Presentation to CE LHIN Board of Directors

Transcription

1 Presentation to CE LHIN Board of Directors Ken Tremblay, President and CEO Peterborough Regional Health Centre October 27,

2 Agenda Hospital Improvement Plan Report 28 Initiatives Update HR Plan Performance Indicators Leadership Changes Governance Development HSAA 2010/11 Operating Plan Working Capital & Cost Per Weighted Case System Improvement Initiatives 2

3 Hospital Improvement Plan Report More than 73 project charters related to the 28 strategies of the HIP all with dedicated program leadership teams Each of the 28 HIP strategies is being tracked and regularly reported on - most strategies are tracking according to plan Significant improvements in sick time (17% fewer sick days), and overtime (70% reduction in overtime) As of August 2010, $9.86M vs. $27M of projects have been implemented/revenue secured 3

4 Hospital Improvement Plan Report Critical to the success of the HIP is workflow redesign, the sequencing of bed changes and the implementation of the Human Resource plan While, a deficit of $1.0M for the month of September and a year-to-date deficit of $6.6M, our mandate remains to achieve a balance run rate by March 31, 2011 Current forecast is a $8.9M deficit for 2010/ down from the $27M projected prior to the HIP, plus one-time restructuring costs of $8.9M 4

5 Hospital Improvement Plan Report HR Plan is on Track Each of the four unions (ONA, CUPE, OPSEU 345 & OPSEU Para) is working through its unique redeployment processes. It is a time of change and uncertainty for many staff members, as they transition to new roles at PRHC 5

6 Hospital Improvement Plan Report Cont d Through early retirement, voluntary exit, transfer to vacancies, natural attrition, re-assignment, hiring freeze, separation allowance and acceptance of layoffs, the number of individual layoffs has been reduced. Currently there are banked vacancies however not all vacancies appropriately match to mitigate the total number of layoffs Further efficiencies are required to ensure PRHC achieves mandate of a balanced budget by March Therefore, it is expected that additional layoffs will be issued as PRHC continues to quantify HIP initiative #28 during the month of October. 6

7 HIP Project Plan - Activity To-Date PRHCs Recovery Challenge Progress to Aug 31, 2010 Portion of project completed 4 3 $ in Millions Source: PRHC Board Approved HIP, Project Charter and Project Plan activities to date (Aug 31/10) HIP Strategy Number Total Progress to date $9.86 M 7

8 Hospital Improvement Plan Report 5,000 PRHC - FINANICAL ANNUALIZED RUN RATE Dollars in thousands 0 (5,000) (10,000) (15,000) (20,000) Mar-09 Jun-09 Sep-09 Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Fiscal 2009/10 Fiscal 2010/11 Fiscal 2011/12 Fiscal 2012/13 (25,000) (30,000) Fiscal Year (Quarterly) Forecast Monthly Run Rate Actual Run Rate 8

9 Leadership Changes New Vice President and CFO hired Laura Freeman comes to PRHC from Royal Victoria Hospital in Barrie New Medical Director of Medicine Dr. Warren Wilkins, an Internist and experienced physician leader New Medical Director of Surgery Dr. Alan Thompson, a vascular surgeon and experienced physician leader New President of the Medical Staff Dr. Srinu Kamilla, a nephrologist and experienced physician leader 9

10 Governance Development Board Coach Retained Berkley Group Governance and Planning Committee - now 2 distinct committees Quality Committee Indicator scorecard developed Strategic Planning cycle now underway (see next slides) 10

11 Strategic Planning Process Environmental scan External input STRATEGIC ANALYSIS Internal input STRATEGI C PLANNING WORKSHO P Draft strategies CONSULTATION FINE-TUNE/ VALIDATE APPROVED STRATEGIC PLAN Final Strategies OPERATIONAL PLAN/BUDGET Actions PERFORMANCE MANAGEMENT Success Measures * Adapted from Strategic Planning for Associations and Not-for-profit Organization, Knowles & Hayward, CSAE,

12 Planning Scope What is the scope of this planning cycle? Given the cycle of rapid change underway, and the relatively recent highlevel planning that was completed in 2009, we suggest the following scope: Goal: To broadly engage PRHC s stakeholders in a transparent planning cycle that clearly defines the hospital's priorities given its existing strategic directions, values, mission and vision. Objective: That by summer 2011, PRHC, along with its internal and external stakeholders, will have defined the Hospital's priorities in a plan that positions PRHC for service growth based on the needs of our community, our partners priorities, and the patients in our catchment area. Out of scope: Three Strategic Directions (revisit in 2012) Vision, Mission & Values (revisit in 2012) 12

13 Defining Roles and Responsibilities Responsible: Board of Directors Accountable: Senior Management Consulted: Internal & external stakeholders in the continuum of care Informed / Engaged: general public Determine planning process (Planning cmte) Develop the plan Approve the plan Est. success indicators Monitor progress Ensure corrective action when needed Support planning process Propose strategies Develop the plan Action the plan Report on progress Propose corrective action when needed Internal Develop the plan Propose strategies Execute the plan External Provide input into plan development Provide feedback on progress Be informed of planning timelines and process Provide input to plan development Have access to final plan Have access to results and hold PRHC accountable 13

14 Planning the planning Task Deliverable / Milestone Accountability timeline Set scope Set budget Set process Identify, collect, engage, prepare and review proposals, data, evidence and materials Motion initiating goal and objective of this planning cycle Set date, book retreat venue, RFP for facilitator Identify stakeholders, methodology, retreat formal, participants environmental scan, market share data, evidence gathering (clinical & financial), stakeholder engagement, analysis (gap, SWOT, trend), expert input, program presentations, literature review, etc. Planning Cmte Planning Cmte and CEO Planning Cmte, CEO, and staff Retreat Planning retreat Planning Cmte, CEO, and staff Plan writing Tabling of drafts to planning cmte, editing and re-writes. Planning staff Sept Sept Oct Oct - Feb March April May Staff/Stakeholder/ Community Engagement and Consultation of plan Draft plan to be shared and feedback incorporated Board and CEO April May Plan and monitoring indicators approval, & rollout communications Public tabling of approved report, stakeholder communications, publishing of monitoring scorecard, etc Planning Cmte, CEO, and staff June 14

15 PRHC Operating Plan 2010/11 15

16 2010/11 Operating Budget Operating Assumptions Revenue Increase $6.1M Includes only approved LHIN HSIP proposals, Internal Business Cases Base increase 1.38%, $2.6M Compensation Costs Increase $1.7M Labour increase $5.3M union closed contract wage awards, step & benefit increase annualization of MHS Crisis beds & ALC cohort unit Offset by HIP initiatives prorated for 2010/11 $4M Medical Remuneration increase $0.4M 16

17 2010/11 Operating Budget Operating Assumptions Supply Costs Decrease $0.3M Operating Supply, Medical & Surgical Costs: 2.5% inflation Annualization of all Maintenance Agreements in new facility Drugs Costs: 2%-8%, average 4% inflation Offset by HIP initiatives implemented: $723K Other Vote MHS and WHCC program costs remain flat to prior year One-Time Restructuring Costs Site Consolidation (WHCC & Nicholls) $ 75K Nursing and other retraining costs $ 600K Early retirement/severance costs* $ 8,200K *based on labour strategies as of Oct 2010 Total: $ 8,875K 17

18 2010/11 Operating Budget Actual 2009/10 Budget 2010/11 Forecast 2011/12 Total Revenue $ 224.2M $230.3M $231.8M Total Expenses $ 237.6M $239.3M $230.8M Surplus/(Deficit) (before restructuring) $ (13.4M) $(8.9M) $ 1.0M One time $ 0.5M $ 8.9M Restructuring Net Allowable Surplus/(Deficit) $ (13.9M) $(17.8M) $ 1.0M 18

19 Revenues & Expenditures, Weighted Cases Pre HIP Post HIP Millions Weighted Cases / / / / / / / /12 Revenue Expense Weighted Cases Source: Audited Financial Statements 19

20 PRHC Volume Targets 20

21 PRHC Cash flow Forecast PRHC Cashflow Forecast ,000 15,000 10,000 Forecasted Bank Balance 5,000 - (5,000) (10,000) (15,000) Mar 10 Apr 10 Jun 10 Sept 10 Dec 10 Mar 11 June 11 Sept 11 Dec 11 Mar 2012 Mar 2013 (20,000) (25,000) Forecast Actual BMO line of credit LHIN Advance Source: Internal Financial Statements 21

22 Working Capital Fixing our working capital position will, over time, allow PRHC to properly invest in clinical equipment, ensure we keep up our infrastructure and meet our operating obligations. Current Ratio Working Capital September 30, $98M March 31, 2011 (Est.) 0.13 $107M Includes LT Portion of Debt 22

23 Working Capital $100 Pre - HIP Post - HIP $50 Millions $- Mar 2005 Mar 2006 Mar 2007 Mar 2008 Mar 2009 Mar 2010 Mar 2011 (forcast) $(50) Mar 2012 (forcast) $(100) $(150) Source: Audited Financial Statements 23

24 Cost Per Weighted Case Methodology used to articulate the cost of delivering patient care. It is a calculation that takes into account multiple factors associated with delivering hospital care. 2008/9 Actual $5,888 vs $4,955 Expected 2009/10 Actual $5, /11 Forecast $5, /11 Forecast includes one time restructuring costs related to HIP $8.9M 24

25 System Improvement Initiatives CE LHIN Programming Confirmed PIP $960K GAIN $241K ILTC & Slow stream beds $651K 1.39% base funding $2.6M 25

26 System Improvement Initiatives New CE LHIN Programming Endovascular Surgery $2.6M PCI $2.8M Dialysis Home Hemo to ORN $TBD Geriatric Urgent Care $0.6M Capital New Hospital Construction holdback $13M 26