Ontario Wait Time Strategy
Visit to Central LHIN
January 14, 2008
Alan R. Hudson, OC, FRCSC
Progress to Date
Provincial Trend 90th Percentile Analysis - November 07 Wait Times Data
90% Completed Within
Service Area
Service Area
Baseline
Current
Priority Level 4 % completed
(PL4) access
within PL4
target (days) access target
Current vs. Baseline
(Aug/ Sept05)
(Nov 07)
Cancer surgery
81
63
84
95%
Net change
-18
% change
-22.2
Angiography
Angioplasty
Bypass surgery
56
28
49
21
13
51
182
100%
-35
-15
2
-62.5
-53.6
4.1
Cataract surgery
311
141
182
95%
-170
-54.7
Hip replacement
Knee replacement
351
440
202
258
182
182
86%
80%
-149
-182
-42.5
-41.4
MRI
CT
120
81
124
55
28
28
45%
77%
4
-26
3.3
-32.1
Paediatric surgery*
273
238
182
82%
-35
-12.8
*Apr/May06 data used as baseline for paediatric surgery; **bypass surgery wait time includes elective referrals only
Current State (November 2007) - % of cases
completed within target
Cancer Surgery
100%
95%
CT
Bypass Surgery
100%
77%
0%
45%
95%
MRI
Cataract Surgery
80%
Knee Replacement
Target
Actual
Note: Based on priority level 4 targets.
86%
Hip Replacement
DETAILED VIEW
Indicator:
Cataract Surgery Wait Time
Objective:
Improve surgical wait times
Time Period:
February/March 2007
Definition:
Trend
Number of days at which point 90% of
patients have had surgery. Wait time is
calculated from decision to treat date to
surgery date.
3 50
300
2 50
Results:
200
Benchmark/
Target
182
Baseline
Current
Period
311
159
Status
15 0
18 2
10 0
50
Analysis:
0
Wait time has decreased by 49% since
Aug/Sep’05 and 93% of cases are completed
within 6 months.
Action Plan:
The indicator exceeds the benchmark. No action plan is required at this time.
Cataract Surgery Wait Times – LHIN Variation
Central LHIN Wait Time Trend Analysis - Nov 2007 Data
Central LHIN Monthly Trend
Cataract
Surgery
Hip
Replacement
Knee
Replacement
Central LHIN Hospital Performance – November 2007 data
Central LHIN Priority Analysis – November 2007 data
Central LHIN - Hospital Implementation Activities by Quarter
Implementation Activities
Wherever possible, we are using the emerging LHIN PMOs to coordinate
these activities and leverage resources across the LHIN
EDRS Beta Sites
EDRS
WTIS–CCN
WTIS–CCN
EDRS
EDRS
WTIS – Expansion
Group 1
WTIS – Expansion
Group 2, All Paed Sites
WTIS – Expansion
Group 2, All Paed Sites
WTIS – Expansion
Group 2, All Paed Sites
SET Program
SET Program
CCIS Phase 3:
Specialty ICUs
CCIS Phase 3:
Specialty ICUs
SET Program Phase 1
WTIS – Expansion
Group 1
SET Program Phase 2
SET Program Phase 2
CCIS Roll-out to all
MSICUs
CCIS Roll-out to all
MSICUs
CCIS Phase 3:
Specialty ICUs
CCIS Phase 3:
Specialty ICUs
Q2 (07/08)
Q3 (07/08)
Q4 (07/08)
SETP Phase 1
Humber River Regional Hospital
North York General Hospital
Southlake Regional Hospital
Stevenson Memorial Hospital
York Central Hospital
CCIS Roll-out
Markham Stouffville Hospital
Southlake Regional Hospital
WTIS-Expansion
Humber River Regional Hospital
Markham Stouffville Hospital
North York General Hospital
Southlake Regional Hospital
Stevenson Memorial Hospital
York Central Hospital
CCIS Roll-out
Markham Stouffville Hospital
Southlake Regional Hospital
EDRS Beta Sites
Southlake Regional Hospital
WTIS-CCN
Southlake Regional Hospital
WTIS-Expansion
Humber River Regional Hospital
Markham Stouffville Hospital
North York General Hospital
Southlake Regional Hospital
Stevenson Memorial Hospital
York Central Hospital
SETP Phase 2
Humber River Regional Hospital
Markham Stouffville Hospital
North York General Hospital
Southlake Regional Hospital
Stevenson Memorial Hospital
York Central Hospital
CCIS Roll-out
TBD
Q2 (07/08)
Q3 (07/08)
Q4 (07/08)
Implementation Activities
By Hospital in LHIN #8
*slide specific to Central LHIN hospitals
Q1 (08/09)
EDRS
TBD
WTIS-CCN
Southlake Regional Hospital
WTIS-Expansion
TBD
SETP Phase 2
Humber River Regional Hospital
Markham Stouffville Hospital
North York General Hospital
Southlake Regional Hospital
Stevenson Memorial Hospital
York Central Hospital
CCIS Roll-out
TBD
Q1 (08/09)
Q2 (08/09)
EDRS
TBD
WTIS-Expansion
TBD
SETP
TBD
CCIS Roll-out
TBD
Q2 (08/09)
Q3 (08/09)
WTIS-Expansion
TBD
SETP
TBD
CCIS Roll-out
TBD
Q3 (08/09)
ER
Who is the customer?
ER Wait Time
Demand Control
•
•
•
•
CDM
Mental Health
FHT
Streaming
ER
•
•
•
•
WT – Public Reporting
CS – Consumerism
Tool Kits
HR
Exit
• ALC
• Community Services
ALC
Hospital Board/CEO
• Authority
• Responsibility
• Accountability
Patient Flow
•
•
•
•
•
Imaging and other Diagnostics
GIM
Intensive Care
Operating Room
Chiefs of Services
LHIN Board/CEO
• LHIN ER Plan
• Competition intra-LHIN
• Competition inter-LHIN
Implementation of EDRS across Ontario
Technical
Development
Beta Site
Testing
Hospital
Training
Provincial Implementation
All Hospitals submitting
data to EDRS
Public Reporting of ED Wait Times
ED Wait Time data informing decision making
Q2 07/08
Q3 07/08
Q4 07/08
Q1 08/09
Q2 08/09
Approximately 80 hospitals will be participating
EDs volumes >20,000 will be a priority in implementation
Q3 08/09
Proposed Beta Sites for EDRS
Grey Bruce Health Services
Hotel-Dieu Grace Hospital
Mount Sinai Hospital
Northumberland Hills
Hospital
Sault Area Hospital
Southlake Regional Hospital
Proposed EDRS Indicators
Ambulance Off-load Time
Time to Physician
Assessment
EDRS indicators are currently
being refined, in consultation
with the EDRS Advisory
Committee
Time to Admission
ED Length of Stay
ALC Census
ED Census
Patient
Arrival
Ambulance Offload Time
Triage
Registration
Physician
Assessment
Patient
Intervention
Disposition/
Admit/
Discharge
Patient
leaves ED
Time to Physician Assessment
ED Time to Admission
ED LOS
Expansion of IM/IT is underway to improve access to care . . .
EDRS
ER Wait
Emergency
Room
Screening
Other
Specialized Services
(Systemic; Radiation)
WTIS – Wait 1
pilot
Primary
Provider
CCIS
ICU
WTIS –all surgery
Specialist
After Care
OR
SETP
MRI/CT
Other
Diagnostic
Procedures
Provincial Client Registry
(i.e. Rehab,
Home Care)
Nursing
Unit
Over time, access to care will be improved through information
across the spectrum of care
EDRS
ER Wait
Neurosurgery
Emergency
Room
Disease
Family Docs IT
Screening Management
Other
Specialized Services
(Systemic; Radiation)
WTIS – Wait 1
Primary
Provider
ICU
WTIS –all surgery
Specialist
After Care
OR
(i.e. Rehab,
Home Care)
Nursing
Unit
MRI/CT
Other
Diagnostic
Procedures
Provincial Registries (Client, Provider, Facility)
Quality and Safety
•
•
•
•
Dr. Michael Baker
Dr. Ross Baker
Mortality Rates
April 1, 2008 -- Conditionality
From Deference to
Data
to Direct Management
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