Thursday, October 21, 2010

Putting meat on the bones of strategic planning

By Rik Ganderton
President and CEO

We’re getting there!

Thanks to your participation in our strategic planning process since last April, we are now able to start putting some meat on the bones of our new strategic plan.

My thanks to all who’ve taken part so far, including staff, physicians, volunteers, community members and political leaders for your thoughts and input on our questions, surveys and many presentations.

All of this input and information was used to produce a comprehensive Current State Analysis Report. The full report and an executive summary are available on our strategic planning web page.

The report examined our current environment in terms of our:
• Programs and services;
• Patient profile;
• Workforce;
• Infrastructure;
• Approach to quality, transformation and organizational culture;
• Community Demographics;
• Inventory of providers in Central East Local Health Integration Network (CE LHIN);
• Provincial and LHIN priorities;
• Internal and external stakeholder feedback; and
• Key trends likely to impact our organization.

- Key findings –

Here are some of the key findings from the Current State Analysis Report.
• We are facing significant growth in the 905 area.
• Patient mix is changing – average age of patients is getting older and have higher levels of acuity and dependency; greater cultural diversity reflective of the catchment area. Scarborough and Durham are becoming more similar from a diversity perspective.
• There is a new normal when it comes to clinical service delivery. The number of inpatients has declined; the vast majority of surgical and diagnostic procedures can now be done on an outpatient basis; throughout the hospital sector, inpatient length of stay has decreased and occupancy rates have increased; alternate level of care (ALC) days are a system issue that create flow challenges for the hospital; there is more transfer activity between hospitals and RVHS is seeing an increase in the patients transferred in to our hospital from other places, particularly for circulatory system conditions.
• Our efforts to align with industry benchmarks have resulted in a higher occupancy rate and a lower average length of stay. But our readmission rates have also declined suggesting that we are making improvements to patient flow without sacrificing quality.
• We need to focus on the patient experience and be cognizant of how the community measures the patient experience; consumer expectations are changing and patients are much better informed on health issues than in the past.
• Regional integration is a priority for the LHIN and health system partners; we need strategies to pick up the pace, maintain momentum and make tangible change; there are many untapped opportunities for regional collaboration – both clinical and non-clinical.
• Emergency department (ED) wait times and ALC management are top priorities at the provincial level and also challenge our ability to provide smooth patient flow.
• There are opportunities to repatriate some of our catchment area residents, who are seeking services at other hospitals; the flow of patients in our catchment area is to the west and RVHS partnerships are in the east.
• Relationships with family physicians in the community are essential and can be improved through better communication mechanisms and easier access.
• Our human resources are our greatest asset; our people share a strong commitment to quality; we need to watch morale levels of staff and physicians.
• Our workforce is aging and we must implement strategies to manage the forecasted potential retirements.
• Operational and cultural transformation are taking shape and yielding tangible improvements; this is an ongoing journey and key to reaping the benefits of increased emphasis on pay for performance.
• The hospital is on the road to financial recovery, but keeping pace with infrastructure maintenance/repairs and advances in technology is an ongoing financial challenge.
• The planning environment is complex with many trends that will impact our hospital, including a provincial election in the fall of 2011.

The current state report findings put us in good shape heading into our strategic planning retreat last weekend. Thanks to the keen engagement of our Board; MAC (medical advisory committee); senior management team; directors; and members of the Strategic Plan Steering Committee, it’s my pleasure to report to you that we now have a new set of draft strategic directions.

- More consultation –

Consultation on the draft directions will begin shortly, in meetings and venues such as, but not limited to:
• RVHS Board meetings – open to the public;
• Meetings of our Community Advisory Group – volunteers who advise the board;
• Community outreach meetings – which we do throughout the year at meetings of service clubs, health care partners, municipal councils and many others;
• Leadership Forum – for management;
• MAC and/or Medical Staff Society meetings – for doctors;
• Town Halls – for all staff, physicians and volunteers; and
Strategic planning web page – for the public.

I look forward to our next blog update on this evolving process. Stay tuned and thanks for your participation.

(- For background, you could read my previous blog on this from July 6, 2010.)