developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
And our approach to strategy
Presented by: Lyn Hamill
A/Director, Integrating Strategy and Performance
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
I will
• Introduce Queensland Health
• Introduce ISAP and our strategic
framework – our achievements
• Describe what we plan to do from this
point on
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Introducing Queensland Health
• Network of 38 Health Service Districts covering
•
•
•
•
the state of Queensland
64,500 staff on payroll
700,000 inpatient and 340,000 day patient
episodes of care using 2m bed days
8.7m non inpatient episodes of care including
800,000 emergency episodes
$A4.8 billion revenue FY 2003-4
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Critical points for QH in last two years
• Publication of Health 2020
• Change in leadership – after 8 years
• New strategic agenda – new mission,
vision and 5 strategic intents reflected in
a new strategic plan
• Organisation restructured to be more
”corporate” – Board, Directorates
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Health 2020
• Research undertaken 2001-2
• Produced a directions
statement for the Department
• Identified challenges and
implications
• Provide guidance to strategic
direction
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Future challenges (Health 2020)
ISSUES
IMPLICATIONS
• Ageing population
• Technological changes
• Slowing workforce growth
• How do we ensure equitable
• Rising chronic and
preventable disease
access?
•
How do we best use/maximise the
advantages of new technologies?
• Can we keep up with the pace of
social and technological change?
• What will be the impact of a
shrinking revenue base?
developing a sustainable
health system
.
ISAP:
Video
“Queensland’s health – our future”
2003
Integrating Strategy and Performance
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Introducing Queensland Health’s strategy
• Mission
•
•
– Promoting a healthier Queensland
Vision
– Leaders in health – partners for life
Five intents
– Healthier staff
– Healthier partnerships
– Healthier people and communities
– Healthier hospitals
– Healthier resources
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
ISAP (Integrating Strategy and
Performance) – What is it ?
•
A two year project commenced in 2003
to introduce the Balanced Scorecard into
Queensland Health
• Ends June 2005 – transfers to a
permanent function
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Critical components of BSC in our project
• More than just strategic planning
• To drive the implementation of strategy
•
– the technical process – development,
maintenance and use of the strategy maps
and scorecards
To make QH a strategy focussed organisation
– the change management processes –the
less tangible component
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
ISAP – needed to address
• Buy-in amongst diverse group of highly educated
•
•
•
people
– Mostly located in districts
– Cautious of corporate driven models
An organisation adverse to risk and resistant to
change
– Use of pilots
– Multi-level support – statewide, zonal, district
Lack of internal consulting skills – whilst using internal
staff
Ensuring required level of communication
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
ISAP – is made up of
• Director General sponsorship
• Up to 17 dedicated people at corporate, zonal
•
•
and district level providing training, guidance
and assistance in the implementation of the
process
Allocated persons at various levels owning to
administration of the scorecards
Input by Balanced Scorecard Collaborative
(ongoing development of model)
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
ISAP - What have we achieved to date?
• Created and began using a corporate strategy
•
•
•
map and scorecard
Cascaded corporate scorecard to 38 Health
Service Districts and a number of corporate
support areas
Created a 1st version of an integrated planning
calendar – to coordinate planning, budgeting
and reporting
Influenced the new initiative funding model to
look at strategic issues – linked $ to change
August 2004
developing
a sustainable
Queensland Health
Strategy
Map
health system
our mission
Promoting a healthier Queensland
our vision
.
ISAP:
Integrating Strategy and Performance
Leaders in health — partners for life
Paying for health
Consumer
Promoting a healthier Queensland
Critical components of BSC
C1. Achieve
whole-ofgovernment
approach to
quality of life
C2. Increase
confidence
in health
system
C3. Increase
knowledge
and skills for
health
C4. Improve
access to
primary health
care
C5. Reduce
impact of chronic
disease including
on Indigenous
peoples
C8. Appropriate
access to
specialist services
across
Queensland
Healthier resources
maintenance and use of the strategy
maps and scorecards – data, reporting
• Change management –the less tangible
component required to become more
strategy focussed
• More than just strategic planning – it
drives the implementation of strategy
P1. Balanced budget
Healthier partnerships
Internal processes
C7. Ensure
safe and
quality health
outcomes
• The process – development,
P2. Leverage other sectors
Shaping our
workforce
C6. Smooth
transition between
community
services, hospitals
and GPs
IP1. Improve
community
participation in the
planning and delivery
of health services
IP2. Proactive
marketing and
education about
QH services
IP3. Progress shared
priorities with
government and nongovernment sector
P3. Maximise revenue
Healthier people & communities
IP4. Inform
and skill
health consumers
IP5. Reduce
risk factors
in high risk
consumers
Healthier hospitals
IP7. Increase use
of clinical evidencebased decision
making
IP6. Primary
prevention targeting
areas of high return
IP8. Continuously
improve key
business processes
IP9. Effective
service and
workforce planning
Healthier staff
WF1. Encourage innovation
and targeted research
WF2. Develop values-based
organisation
WF3. Recruit, develop and retain an
appropriately skilled workforce
WF4. Right information at the right time
at the right place in the right medium
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Integrated Planning
• Included planning, budgeting and reporting (at
multiple levels) into the one calendar
• Identified key activities and the require pre and
post activities
• Version 1 mainly drove funding cycle however
Health Service Directorate seeking to ensure
all its activities are logically planned for
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Initiative Funding
• Majority of budgeting is historical – covering
•
•
business as usual
Identified need for a transparent process for
allocating operating funds for new activities
– Initiative funding model trialled 2004
– Requires initiative to be linked to strategic
objective as criteria
Intended to extend use into capital allocations
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Strategic Management Branch
•
Based on BSCol SMOmodel to provide:
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–
–
–
–
–
–
•
Support for the senior executives for leadership on strategy
Governance process to support execution of strategy
Ongoing utilisation and review of QH Scorecard
Improved alignment to the strategy of scorecards and business
processes throughout Queensland Health
Establishment of a strategic management function within
Queensland Health
Ongoing change management support
Ongoing evaluation and continuous improvement
Additional role in some performance reporting to
external bodies
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Strategic Management Branch
19 staff positions funded
• Strategic Management Branch – 10 staff
– Board secretariat
– Strategic Planning and Scorecard
– Model development and promulgation
• Zonal and District staff – 8 staff
• Public Affairs – 1 staff – internal
communications
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Challenges
• Ensuring leadership remains publicly
committed to the strategy and the
methodology
• Ensuring that strategy is something we
do as part of our normal role – not an
add-on
• Providing systems and processes to
embed the methodology
developing a sustainable
health system
.
ISAP:
Integrating Strategy and Performance
Summary
• Queensland Health has embarked on a
journey to move away from just strategy
planning to becoming a strategy focussed
organisation
• We have completed through the “design”
phase and now move to embed the
processes into the organisation