accountability & performance management

Accountability & Performance Management

John Lohrenz, Vince Ruttan, Nancy Hunter & Ritva Gallant

Central East LHIN SymposiumMay 14th, 2009

CE LHIN

Outline

• WHY—The Context John 10

– Accountability Framework

– Scenario Example

• HOW—Tools to get us There 40

– Data Tools Vince

– Performance Tools Nancy

– Investments (HSIP) Ritva

• TIE-BACK, FEEDBACK & FEEDFORWARD All 10

Impetus for Change

Social Services, $12.7, 12%

Education, $14.2, 13%

Post-Secondary, $6.6, 6%

Justice, $3.9, 4%

Other Programs, $19.6, 18%

Interest, $9.3, 9%

Health, $42.6, 38%

Impetus for Change:

• $33B to $43B in 3 years, (30% increase)

• $275M increase in health expenditures in last year alone.

• Fragmented, disconnected and reactive system.

Solution:

• Decentralized ‘place-based’funding and planning model.

• Mechanisms to achieve efficiencies within fiscal and policy framework.

Cascading of Actions

Impetus for Change = 2004 Transformation Agenda

The Commitment to the Future of Medicare Act (2004)Local Health System Integration Act (2006), and

Contract between the Ministry of Health and each LHINFor System OUTCOMES

Contract between each LHIN and each health serviceprovider for specified OUTPUTS

A Current Real World Example

• “People Caring for People”, May 2008 Sharkey Report.

• Mandate to provide advice on a framework for human resource

implications for residents’ quality of care and quality of life in LTC

Homes.

• Recommendation to raise funding to support 3.5 hours of direct care

to residents.

StrengthenCapacity forBetter Care

Accountabilityfor Outcomes

BetterCare

Introduction

“The temptation to form premature theories upon

insufficient data is the bane of our profession.”

Sherlock Holmes

Data Tools Demonstration

• WERS data extraction

• One Pagers

• Shared Data Collection / Reporting.

WERS data extractionCE

D-Mart

Central East Data Mart screen shots…

Enter the name or part name or Main Contact of an HSP and click on Search.

You will be returned with a list of matching “hits”

Screen Shots continued…

From the search results you can click on the “Click Here” link on the right to navigate to the HSP’s webpage, or you can click on the link on the left containing the HSP’s name to drill down into basic demographic data.

Screen Shots Continued…

This screen is currently editable by all users. In the near future, once the data “stabilizes”, this data will be read only to most and editable to a few designates.

Screen Shots Continued…

Some Agency SomewhereThis section of the “One Pager” contains the Mission and Vision statement or other descriptive text of the organization being featured. Typically this information is copied directly off of the Organization's Web-Site. Note: this is a fictitious agency for demonstration.

Also in this section is the street address, city, phone number and website of the organization.

Finance (Source: Sheet 2A Community Annual Planning Submission)

Agency Logo

Needs Follow Up

Schedule B

Some Agency SomewherePlanning (Source: Schedule B – Advancement of the Integrated Health Services Plan)

This narrative is copied directly out of the Community Annual Planning document that the Health Service Provider has submitted. This particular section highlights approaches and efforts used by the health service provider to advance the Central East “Integrated Health Services Plan”.

Reporting Tools

HIT Tool Data Comparison

Public Data Mart Log In (www.celhin.com)

Data Mart Services

ALC Survey

ALC Survey – Read Me

ALC Survey – Data Review

ALC Survey - Reports

ALC Survey – Live Data

ALC Survey – Live Data

HOW: Healthcare Indicator Tool (HIT) (Nancy)

Central LHIN Scorecards/Dashboards

Central East LHIN is currently developing and implementing

Scorecards and/or Dashboards (enablers) for key initiatives as well

as for an overall Central East LHIN System Balanced Scorecard.

These Enablers will serve two key objectives:

To better enable Central East in the execution of its

responsibilities;

Ensure alignment with Central East LHIN as well as provincial

priorities and strategies

Central LHIN Scorecards/Dashboards

Currently, two scorecards have been developed and are in the process of

being finalized.

1. Ministry-LHIN Accountability Agreement (MLAA) at the system level;

2. Hospital Service Accountability Agreement (H-SAA)/Hospital Annual Planning Submission (HAPS) at the Health Service Provider level.

Each scorecard and/or dashboard will be two-tiered.

1. System level;

2. Health Service Provider Level.

The overall scorecards/dashboards for each current and/or planned initiative

and operational outputs will embedded within a cascading framework where

each will be hierarchal in framework to cascade up into the Central East LHIN

System Scorecard which will reflect its over-arching strategies and priorities.

Central LHIN Scorecards/Dashboards

The Scorecards and/or Dashboards is intended to give an overview of a

current period (current assessment) to enable the LHIN to fulfill the following

objectives:

1. Strategic planning and management;

2. Sharpen focus and ensure a results-oriented perspective;

3. Align our strategies, both LHIN and Provincial with daily operations;

4. Identify drivers within a current and future-oriented perspective;

5. Assess accomplishments within standardized communicable measuresfacilitating validity and reliability;

6. Ensure transparency to both internal and external stakeholders;

7. Assist in decision-making and prioritization.

Central LHIN Scorecards/Dashboards – Demonstration1. MLAA

Complete One-pagerIndicator Snapshot + Legend

2. H-SAA/HAPSComplete One-pagerIndicator Snapshot + Legend

HOW: H-SIP Tool Data Entry (www.celhin.com/hsip/) (Ritva)

CE LHIN H-SIP Contents Page

Tie-Back, Feedback and ‘Feedforward’….

• Accountability Framework developed to manage health system through

two contracts.

• Contract with the LHINS for OUTCOMES

• Contract with providers for OUTPUTS

• New processes and tools are needed to manage these contracts, our

relationship and the data to achieve the best possible outcomes.

Questions for Discussion:

• What is required to manage these new relationships?

• What are preconditions for success of the Accountability Framework

(Contracts)

• How do LHINS and HSPs work together to ensure success of their

agreements?