by seasonal challenges - an increase during Q3 could be anticipated. Slight increases in Q3 and Q4 have been experienced in past. The LHIN review of hospital submissions identified that their activities will focus on implementing best practice care and strengthening partnerships across the continuum of care within the hospital and community to address one or more of the following key components of care. Active QIP processes are in place for CHF and COPD.

14 Percentage of Alternate Level of Care (ALC) Days 5.% 45.% 4.% 35.% 3.% 25.% 2.% 15.% 1.% 5.%.% Q Q Q Q CMH PRHC RMH HHHS NHH LHC - O LHC - PP LHC - B RVHS - A RVHS - C TSH - G TSH - B CE LHIN Actual CE LHIN Target There has been a decrease in %ALC at the LHIN level in Q4 of FY21, but performance remains above both the MLPA target of 12.2% and the provincial target of 9.6%. Because %ALC is calculated only on discharge, it is not an indicator that helps HSP s and LHIN s plan for future interventions. Additionally, LHIN s have been informed that %ALC is not an indicator that will be available from the WTIS tool. Thus, monitoring this indicator will continue to be difficult and of limited value. As part of the Home First implementation across the LHIN, the Central East CCAC will be monitoring both the overall ALC designation rate and the proportion of ALC patients designated within 2 days of admission at each hospital on a weekly basis. Additionally, HSAA s have been amended to require a decrease in the total volume of ALC-LTC designated patients over baseline. In March 211, NHH was the top performer at 6.8% for this indicator.

15 Days 1 9th Percentile Home Care Wait Time from Application to First Service from 'Community' and 'Hospital' PENDING Q Q Q Q Q Q Q Q Community Central East LHIN Target This indicator has been revised to be consistent with MSAA methodology. This more rigorous method being used to define "community" and "hospital" has resulted in an increase of 8 days for the Ontario wait time. The increase varies across LHINs from to 3 days. CECCAC initiated Home First in 4 of our partner hospitals in this quarter. Included in the rollout was the initiation of Extended Hours Case Management at some of these hospitals. Therefore, assessment initiation is now completed by the Hospital Case Manager and not by our Community intake Team. All of these types of referrals have short wait times (ie. IV Therapy) for service and as a result, all of these assessments have been removed from our Community Intake. Consequently, there was a growth in our wait times for Community clients. As well, in this quarter the CCAC received dedicated funds from the CELHIN to support targeted reductions in community waitlists. Therefore the waiting days for these clients which are only accounted for when the service begins would have been added to the total waiting time when they were removed from the list which increased the total wait time number to 92 days. In other words, this measurement increased as a result of a clearing of waitlist clients.

16 Hospital Site 1. The Scarborough Hospital - General 2. Rouge Valley Health System - Centenery 3. Lakeridge Health Corporation - Oshawa Distance Between Wait Time Hospitals in Central East LHIN 1. The Scarborough Hospital - General Campus 2. Rouge Valley Health System - Centenery 3. Lakeridge Health Corporation - Oshawa 4. Ross Memorial Hospital 5. Peterborough Regional Health Centre 6. Northumberland Hills Hospital 7. Campbellford Memorial Hospital 6 km 38 km 16 km 11 km 91 km 157 km 6 km 36 km 13 km 19 km 88 km 155 km 38 km 36 km 7 km 74 km 58 km 125 km 4. Ross Memorial Hospital 16 km 13 km 7 km 42 km 81 km 11 km 5. Peterborough Regional Health Centre 6. Northumberland Hills Hospital 7. Campbellford Memorial Hospital 11 km 19 km 74 km 42 km 5 km 55 km 91 km 88 km 58 km 81 km 5 km 58 km 157 km 155 km 125 km 11 km 55 km 58 km Note: The following hospitals are part of the Central East Local Health Integration Network but do not provide Wait Time services: Haliburton Highlands Health Services and Ontario Shores Centre for Mental Health Sciences.