Balanced Score Card
Review of September 2015 Data
Balanced Scorecard
Finance
Patient
Access
Quality
Human
Resource
Management
&
Safety
Finance
Finance Report - September 2015
•
Actual outturn YTD August 2015
•
•
•
Group budget €188.2m (2014 €183.0m)
Group actual expenditure €188.1m (2014 €191.9m)
Group actual surplus €104k ( 2014 deficit: €8.9m)
•
•
•
CUH Budget €176.7m (2014:€170.1m)
CUH /SMOH actual expenditure €177.1m (€178.6m)
CUH /SMOH actual deficit €421k (2014 €8.5m)
•
•
•
Mallow Budget €11.5m (2014:€11.2m)
Mallow actual expenditure €11.0m (2014 €11.8m)
Mallow actual surplus €525k ( 2014 deficit €617k)
Forecast 2015
 Group Budget €282.58m (2014 €284.9m)
 Group projected expenditure €282.2m (€284.2m)
 Group Projected Surplus €379k ( surplus 0.7m)
 CUH Budget €265.3m (2014:€262.8m)
 CUH projected actual €265.4m (€265.2m)
 CUH projected Deficit €97k (€2.4m)
 Mallow Budget €17.3m (2014:€17.5m)
 Mallow Projected Actual €16.8m (€16.8m)
 Mallow Projected Surplus €476k
5
CUH Group Summary – Budget v Actual Expenditure
YTD September 2015
Pay €k Non-Pay €k Income €k Total
CUH
SMOH
CUH-SMOH
Mallow
Total
-2,382
-5,932
7,768
-546
0
-24
73
49
-2,382
-5,956
7,841
-497
37
-375
933
595
-2,345
-6,331
8,774
98
CUH Budget v Actual Pay YTD - September
2015 Budget €k 2015 Actual €k Variance €k % Variance 2014 Actual €k v 2014 Variance €k
Medical/Dental
48,118
48,694
-577
-1%
47,194
-1,500
Nursing/Midwifery 65,197
65,674
-477
-1%
65,451
-223
Paramedical
24,072
24,069
4
0%
24,113
45
Housekeeping
8,959
10,069
1,110
-12%
9,591
-478
Catering
2,974
3,041
-67
-2%
3,136
95
Portering
4,413
4,336
77
2%
4,494
158
Administration
13,377
13,529
152
-1%
13,228
-301
Other Staff
2,518
2,697
79
-3%
2,625
-72
Total
169,728 172,109 2,382
-1%
169,833
-2,277
CUH Group –Surplus / (Deficit) percentage %
(September)
CUH Actual Non-pay Expenditure €k YTD
September 2015 v 2014
CUH Debtor days –September 2015
CUH AGENCY COSTS €k 2013 – September 2015
CUH AGENCY WTE – September 2015
CUH Agency Costs – September 2015
CUH Average Nursing & HCA Agency WTE’s per Week 2013-15
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2014-15
Patient Income 2013 –September 2015
Mallow Budget v Actual YTD September 2015
Patient Access
CUH Weekly INMO Trolley Report
Week ending 16th October 2015
Ambulance Turnaround Times (September)
90% of patients clinically transferred <60 minutes after the 1st two weeks of the month to 94% at the
end of September.
ED – 6hr & 9hr Target
(9hr – 73% - 6hr – 56%)
12th October)
R
ED – 6hr & 9hr Target (Jan – Sept - Trend line)
Delayed Discharges - 2015
January - October (13th October)
Inpatient – Day case Waiting Lists
Total Adult Inpatient Waiting List ( 22/10/2015)
Count
of id
hospital name
Cork University Hospital
Cork University Hospital Total
Grand Total
wl type
Adult
Child
GI Scope
Wait category
ACTIVE
PREADMIT SUSPENSION Grand Total
1517
317
44
1878
61
32
4
97
131
166
15
312
1709
515
63
2287
1709
515
63
2287
Waiting List – 15 month Target (22/10/2015)
Cardio Th
6
Cardiology
7
0
Pl Surgery
36
G Surgery
12
Urology
49
Vascular
91
Gynae
0
20
40
60
80
100
Outpatient Waiting Lists
OPD - Potential Breaches (4,499)
Patients to be seen by the 31st of December 2015
3000
2618
2500
4417 Urgent patients waiting
0-12 months not due to
breach
2000
1790
1584
1500
1000
500
970
518
4499 Urgent and Routine patients due
to breach the 15 month deadline of
the 31.12.15:
• 1157 have been booked and
capacity maximised to EOY
• 3342 Potential Breaches
• 2342 Gynae & Ophthalmology
• 523 Difficulties
• 163 Diabetes
• 74 Endocrine
• 90 Plastics
• 80 Vascular Surgery
• 23 Paeds Neurology ? NL
• 93 Gen Surg ?SIVUH but
899
includes Children
• The remaining patients will be
managed through additional out of
hours clinics
311
46
0
0-3 Months 3-6 Months 6-9 Months
9-12
Months
12-15
Months
15-18
Months
18-21
Months
21-24
Months
110
24-36
Months
68
36-48
Months
2
48+ Months
28
Medical Patients to be seen by the 31st of December 2015
160
140
136
125
120
100
89
83
80
74
60
46
40
44
33
24
23
20
7
6
2
2
0
29
Surgical Patients to be seen by the 31st of December 2015
500
450
449
400
350
316
300
262
250
200
229
199
160
150
146
100
100
100
97
94
80
78
53
50
49
30
26
26
7
4
3
0
30
New and Return DNA Rate
Scope Waiting List
Scopes Urgent – September
G
Scopes Routine - September
R
Medical ALOS
(August Dashboard)
A
New Patients Treated with Radiation Oncology
September
Reason for Treatment Delay - September 2015
Quality & Safety
Day Surgery Admission Rate
(August Dashboard)
G
Surgery – Length of Stay
G
ALOS – Excluding LOS over 30 days
(August Dashboard)
A
Cancer KPI – Breast-Lung-Prostate -Jan – September
September
August
July
June
Prostate
Lung
May
Breast Routine
Breast Urgent
April
March
February
January
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Quality Programme
Clinical Care Indicators
1) Medical Readmission rates
2) Surgical readmission rates
3) Patient experience of nursing care
4) Staph Aureus rates
5) C. Difficile Rates
6) Training in hand hygiene (online or in person)
7) End of life care in a single room
8) Presence of family room on ward (and further standard or
room)
9) Falls
10) Smoking cessation
Learning – Hold to Account
•
•
•
•
Restructuring of Board Agenda
Spend time at board meeting on discussing quality (and measure)
Act - Restructuring of Board minutes to reflect recommendations
Non executive quality walk rounds to meet clinical team on wards
providing the care
Results
• Dedicated time for the discussion of quality of clinical care at board
meetings
• Quality of Clinical Care Indicators are analysed monthly by the Board
• 150% increase in the time spent discussing quality of clinical care at board
meetings
Improvement in quality of discussion & number of recommendations by the
Board in relation to quality of clinical care
Risk Register
Risk Register update submitted 22nd October
2015
49 Open Risk Assessments on Risk Register
Two new risks escalated to Group CEO:
• Risk Assessment 56 – Keogh Billing system
• Risk Assessment 57 - Delayed intervention for patients
requiring Implantable Cardio Defibrillator (ICD)
procedures.
Reducing Healthcare Acquired Infection (MRSA)
(August Dashboard)
G
Reducing Healthcare Acquired Infection- C diff
(August Dashboard)
G
Reducing Healthcare Acquired Infection
August Dashboard)
G
Human Resource Management
Sick Leave – August 2015
%
CUH - Total % Sick Leave 2014 v 2015
4.44
4.16
4.09
3.79
3.86
3.75
3.68
3.74
3.16
3.07
3.7
3.37
3.91
3.74
3.89
% Target
Dec
% 2014 Sick Leave
Nov
Oct
Month
% 2015 Sick Leave
4.22
3.8
3.86
Sept
Aug
July
June
May
April
Feb
Jan
Mar
5 4.58
4.5 4.01
4
3.5
3
2.5
2
1.5
1
0.5
0
Staffing & Costs
EWTD Compliance ( Jan – Sept)
Capital Projects
Project
Status
MRI Unit
Completed and operational
Paediatric Unit
Phase 1 - build programme commenced in July
Phase 2 – submitted for capital funding
Completed and operational
Mental Health Unit
Acute Medical Assessment Unit – Phase 3 &
Endoscopy Unit
Completed and operational
Radiation Oncology Unit


Cystic Fibrosis/ Respiratory Ward
Opening on 24th October 2015
Education and Training Centre
Statement of Need being developed
Blood Sciences Project
Design Team appointed – request for managed service approved
Oncology Service



Planning permission granted
Enabling works to commence in November 2015
Expansion of Day Unit – plan signed off – submitted for Philanthropic
funding (ACT)
Refurbishment of Ward 2D – capital funding in place
Medical Oncology Centre – developing Statement of Need
Ophthalmology Transfer – phase 2
Project group in place
Helipad
Interim helipad in place - final solution being assessed by CAA.
Step Down Unit
Procurement Process for staffing being progressed
Key Issues
• Recruitment of Nursing staff – 31 beds closed
• Recognition of Budgetary performance
• Dependency on patient income
• 2016 Estimates
• Undergraduate Training costs - €6.5m per annum
• Management of Unscheduled Care
Implementation of Change Programme Initiatives
• Scheduled Care
Implementation of plan to meet waiting list targets –Hospital
Group approach to maximise capacity