2009 CEO Forum
Kananaskis, Alberta
Alan R. Hudson, OC, FRCSC
February 16, 2009
Dec 08
Nov 08
Oct 08
Sept 08
Aug 08
Jul 08
Jun 08
May 08
April 08
Mar 08
Feb 08
Jan 08
Dec 07
Nov 07
Oct 07
Sep 07
Aug 07
Jun-Jul 07
Apr-May 07
Feb-Mar 07
Dec-Jan 07
Oct-Nov 06
Aug-Sep 06
Jun-Jul 06
Apr-May 06
Feb-Mar 06
Dec-Jan 06
Oct-Nov 05
Aug-Sep 05
Wait Days
Cataract Surgery Wait Time Trend
350
300
250
trendline
200
Priority 4 Target - 182 days
150
100
50
0
Benchmark
vs.
Targets
Dec 08
Nov 08
Oct 08
Sept 08
Aug 08
Jul 08
Jun 08
May 08
Apr 08
Mar 08
Feb 08
Jan 08
Dec 07
Nov 07
150
Oct 07
Sep 07
Aug 07
Jun-Jul 07
Apr-May 07
Feb-Mar 07
Dec-Jan 07
Oct-Nov 06
Aug-Sep 06
Jun-Jul 06
Apr-May 06
Feb-Mar 06
200
Dec-Jan 06
Oct-Nov 05
Aug-Sep 05
Wait Days
Hip Replacement Surgery Wait Time Trend
400
350
300
trendline
250
Priority 4 Target - 182 days
v
100
50
0
Cataract Surgery Wait Times – LHIN Variation
Current State (December 2008) - % of cases
completed within target
Cancer Surgery
100%
97%
CT
Bypass Surgery
86%
100%
0%
43%
98%
MRI
Cataract Surgery
89%
Knee Replacement
Target
Actual
Note: Based on priority level 4 targets.
92%
Hip Replacement
Progress Developing Ontario’s
Wait Time Information System
June 2007
March 2008
2008/09
Cardiac
Ophthalmic Surgery
Neurosurgery
Cancer
Orthopaedic Surgery
Vascular Surgery
Hip and Knee Replacements
General Surgery
Thoracic Surgery
Cataract
Paediatric Surgery Pilot
Otolaryngic Surgery
Ob/Gyn Surgery
MRI and CT Scans
Urologic Surgery
WTIS Adult Group 1
Expansion
Plastics/Reconstruction
Oral Surgery
Paediatric Surgery
• 74 WT funded hospitals (surgery only)
• Cumulative surgeons: 2,600
• Total cumulative cases 2007/08:
1,610,000
WTIS Phase 1-3
• 81 WT funded hospitals
• Surgeons: 1,700
• Total cases 2006/07: 1,301,069
• Total MRI and CT scans (2006/07):
1.2 million
Paediatric (Pilot)
• London Health Sciences Centre and St.
Joseph’s Health Care (London)
• All paediatric surgical procedures
WTIS Adult Group 2
Expansion
• ~74 WT funded hospitals (surgery
only)
• Cumulative surgeons: ~3,350
• Total cumulative cases 2008/09:
~2,225,000
Progress to Date
Principles
1. Accountability
2. Transparency – D.C.C. – public reporting
3. I.T.
4. Expert panels
5. Political will
6. Pay for performance
(money, data and embarrassment)
Pay for Performance
P4P
$
Unintended Consequences
• I.C.E.S.
• CIHI
• General Surgery
The ER Strategy calls for System-wide
Improvements
Reducing ER Wait Times and Improving Public Satisfaction can only be achieved by
making improvements across the entire system
Therefore, accountability for improvement must rest with Hospital Boards
and CEOs, LHIN Boards and CEOs and community partners such as
CCACs
Reducing Demand for Services Improving Processes within the ER
Increasing Supply of Services
OR
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• Aging at Home
• Family Health Care for All
• Chronic Disease Prevention and
Management (Diabetes)
• Mental Health and Addiction
ED
ER
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• Emergency Room Strategy
• HHR - Emergency Department
Coverage
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H
Alternate Levels
of Care
Community
and home-based
Home
Home
services

Rehabilitation
Rehabilitation
Rehabilitation

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Complex and
Continuing
Care

Long Term
Long
Term
Long
Term
Care
Care
Care
• Aging at Home (ALC)
• High Growth Hospital Funding
The infrastructure and resources to reduce demand and increase supply cannot be put in place overnight, therefore,
efforts must start early and will take time to show results
Future
eHealth Ontario $2.4
• Diabetes
• ePrescribing
• E.H.R.
• LHIN accountability for program integration
tracked and managed quarterly
• Emphasis now on transparent reporting of
RESULTS, e.g. post op improvement and
QUALITY results tracked over time
• Customer satisfaction
• R.O.I. = results + quality
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