hospital de cascais from good to great - tpg international health … · 2018-10-23 · hospital de...

Hospital de Cascais – From good to great

TPG International Health

Cascais, October, 16th 2018

UnitedHealthcare Group

2

Serving

142Mindividuals worldwide

Supported by a staff of

>285,000 people, including

>39,000physicians & nurses

Fast Facts

Revenues

~$225B

2

Revenues

United Healthcare Global operating locations

33Lusíadas Saúde

Focusing on customization and quality of

care, Lusíadas Saúde provides an

integrated overall service based on a

nationwide network.

HOSPITALS7OUTPATIENT CENTERS6

OPORTOH. L. PortoC. L. Gaia

CASCAISHospital de Cascais (PPP)

LISBONH. L. LisboaC. L. Pq. NaçõesC. L. AlmadaClisa - AmadoraClisa - Sacavém

ALGARVEH. L. AlbufeiraH. L. FaroC. L. Forum AlgarveC. L. Faro

34OPERATING

ROOMS

789INPATIENT

BEDS

19DELIVERYROOMS

401CONSULTATION

ROOMS(Includes ICU)

BRAGASanta Tecla

H. L. – Hospital LusíadasC. L. – Clínica Lusíadas

44Hospital de Cascais – Video

55Hospital de Cascais – A PPP Model

Hospitals under

public management

Hospitals under

private

management (PPP

contract)

Better access, better

quality, lower costs and

Lower Risks

Improve population’s

access to health careMandatory quality

assessement (benchmark, KPIs and Accreditation)

Comparable outcomes at a lower cost

Most operacional risks transferred to private

partners

CLINICAL OPERATION10 years

(Lusíadas Parceiras

Cascais, SA)

INFRASTRUCTURE30 years

(TDHOSP – Gestão Ed.

Hospitalar)

(...) required to provide,

within the Public Health

Service (...) access to

health care, to all

beneficiaries, in similar

terms as all other public

establishments integrated

in the National Health

System

Contratual Model with NHS

management of the

[current] Hospital

Building, comprising (...)

the design, project,

construction, financing,

maintenance and

servicing

NHS – Hospitals Organization Model

66

Hospital de Cascais – Integration and

alignment with the NHS

77Hospital de Cascais – Care profile

Surgical Specialties

General Surgery

Gynecology

Obstetrics

Ophthalmology

Orthopedics

ENT

Urology

Dermatology

Diagnosis and Therapeutics

Pathology (Anatomic)

Anesthesiology

Clinical Pathology

Radiology

Immunohemotherapy

Physical Medicine and Rehabilitation

Medical Specialties

Cardiology

Gastroenterology

Internal Medicine

Pediatrics/Neonatology

Respiratory Medicine

Neurology

Psychiatry

Medical-Surgical Emergency

Adults Emergency

Pediatric Emergency

OB/GYN Emergency

8The hospital in numbers

• 282.000 people served

• 1.237 FTEs

• 277 Beds

• 33 Consultation Rooms

• 6 Operating rooms

• 10 Delivering rooms

• 78M€ Revenues

A Day at the hospital (2017)…

• Production

• 44 surgeries

• 854 medical consultations

• 30 oncology sessions

• 463 Urgency episodes

• 10 Births

• Consumption

• 19958 kWh energy

• 143 m3 water

• 748 m3 Gas

• Medical and pharmaceutical

consumption expenses

• 44.629€

99

Hospital de Cascais – Alignment of

the NHS and UHG mission

Article 64 of the Portuguese Constitution

Everyone shall have the right to health protection and the duty to defend and promote it (…) through a comprehensive and universal national health system (...) mostly free of charge.

Mission

Our mission is to help people live healthier lives and to help make the health system work better for everyone.

10

Mission

To help people live healthier

lives and

to help make the health

system work better for

everyone

Integrity Compassion Relationships

Innovation Performance

Clinical Excellence

Best Patient Experience

Human Capital Development

Efficiency and Sustainability

Str

ate

gy

NH

S

4 drivers strategy based on IHI Triple Aim framework

Going from good to great…

11Our strategic commitment

Clinical

Excellence

Best Patient

Experience

Efficiency and

Sustainability

1

4 drivers strategy based on IHI Triple Aim framework

12

Clinical Excelence – Better System

and better Health

Care Profile

Human Capital

Quality of CarePatient Safety

Innovation Performance

Clinical Excellence and Health Outcomes

Better Healthcare System and Better Health for 1 person at a time

1

13

Clinical Excelence – Quality of care

and patient safety

Quality of CarePatient Safety

• Best Practices • JCI Standards• ISO 9001 Quality

Certification• Radiology• Imunohemotherapy• Pathology (Anatomic)• Pharmacy• Sterilization

• ISO 14001 Environmental Certification

1

14

Clinical Excelence – Innovation

The 1st Portuguese Hospital certified with EMRAM Stage 7 and 1 out of only 3 in Europe.

HOSPITAL WITH THE HIGHEST IMPACT OF TECHNOLOGY IN PATIENT QUALITY AND SAFETY

• Embodies our commitment to:• Continuous improvement of health outcomes• Quality and safety as intrinsic values• Patient satisfaction as a priority

• Supports and clarifies IT Strategy• Provides an IT strategy roadmap to achieve clinical

and operational excellence

• Values the use of Data Analytics• From perceived value added to evidence based

outcomes

• Is in itself a differentiator• Comparative quality advantage• Return on investment

Pioneer in standardization through the use of GS1 standards in Healthcare.

The Hospital was awarded for the impressive results obtained with a project where the mail goal was to increase patient safety and greater efficiency in the use of available resources, especially in the nursing area; this involved the revision of the entire nursing care process as well as the introduction of innovative technology whilst maintaining and ensuring the highest possible quality of care.

GS1 Healthcare Award | Best Provider Implementation Case

1

15

Clinical Excelence – Performance

Leader in Clinical Excellence in PortugalSINAS is a system for the evaluation of the overall quality of health services in Portugal (public and private).

Developed by the National Health Regulatory Entity (ERS).

The performance indicators of this evaluation tool are the result of a partnership between Joint Commission International andSiemens.

Considered the best public hospital in it’s category 2016

“TOP 5 - The excellence of Portuguese hospitals" 2016

a ranking from IASIST, which aims to acknowledge and reward public hospitals that presented the best results

throughout the year.

.

Clinical Records - Hospital de Cascais is 36% above benchmark.Performance rose 16% in 2016.

Accuracy of clinical records demonstrate the real complexity of the patient.

1

16

Best Patient experience – High care

initiative 1

HIGH TECH HIGH TOUCHCompassion

Know how to care

Respect of individuality

Investment in human relationships

State-of-the-art technology

Innovation

Development

Investment in technology

HIGH CARE

+

17

Best Patient experience – Examples 1

“Visit to the Delivery Room” “Caring Workshop” “Vasco goes to the movies” “Circuit of the child submitted to outpatient surgery”

“Red Noses Clowndoctors” “Better Care in Emergency Department”

18

Best Patient experience – NPS1

Patient Satisfaction

63%

28%

9%

Promoters Passives Detractors

8,5 (out of 10)

1 2 3 4 5 6 7 8 9 1

0Negative Neutral Positive Excellent

“Completely Dissatisfied” “Completely Satisfied”

8,5

Net Promoter

Score 53

19

Efficiency and Sustainability –

Dedicated department 1

1st place in “Excellence in the Health Sector” category of the Kaizen Institute Award 2016,

for the implementation of several efficiency projects, which allowed an increase in sustainability, maintaining the high standards of health services

provided to patients.

Efficiency and Continuous

Improvement Projects

• Operational agility

• 1.5M€/year

• Continued reinvestment

• Better quality

• Greater equity in access

• Sustainability

20

Efficiency and Sustainability –

External Evaluation1

Value For Money*: Lusíadas’ management of Hospital de Cascais saved the Portuguese Government €17,5 million per year.

If the Hospital had a public management, it would increase the costs for the Portuguese Government by 24%.

*Evaluation study - Value for Money of the Public Private Partnership of Hospital de Cascais, conducted by the Center for Applied Studies of the Portuguese Catholic University, October 2016, taking into account the reference group hospital - Cova da Beira Hospital Center.

Court of Auditors Evaluation:Hospital de Cascais’ PPP model did not add costs to the NHS. Compared to the public standard, there was a reduction of current expenditure.

21


1 employee at a time

We care about our employees.

Some initiatives have been carried out to improve this pillar

of our strategy:

Free Parking

Welcoming Environment

“Boa Esperança” Social Responsability

Happiness Committee

Sintra-Cascais Natural ParkEnvironmental Responsability

Gym Classes

Dance Classes

Running Team

Psychology Support

22


Internal evaluation

Employee Average Happiness Index 2018

6,9Happiness Committee Employee Annual Survey

(0 – 6)(0 –10)

https://www.youtube.com/watch?v=kJQP7kiw5Fk

23

Our journey to HIMSS 7

EMR Implementation Timeline

24


The Goal

25


What to ensure and how to start

MONEY

Where are the leaders and are

they strong enough?

Are clinicians involved at all

levels?

Is there a willingness to

invest?CLINICAL

ENGAGEMENT

LEADERSHIP

2017 GOAL

117 REQUIREMENTS

7 TEAMS

26


Requirements status

27


EMR implementation Timeline

• ReviewStructured Fields

• Review Strutured Templates

• CompoundMedication

• Triage New Version

• BarcodedMedicines reception

• Nursing Panel

• Milktrac

• PharmacyDispensing

• ED Visits

• Results Notification

• Drug-Food

• Live Dashboards

• Nutritional RiskAssessment

• ICU Integration

• NICU Integration

• CumulativeDoses

• LAB Orders onthe EMR

• CDSS Sepsis, MI, HIP Fracture, Stroke

• DisasterRecovery & Business ContinuityReview

OCT NOV DEC FEB APR MAY JUN JUL AUG

2016 2017

What we had to do…

28


Project Timeline

Feb

2017

Mar

2017

PRE AUDIT

FINAL AUDIT

Nov 2017

Jun

2017

May

2017

4 MONTHS OF

MATURITY

Apr

2017

PROJECT

KICK-OFF

VISIT TO STAGE

7 HOSPITALSCMIO and CNIO

ROLES

29


We Did it!!

30


Key to success

1

2

3

4

5

Alignment with Hospital Strategy

Commitment to leverage technology to maximize patient outcomes

Sponsorship of the Board

Focus on Process Improvement

Project manager, CMIO and CNIO ensuring the focus on quality and safety through process improvement

Celebrating Successes

Celebrate all small victories during the project

Proactive change management

Applying technology is not enough! It is much more about people,

processes and leading the change.

People engagement - Communication

Culture of cooperation – both with internal and external partners

Challenging the limits

31


Next steps

• Continuous Improvement

• Incident Notification Analysis

• Processes review and optimization

• Weekly meetings with CMIO, CNIO,

CIO, partners and teams

• How are we using data to improve outcomes?

Questions and answers

Thank you

hospital de cascais from good to great - tpg international health … · 2018-10-23 · hospital de...

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