Ministry-LHIN Priority Indicators Quality and Safety Committee January 23, 2013 Philip Christoff, Director, Quality and Risk Management
Phase 1 Surgical and Diagnostic Wait Times 2
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) Cancer Surgery at the HNHB LHIN 90 80 70 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for Cancer 60 50 40 30 20 10 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) 0 Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 3
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) Cardiac By-Pass Surgery at the HNHB LHIN 120 100 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for Elective Isolated Coronary Artery Bypass Graft (CABG) surgery 80 60 40 20 0 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 4
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) Cataract Surgery at the HNHB LHIN 250 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for Cataract Surgery 200 150 100 50 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) 0 Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 5
90th Percentile (Days) Hip Replacement Surgery at the HNHB LHIN Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 350 300 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for Hip Replacement 250 200 150 100 50 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) 0 Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 6
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) Knee Replacement Surgery at the HNHB LHIN 400 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for Knee Replacement 350 300 250 200 150 100 50 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) 0 Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 7
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) MRI Scans at the HNHB LHIN 160 140 120 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for MRI HNHB LHIN (p90) HNHB Target 100 80 60 40 20 0 UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 8
Apr 09 Jun 09 Aug 09 Oct 09 Dec 09 Feb 10 Apr 10 Jun 10 Aug 10 Oct 10 Dec 10 Feb 11 Apr 11 Jun 11 Aug 11 Oct 11 Dec 11 Feb 12 Apr 12 Jun 12 Aug 12 Oct 12 Dec 12 Feb 13 Apr 13 Jun 13 Aug 13 Oct 13 Dec 13 Feb 14 Apr 14 Jun 14 Aug 14 Oct 14 Dec 14 Feb 15 90th Percentile (Days) CT Scans at the HNHB LHIN 60 Comparison against Baseline (2009/10) Control Chart: HNHB LHIN for CT 50 40 30 20 10 HNHB LHIN (p90) HNHB Target UCL 3 (baseline) Average (baseline) LCL 3 (baseline) UCL 3 (extended) Average (extended) LCL 3 (extended) 0 Source: Adult Surgery and DI Hospital Comparison Report, WTIS, Access to Care, Cancer Care Ontario 9
Phase 2 Emergency Room (ER) and Alternative Level of Care (ALC) 10
ER Admitted Patients 90 th Percentile Wait Time 11
Non-Admitted High Acuity ED LOS 12
Non-Admitted Low Acuity ED LOS 13
22.3% 20.0% 23.6% 25.2% 21.5% 18.1% 16.9% 15.8% 18.3% 18.4% 18.7% 17.5% 15.5% 15.6% 15.3% 14.9% 17.9% 21.7% 17.1% 16.9% 16.4% 17.3% 17.3% 16.3% 12.8% 12.1% 12.5% 12.5% 13.1% 13.6% 14.4% 17.1% 14.7% 17.2% 14.9% 13.6% 10.8% 13.0% 13.9% 12.7% 11.7% 12.4% 12.2% HNHB LHIN Acute ALC Rate (DAD) MLPA 30.0% HNHB LHIN Acute ALC Rate (DAD) MLPA Source: HNHB LHIN IDS - DAD 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 14
Individuals Designated ALC All bed types Individuals Designated ALC - ALL bed types January 2010 to December 16, 2012 Source: ALCIS 700 600 656 500 400 384 300 200 100 0 1/3/2010 4/3/2010 7/3/2010 10/3/2010 1/3/2011 4/3/2011 7/3/2011 10/3/2011 1/3/2012 4/3/2012 7/3/2012 10/3/2012 Home with CCAC Total Long Term Care Grand Total Linear (Grand Total) 15
22.5% 23.1% 21.8% 20.6% 18.5% 17.1% 16.1% 14.8% 15.2% 14.8% 14.1% 14.3% 13.2% 13.3% 13.3% 15.4% 15.6% 15.3% 14.8% 16.5% 15.2% 15.2% 14.2% 12.6% 13.2% 13.0% 13.2% 14.6% 15.4% 14.4% 14.4% 14.1% 14.2% 15.7% 14.0% 13.3% 12.8% 14.0% 13.5% 13.2% 12.7% 12.7% 12.5% 12.3% HNHB LHIN Acute ALC Rate (Internally Monitored) 25.0% HNHB LHIN Acute ALC Rate (Internally Monitored) Source: Weekly Hospital ALC Trigger Report 20.0% 15.0% 10.0% 5.0% 0.0% 16
Phase 3 Mental Health and Community 17
Percentage (%) Readmission within 30 Days for Selected CMGs 16.5 Hospital Readmission Within 30 Days 16 15.5 15 14.5 14 13.5 HNHB ONT HNHB LHIN Baseline HNHB LHIN Target 13 12.5 12 Q3 2009/10 Q4 2009/10 Q1 2010/11 Q2 010/11 Q3 2010/11 Q4 2010/11 Q1 2011/12 Q2 2011/12 Quarter - Year 18
Percentage of Repeat Visits (%) Repeat Unscheduled ER Visit within 30 Days for Mental Health 35 HNHB LHIN Repeat Unscheduled ER Visits Within 30 days for Mental Health by Hospital and Hospital Site for 2011/12 Q4 30 25 20 15 10 5 0 Hospital - Hospital Site 19
Percentage of Repeat Visits (%) Repeat Unscheduled ER Visit within 30 Days for Substance Abuse 35.0 HNHB LHIN Repeat Unscheduled ER Visits Within 30 days for Substance Abuse by Hospital and Hospital Site for 2011/12 Q4 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Hospital - Hospital Site 20
Wait Time for CCAC In-Home Services Community Application to 1 st CCAC Service - Q1 2012/13 21
Thank You 22