Post on 18-Dec-2021
Introduction and Logistics
Housekeeping
• Washrooms
• WiFi Password: qcc201603
• Handouts on each table
Objectives of the Day
2016-17 Q4 Report out and Celebrating Success
Facilitated learning and networking opportunities
Provide information and tools to help manage change
Recognize RQHR’s newest Lean leaders
Welcome and Opening Remarks
Dick Carter
Board Chairman
Welcome from the Board Chair
Welcome
– Patient Representatives, Dr. Pappas, Board of
Directors, Senior Leadership Team,
Department Head Council, Executive Directors,
Directors, Managers, Affiliates, and Provincial
Colleagues
CEO Update
Keith Dewar
President and CEO
Our Purpose
Why we are here
Strategic Hierarchy
Government of Saskatchewan
Ministry of Health
Regina Qu’Appelle Health Region
Provincial Health System Patient,
Staff and Physician
Input
Patients, Clients, Residents and Families
Patients, Clients, Residents and Families
Reflection on 2016/17
• Are making progress
• 0 Harm – hand hygiene/appropriateness/staff
injuries/computerized provider order entry (CPOE)
• 0 Waits – accountable community and hospital care
• 0 Deficit – reduced to $3.5 million
• This in spite of the impact of a growing and aging
population
RQHR Population Growth
Reflection on 2016-17
• Transition to a single provincial health authority
• 4 months into the transition
– Significant effort required by transition team and RHAs
– Announcement of the location, name and CEO search
• Recognition of RQHR leadership and innovation
– Accountable community care/Primary Health Care
Networks
• Much work to be done
– Transition not transformation
2017-18 RQHR Focus Areas
2017-18 Focus Areas
• Quality and Safety – 0 Harm
• Access/Patient Flow – 0 Waits
• System Sustainability – 0 Deficit
SLT
informs and
owns focused
areas
All staff
and physicians
execute plans
Board approves
plans and monitors
progress
Portfolio and service line leaders develop plans
to identify the work needed to advance priority areas
• Amalgamation of RHAs to the Saskatchewan
Health Authority will affect work planned for
next year
– May lead to redefined priorities and a reallocation of
resources to support the new structure
• Provincial financial situation will affect how
initiatives are funded and supported
• Potential for essential services
• Infrastructure deficiencies
Risks to Business Plan Implementation
• Support implementation of business
plan initiatives and monitor progress
• Continue to provide the safest,
highest quality care we can to the
people of this province
• Business as usual unless otherwise
directed
• Engage in the work of the Transition
Team and support a successful
transition
– What can your area do to help with
transition
• Prepare for Essential Services
in case required
Direction to Management and Staff
Working Through Change
Communication/Change Management
• Transition Team Weekly Updates
• CEO Weekly Updates
• CEO meetings/presentations
• VP communication – portfolio meetings
• Executive Director/Director/Manager
communication to staff
• Tools - MoH Website, Elink, The Physician
• Daily huddles/visibility walls
• Sharon and her team
Reminder of Today’s Objectives
• Q4 celebration of organizational successes
from the past year
• By doing the right thing, we can achieve
outstanding results
• Provide meaningful learning opportunities
and share information
Q4 Report out and Celebrating Success
Senior Leadership Team (SLT)
Carol Klassen, VP
Knowledge and Technology Services
Portfolio Overview
Knowledge & Technology Services
– Academic Health Sciences
– Research & Health Information Services
– Patient Point of Care IT Services
– Corporate and Clinical Support IT Services
– Clinical Engineering and IT Infrastructure
Services
Celebrating Successes
Quality & Safety - Launched CPOE using Sunrise Clinical Manager
(SCM) Order Management – now a joint
Regina-Saskatoon tertiary hospitals project
Access/Patient Flow - Expanded use of SCM and electronic clinical
documentation to support safer delivery of care: - Mental Health & Addictions
- Endoscopy, Approach database, Pharmacy
- SWADD, Therapies, speech language pathologist, Facility Boards,
18 rural site access to Clinician Viewer
- MDMobile licensing, IMO coding of diagnosis
- Training to support more users
Celebrating Successes
System Sustainability - Replaced Enovation registration with Sunrise
Enterprise Registration;
- Supported significant growth and improvement in
I.T. infrastructure and availability of devices: e.g.
new desktops, upgraded phone infrastructure, more Apple mobile
devices
- Managed health record information for 184,368
visits (inpatient, day surgery outpatient and
emergency visits) - More coding, more transcription, more records filed
- No duplication of electronic information in paper record (01/01/2017)
Celebrating Successes
System Sustainability - Signed new Affiliation Agreement with the
College of Medicine; Memorandum of
Understanding to support further development of
Regina campus agreed to in principle
- Supported 330 research studies - 11th Annual Research Showcase
- New policies and procedures
- Supported 40 new research related collaborations with
institutions or industry (100% increase)
- Improved and expanded library services - 5% increase in literature searches 683 requests
- New integrated library system with 4 other RHAs
Michael Redenbach, VP
Integrated Health Services
Falls Resulting in Harm
(Code 3 and 4)
Executive Sponsors:
Michael Redenbach and Karen Earnshaw
VPs of Integrated Health Services
Quality & Safety Indicators - Falls
Target = Reduce Falls Resulting in Harm by 50%
Code 3 & 4 Falls by Quarter
April, 2014-March 31, 2017
0
5
10
15
20
25
Ap
r-1
4
May
-14
Jun
-14
Jul-
14
Au
g-1
4
Sep
-14
Oct
-14
No
v-1
4
Dec
-14
Jan
-15
Feb
-15
Mar
-15
Ap
r-1
5
May
-15
Jun
-15
Jul-
15
Au
g-1
5
Sep
-15
Oct
-15
No
v-1
5
Dec
-15
Jan
-16
Feb
-16
Mar
-16
Ap
r-1
6
May
-16
Jun
-16
Jul-
16
Au
g-1
6
Sep
-16
Oct
-16
No
v-1
6
Dec
-16
Jan
-17
Feb
-17
Mar
-17
Nu
mb
er o
f F
alls
Target
Seniors Current State Analysis
Michael Redenbach, VP
Integrated Health Services
Access/Patient Flow Indicator –
Seniors Current State Analysis (LTC)
- Current state analysis complete
- Shared with the Regional Health Authority Board
Portfolio Overview
Mental Health & Addiction Services • Outpatient Adult Mental Health Services
• Outpatient Child & Youth Mental Health & Addictions
Services
• Inpatient Mental Health Services
• Outpatient & Inpatient Addiction Services
• Quality, Strategy, Business Unit
Long Term Care • Regina Pioneer Village
• Extended Care / Veterans Program, WRC
• Continuing Care, Programing & Utilization
• Health Services Organizations
Celebrating Successes:
Long Term Care
• Established South Sask Dementia Assessment
Unit
• Established Geriatric Services Resource Team
• Improved Resident Dining Experience
• Improved MDS QI Scores
• Established Falls Rollout Program
• Reviewed Special Care Home Guidelines
• Increased Subsidized Assisted Living &
Convalescent Care Beds
Celebrating Successes:
Long Term Care
• Created Family Orientation Program
• New Spaces & More Room thru 5S Projects
• Reduced O2 Errors
• Affiliate & Contracted Facilities Accredited
• Staffing Mix Changes
• Improved Care Staff Shift Handover
• Improved Physician to Physician Handover
• Completed Provincial Resident & Family
Satisfaction Survey
Celebrating Successes:
Mental Health and Addictions
• Increased access to child & youth outpatient
services
• Increased access to adult outpatient services
• Increased access to child psychiatry services
• Centralized Referral Management and
Electronic Health Record
• Consult Liaison Team
Celebrating Successes:
Mental Health and Addictions
• Police & Crisis Team
• Internet Cognitive Behaviour Therapy
Outcomes
• Take Home Naloxone Program
• Psych support available for Brief and Social
Detox
• Dedicated Substance Abuse Treatment Unit
Jan Besse & Terri Carlson, Acting VP’s
Clinical Support Services
Portfolio Overview
Clinical Support Service Line 5 Portfolios – 30 distinct services
– Medical Imaging
– Lab Services
– Pharmacy Services
– Rehabilitation, Spiritual Care, Native Health
Services, Respiratory Services
– Support Services
Celebrating Successes
Medical Imaging
• Reduction in MRI wait times from 239 days
to 114 – a 52% reduction from September
2017 to January 2017
Laboratory Services
• College of American Pathologists
Accreditation Award in April 2017
Celebrating Successes
Rehab, Spiritual Care, Native Health Services,
Respiratory Services
• Rehab: Major focus on supporting flow (acute
therapy & rehab), quality & safety (employee injury
reduction, TLR audits) and system sustainability
(March 31, 2017 paid hours result 2,200 hours
favorable)
• Native Health Services support to facilitate provision
of pediatrician care to 1st Nations Communities
• Respiratory working in partnership with Primary
Health Care to support community clients with
COPD
Celebrating Successes
Pharmacy
• Celebration of 50 Years of Hospital
Pharmacy Residency May 30, 2017
Support Services
• Environmental Services quality improvement
work to support the Emergency Department
and align services
• Nutrition & Food Services – More to Eat
Study on Unit 4A
Karen Earnshaw, VP
Integrated Health Services
Coverage Rate for DPT for
Two-year Olds Residing in RQHR
Karen Earnshaw, VP
Integrated Health Services
Quality & Safety Indicators –
Diphtheria-Pertussis-Tetanus (DPT)
Coverage rate for DPT for two-year olds residing in RQHR (Regina & Rural)
Coverage Rate for MMR for
Two-year Olds Residing in RQHR
Karen Earnshaw, VP
Integrated Health Services
Quality & Safety Indicators –
Measles-Mumps-Rubella (MMR)
Coverage rate for MMR for two-year olds residing in RQHR (Regina & Rural)
Portfolio Overview
Primary Health Care Service Line
Urban Networks (North, South, Central, East)
Rural Networks (Touchwood, Twin Valleys, Prairie East)
Home Care/SWADD
Palliative Care
Population & Public Health
Eagle Moon Health Office
Saskatchewan Health Line
Celebrating Successes
Immunization Outcomes: Taking Care to the Clients
The Central network took on the challenge of bringing up immunization rates to heart in the past year.
By changing the way they deliver public health in their community, they have seen an increase in
immunization rates across the board and they have also seen an increase in community engagement.
They started taking public health to the places their clients are – schools, community centers, etc. By
doing this, it has improved access to services for that group and the result has been increased
immunization rates.
Seniors House Calls: Taking healthcare to those who can’t access it themselves
In the past year, the Seniors House Calls team has expanded their staff and been a critical link in
improving access to service for Regina seniors who have mobility issues, complex medical issue and
who are frequent visitors to the ER. AS part of a multi-disciplinary team, they liaise with their
colleagues through the region to bring care to those who cannot seek it themselves thereby reducing
the reliance on acute beds in hospital and in ER visits.
Breathe Easy: Respiratory Therapy being done in community
Access to Respiratory Therapy Services in community has improved over the past 12 months. An
interdisciplinary Primary Health Care team has been collaborating with Physicians and Nurse
Practitioner’s in Private and Primary Health Care practices to offer pulmonary services to RQHR
clients. Spirometry is being performed in community clinics as well as in client homes. The team has
been working closely with clients and their care teams to better manage COPD in community. This
team has also been facilitating COPD rehabilitation programs in our PHC Networks.
Celebrating Successes
RN in hospital supporting high quality transitions
Our hospital colleagues care for a high volume of COPD clients. To help improve quality transitions
from hospital to home, a community Registered Nurse is working in hospital to support clients with
suspected and diagnosed COPD.. She connects with colleagues in hospital to collaboratively care for
clients and supportively transition them to our Primary Health Care Networks who provide care to
clients to remain well at home.
Community Support Worker: Improving safety and access one patient at a time
In the urban Primary Health Care portfolio, North, Central and now South, have embraced a new type
of heath care provider that focuses on medical and social needs. The Community Support Worker fills
in the gaps in care for those people who need much more than medical intervention. Their health is
also reliant on accessing safe housing, medical appointments and food. But they are not in it alone,
they often work with other providers to ensure continuity of care and high quality transitions between
providers to ensure their clients continue to stay out of acute and ER facilities.
Medication Room Kanban at Wolseley Memorial Integrated Care Centre.
An improvement event at Wolseley Memorial Integrated Care Centre has reduced the amount of time
staff needs to order medications by 93% (from 2.5 hours to 10 minutes every two weeks). Staff
grouped similar items together, set regular ordering amounts and posted those amounts on the
medication bins to improve ordering practices. Nurses now use a cart to deliver patient medications
which has reduced the amount of unnecessary walking by 100% (from 18 feet per patient to 0). This
success built on the work completed in the last fiscal year by Indian Head and Broadview. It’s a true
example of team work.
Celebrating Successes
Palliative Care Comfort Cart
When people arrive onto the Palliative Care unit, they are in a fragile state of health and often families
are accompanying them for long periods of time. To ensure that both patients and families are
comfortable, a Comfort Cart was implemented. Thanks to volunteers from St Cecilia Parish, Holy
Trinity Parish and a donation by Alfords, a cart stocked with the comforts of home is providing some
much needed comfort. They even have homemade quilts that families and patients can keep after their
stay.
Home Care cuts care supply costs 16 per cent
Home Care is spending 16 per cent less on supplies (a projected $585,051 in 2016-17 compared to
$695,591 in 2013-14) all while providing more units of service* and caring for more clients, in part,
because of the implementation of a new inventory management system. The system includes a daily
supply order board that allows supply depot staff to see at a glance whether supplies need to be
ordered, have been ordered or are on back order and an electronic supply order form that’s part of a
client’s electronic medical record. Keeping the order form with the record allows nurses to see
whether care supplies have been ordered or more are required. Staff no longer wastes supplies
Dr. David McCutcheon, VP
Physician & Integrated Health Services
Hand Hygiene Audit
Regional Compliance Rate
Dr. David McCutcheon, VP
Physician Services & Integrated Health Services
Quality & Safety Indicators –
Hand Hygiene
Source: RQHR IPAC
Date: February 2017
Define Characteristics of Culture of
Accountability and Develop an Action Plan
for Physicians (Merging into Clinical Quality Plan)
Dr. David McCutcheon, VP
Physician Services & Integrated Health Services
System Sustainability Indicator -
Culture of Accountability (physicians)
• Appointment of 3 New Department Heads
• Department Head Council retreat held in October
2016
• 6 physicians enrolled in Physician Leadership
Institute (PLI) program.
• 3 physicians enrolled in Saskatchewan Clinical
Quality Improvement Program offered through
HQC and SMA
• Clinical Quality Plan Framework Developed
merging Comprehensive Medical Quality Plan,
Culture of Accountability and Improving
Appropriateness of Care
Portfolio Overview
Medicine Service Line
– Emergency Department/EMS
– Critical Care & Cardioscience Units
– Medicine Inpatient Units
– Regional Infection Prevention & Control
– Transfusion Safety
– Antimicrobial Stewardship Program
Physician Services – Practitioner Staff Affairs
– Department Heads
Celebrating Successes
Portfolio Success
• Integrated three distinct program areas into the Medicine Service Line
• Open new Medicine Inpatient Unit and close Code Burgundy at PH
Emergency Departments
• Modified Primary Nursing in Pasqua ED
• Synergy Tool
• Collaboration with Connecting to Care Team
EMS
• RQHR Comm-Centre: Safe Practice reduction of “Hot Responses”
• Improved response times
• Ambulance Deep Cleaning Process; Uniform Laundering
• Community Paramedicine
Critical Care/Cardiosciences
• Revised the Cardiac Service Model
• Transaortic Valve Implantation – First in Saskatchewan
• Left Atrial Appendage Occlusion
• Replication of ACU model on MSU PH
• Implemented an Appropriateness of Care project in Critical Care Units
Celebrating Successes
MIU
• First in Canada to implement an Accountable Care Unit on Pasqua 4A
• Opened a new Medicine Inpatient Unit on Pasqua 4B
• Standardized MIU program
• Medicine Admission PPO
• SCM usage for electronic charting/audit collection on 4A
Infection Prevention and Control
• Community Physician MDR/IPAC Audit
• Collaboration with Saskatoon Health Region for provincial IPAC
alignment
• Revisions to Regional Hand Hygiene policy and auditing process
Transfusion Safety
• Creation of a Patient Blood Management Program – led by Dr Lett
• Creation of a Red Blood Cell (RBC) ordering Pre Printed Order (PPO)
Celebrating Successes
Antimicrobial Stewardship Program
• Awareness Campaign
• Viral Prescription Pad
• Website developed www.rqhealth.ca/asp
• Asymptomatic Bacteriuria project
Practitioner Staff Affairs
• PSA Review
• Recruitment of 28 specialist physicians and 16 general practitioners
• Core/non-core privileging process review
• Standardized physician onboarding process
• Concern Handling Process
Appropriateness of Care
• 17 projects have progressed to the complete and audit phase
• 4 projects are in the PDCA phase
• 10 projects are in the planning and data gathering phase
• 26 new PPOs were approved; 65 PPOs were updated/revised
Michele Vogt, Acting VP
People and Safety
# of Workers' Compensation Board
Claims per 100 FTE
Michele Vogt, VP
People & Safety
Reduce Number of Workers' Compensation Board
Claims (Lost Time Claims) per 100 FTE
Quality & Safety Indicators –
WCB LTCs
Quality & safety Indicators – WCB LTCs
Quality & safety Indicators – WCB LTCs
Define Characteristics of a Culture of
Accountability and Develop
an Action Plan for Staff
Michele Vogt, VP
People & Safety
System Sustainability Indicator –
Culture of Accountability (staff)
Culture of Accountability Framework developed
• Multidimensional, cross-functional work ongoing
Portfolio Overview
People and Safety HR Operations and Volunteers
• Labour Relations
• Workplace Accommodation and Attendance Support
• Employment Services
• Volunteers
Legal & Policy
• Privacy
Patient & Employee Safety
• Patient Safety & Risk Management
• Employee health & Safety
Workforce Planning & Development
• Organizational learning and Development
• Central Scheduling
• Workforce Planning
Representative Workforce
• Diversity & Inclusion
Celebrating Successes
Collaboration with Managers to impact: - Safe work practices on the units – daily huddles that focus on
safety
- Violence assessments completed
- Electronic Confidential Occurrence Report rolled out
- New manager orientation checklists for all departments
- Value stream maps and work standards developed to help support
organizational change processes
- The development of a new
scheduling office in Grenfell
- Enhanced volunteer support
screening
Celebrating Successes
Commitment to Quality Improvement: • Leveraging LILT training to enhance H.R. processes to better meet
customer needs
• Developing metrics and data to drive improvement
• Commitment to SLP to build capacity and leadership
• Enhanced financial management
Support for each other. - While vacancy managing
- While dealing with personal loss
- While balancing work and family
Celebrating Successes
WE ROCK THE SOCKS
Darlene Rorbeck & Andre Kroeger
Acting VP’s, Financial Services
Operating Surplus/Deficit
Darlene Rorbeck on behalf of
Robbie Peters, VP
Financial Services
System Sustainability Indicator -
Operating Surplus/Deficit
-3011
-4755
-8165
-5128 -4678
-6629
-3517
-4667
-3291
-2235 -2952
-3546
-16500
-11500
-6500
-1500
3500
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
$'0
00
's
Financial Sustainability Strategy Surplus / Deficit as of March 31, 2017
Actual (Year to Date) 2015-16 Actual (Year to Date) 2016-17 2016-17 Target
Date Prepared: May 11, 2017
Report Contact: Darlene Rorbeck
Source: Finance
Refresh Cycle: Monthly
Operational Definition: Total operating revenues less
total operating expenditures at the end of a specified time
period.
Portfolio Overview
Financial Services
– Accounting
– Payroll & Benefits
– Decision Support
– Materials Management
– Facilities Management
– Security & Parking Services
Celebrating Successes
• RQHR Financial Results
• Enovation replacement
Materials Management
• Procurement Suite and training launched
• Direct order, and inventory management
• Adding racking to Inventory to accommodate additional
high volume items
Celebrating Successes
Facilities Management
• Maintenance and Renewal Projects
• Implemented Space Change Request Process
• Implemented Real Estate Management Plan to advance
real estate strategy and controls
• Developed pilot capital intake and prioritization process
• Negotiated Provincial Natural Gas Purchasing producing
more than $2.4M in savings for the Health Regions of
Saskatchewan
• Preventative maintenance outcomes on beds (Stryker)
• Portfolio Strategic Alignment and Planning Session
Sharon Garratt, VP
Integrated Health Services
Surgical Site Infection Surveillance
Sharon Garratt, VP
Integrated Health Services
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
3.5%
4.0%
Q3 Q4 Q1 Q2
SSI Rate, targeted procedures, RQHR, 2015-16 ,2015-17
SSI Rate (%) Target
Quality & Safety Indicator –
SSI Rate
# of Surgical Cases Waiting
Greater than Three Months
Sharon Garratt, VP
Integrated Health Services
Access/Patient Flow Indicator –
Surgical Cases Waiting >3months
Portfolio Overview
Integrated Health Services
– Clinical Quality & Professional Practice
– Specialized Ambulatory Care
– Integrated Renal Program
– Women’s & Children’s Health
– Surgical Services
– Provincial Smart IV Pump Program
Celebrating Successes
• Nursing Orientation revised and is more comprehensive
• Advanced Trauma Life Support (ATLS) training centre
• Endoscopy/GI replaced EMR, revised SCM clinical nursing
documentation.
• Major renovations to scope reprocessing area at RGH to meet
accreditation standards.
• Ambulatory Care re-implemented HALO standby and reduced
late clinics.
• Eye Centre improved patient experience by bundling diagnostic
and therapeutic appointments.
• Infusion Clinic returned to their home space and the Eye Bank
moved to a better designed space.
• Completed evaluation and implementation plan for master roster
review outcomes in Renal Unit.
Celebrating Successes
• Co-authored & implemented Provincial Policy for Dialysis Water
• Fundraising by patients, staff, physicians and HRF to replace the
entire fleet of patient TV’s for the RGH Dialysis unit
• Renal specific patient-family survey to inform strategic directions
• Eliminated flashing in OR’s, collaborated with rural facilities re:
surgical accreditation standards
• AAA & Acute Thoracic Algorithm implemented to move patient
direct from helipad to OR
• Implemented SCM facility boards in OR, decreased preoperative
LOS, Stroke Clinic decreasing wait times for patients.
• Implemented after-hours booking rules for RGH & PH resulting
in 11% decrease in emergency procedures
• 5S in Pasqua OR, procured O-Arm, strategic plan initiated to
address deficit in OR instruments & equipment
• Strengthened teamwork/collaboration between OR’s & MDRD’s
Celebrating Successes
• Pediatric High Acuity Area and Early Pregnancy Assessment
Clinic opened
• Perinatal Advisory Council provided input to development of
Perinatal Loss Response Team & Dept Obs/Gyne approach to
postpartum tubal ligation requests
• Peds Home Care RN trial achieved better skill task alignment
and improved care
• Peds Outpatient Unit accredited by Cystic Fibrosis Canada
• NICU had no needle stick injuries x 1 year and introduced
enteral feeding only products
• MBU revised standards of care for postpartum and c/section
patients and created coinciding charts
• Zoom Zoom Kids – partnership with UofR Engineering to
support mobility of children with disabilities
Keith Dewar,
President and CEO
Emergency Department Length of Stay at 90th
Percentile All Patients
Keith Dewar, CEO
Access/Patient Flow Indicator –
ED LOS at 90th
Percentile
Lunch Break
Building Resilience During Uncertain Times
Dr. James Pappas
Psychologist
Afternoon Break
RQHR Lean Leader Certifications
Amy Strudwick, Specialist
Quality and Strategy Management Office
Lean Leader Certifications
• Alexander Wong
• Andrea Lavoie
• Andriyka Papish
• Brian Danyliw
• Cara Benz-Tramer
• Cathy Peters
• Dan Drummond
• David McCutcheon
• Debbie Sinnett
• Diane Kozakewycz
• Donna Ledingham
• Erin Roesch
• Fiona O’Connor
• Gord Bellavance
• Jessica Minion
• Kateri Singer
• Laveena Tratch
• Linda McPhee
• Lori Hopfauf
• Maggie Petrychyn
• Maurice Hennink
• Mohamed Eisa
• Poornima Murthy
• Roxanne Martin
• Vicki Ehrlich
2016-17 Accomplishments Video
Recap and Closing Remarks
Keith Dewar
President and CEO