balanced score card review of october 2015 data. balanced scorecard finance patient access quality...
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Balanced Score CardReview of October 2015 Data
Balanced Scorecard
Finance
Finance Report – October 2015
Actual outturn YTD - October 2015
• Group budget €235.2m (2014 €228.3m)• Group actual expenditure €236.5m (2014 €235.8m)• Group actual deficit €1.3m ( 2014 : €7.5m)• Less: Additional bad debts provision re MOU €1.1m• Loss of earnings –Radiation therapists €150k• Waiting list penalties €170K• Adjusted group surplus –YTD Oct €0m
• CUH Budget €220.8m (2014:€212.5m)• CUH /SMOH actual expenditure €222.6m (2014 €219.6m)• CUH /SMOH actual deficit €1.8m (2014 €7.1m)• Adjusted deficit (excl bad debt/LOE)–ytd Oct €0.4m
• Mallow Budget €14.4m (2014:€13.9m)• Mallow actual expenditure €13.9m (2014 €14.3m)• Mallow actual surplus €460k ( 2014 deficit €372k)
CUH Group –Surplus / (Deficit) percentage % (October)
CUH Group Summary – Budget v Actual Expenditure YTD - October 2015
Pay €k Non-Pay €k Income €k Total
CUH -2,816 -7,615 8,579 -1,852
SMOH 0 -24 73 49
CUH-SMOH -2,816 -7,639 8,652 -1,805
Mallow -4 -504 968 460
Total -2,820 -8,143 9,620 -1,343
CUH Budget v Actual Pay YTD – October 2015
2015 Budget €k
2015 Actual €k
Variance €k
% Variance
2014 Actual €k
v 2014 Variance €k
Medical/Dental 53,447 54,344 -(897) -1.7% 52,797 -(1,547)Nursing/Midwifery 72,386 73,002 -(616) -.9% 72,862 -(140)
Paramedical 26,739 27,016 -(277) 1% 26,918 -(98)
Housekeeping 5,479 5,652 -(173) -3% 5,324 - (327)
Care Assistants 5,053 5,567 -(514) -10% 5,324 -(243)
Catering 3,303 3,382 -79 -2.4% 3,482 100
Portering 4,814 4,827 -13 -.3% 4,981 154
Administration 14,865 15,075 -210 -1.4% 14,757 -319
Other Staff 2,908 2,945 -37 -1.3% 2,978 33
Total 188,994 191,810 -2,816 -1.5% 189,424 -2,386
CUH Actual Non-pay Expenditure €k YTD 2015
CUH AGENCY COSTS €k 2013 – YTD 2015
CUH AGENCY WTE – YTD 2015
CUH Average Nursing & HCA Agency WTE’s per Week 2013-15
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2014-15
Patient Income 2013 – YTD 2015
CUH Debtor days –YTD 2015
Mallow Budget v Actual YTD October 2015
Budget € Actual € Variance € % VariancePay 12,631 12,635 -4 0.0%Non Pay 3,604 4,108 -504 -14.0%
16,235 16,744 -509 -3.1%Income -1,869 2,837 968 51.8%Total 14,366 13,907 459 3.2%
Forecast
• Group Budget €283.0m (2014 €284.9m)• Group projected expenditure €286.4m (€284.2m)• Collection of EU Charges €0.7m• Group Projected Deficit €2.6m ( surplus 0.7m)• Less: Additional bad debts provision re MOU €2.2m• Loss of earnings –Radiation therapists €0.4m• Waiting list penalties €170k• Add National service contracts €210k• Adjusted group projected surplus €0.4m
• CUH Budget €265.8m (2014:€265.1m)• CUH projected actual €268.7m (€265.3m)• CUH projected Deficit €2.9m (€0.2m)
• Mallow Budget €17.2m (2014:€17.5m)• Mallow Projected Actual €16.9m (€16.8m)• Mallow Projected Surplus €0.3m (€0.7m)
Patient Access
CUH Weekly INMO Trolley ReportWeek ending 13th November 2015
Ambulance Turnaround Times - October
ED – 6hr & 9hr Target – All Patients (January – October )
R
ED – 6hr & 9hr Target – Non Admitted Patients (January – October )
ED – 6hr & 9hr Target –Admitted Patients (January – October )
Delayed Discharges - 2015January - October (10th November)
Inpatient – Day case Waiting Lists
Inpatient & Daycase Breaches – 31st December 2015
Outpatient Waiting Lists
OPD Potential Breaches – 21st December 2105Date Speciality planned in house Insourcing number remaining Balance To be Outsourced breaching Column1
21/12/2015 Cardiology 4 0Diabetes Mellitus 0 155 155Endocrinology 0 38 38Gastro-Enterology 0 0General Medicine 0 0General Surgery 0 89 50 39Gynaecology 0 850 850 ?Bon Secours Limerick 850Neurosurgery 3 2 0Ophthalmology 0 286 286Paediatric Neurology 0 22 22 ? 0Paediatrics 8 23 23 ? 0Plastic Surgery 2 136 90 46Respiratory Medicine 8 0Rheumatology 7 5Urology 0 0 11Vascular Surgery 0 0
28/12/2015 Rheumatology 4 1 0
Scope Waiting List
Scopes Urgent – September G
Scopes Routine - September R
Medical ALOS(September Dashboard)
A
New Patients Treated with Radiation Oncology in Target - October
Reasons for Treatment Delay - October
New Patients Treated within Target2014 Vs 2015
Brachytherapy ActivityJanuary 2015 – October 2015
Quality & Safety
Day Surgery Admission Rate (September Dashboard)
G
Surgery – Length of Stay(September Dashboard)
A
ALOS – Excluding LOS over 30 days(September Dashboard) A
Cancer KPI – Breast-Lung-Prostate –January – October
OPAT
Outpatient Parenteral Antimicrobial Therapy
– IV antibiotics/antifungals/antivirals given at home
• Reduces patients length of stay in hospital
• Avoids Admission for long period
• Reduces healthcare associated infection risk
• Patients can return to work
Bed Days Saved
Quality and Safety Appointment of Clinical Director for Women and Children Directorate
Appointment of Lead for Clinical Audit
External Expert for Radiology Review identified
Improvement Programme on Complaints Management
Housekeeping Services Project Group – Principals agreed
Pilot project on risk assessment , risk escalation and risk register using module on Q Pulse (medium term plan is an electronic system)
Quality Improvement programme for Outpatient services
Interviews for post of Risk Manager, Quality Assurance Manager and Quality Improvement Manager
Patient Experience Report Jan – June 2015
Complaints by Directorate
Compliance with Timeframes
Compliments
Complaint Management Review Group
Lean mapping project June 2015
Pilot project November 2015 on improvements in the Triageadministration supportpooling of investigative resourcesdata capture on processrecommendations for improvements monitoring of recommendations
Risk Register
Risk Register update submitted 22nd October
11 on-going investigations
Three new risks escalated to Group CEO in NovemberRisk Assessment –Grade 3 Pressure UlcerRisk Assessment –Grade 4 Pressure UlcerRisk Assessment – Sexual Assault
HIQA Announced VisitAntimicrobial Stewardship Programme
Site visit on Tuesday 20th October 2015Acknowledged good progress with Antimicrobial Stewardship Programme that ties in with the National Stewardship programme
ChallengesMedication Safety officerInfection Control Nurse staffing levels Clinical Pharmacist resourcesLack of surgical site surveillance Laboratory surveillance of multi-drug resistant organisms not performed
Reducing Healthcare Acquired Infection (MRSA)(September Dashboard)
R
Reducing Healthcare Acquired Infection- C diff(August Dashboard)
R
Antibiotic Consumption Rate(September Dashboard)
G
Human Resource Management
Sick Leave – October 2015
Staffing & Costs October 2015
EWTD Compliance (Jan – October)
Nursing - Starters/Leavers 2015
Capital ProjectsProject Status
MRI Unit Completed and operational
Paediatric Unit Phase 1 - build programme commenced in JulyPhase 2 – submitted for capital funding
Mental Health Unit Completed and operational
Acute Medical Assessment Unit – Phase 3 & Endoscopy Unit
Completed and operational
Radiation Oncology Unit Planning permission granted Enabling works to commence in November 2015
Cystic Fibrosis/ Respiratory Ward Completed
Education and Training Centre Statement of Need being developed
Blood Sciences Project Design Team appointed – request for managed service approved
Oncology Service Expansion of Day Unit – plan signed off – submitted for Philanthropic funding (ACT)
Refurbishment of Ward 2D – capital funding in place Medical Oncology Centre – developing Statement of Need
Ophthalmology Transfer – phase 2 Project group in place
Helipad Interim helipad in place - final solution being assessed by CAA.
Transitional Care Unit Completed
Key Issues
• Reopening of 31 inpatient beds
• Recognition of Budgetary performance
• Dependency on patient income
• 2016 Estimates
• Undergraduate Training costs - €6.5m per annum
• Management of Unscheduled Care Implementation of Change Programme Initiatives
• Scheduled Care Implementation of plan to meet waiting list targets –Hospital Group approach to maximise capacity