CAPHC CPDSN Symposium Achieving System Improvement and Performance CEO Perspective

1. CAPHC – CPDSN NATIONAL SYMPOSIUM:
CEO PERSPECTIVE

2. DATA ANALYTICS
• We need to use data to first improve care
and then to help contain costs
• Clinical data, cost data and mixture of both
• The amount of available data and
reporting requirements are increasing
every month
– Internal, provincial, national, international
– So be sure to pick your battles!

3. DATA ANALYTICS
• Basic principles when using data
– Patient safety and quality are top priorities
– It takes a team to use the data properly
– External benchmarking is often key to
engagement of staff
– Form follows function

4. • Critical Care LHIN Name Total Percent
Hamilton Niagara Haldimand Brant 1428
68.5% Waterloo Wellington 457 21.9% N/A
75 3.6% Mississauga Halton 54 2.6% North
East 13 0.6% South West 13 0.6% Central
West 12 0.6% Central East 9 0.4% Central 8
0.4% North Simcoe Muskoka 6 0.3% Toronto
Central 5 0.2% North West 3 0.1% Erie St.
Clair 2 0.1% Total 2,085 100.0%

5. 68.5%
21.9%
3.6%
2.6%
0.6%
0.6%
0.6% 0.4%
0.4%
0.3%
0.2% 0.1%
Critical Care
Hamilton Niagara Haldimand Brant
Waterloo Wellington
N/A
Mississauga Halton
North East
South West
Central West
Central East
Central
North Simcoe Muskoka
Toronto Central
North West

6. The SEC index includes Low SES and the Ontario Marginalization Index’s
Instability and Ethnicity measures

8. DATA ANALYTICS
• We need to use “big data” as we move
more into population health initiatives
– Taking an upstream approach to disease
prevention and management
– Assessing models of care delivery outside of
our walls

11. MCH Approach to Reduce Admit Rate
Challenge: Unsustainable increase in admission
through the Pediatric Emergency Department.
DATA:
Admit Rate: Admits as a % of Visits - 10.1% (CIHI, 2015).
Absolute Values: Admits increased from 3,327 to 4,878 (CIHI,
2013-15)
46.6% increase above 2013 baseline

12. MCH Approach to Reduce Admit Rate
Goal: Determine what is the ideal admission rate
for MCH utilizing CAPHC National Benchmarking?
Background:
Emergency Department Visit volume ranged from
~1,000 - 76,000 per ED (CIHI, 2015)
Canadian Pediatric Hospitals Average Admit Rate
through the Emergency Department – 8.1% of
total visits (CIHI, 2015)

13. MCH Approach to Reduce Admit Rate
Drilling Down:
Hospitals with a similar range of ED visits
(50,000/year) generated the following admit
rates:
BC Children’s Hospital – 7.4%
Stollery Children’s – 9.7%
Winnipeg Children’s – 7.2%
McMaster Children’s – 10.3%

14. MCH Approach to Reduce Admit Rate
Goal 8% Target (2016) 9.5%
Action: Investigate alternatives to Admission to
Reduce Admit Rate – upstream focus
1. Focused on 24hour admits and discharges
a) Launched an expanded wait at home practice to
include our Ronald McDonald House for patients
that meet criteria but live outside of our City.

15. MCH Approach to Reduce Admit Rate
2. Partnered with our Ambulatory Sub-
Speciality Teams to improve the ED
physician’s knowledge of complex
patient’s medical history on arrival to the
ED – upstream focus
a) Re-launched our patient alert card system
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16. MCH Approach to Reduce Admit Rate
3. Clustered long stay patients onto one
Medical Unit to focus efforts on similar
discharge barriers – downstream focus
a) Strengthen partnerships with community and
home care providers
b) Explore the opportunity to expand care
parameters in the community and/or home

18. Questions?