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![Page 1: Lower Mainland (B.C.) Health Consolidation A look into Integrated Protection Services (IPS) Successes and Challenges Jeff Young Executive Director.](https://reader033.fdocuments.us/reader033/viewer/2022051018/56649de95503460f94ae4162/html5/thumbnails/1.jpg)
Lower Mainland (B.C.) Health Consolidation
A look intoIntegrated Protection Services (IPS)
Successes and Challenges
Jeff YoungExecutive Director
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2009 - A Brewing Storm
• Rapidly escalating healthcare demands from a growing and aging population.
• Increasing costs & inflation - unsustainable in the long term.
• All six (seven) BC health authorities were facing deficits despite getting a significant portion of the provincial budget.
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The OpportunityGeographic proximity of the four Lower Mainland healthorganizations (FH, PHSA, VCH & PHC) afforded the opportunity to look for efficiencies in common services.
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Lower Mainland Health Organizations
• Serve 60% of BC’s population
• Have a combined budget of ~$7B
• Total employees across the organizations number 65,000
• Provide a wide range of health services at: 28 Acute Facilities 27 Residential Care Facilities Hundreds of community based facilities i.e. storefront clinics
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August 2009 LMC Mandate
• MoH and health organizations initiated consolidation of select service areas for LM-based health organizations
• Consolidate as many services as possible
• Initiatives in scope specified, timelinesand objectives set
• Services provided as a single entity
• Build on existing collaboration
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Financial Target
• $100M annual savings across LMC
• = 10% of the $1.0B non-clinical budget
• $100M target allocated among the departments
• Pace was critical
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Process
• One organization accountable for provision of each consolidated service across the LM
• Consolidated service will: Provide quality services on behalf of all participating
organizations based on service agreement Have authority under the Master Services Agreement Achieve its specific cost savings target (sustainable savings) Ensure patient care is not negatively impacted
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Original LMC Initiatives
Biomedical Engineering
Interpreting Services
Integrated Protection
Services
Health Information Management
IMITS(PHC, PHSA, VCH)
Facilities Management
Pathology and Laboratory Services
Business Initiatives & Support Services
FH PHSA PHCVCH
Communications & Public Affairs
IntegratedMedical Imaging
Pharmacy Services
Health Emergency
Management
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Strategies
• Increased process efficiency through: Alignment and integration across the organizations, including initial staffing
reductions
Standardization
Reducing duplication
• Leveraging of buying power• Sharing resources and knowledge
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Governance & StructureGovernance Committee
Collaboration CouncilMoH
CAO
Program Management
Office
Finance & Capital
Working Group
Data Management
CommitteeHR
Working Group
BISS
Dr. David Ostrow
David Handley
Facilities Management
Dr. Nigel Murray
Peter Goldthorpe
IMITS
Carl Roy*
Barry Rivelis
Health Info. Mgmt.
Dianne Doyle
Yoel Robens-Paradise
Integ. Medical Imaging
Dr. David Ostrow
Mike Nader
Comm. & Pub. Affairs
Dr. David Ostrow
Clay Adams
Integrated Protection Svs.
Dr. Nigel Murray
Jeff Young
Pharmacy Services
Dr. Nigel Murray
Dr. Shallen Letwin
Interpreting Services
Carl Roy*
Suzanne Barclay
Path. & Lab. Medicine
Carl Roy*
John Andruschak
Biomedical Engineering
Dianne Doyle
Chris Buck
Remain accountable through CEOs for Project Delivery & Savings
HSSBC
Jim Eckler
LMC Initiative
Executive Champion
Executive Lead
IT Design Authority
Working Group
Lead organization:
VCH
FH
PHSA
PHC
Health Emergency Management
Carl Roy*
John Lavery
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Key Enablers
• Master Services Agreement is the governing document that specifies the roles, responsibilities and obligations of the participating organizations with respect to service quality, access, financial, human resources and other aspects of the program
• Information Sharing Agreement facilitates cross-organizational systems access
• Signing Authority with consistent authorization levels for similar management grades across the LM
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Key Enablers
• Sharing Formula – to distribute financial risks and rewards resulting from consolidation activities
• Customer Service Committees – to enable consolidated services and oversee service performance metrics
• Consolidated financial reporting to monitor budgets and savings• Staff Transfers – to Lead organization. (There is an ongoing effort
to harmonize HR Benefits, Employee Terms and Conditions)
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• By the end of FY12/13, LMC had achieved an estimated $74.6M in annual savings.
• Add cost avoidance: Total estimated savings = $116.4M
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Consistent approach for HR issuesMutual systems access
Data governance
Joint capital and IMIT planning
Legal/risk issues
Savings sharing formula
Consolidated Budgets
Performance measures
Privacy Information Agreements
Systemic Issues
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PMO & Standard Processes
Consolidated LM Structures
Master Service Agreement & 12 Service
Schedules
Consolidated LM
Budgets/Reporting
Quality Assurance Mechanisms
Standardized Best Practices
Savings Sharing Formula
SAVINGS
Integrated Service Models
NO NEG. IMPACT ON PATIENT CARE
Achievements
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Efficiencies Leaner structures, reduced duplication Economies of scale, leveraging buying power Shared resources
Financial reporting Consolidated budgets LM financial reporting structures Savings sharing formula
LMC Successes
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Other LMC Successes
Consolidated LM structures Streamlined roles and accountabilities
across LM for better efficiency & productivity Alignment & integration Staff transfers to lead health authority (where identified as an enabler)
Standardization, moving to Best Practices Standardization to agreed-on service levels No negative impact on patient care
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Service Agreements Master Service Agreement with 12 Service Schedules Ensure consistent quality service across the LM Commitment to provide service levels that are acceptable for each organization Customer Service Committees for feedback/input KPIs monitored Mechanisms to escalate issues identified Include solutions to most systemic LMC issues
Other LMC Successes
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The Future
• Savings goal will be substantially (if not entirely) achieved by end of 2013/14
• LMC provides a solid platform for provincial collaboration and consolidation strategies
• HEM
• BioMed
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Core Services1. Protection/Security2. Parking, Access & Commuter Services (PACS)
Budget LMC Protection/Security $21M
• With additional budget exists outside LMC budgets LMC PACS $20M net revenues
• 1/3 operating costs includes access costs
Note: Each HO retains its own net parking revenue
Integrated Protection Services
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Core Objectives
Integrated Protection Services
1) Support a secure and accessible environment of care to ensure the highest standard of quality services being delivered across the 4 Health Organizations.
2) Create an integrated program that incorporates process excellence and industry best practices to provide quality service to the Health Organizations.
3) To seek innovative and sustainable value solutions.
4) Foster a culture that develops High Performance Teams.
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IPS Streams - Overview1. Security/Protection
• Strategic Initiatives & Contract Management• Operations
2. Parking, Access & Commuter Services (PACS)
3. Process Excellence & Performance Reporting *NEW*
Integrated Protection Services
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Service Delivery Model Overview
•Outsourced site based security services & parking management with corporate IPS oversight
– Inherited 3 legacy security contracts each with different scope of services
– 3 legacy parking management contracts
Integrated Protection Services
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Service Delivery Model Overview
•Functional program management model that aligned protection leadership to LMC wide responsibility vs. previous East - West model
• Consolidate PACS core production services and IPS management having LMC wide responsibility into one of two “hubs” - East & West with vision to move to one (Centralized vs. Decentralized)
Integrated Protection Services
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Protection/Security - Operations• Governance of the site based security vendor services• Direct management of Forensic Psychiatric Hospital & Provincial
Special Constables• Routine incident review, Tier notification and management
thereof when required• HO / Site / Program liaison• Threat Management program• Investigations
Integrated Protection Services
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Protection/Security – Strategic Initiatives and Contract Management
• Recently combined security services RFP contract for the LMC: Aligned scope to our preferred service delivery model Additional cost savings by bundling services and other
contract initiatives realizing ~ $2.85M in savings !!!
Integrated Protection Services
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Protection/Security –Strategic Initiatives and Contract Management
• Review, reconciles and audits the security vendor partner invoicing ~ $20M annual combined spend
• Currently engaged in 103 construction projects LMC wide• Development of standardized assessment and audit tools for
Operations team• Further consolidation and standardization of security related
systems i.e. card access, CCTV
Integrated Protection Services
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Parking, Access & Commuter Services (PACS)• Expand Transportation Demand initiatives ~ where parking capacity
issues• Continue with expanding automation & pay parking sites• LMC wide Parking Policy• Continue with centralization of access services and LEAN processes to
reduce production time• Evaluate and roll out new integrated technologies i.e. Smart Cards• RFP to consolidate legacy parking management contracts into 1 LM
wide contract for fiscal 15/16
Integrated Protection Services
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Process Excellence & Performance Reporting • Supports both Protection/Security & PACS programs• Lower mainland PMO/CSC Reporting• Process mapping / LEAN initiatives• IPS Enterprise Incident Reporting system oversight• IPS data warehouse management• Analysis of data to support evidence based decision making• Standardized quarterly reporting at site/program/HO level in progress
Integrated Protection Services
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Performance Reporting – Quick Facts
Integrated Protection Services
OPERATIONS CENTRE CALLS 2012 - 2013 Fiscal Year
PHSA FH VCH/PHC TOTALS
Urgent Calls 1,491 5,589 8,490 15,570
Non-Urgent Calls 22,228 75,208 98,471 195,907
TOTAL ANNUAL CALLS 23,719 80,792 106,961 211,472
PHSA FH VCH/PHC AVERAGES
Percentage of Urgent Calls 6.3% 6.9% 7.9% 7%
Percentage of Non-Urgent Calls 93.7% 93.1% 92.1% 93%
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Performance Reporting – Quick Facts
Integrated Protection Services
TOTAL SECURITY INCIDENT REPORTS 2012 Calendar Year
PHSA FH VCH/PHC TOTALS
Security Incident Reports
754
47,094
48,090
95,938
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Progress to date
• At the end of the FY 2012/13, IPS fully achieved its LMC targets: Protection realized $0.518M in cost direct savings Parking realized $5.98M in net new revenues
• Completed employer transfer of all staff to Fraser Health• Rolled out an enterprise incident reporting systems across the
LM
Integrated Protection Services
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Progress to date
•Expanded program through system resource transfer or reinvestment of efficiency savings
Heliport management Security systems maintenance & repair Commuter services
•Consolidated 3 legacy security contracts into 1 single scope contract•Consolidated card access platforms from 7 to 2 •Expanded preferred CCTV NVR platform from 3 to 24 sites
Integrated Protection Services
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Priorities 14/15
• Review/renew 5-Year IPS Strategic Plan• Provide → Support → Partnership Evolution
• Further standardization of systems, processes and reporting throughout LMC
• Further pursue automation, reducing operating costs and revenue enhancements within PACS
• Build upon the creation of high performing team
Integrated Protection Services
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Priorities 14/15
•Continue to expand Protection/Security community sector* and community based facilities outreach •Expand MOU with FM (key management, heliport management and security systems maintenance and repair) to leased site facilities.•Prepare RFP for LM Parking management for 24 locations combined for 16,500 parking stalls
Integrated Protection Services
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Challenges
• Reality of having 4 “masters” with 20 combined “strategic imperatives”
• Increased system wide budget constraints / access to capital $• IT connectivity between the 4 HO’s• Support programs to IPS not being consolidated adds
complexity• Increased activity compounded by downloading/scope creep
with no resource increase
Integrated Protection Services
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Challenges
•Global reduction in vehicle use, increased local taxation, TDM success and corresponding decrease on parking demand impacting revenues negatively, but also celebrated as a success too!•Media / public and advocate group applying political pressure on hospital pay parking
Integrated Protection Services
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British Columbia
Fiscal 13/14 - $16.5B / $43.3B or 38% of the Provincial Budget
Total spending increase of 75% between 2000 and 2010 – which equates to an average annual increase of 6% during that time period
Healthcare Spending….unsustainable!
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Ontario
•Fiscal 13/14 $48.9B/$112.6B or 43% of the total Provincial budget•The Ontario government is committed to eliminating the deficit by 2017-18.•The deficit for 2012-13 is estimated to be $9.8 billion
Healthcare Spending….unsustainable!
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• The government will build on Ontario’s Action Plan for Health Care to create a sustainable and high-quality health care system by:– Transforming health care to reduce the rate of growth of spending to an
average of 2.1 per cent annually over the next three years– Enhancing community-based care to treat patients in alternative settings
such as non-profit clinics and at home instead of in hospitals, where appropriate
– Moving to patient-centred funding models to improve the value and quality of care
So GTA …..are you ready?!
Transforming Health Care
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So GTA AKA Lower Mainland ONT …..Are you ready?!
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So GTA …..are you ready?!
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So GTA…..My advice
Be part of the solution…
Be proactively looking for cost savings, efficiencies and
standardization through partnerships with other LHIN’s or
risk it (consolidation) being forced upon you.
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• Scalable to absorb increased capacity• Flexible to absorb “other” services: Parking, HEM,
transportation/fleet mgmt., etc.• Show cost savings! Find $ through efficiencies • Risk based / data supported decision making (have the
data!)
Build A Program
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• That has a business acumen about it• Fiduciary responsible – oversight of taxpayer $
– Every operating support $ spent takes $ away from direct patient care
• Process excellence / performance reporting / evidence based / data supported decision making / tie to clinical indicators
• Tie services directly back to support patient care wherever possible
• HAVE THE VISION !
Build A Program
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Online survey seekscommunity views onpossible hospital merger
Consolidation….It’s coming…
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Lower MainlandIntegrated Protection Services