minutes board of directors meeting held october 9, 2013 head office boardroom...

Minutes – Champlain CCAC Board of Directors, October 9, 2013

Champlain Community Care Access Centre Centre d’accès aux soins communautaires de Champlain

Head Office

4200 Labelle Street Suite 100 Ottawa ON K1J 1J8 Siège social 4200, rue Labelle Bureau 100 Ottawa ON K1J 1J8

Tel/Tél : 613 745 5525 800 538 0520 Fax/Téléc : 613 745 1422

www.champlain.ccac-ont.ca

MINUTES

Board of Directors Meeting

Held October 9, 2013

Head Office Boardroom

BOARD

MEMBERS:

Michael Ennis

Denise Alcock

Colette Rivet

Célestin Abedi

Maria Barrados

Hugh Brownlee

Lynn Graham

Diane Hupé

Ralph Moxness

Bill Skinner

Sherryl Smith

Chair

Vice-Chair

Treasurer

REGRETS: Melody Isinger

STAFF

PRESENT:

Gilles Lanteigne

Patrice Connolly

Kim Peterson

Deryl Rasquinha

Ashley Haugh

Steven Carswell

Dan Merritt

Jennifer Proulx

Chief Executive Officer

Vice-President, People and Stakeholder Engagement

Vice-President, Clinical Care

Vice-President, Performance and Strategy

Executive Assistant

Manager, Quality, Safety and Risk

Director, Organizational Development

Director, Quality and Program Evaluation

RECORDER: Ashley Haugh Executive Assistant

GUESTS: Siobhan MacManus

Beverlee McIntosh

Ottawa Council of Women

Ottawa Council of Women

AGENDA ITEM ACTION TO BE

TAKEN

1.0 CALL TO ORDER

1.1 Welcome

Michael Ennis, Board Chair, welcomed everyone to the meeting.

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1.2 Declaration of Conflict of Interest

There was no declaration of conflict.

2.0 APPROVAL OF AGENDA

It was moved by Sherryl Smith, seconded by Denise Alcock and agreed to approve

the agenda as amended.

CARRIED

Motion Carried

10-13-49

3.0 CONSENT AGENDA

The consent agenda for the October 10, 2013 Champlain CCAC Board meeting

containing the following information items and motions:

3.1 That the Champlain CCAC Board approves the minutes from the

September 11, 2013 Board meeting.

3.3 Report from the Client Services, Quality and Safety Committee

containing information/updates on the following:

o Updated Guidelines for Informed Consent in Quality Improvement

and Program Evaluation

o Adverse Events Update

o Current Research Activities

o Informed Consent for Research

o Board Scorecard

3.4 Champlain CCAC Scorecard

CARRIED

The following item was moved from the consent agenda to the agenda:

3.2 Report from the Finance Committee – Financial Statements o For the five month period ended August 31, 2013, Champlain CCAC

is in a deficit position of $107K. o Budget numbers reflect a base increase of 4% as directed by the

Champlain LHIN. Funding letters for the current fiscal year were issued by the Champlain LHIN on September 24

th for base funding

and one-time funding totally approximately a 6% increase in funding. This increase will be reflected in next month’s statements. .

o With referrals and client acuity continuing to increase, there still will be a funding gap, which staff is attempting to address through internal mitigation measures.

o Additional funding is still expected for nursing and physiotherapy start-up costs, however, the timing and amount is still unknown.

Discussion included: o At the Board retreat, the Board may want to discuss the “risk” of

saying no to a project or program that CCACs are asked to implement as funding that accompanies these programs often doesn’t cover all costs.

Motion Carried

10-13-50

3


4.0 GENERATIVE DISCUSSION – GOVERNANCE AS LEADERSHIP

Michael Miles, Director, MBA Program, Telfer School of Management and Centre

on Executive Leadership, led the Board generative discussion related to governance

as leadership:

It is essential to stay at the governance level; experience as a member of the

“front-line” does provide a great background for discussion, but it is

important to remember to stay at the strategic level.

Governors need to step out of the “action” and look at the underlying

principles during discussion, etc.

Making the strategic choices is a fundamental part of Board operations, from

there staff implements strategy via operational choices.

Discussion focused on three questions/statements:

1. What are the truly strategic areas that the Board of the Champlain CCAC has

been and needs to address over the timeframe of the 2013 Strategic Plan?

2. What would Champlain CCAC Board members have to do to be seen as

leaders around these areas – what would individual Board member leadership

look like and what would collective Board leadership look like?

3. How could the Board measure their leadership quotient (i.e., the degree to

which those they represent see them as true leaders) in their role as strategy

formulators and promoters?

Discussion included:

Boards aren’t always in control of the strategic direction the organization will

take as the Government can implement mandatory policies and programs. As

well, the mandatory policies and programs don’t always come with enough

funding for start-up or ongoing operations (travel costs, hardware costs –

desks, computers, etc.).

o There will always be multiple demands on an organization; the

Board’s job is to balance them.

o The Board has to make a decision on what strategic priorities it will do

better on if not all can be implemented due to other pressures.

Boards have a responsibility to look where an organization wants to go and to

gather the necessary information to move the organization towards the goal.

This may involve proactive discussions with decision makers and influencers

so the Board is thought of and consulted as policies and programs are

developed.

Sometimes being a strategic leader means taking calculated risks.

Good Boards commit to what they want to achieve long-term. With this vision, the Board can make the tough decisions to meet the long-term goal.

The strategic “vision” of where an organization is going is developed by the Board and then turned over to staff to operationalize and implement. Part of a Board’s responsibility is to motivate the staff who operationalizes the

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strategic plan.

Metrics/measurements are essential to determining if a Board is doing a

“good” job – Boards need to determine what they need/want to measure in

order to show whether the Board is successfully monitoring strategic

directions.

There may be the opportunity for University of Ottawa MBA students to work

with the Champlain CCAC Board on metrics or other governance projects.

On behalf of the Board, Sherryl Smith thanked Mike Miles for his excellent

presentation and discussion.

5.0 STRATEGIC PLANNING

The Board reviewed and discussed the vision, mission and value statement input and

the principles that will guide the final statements:

In 2009, a common mission and vision were adopted by all 14 CCACs. At

this time, the Champlain CCAC will continue to use the common mission and

the provincial vision with the Champlain region emphasis.

o Mission: to deliver a seamless experience through the health care

system for people in our diverse communities, providing equitable

access, individualized care coordination and quality health care.

o Vision: Outstanding Care – every person, every day, every Champlain

community.

Inputs gathered to date will continue to guide the strategic planning process

and the organization’s values.

The Board reviewed the key themes and feedback from the staff survey. Over

half of the Champlain CCAC’s staff, 362, responded to the strategic planning

survey.

The Board reviewed some draft strategic themes and values; the retreat

planning committee will continue to review the material and will develop

ideas for Board feedback.

6.0 RISK MANAGEMENT

The Risk Management program and structure at the Champlain CCAC was reviewed

by the Board:

In spring 2011, the Board participated in a risk survey and discussion that led

to the creation of the Risk Management Framework.

In fall 2012, the Board participated in a survey to determine the appetite to

take on risk at the Champlain CCAC. The survey is now being refreshed for

2013 to determine the organization’s current risk appetite.

The risk management program has been used in many different areas in the

past year, including: Mental Health and Addiction programs, Personal

Support Services, Immunization policy, etc.

Action: Ashley Haugh

to provide Board with

list of positions which sit

on the Strategic

Operations Committee

(SOC).

5


Results of the survey will be available before the November Board retreat.

7.0 EMPLOYEE ENGAGEMENT SURVEY

Champlain CCAC staff recently completed the third Employee Engagement Survey

since becoming an organization in 2007. Out of the 55 sector-wide questions,

Champlain CCAC is lower (from a statistically significant perspective) on only one

question when benchmarked against the sector. Major Trending Improvements of

19% or more were identified in the areas of Health and Wellness. Decision Input,

Ability to Take Initiative and Trust. For the first time results will also be available by

team and therefore specific actions may be tailored to specific groups. Our lowest

rankings, feedback from over 250 comments, and focus groups will help inform the

Action Plan for improvement.

8.0 OTHER BUSINESS

8.1 Public Questions and Comments

There were no public questions or comments.

9.0 IN-CAMERA

It was moved by Célestin Abedi, seconded by Colette Rivet and agreed to move in-

camera.

CARRIED

It was moved by Sherryl Smith, seconded by Maria Barrados and agreed to adjourn

the meeting.

CARRIED

Motion Carried

10-13-51

Motion Carried

10-13-54

CONFIRMED: _ __Original Signed by______________________________

MICHAEL ENNIS, CHAIR

_ __ Original Signed by _____________________________

GILLES LANTEIGNE, CEO AND BOARD SECRETARY

DRAFT

Outcomes: DM – Decision Making DS – Discussion IE- Information/Education Strategic Direction: SDE – Service Delivery Excellence LEAD – Leadership in Home and Community Care in an Integrated Health System ORG – Organizational Capacity and Performance

1

BOARD OF DIRECTORS’ MEETING DATE: October 9, 2013

TIME: 12:00 PLACE: CCAC Head Office Boardroom

AGENDA

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12:00-12:05

1.0 Call to Order 1.1 Welcome


Michael Ennis

Michael Ennis

V-B-14

2.0

Approval of Agenda (including the consent

agenda)

Michael Ennis

DM

3.0

Consent Agenda (Any Board Member may request that any item be removed from this consent agenda and moved to the regular

agenda)

Michael Ennis

DM

3.1 Minutes from the September 11, 2013 Board meeting

DM

3.2 Report from the Finance Committee – Financial Statements

IE LEAD

3.3 Report from the Client Services, Quality and Safety Committee (CSQS)

IE

SDE

3.4 Champlain CCAC Scorecard IE ALL

12:05-13:05

4.0

Generative Discussion – Governance as Leadership

Sherryl Smith/ Mike Miles

DM

ALL

13:05-14:35

5.0

Strategic Planning

Deryl Rasquinha

DS

ALL

14:35-14:55

6.0

Risk Management

Jennifer Proulx

DS

ALL

14:55-15:15

7.0

Employee Engagement Survey

Patrice Connolly

IE

ORG

DRAFT

DRAFT

Outcomes: DM – Decision Making DS – Discussion IE- Information/Education Strategic Direction: SDE – Service Delivery Excellence LEAD – Leadership in Home and Community Care in an Integrated Health System ORG – Organizational Capacity and Performance

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15:15-15:20

8.0

Other Business 7.1 Public questions and comments

IE

9.0

In-camera

DM

Adjournment Michael Ennis DM

Item 3.0 Consent Agenda

MOTION

WEDNESDAY OCTOBER 9, 2013

Champlain CCAC Board of Directors

Consent Agenda

For all presentations and reports on the entire agenda (i.e., not just the consent

agenda), presenters have been asked to assume that the Board has read all of the

material in advance. Time with the Board will focus on questions and discussions

rather than repetition of the written material.

Any one Board Member may request that any item be removed from the consent

agenda and moved to the regular agenda for discussion.

By approving the consent agenda, the Board will be approving and accepting the

material on the consent agenda. The minutes of the meeting will reflect that the

consent agenda passed and note all of the items and full motions approved as part

of the consent agenda.

Moved by: Seconded by:

Be it resolved, That the Champlain CCAC Board approves the consent

agenda for the October 9, 2013 meeting.

• 3.1 Minutes from the September 11, 2013 Board meeting (approval)

• 3.2 Report from the Finance Committee – Financial Statements (info)

• 3.3 Report from the CSQS Committee (info)

• 3.4 Champlain CCAC Scorecard (info)

Carried Defeated

Minutes – Champlain CCAC Board of Directors, september 11, 2013

Champlain Community Care Access Centre Centre d’accès aux soins communautaires de Champlain

Head Office

4200 Labelle Street Suite 100 Ottawa ON K1J 1J8 Siège social 4200, rue Labelle Bureau 100 Ottawa ON K1J 1J8

Tel/Tél : 613 745 5525 800 538 0520 Fax/Téléc : 613 745 1422

www.champlain.ccac-ont.ca

MINUTES

Board of Directors Meeting

Held September 11, 2013

Head Office Boardroom

BOARD

MEMBERS:

Michael Ennis

Denise Alcock

Colette Rivet

Célestin Abedi

Maria Barrados

Hugh Brownlee

Lynn Graham

Diane Hupé

Melody Isinger

Bill Skinner

Sherryl Smith

Chair

Vice-Chair

Treasurer

REGRETS: Ralph Moxness

STAFF

PRESENT:

Gilles Lanteigne

Patrice Connolly

Kim Peterson

Deryl Rasquinha

Ashley Haugh

Paul Boissonneault

Chief Executive Officer

Vice-President, People and Stakeholder Engagement

Vice-President, Clinical Care

Vice-President, Performance and Strategy

Executive Assistant

Director, Information & CIO

RECORDER: Ashley Haugh Executive Assistant

GUESTS: Melanie MacDonald Perley and Rideau Veterans' Health Centre

AGENDA ITEM ACTION TO BE

TAKEN

1.0 CALL TO ORDER

1.1 Welcome

Michael Ennis, Board Chair, welcomed everyone to the meeting.


There was no declaration of conflict.

2

Minutes – Champlain CCAC Board of Directors, September 11, 2013

2.0 CONSENT AGENDA

It was moved by Diane Hupé, seconded by Denise Alcock and agreed to approve the

consent agenda for the September 11, 2013 Champlain CCAC Board meeting

containing the following information items and motions:

2.1 That the Champlain CCAC Board approves the minutes from the June 13,

2013 Board meetings (2 sets of minutes).

2.2 Report from the Governance Committee containing information/updates

on the following:

o Board Generative Discussion/Education Topics

o Board Representation on the Ethics Committee

o Board Functioning Scorecard

o Board and Committee Dates for 2014

2.2.1 That the Champlain CCAC Board approves the 2014 Board meeting

dates:

o February 12

o March 12

o April 9

o May 14

o June 18

o September 10

o October 8

o November 13

o December 10

2.3 Report from the Finance Committee – Financial Statements

2.4 Report from the Client Services, Quality and Safety Committee

containing information/updates on the following:

o Quality Improvement Plan (QIP) FY 13-14 Q1 Update

o Events Report FY 13-14 Q1 Update

o Client Care Report: Physiotherapy (PT) Program For Retirement

Homes(RH)

o Informed Consent for Research, Quality Improvement and Program

Evaluation

o Proposed CSQS Calendar of Topics

o Board Scorecard

2.5 Champlain CCAC Scorecard

CARRIED

The following item was moved from the consent agenda to the agenda:

2.6 Update on Communications and Stakeholder Engagement Plan o The Champlain CCAC participated in 65 outreach events across

Champlain in Q1 including the Annual Montfort Conference, meetings with primary care providers and Family Health Teams, job fairs, etc.

Motion Carried

09-13-44

3


3.0 APPROVAL OF AGENDA

It was moved by Colette Rivet, seconded by Célestin Abedi and agreed to approve

the amended agenda for the September 11, 2013 meeting.

CARRIED

Motion Carried

09-13-45

4.0 GENERATIVE DISCUSSION – E-HEALTH

The Board reviewed and discussed the Community Leadership in Health Information

Technology presentation including:

An overview of the Champlain CCAC’s Health Information Technology

environment

o Clinical Information Systems

o Information and Communications Technology

o Business Intelligence and Reporting

o Financial and Administrative Systems

o CSS Shared Services Operations

How the Ontario Association of Community Care Access Centres

(OACCAC), Ministry of Health and Long-term Care (MOHLTC), eHealth

Ontario, Local Health Integration Network (LHIN) and local health IT

initiatives fit together.

Opportunities for e-health evolution, enhancements and opportunities for

innovation to support new strategic priorities.

Discussion included:

Consent is collected from clients for the purpose of sharing their records for

healthcare planning and other identified uses.

Security of data is taken very seriously with encryption of files, limited access

to physical data centres, etc.

Technology needs to “work” for a client’s situation/care plan – it shouldn’t be

an extra “burden”.

Technology could allow for greater efficiencies, greater cover of the large

Champlain geography and reduce costs (travel, etc.), but staff need to ensure

technology can be used properly by clients and staff, doesn’t increase

isolation of clients, isn’t intimidating, etc.

Technology can provide earlier identification of issues and alert the

appropriate professional (care coordinator, nurse, etc.).

There needs to be clear planning related to IT projects as there can be

significant costs in training, renewal of licenses, upgrades to software, etc.

There was also agreement to leverage technology for the improvement of

quality of care.

IT and the Champlain CCAC’s role in promoting, supporting, enhancing, etc.

technology in the healthcare system should be considered as the Board moves

forward with the strategic planning process.

Paul Boissonneault was thanked for the excellent presentation.

4


5.0 STRATEGIC PLANNING

The Board reviewed and discussed the vision, mission and value statement input and

the principles that will guide the final statements:

There was general agreement on the themes identified in option three

(community, integration, leadership, partnership, etc.), but combined with the

bolder vision statement option of Health care reimagined:

o Vision - Leading innovation and excellence in community health care

o Mission - to provide quality care and system leadership through

innovation and partnerships to improve the health of people in our

communities

o Values by being caring, collaborative, accountable and innovative

Other themes discussed included:

o Diversity

o Transparency

o Compassionate

Staff input, especially related to the organization’s values, will be sought via

an online survey. There is also the possibility for further consultation at the

All Staff Event in October.

The Champlain CCAC Leadership Team will also be discussing the emerging

strategic directions at a meeting in late September.

Need to keep language simple so everyone understands – e.g., Population

health isn’t a term the “average” person is familiar with.

To be compliant with the Excellent Care for All Act, when it is applicable to

CCACs, public consultation on values is required. This could be done after

the Board retreat.

Additional consultations, with community focused healthcare partners in

Champlain, were requested to provide further input into the environmental

scan.

ACTION: Further

discussions related to

mission, vision, values

and the emerging

strategic directions to

take place at October

Board meeting.

6.0 OTHER BUSINESS

6.1 Public Questions and Comments

Melanie MacDonald from Perley and Rideau Veterans' Health Centre commented on

the Champlain CCAC’s strategic planning process and looks forward to the results

being communicated to partners.

7.0 IN-CAMERA

It was moved by Sherryl Smith, seconded by Lynn Graham and agreed to move in-

camera.

CARRIED

Motion Carried

09-13-46

5


It was moved by Sherryl Smith, seconded by Hugh Brownlee and agreed to adjourn

the meeting.

CARRIED

Motion Carried

09-13-48

CONFIRMED: _ _______________________________________________

MICHAEL ENNIS, CHAIR

_ ________________________________________________

GILLES LANTEIGNE, CEO AND BOARD SECRETARY

of 3 August 2013

Champlain CCAC Financial and Performance Results

For the Five Months Ended August 31, 2013

Summary This executive summary covers Champlain CCAC’s financial results for the five month period ended August 31, 2013.

Financial Results – Summary For the five month period ended August 31, 2013, Champlain CCAC is in a deficit position of ($107K). Budget numbers reflect a base increase of 4.0% as directed by the LHIN. Final funding for the current fiscal year

was issued by the Champlain LHIN in excess of the 4% planning value on September 24th but is not reflected in

the budget values below.

FINANCIAL RESULTS:

YTD YTD YTD Total Variance %

Actuals Budget Variance Budget to Budget

REVENUE

Base Funding 86,842,685 87,409,783 (567,098) 212,230,458 (0.65%)

One-Time Funding 595,691 675,324 (79,633) 1,537,602 (11.79%)

BTI 166,389 200,019 (33,630) 467,019 (16.81%)

Other 41,456 23,333 18,123 56,000 77.67 %

TOTAL REVENUE 87,646,221$ 88,308,459$ (662,238)$ 214,291,079$ (0.75%)

EXPENSES

CHRIS 58,914,285 57,804,670 (1,109,615) 140,337,670 (1.92%)

Non-CHRIS 2,298,726 1,991,962 (306,764) 4,780,708 (15.40%)

Internal Therapies 1,776,947 1,850,851 73,904 4,447,288 3.99 %

Care Coordination 16,902,178 17,758,445 856,267 42,895,349 4.82 %

Nursing Initiatives and Geriatric Assessment 1,057,641 1,588,984 531,343 3,796,262 33.44 %

Information & Referral 418,810 491,149 72,339 1,186,509 14.73 %

Administration 6,384,704 6,822,398 437,694 16,847,293 6.42 %

TOTAL EXPENSES 87,753,291$ 88,308,459$ 555,168$ 214,291,079$ 0.63 %

TOTAL SURPLUS/(DEFICIT) (107,070)$ -$ (107,070)$ -$

of 3 August 2013

Key Revenue Assumptions

Assumptions and funding updates are shown in the August Budget Guidelines document. August Results

Current Month Surplus/(Deficit)

($ 231K)

Revenues ($135K)

Base funding (131K) Base revenue is lower than budget due to unspent Nursing Initiatives and a shortfall of physiotherapy (PT) funding for congregate settings (e.g. retirement homes). Base funding related to nursing initiatives is only recognized as the money is spent. New PT revenue is currently recognized below actual costs to account for a previously expected funding shortfall relating to this initiative. Recent funding letters from the LHIN (as at September 24) should address that gap.

One-time funding ( 7K) BTI and Other Revenue 3K

The deficit in Purchased Clinical Services is driven by higher than expected client demand. This demand has driven increases particularly in visit and clinic nursing as well as budget shortfalls in PSS and medical supplies. Chronic clients and their average acuity have increased more than planned. In addition, wound referrals from hospital have been increasing at an ardent pace over the past few months. Costs are also up in adult physiotherapy as a result of focused effort and progress to remove wait lists. The implementation of new PT service in congregate care settings also began in late August. Expense surpluses are primarily limits on clinical care staffing limits as well as Nursing Initiative staffing (nearly at full staffing at the end of August). Administrative expenditures (primarily facility changes and IT enhancements) have been restricted while funding was not yet confirmed.

Expenses ($ 95K)

Purchased Clinical Services

(574K)

Direct Care1 70K

Care Coordination/I&R 278K Administration 131K

of 3 August 2013

Year to Date (YTD) Results

YTD Surplus/(Deficit) ($ 107K)

Revenues ($ 662K)

Base funding (567K) The variance in base funding is primarily due to Nursing Initiative unspent funds. One-time funding is under budget due to timing differences of hips and knees volumes and other dedicated funds.

One-time funding ( 80K) BTI and Other Revenue ( 15K)

Significant demand on Purchased Clinical Services has continued to very significantly outstrip the 4% budgetary assumption. Actual funding amounts were confirmed by the Champlain LHIN that should address much of that shortfall. Offsetting high costs in purchased services are temporarily underspent budgets for staffing (nursing, care coordination, etc.) and for infrastructure spend (planned space reductions, IT investment, etc.).

Expenses $ 555K

Purchased Clinical Services

(1,416K)

Direct Care1 605K

Care Coordination/I&R 928K Administration 438K

1 Includes: Internal Therapies, Mental Health and Addictions, Rapid Response, Palliative Home Care and Geriatric

Assessment

Overall Analysis

Client demand has continued to be very strong in the current fiscal year with a steady and demonstrated shift to higher acuity clients. In addition, the Champlain CCAC has been experiencing significant growth of hospital referrals for wound clients, increasing both nursing and medical supplies costs. The level of client demand exceeds the 4% planned budget which will be addressed through added funding through the LHIN as well as internal cost containment and operational efficiency efforts.

CHAMPLAIN CCAC

Board Operating Statements

For the Five Months Ending August 31, 2013

1 Month 1 Month 1 Month YTD YTD YTD TotalActuals Budget Variance Actuals Budget Variance Budget

REVENUE

Base Funding 17,202,964 17,282,558 (79,594) 86,724,083 87,239,782 (515,699) 210,339,158 One-Time Funding 104,618 111,533 (6,915) 595,691 675,324 (79,633) 1,537,602 Physiotherapy Congregate Settings (new) 118,602 170,000 (51,398) 118,602 170,000 (51,398) 1,891,300 BTI 166,389 166,000 389 166,389 200,019 (33,630) 467,019 Other 6,991 4,667 2,324 41,456 23,333 18,123 56,000

Total Revenue 17,599,564 17,734,758 (135,194) 87,646,221 88,308,458 (662,237) 214,291,079

EXPENSES

Clinical CarePurchased ServicesPersonal Support Services 6,446,771 6,323,167 (123,604) 31,443,759 31,349,405 (94,354) 74,543,759 Visit Nursing (includes dialysis) 2,441,659 2,276,967 (164,692) 11,684,149 11,422,005 (262,144) 26,944,761 Visit Nursing - Clinic 314,305 231,603 (82,702) 1,409,655 1,161,020 (248,635) 2,725,212 Nursing Shifts 556,876 590,145 33,270 3,403,221 3,420,051 16,830 8,755,139 Community - OT 326,885 406,154 79,270 1,712,390 1,856,772 144,382 4,052,484 Community - PT 273,609 219,277 (54,332) 1,191,003 1,101,668 (89,335) 2,584,808 Community - PT Congragate Settings 158,136 170,000 11,864 158,136 170,000 11,864 1,891,300 Community - Speech 17,218 15,263 (1,956) 84,474 76,514 (7,960) 180,036 School - OT 621 10,561 9,940 666,121 735,084 68,963 2,396,442 School - PT 329 2,454 2,125 160,589 169,976 9,387 554,164 School - Speech 139 7,086 6,947 459,872 509,897 50,025 1,663,687 Social Work 22,703 27,257 4,553 132,916 136,261 3,345 321,154 Nutrition 32,482 32,404 (77) 187,667 175,999 (11,668) 434,019 Hospice 359,482 359,634 152 1,798,018 1,798,170 152 4,315,608 Aphasia 20,833 20,833 - 104,167 104,167 - 250,000 Medical Supplies 1,271,199 1,016,177 (255,022) 5,891,517 5,026,952 (864,565) 12,128,378 Medical Equipment 143,461 114,446 (29,015) 666,626 569,108 (97,517) 1,344,827 Laboratory Services 90 - (90) 254 - (254) - Recoveries (1,638) (15,208) (13,570) (25,168) (76,042) (50,874) (182,500) Other 15,451 17,925 2,474 83,648 89,625 5,977 215,100 Total Purchased Services 12,400,611 11,826,145 (574,465) 61,213,014 59,796,632 (1,416,381) 145,118,378

Internal TherapiesWages 247,082 256,584 9,502 1,263,062 1,346,545 83,483 3,279,453 Benefits 94,160 95,999 1,839 415,658 394,723 (20,935) 904,835 Travel 22,565 19,167 (3,399) 84,759 95,833 11,075 230,000 General Administration Costs 1,530 2,750 1,220 13,468 13,750 282 33,000 Total Internal Therapies 365,338 374,500 9,162 1,776,947 1,850,851 73,905 4,447,288

Care CoordinationWages 2,354,670 2,589,632 234,962 12,773,029 13,403,267 630,238 32,926,657 Benefits 902,726 947,557 44,831 3,724,724 3,912,623 187,899 8,947,512 Travel 56,758 40,833 (15,925) 227,541 204,167 (23,375) 520,000 Professional Service 29,465 23,300 (6,165) 81,729 112,498 30,769 171,500 Office Supplies 3,208 8,111 4,903 19,673 28,223 8,550 85,000 Printing 3,725 11,250 7,525 25,577 56,250 30,673 135,000 Photocopy Charges 361 7,100 6,739 39,460 35,300 (4,160) 85,000 Delivery & Courier 2,263 3,750 1,487 10,570 18,750 8,180 45,000 Courses/Training/Conferences 320 4,583 4,263 13,670 22,919 9,249 65,000 Equipment Maintenance - 208 208 - 1,042 1,042 2,500 Minor Equipment - 833 833 - 4,167 4,167 10,000 Wireless Service 12,368 8,333 (4,035) 63,599 41,665 (21,934) 100,000 Recoveries (5,064) (17,193) (12,129) (79,538) (85,967) (6,429) (206,320) Other 708 708 2,143 3,542 1,399 8,500 Total Care Coordination 3,360,800 3,629,006 268,206 16,902,178 17,758,445 856,268 42,895,349

Page 1 of 4

CHAMPLAIN CCAC




Nursing Initiatives and Geriatric AssessmentWages 185,375 227,649 42,274 798,874 1,188,071 389,197 2,892,553 Benefits 61,413 76,006 14,593 210,253 334,246 123,993 743,709 Travel 8,748 13,333 4,585 37,568 66,667 29,099 160,000 Other - - - 10,946 - (10,946) - Total Nursing Initiatives and Geriatric Assessment 255,536 316,988 61,452 1,057,641 1,588,984 531,343 3,796,262

Information & ReferralWages 66,482 71,604 5,122 320,311 372,055 51,744 910,238 Benefits 25,975 30,125 4,150 97,951 115,644 17,693 267,271 Travel 199 450 251 548 3,450 2,902 9,000 Total for Information & Referral 92,655 102,179 9,524 418,810 491,149 72,339 1,186,509

Total Clinical Care 16,474,940 16,248,818 (226,121) 81,368,590 81,486,061 117,474 197,443,786

ADMINISTRATION

Executive OfficeWages 64,573 90,013 25,440 454,189 431,851 (22,338) 1,046,226 Benefits 21,478 21,826 348 91,411 91,504 93 222,159 Travel 1,726 1,583 (142) 10,806 7,917 (2,889) 19,000 Legal Services 5,359 1,833 (3,526) 12,364 9,167 (3,197) 22,000 Consultants 33,672 - (33,672) 31,711 - (31,711) 10,000 Membership (OACCAC) 31,049 31,667 617 159,201 158,333 (868) 380,000 Minor Equipment - - - - - - Meeting Expenses - 292 292 502 1,458 957 3,500 Printed Matter & Subscriptions - 167 167 169 833 665 2,000 Board Expenses 321 1,238 917 16,651 6,188 (10,464) 27,500 Recoveries (258) - 258 (1,292) - 1,292 - Other - 292 292 655 1,458 803 3,500 Total for Executive Office 157,921 148,910 (9,011) 776,366 708,709 (67,657) 1,735,885

Performance and StrategyBusiness IntelligenceWages 31,635 31,302 (333) 157,209 158,920 1,711 386,483 Benefits 10,884 10,364 (520) 43,584 43,350 (234) 96,676 Travel - - - 1,204 - (1,204) 500 Other - 100 100 - 300 300 1,000 Total for Business Intelligence 42,519 41,766 (753) 201,997 202,570 573 484,659

Quality & Program EvaluationWages 27,690 50,841 23,151 150,770 236,725 85,955 573,626 Benefits 7,009 14,419 7,410 38,745 62,313 23,568 140,307 Travel 237 417 179 3,648 2,083 (1,564) 5,000 Other 20,717 2,750 (17,967) 22,072 38,813 16,741 108,250 Total for Quality & Program Evaluation 55,654 68,427 12,773 215,234 339,934 124,700 827,183

Planning and ProjectsWages 21,704 24,838 3,134 113,554 115,212 1,658 278,709 Benefits 6,393 6,740 347 29,006 28,611 (395) 65,554 Travel - 292 292 1,647 1,458 (189) 3,500 Other 129 - (129) 190 - (190) - Total for Planning and Projects 28,225 31,870 3,644 144,397 145,281 884 347,763

Finance and PayrollWages 46,560 54,514 7,954 249,694 259,215 9,521 631,114 Benefits 17,822 17,599 (223) 70,345 69,447 (898) 161,707 Travel - - - 817 550 (267) 2,250 Insurance 6,254 6,699 446 31,270 33,497 2,227 80,393 Audit Services 2,833 2,833 - 14,167 14,167 - 34,000 Other 200 333 133 1,488 1,667 179 4,000 Total for Finance and Payroll 73,669 81,979 8,311 367,781 378,542 10,762 913,464

Page 2 of 4

CHAMPLAIN CCAC




ContractsWages 27,681 23,606 (4,075) 125,823 109,497 (16,326) 299,431 Benefits 8,650 7,501 (1,149) 36,543 31,202 (5,341) 78,832 Travel - 642 642 818 3,208 2,390 7,700 Other - - - 377 25 (352) 100 Total Contracts 36,331 31,749 (4,582) 163,561 143,932 (19,628) 386,063

FacilitiesWages 13,766 15,331 1,565 77,493 76,205 (1,288) 186,796 Benefits 3,999 5,465 1,466 20,733 21,847 1,114 50,062 Travel 786 483 (303) 2,366 2,419 53 5,800 Office Supplies & Services 522 1,566 1,044 3,543 6,038 2,495 17,000 Postage, courier & photocopy services 1,271 3,666 2,395 7,177 18,338 11,161 44,000 Building Occupancy 191,818 170,833 (20,985) 961,906 854,169 (107,737) 2,050,000 Office Renovations 1,017 8,000 6,983 29,379 132,000 102,621 280,000 Utilities 501 5,833 5,332 18,094 29,169 11,075 70,000 Misc Supplies/Repairs/Cleaning 4,328 7,083 2,755 25,185 35,419 10,234 85,000 Equipment Maintenance-Plant 5,387 500 (4,887) 19,263 18,250 (1,013) 50,000 Furniture & Equipment Purchases (Capital Asset) - - - - - - - Leasehold Improvement Purchases (Capital Asset) - - - 22,540 - (22,540) - Other 3,401 2,749 (652) 24,494 13,757 (10,737) 33,000 Recoveries (374) (750) (377) (118,193) (154,500) (36,307) (160,000) Total for Facilities 226,424 220,759 (5,665) 1,093,980 1,053,111 (40,869) 2,711,658

IT & System CommunicationsWages 96,975 139,578 42,603 656,104 680,677 24,573 1,716,326 Benefits 41,430 52,150 10,720 182,446 189,918 7,472 465,460 Travel 307 2,833 2,526 7,041 15,665 8,624 41,996 Telephone & System Communications 32,551 34,667 2,116 165,739 169,935 4,196 417,004 Telephone Supplies - 3,450 3,450 10,332 17,290 6,958 41,440 Telephone Maintenance & Licenses 2,319 1,000 (1,319) 95,174 84,000 (11,174) 140,000 Telephone System Consultant - - - 30,984 14,000 (16,984) 19,000 Equipment Maintenance - - - 25,685 16,500 (9,185) 19,000 Software Maintenance & Licenses 28,348 (28,348) 88,087 126,500 38,413 245,000 System Development Consultant/CHRIS Development - 9,231 9,231 2,064 71,155 69,091 153,272 Computer Supplies 3,849 5,000 1,151 12,215 25,000 12,785 76,860 BTI 166,389 166,000 (389) 167,531 200,019 32,488 467,019 BTI Refresh/Growth 360 1,000 640 35,799 30,900 (4,899) 54,000 CCAC eHealth Program 142,330 142,330 - 711,652 711,652 - 1,707,964 Renovations 3,911 2,000 (1,911) 15,216 11,000 (4,216) 25,000 Other 407 8,123 7,716 20,996 38,615 17,619 153,496 Recoveries (35,333) - 35,333 (47,424) (7,210) 40,214 (7,210) Equipment Purchases (Capital Asset) - - - 20,631 - (20,631) - Total for IT & System Communications 483,843 567,362 83,519 2,200,273 2,395,616 195,342 5,735,627

Health Information - - - - - - - Wages 25,778 26,264 486 127,533 133,644 6,111 326,720 Benefits 9,221 10,268 1,047 36,183 39,710 3,527 91,974 Travel - 400 400 1,965 2,200 235 5,000 Shredding & Document Destruction 64 2,000 1,936 5,668 10,000 4,332 25,000 Scanning Services - - - 849 - (849) - Storage 879 3,800 2,921 15,948 18,992 3,044 45,500 Recoveries - - - (715) - 715 - Total for Health Information 35,941 42,732 6,791 187,431 204,546 17,115 494,194

Total Performance and Strategy 982,605 1,086,643 104,038 4,574,653 4,863,533 288,879 11,900,611

People and Stakeholder EngagementPeople ServicesWages 54,544 65,916 11,372 268,005 305,754 37,749 739,653 Benefits 17,039 19,123 2,084 65,531 79,561 14,030 181,303 Travel 1,129 688 (441) 4,177 3,434 (743) 8,250 Consultants - HR 902 3,667 2,765 1,019 18,331 17,312 44,000 Labour Relations 11,733 4,000 (7,733) 44,728 17,000 (27,728) 100,000 Occupational Health & Safety 2,082 2,000 (82) 17,322 10,000 (7,322) 147,000

Page 3 of 4

CHAMPLAIN CCAC




Advertising - 3,958 3,958 26,064 19,794 (6,270) 47,500 Employee Assistance Plan 6,588 - (6,588) 13,175 5,750 (7,425) 23,000 Staff Appreciation 4,209 2,000 (2,209) 8,702 10,000 1,298 60,000 Other 416 - (416) 521 - (521) 1,100 Total People Services 98,642 101,352 2,710 449,244 469,624 20,380 1,351,806

Organizational DevelopmentWages 27,124 46,848 19,724 173,283 228,497 55,214 582,154 Benefits 10,918 14,821 3,903 47,130 62,410 15,280 149,312 Travel - 658 658 2,281 4,794 2,513 10,400 Courses/Training/Conferences 15,040 7,917 (7,123) 31,859 43,136 11,277 102,305 Other 2,910 - (2,910) 4,228 70,000 65,772 125,000 Total Organizational Development 55,993 70,244 14,251 258,780 408,837 150,057 969,171

Stakeholder EngagementWages 37,682 43,825 6,143 183,022 207,426 24,404 502,934 Benefits 14,524 13,467 (1,057) 55,464 56,770 1,306 128,886 Travel 1,130 833 (297) 2,751 4,165 1,414 10,000 Public Relations 5,068 18,417 13,349 44,933 92,084 47,151 221,000 Translation/Consultants 1,764 2,250 486 39,267 11,250 (28,017) 27,000 Other 27 - (27) 225 - (225) - Total Stakeholder Engagement 60,195 78,792 18,597 325,661 371,695 46,034 889,820

Total People and Stakeholder Engagement 214,829 250,388 35,559 1,033,685 1,250,156 216,471 3,210,797

Total Administration 1,355,355 1,485,940 130,585 6,384,704 6,822,398 437,693 16,847,293

Total Expenses 17,830,295 17,734,758 (95,537) 87,753,294 88,308,458 555,164 214,291,079

Revenue less Expenses (230,731) - (230,731) (107,073) - (107,073) -

Page 4 of 4

Champlain CCAC Board – October 9, 2013

Item 3.3– Client Services, Quality and Safety Committee Report PAGE 1

Submission to Board of Directors

Client Services, Quality and Safety Committee Report

October 9, 2013

Updated Guidelines for Informed Consent in Quality Improvement and Program Evaluation An updated document was provided summarizing the discussion at the September 3, 2013 CSQS Committee meeting regarding the Tri-Council Policy Statement-2 (TCPS-2) guidelines and the Champlain CCAC’s current practices for obtaining consent and ensuring confidentiality and security of client information. There was agreement from the Committee to proceed with Quality Improvement and Program Evaluation activities. Adverse Events Update There were no new adverse events to report. There was one unexpected death of a client undergoing Chemotherapy and receiving nursing services for medication administration via a pump. The Coroner is investigating and if there is further information to share, it will be brought forward at a future meeting. Current Research Activities An annual update on research projects from the past year was provided. It was noted that many of these are multi-year projects and the majority are initiated by external researchers. Two particular projects pertaining to clinical care coordination and to patient experiences with ostomy care were highlighted for their potential impact to Champlain CCAC processes. All research requests are submitted to the Director Program Development and Clinical Care. The Director chairs the Champlain CCAC Research Committee and there is a mechanism in place to escalate items requiring clarification to the Champlain CCAC’s internal Ethics Committee for discussion and guidance, however, the Ethics Committee does not serve as a Research Ethics Board (REB). It was noted that the REB of record should be added to the annual summary of research activity. Informed Consent for Research In follow up to the last CSQS meeting, a comprehensive checklist has been developed to ensure a more robust evaluation of the requests that are received. The recruitment process ensures that privacy is maintained at all times as the Champlain CCAC will first speak with any eligible participants to determine whether their names may be shared with a researcher. The REB of record will be added to the checklist. There was agreement from the Committee to accept the Informed Consent Guidelines for Research.

Champlain CCAC Board – October 9, 2013

Item 3.3– Client Services, Quality and Safety Committee Report PAGE 2

Board Scorecard Progress on intake and service access metrics for August was provided. As per the Multi-Sectoral Accountability Agreement (MSAA), the 90th percentile wait time from community setting to community home care service target is 66 days. This metric is impacted by the intake wait times and the service wait list. New referrals continue to increase, with approximately 4,000 received per month. The intake waitlist target was reduced from 700 to 450 and there are currently 624 clients waiting however this represents a snapshot and some clients may only be waiting for hours. The highest needs clients are serviced first and 89% of the referrals are processed in less than 14 days. The wait from time of assessment to first service has decreased from 124.7 days in July to 79 days in August. Success in the intake metric is attributed to: 1) triage of the intake queue; 2) managers tracking performance metrics of staff; 3) change in the staffing model; and 4) hiring of additional staff. Success in Occupational Therapy/Physiotherapy (OT/PT) reduction has been related to concentrated waitlist reduction efforts with Service Provider Organizations (SPOs), and additional PTs/ OTs have been hired in Eastern and Renfrew. The 5 day wait time targets for Personal Support Services (PSS) and for Nursing are still under development with definitions and multi-year targets to be defined. There was discussion regarding the utility of targets for events and complaints given the work underway to encourage reporting. It was suggested that performance would be reported for information only and that ‘time of complaint to resolution’ would be a more appropriate measure to report on for complaints. Discussion of Plans to Balance the Budget Based on Latest Funding View During the week of September 23, the Champlain Local Health Integration Network (LHIN) confirmed an increase in funding in three separate letters. With the additional funding, the Champlain CCAC should be able to handle the anticipated additional funding gap operationally, without impacting client care. Additional funds may be forthcoming to support the 5 day nursing target and startup costs for physiotherapy. Dr. Denise Alcock on behalf of Diane Hupé Chair Sponsoring Executive: Deryl Rasquinha Vice-President, Performance and Strategy

Champlain

Board Scorecard

September 2013

(Data as of August 2013)

Champlain

Core Metrics

2

Legend

Good

Caution May or may not require a mitigation strategy

Attention Requires a mitigation strategy

Info Only Information only

Developmental

Service Delivery Excellence

Organizational Capacity and Performance

DRAFT

Client Trends Aug-12 Target Jul-13 Aug-13 FY 2013/14

4. Intake Waitl i s t 1,401 450 Clients 659 624 722

5. PSS Waitl i s t 340-25 clients

(RAI 16+)12 8 9

6. Adult OT/PT Therapy Waitl i s t 2.17 days or less

(RAI 16+)9.4 13.0 12.2

7. School Therapy Waitl i s t 37.028 days or less

(RAI 16+)45.0 35.2 36

8: Community Cl ients Requiring

Enhanced Services23 36 Clients 2 1 1

Organizational Health Target

1: Staff Turnover RatesQ1

11.7%10%

Q1

9.1%

Q1

9.1%

Q1

9.1%

2: Absenteeism Annualized Rate and

Cost

12 mnts to

Aug

10.0

1212 mnts to

Jul

9.4

12 mnts to

Aug

9.2

NA

Jul-13 Aug-13 FY 2013/14

3: Health & Safety Staff Events NA 10 6 4 6

4: % Education Hours 0.1% 1.0% 0.6% 0.3% 0.4%

Quality Aug-12 Target Jul-13 Aug-13 FY 2013/14

1: Service Wait Times: Community 111.0 66 days or less 124.7 79.0 113.3

1: Service Wait Times: Hospita l 19.0 3 days or less 18.0 18.0 15.3

2: Cl ient Events 20 40 42 55 45.2

3: Cl ient Complaints 64 100 44 50 57

4: % of OBC Wound Cl ients within

target Vis i tsN/A 80% 82% 85% 85%

7: ED Registration/Hospita l Admits

(QCH)513/105

444 clients/

117 clientsN/A 518 / 187 472 / 160

2012-Q1 2013-Q1 2013-Q1 2012-Q1

9: Medication Safety for Long Stay

Home Care Cl ients1.1% 1.4% 1.3% 1.3% 1.3%

10: Fa l ls for Long Stay Cl ients 31.5% 33.4% 37.8% 37.8% 37.8%

Financials / Sustainability Aug-12 Target Jul-13 Aug-13 FY 2013/14

1: Tracking to Monthly Financial

Targets+$1,481k

+ $138k per

month-$306k -$231k -$107k

3: Tracking to Avg. Cost/Client Budget

Expectations$711

$639/client($734 Summer)

$717 $726 $721

Provincial Comparisons 2012-Q1 2012-FY 2012-Q1 2012-Q1 2013-FY

6: Cost per Episode - Adult Short Stay

Acute$659

Prov Avg

$657$659 $659 $633

7: Cost per Episode - Adult Short Stay

Rehab$557

Prov Avg

$766$557 $557 $691

8: Monthly Average Cost - Adult Long

Stay Complex$913

Prov Avg

$923$913 $913 $913

9: Cost per Episode - End of Life $3,738Prov Avg

$5001$3,738 $3,738 $5,090

10: Monthly Average Cost - Long Stay

Medically Fragile Children$2,976

Prov Avg

$2825$2,976 $2,976 $2,961

Champlain

Enhanced Role Metrics

3

Legend

Good

Caution May or may not require a mitigation strategy

Attention Requires a mitigation strategy

Info Only Information only

Developmental

Leadership in Home & Community Care in an Integrated Health System

DRAFT

Acute Hospitals Aug-12 Target Jul-13 Aug-13 FY 2013/14

1: Home First Enhanced Volumes 67 72 Clients 86 49 76

2: % of clients remaining in

community after initial transition

from H2H

97.8%90% In

Community85.0% 92.9% 91.8%

3. Total Days & Number of Clients

Waiting for Home First Enhanced

Clients

2 clients

7 days avg.0

0 clients

0 days avg.

0 clients

0 days avg.

0 clients

0 days avg.

Sub Acute Hospitals Aug-12 Target / Baseline Jul-13 Aug-13 FY 2013/14

1: Volume of Placements to Other

Settings264 310 357 304 316

2: % of Spaces that CCAC is Managing 15% 0 15% 15% 15%

Long Term Care Homes Aug-12 Target / Baseline Jul-13 Aug-13 FY 2013/14

1: % of LTCH placements with a

MAPLe score of 4 or 583.1% 78% or more 80.6% 84.2% 81.4%

2: Admission to LTCH from

Community/Hospital37.1%

% Hospital

40%31.5% 34.4% 36.6%

3: Percent of Clients on LTCH Waitlist

with CCAC Services58% 51% 69% 71% 67%

At Home Aug-12 Target Jul-13 Aug-13 FY 2013/14

1: Number of Clients in Community

(MAPLe 4,5)

2012/13 Q1

4,7614500 Clients

2013/14 Q1

5,397

2013/14 Q1

5,397

2013/14

Avg

5,397

2: Number of Clients in Community

85 & Over6,268 6276 clients 6,852 7,725 6,725

Primary Care Aug-12 Target Jul-13 Aug-13 FY 2013/14

1: Number of Referrals from

Physicians563 550 528 516 511

Adult Day Program Aug-12 Target / Baseline Jul-13 Aug-13 FY 2013/14

1: Waitlist Volume 150 138 173 174 158

ALS-HRS Aug-12 Target / Baseline Jul-13 Aug-13 FY 2013/14

1: % of clients placed into ALS-HRS

with a Moderate or above MAPLe61.5% 80.0% 90.9% 100.0% 95.2%

2: Waitlist Volumes 142 109 68 63 75

CSS Aug-12 Target / Baseline Jul-13 Aug-13 FY 2013/14

1: Referral Volumes TBD TBD TBD TBD TBD

2: % of clients referred where CSS

accepted the clientTBD TBD TBD TBD TBD

Champlain CCAC Board of Directors - October 9, 2013 Generative Discussion: Governance as Leadership

Introduction: Organizational development and evolution literature demonstrates that the Governance

function has evolved considerably over time. While this evolution can be categorized in specific

governance/management models (Agency, Stakeholders, Stewardship), it also seems that

organization themselves evolve within these general categories depending on their stage of

maturation.

While there are some recognized governance practices established, there remains a wide

variation in how Board of Directors exercise their stewardship responsibilities and how the

delegation of authority is defined to the leadership of the organization.

This grey zone between what constitute good governance and appropriate level of delegation

to leadership/management is evolving based on research, practice and a specific set of

considerations unique to every organization (level of maturity, type of organization, specific

sector of operation etc….)

Champlain CCAC Context: The Governance Committee of the Board of Directors identified that there would be value in

having the opportunity for a generative discussion on what constitutes best governance

practice at this time, particularly as the organization is in the process of developing a new

Strategic Plan. Understanding and shared vision would also provide good guidance to staff and

could also lead to even better governance practice of the organization within the context of a

dynamic and challenging health care environment.

Objectives:

To achieve shared understanding on the role of Governance at the Champlain CCAC

Identification of Board Leadership in the context of Strategic Issues

Reflection on the role of a Board Member in leading strategy and strategic issues

Participants:

Sherryl Smith, Moderator

Michael Miles, Director, MBA Program, Telfer School of Management and Centre on Executive Leadership


Questions: The discussion will be focused around the following thematic questions:

1. What are the truly strategic areas that the Board of the Champlain CCAC has been and needs to address over the timeframe of the 2013 Strategic Plan?

2. What would Champlain CCAC Board members have to do to be seen as leaders around

these areas – what would individual Board member leadership look like and what would collective Board leadership look like?

3. How could the Board measure their leadership quotient (i.e., the degree to which those

they represent see them as true leaders) in their role as strategy formulators and promoters?

Format:

No PowerPoint needed;

Open discussion format for each question with guest and Board

Board Workshop

October 9, 2013

Strategic Plan 2014-2016

© 2013 All rights reserved

Goals for today

1. Consider feedback from staff

2. Refine Mission, Vision and Values Statement

3. Refine Emerging Strategic Directions

1


Agenda

1. Progress on current strategic plan

2. Staff survey results

3. Principles for Mission and Values

4. Refine Mission, Vision and Values Statement

5. Refine the Emerging Strategic Directions

2

Progress on current Strategic

Plan


Progress

4

Refer to separate document

Assessment of Progress Against the Champlain CCAC 2011-13 Strategic Plan

Staff Survey Feedback

For Strategic Plan


Staff Survey Feedback for Strategic Plan

6

Survey is available to staff until October 4th

Consolidated results will be presented at the Board Meeting

Mission, Vision & Values

Recap


Key Definitions

Vision: Outlines Goals and Aspirations for the future

Describes what the organization wants to be

Should serve as a source of inspiration

Mission: The fundamental purpose of an organization

Describes why it exists and what it does to achieve its vision.

Values: Beliefs that are shared by an organization

Values drive an organization's culture and behaviours

8


Vision, Mission, Values Original Option 3

Option #3 from September 11th Board Meeting:

9

Vision Leading innovation and excellence in community health care

Mission to provide quality care and system leadership through innovation and partnerships to improve the health of people in our communities

Values by being caring, collaborative, accountable and innovative


Vision, Mission, Values - Alternative 1

Updated: Bold Vision and Additions to Mission:

10

Vision Health Care Reimagined in Community Settings

Mission to provide quality care and leadership through innovation and partnerships to improve the quality of life for people in our diverse communities

Values by being collaborative, transparent, client-focused and compassionate



Updated: Bold in a Shorter Version:

11

Vision Health and Care Reimagined

Mission Partnering and providing care to improve the health of people in our diverse communities

Values by being client-focused, collaborative, respectful, innovative, and transparent



Updated: Re-Worded:

12

Vision Community Health Care Reimagined

Mission to provide innovative, quality care to improve the quality of life for people in our diverse communities

Values by being compassionate, collaborative, accountable and respectful



Updated: Speaking Directly to the Public:

13

Vision Your Health Care Reimagined

Mission to partner with you and your circle of care to keep you healthy at home

Values by being collaborative, inclusive, innovative, and creative


Principles

For each Vision, Mission and Values option, verify the statements against the principles:

Easily understood by our clients (lay-person)

Simple, concise and memorable

Inspiring and Powerful

Good French translation

14


Reviewing the DRAFT Statements

15

Criteria Alternative #1 Alternative #2 Alternative #3 Alternative #4

Easily Understood

Simple

Concise

Memorable

Inspiring

Powerful

Good French translation


Draft Statement

16

Vision

Mission

Values

Emerging Strategic Directions


Background

Members of the Board of Directors, Strategic Operations Committee (SOC), and Leadership, have provided numerous insights that can help inform Champlain CCAC Strategic Directions

This long-list of Emerging Strategic Directions is neither Mutually Exclusive nor Collectively Exhaustive

The list represents the breadth of ideas generated during initial Strategic Planning workshops

18


Preliminary Themes

19

Focusing on Client Centred Care

Ensuring Patient Privacy and Confidentiality

Empowering Clients

Increased Focus on Client and Family

Ensuring Equitable Access

Leading Innovation and Change

Leading Innovation through Community Clinical Research

Using Evidence Based and Best Practice

Ensuring Quality Outcomes

Prioritizing Safety

Active System Planning

Driving Integration and Partnerships

Drivers of Integration and System-Level Improvements

Increasing System-Level Sustainability

Refocusing to meet the Shift in Populations, specialities, complexities

Building Resources and Capacity

Focusing on Our People and promoting Employee Development

Promoting and Sustaining Lean and Efficient Operations

Safe and Efficient Transitions

Technology to drive Quality Improvements for Client Care

The similar considerations have been grouped into 5 Categories in the next 5 slides:

The following list of considerations have been generated from all inputs to date:


5 Emerging Strategic Directions

1. Patient-Centred Care

2. Culture of Innovation and Leadership

3. Improving Value for Patients (Clients)

4. System Thinking

5. Enabling and Empowering our People

20


1. Patient-Centered Care

Focusing on Client Centred Care (flexibility)

Empowering Clients

Increased Focus on Client and Family / Caregiver

Ensuring each client has Equitable Access

21


2. Culture of Innovation & Leadership

Build awareness of CCAC (who we are, what we do and what we can do for you)

Leading Innovation and Health System Change

Leading Innovation Through Community Clinical Research

Using Evidence-based Best Practice

22


3. Improving Value for Patients

Ensuring Quality Outcomes

Prioritizing Safety

Safe and Efficient Transitions

Technology to drive Quality Improvements for Client Care

23


4. System Thinking

Driving Integration and Partnerships

Drivers of Integration and System-Level Improvements

Active System Planning

Increasing System-Level Sustainability

Refocusing to Meet the Shift in Populations, Specialities, Complexities

Building CCAC awareness and brand recognition

24


5. Enabling and Empowering our People

Developing our Resources and Capacity

Recognizing Our People

Employee Development (new opportunities)

Promoting and Sustaining Lean and Efficient Operations

Linking new strategy to individual performance (PDP) - what is the employee expected to do differently?

25

Assessment of Progress Against the Champlain CCAC 2011-13 Strategic Plan PAGE 1

Assessment of Progress Against the Champlain CCAC 2011-13 Strategic Plan

The following analysis captures Champlain CCAC’s progress and gaps against the 2011-13 Strategic Plan. A summary of F2011-13 Strategic Plan is found in Appendix A.

Successes & Gaps Strategic Direction Successes Gaps Service Delivery Excellence

Delivery on key programs – Home First; Retirement Home Physiotherapy; CCAC Expanded Role for Adult Day, ALS-HRS, CCC/Rehab in select hospitals; Client Care Model phase1 & 2 Implementation (for Population based care); Improved / safer transitions (Hospital-Home; Home-CSS; Home-LTCH)

Excellence recognition – Dementia Project (Recognition from Regional Geriatric Program for Excellence in Geriatric Care); Elder Mediation (Outstanding Projects award by 5

th

World Summit on Elder Care; External recognition of Champlain CCAC’s work through presentations at conferences, media

Best practice leaders – Wound pathways Hip/Knee pathways

Integrated care leaders – Integrated point of access for hospice palliative care beds and acute palliative beds

New Mandates – Adoption of new mandates including : Nursing initiatives; Retirement home physiotherapy; Expanded role for system wide navigation

Waitlist Reduction – At intake, and for PT/OT services

Quality Program launch- Annual quality improvement program; Frameworks for ethics, risk, resource prioritization, A4R; Integrated events reporting; Nearing Excellent Care for All Act (ECFAA) Compliance

Client Experience Results – Improved year/year results for last 3 years

Keeping Pace with Client Demand - Need more focus on innovation, process improvement, etc. to address funding gap to keep up with client demand and keep push on quality care outcomes

Client Care Model (population based care) implementation completion – Not anticipated to be done in 2011-13. It is a multi-year journey that needs to continue

Safe Transitions – Focus needs to continue, especially in light of growth of client acuity, to support safe transitions between health service providers and CCAC

Quality and Client Safety Journey – Quality and client safety journey needs to continue to build on initial momentum gained

Challenge of Moving to higher acuity, heavier care needs clients.


Strategic Direction Successes Gaps Leadership in Home and Community Care in an Integrated Health System

ALC Reductions – Significant contributor to Champlain LHIN ALC results via programs like Home First

CSS Integration – Support for CSS sector via shared services operations for 40 agencies

Partner Integration – CCAC information sharing with 165 LHIN Programs across 140 organizations, electronically

CCAC Expanded Role - for Adult Day, ALS-HRS, CCC/Rehab in select hospitals, and for Regional Hospice Program

Health System Integration o Much more work to do to support integrated client care,

across multiple HSPs o Ongoing participation in Health Links, and Primary Care

Networks to focus on high needs, high cost clients o More integration work with Acute care, CSS, and primary

care to support safer transitions, and integrated client care

Research and Program Evaluation o Have not significantly moved the research agenda to get

to aspirations of being a “Teaching CCAC “ o Formal Program Evaluation function just being launched

Organizational Capacity and Performance

Communications and Stakeholder Engagement Plan 2013-15

Integrated HR and Talent t Management Plan adopted

Employee Engagement – Significant improvement in employee survey results 2010/ 2013

2012 National Work life Balance Survey findings healthy work culture at Champlain CCAC

Best Employer Recognitions o Silver – OHA Healthy Workplace (2012) o Shortlisted for Canada’s top 100 employer (2013)

Capacity Development – Deployment of automated performance management system; enhanced eLearning system

Orientation and onboarding efficiencies Infection Prevention and Control Program-significant

progress

Employee Health and Safety – Healthy Work Environment Framework ; ) Health & Safety event reporting increased

French Languages Services- Designation plan approved by LHIN

Robust Ethics Program- Developed and Implemented

Emergency Management System- Improved and Automated.

Communication & Stakeholder Engagement – still working to increase CCAC branding & general population awareness of CCAC

Workforce Planning – More focus on workforce planning to support population-based care implementation, and to address emerging greying workforce.

Staff Capacity Development – Ongoing journey requiring ongoing focus, as CCAC role evolves

Staff wellness and safety – Ongoing journey requiring ongoing focus

Succession Planning -completed after last Strategic Plan adoption and will need to be repeated.


Strategic Direction Successes Gaps Others Financial stability – F2010 ($5M surplus); F2011 ($1.6M

deficit); F2012 (Balanced)

Accreditation with Exemplary Standing – and two national leading practices recognized by Accreditation Canada

Board governance functioning tools; staff governance structures; board-staff alignment

Improved LHIN relationship, MPP relationship, HSP partner relationships

Swing to positive media coverage

Business Intelligence – Vastly improved information management, and informed evidence based decision making


Appendix A

Champlain

Risk Management Risk Appetite


October 9, 2013

1

Champlain

Risk Management

• Review Risk Management Program at the Champlain CCAC

• Risk Appetite

• Previous Results

• New Exercise

• Next Steps in the program

Risk Management Purpose

2

Champlain

Risk Management Risk Management Program

Framework Categories Tools

3

Champlain

Risk Management

• In the last year, the Risk Management Program has been utilized in many different areas:

• Mental Health and Addictions Program

• Short Stay PSS (Personal Support Services)

• Community Discharge Team (Peds and CHEO)

• Outcome Based Care

• Staff Immunization Policy

• Recruitment and Selection

Risk Management Program

4

Champlain

Risk Management

• Why do we conduct this exercise?

• Risk appetite is strategic and relates to the pursuit of the organization’s objectives

• Helps guide the allocation of resources

• Guides an organization’s decisions in the implementation of risk mitigation strategies

• Provides Staff and Management with a baseline in the management of risk

• Where is the Risk Appetite utilized?

• Board Decision Making Framework

• Executive Committee Decision Making

• Project Risk Management Tools

• Risk Categories

• Risk Management Framework


5

Champlain

Risk Management Categories

6

Champlain

Risk Appetite 2012 Risk Levels

-1

1

3

5

7

9

11

Financial &Resource Risk

Reputation &Public Image

Risk

Legal &Compliance

Risk

Service Quality& Client Safety

Risk

Information &Technology

Risk

EnvironmentalRisk

HumanResources Risk

CorporateGovernance

Risk

Standards Risk

5

4

1 1 1

5

3

3

8

4

7 7

5 3

1

3

6

2

7

4 4

6

6

1 1 1

Current Level of Risk (2012 Results - Board)

High-Very High Medium Very Low-Low Unsure7

Champlain

Risk Appetite 2012 by Category

0

1

2

3

4

5

6

7

8

9

10

Financial &Resource Risk

Reputation &Public Image

Risk

Legal &Compliance

Risk

Service Quality& Client Safety

Risk

Information &Technology

Risk

EnvironmentalRisk

HumanResources Risk

CorporateGovernance

Risk

Standards Risk

2

4

7

2

4

1

2

5

5

3

2

6

4

5

4

5

3

4

2

1

1

2

4

5

3

1 1

Risk Appetite (2012 Results - Board)

Zero Risk Appetite Low Risk Appetite Modest Risk Appetite Moderate Risk Appetite High Risk Appetite Unsure

8

Champlain

9

Risk Management Categories and Sub-Categories

Some minor revisions to sub categories in preparation for risk appetite exercise

Champlain


A risk appetite is a company-wide statement of the amount of risk that is acceptable in day-to-day affairs.

10

http://www.surveymonkey.com/s/G7HV58S

Champlain

Next Steps with the Board

Risk Appetite Survey

• Year 2 with Board and Strategic Operations Committee (SOC)

• Results to be shared at November Board meeting

11

Champlain

2013 Employee Engagement

Survey

Organizational Results

Board of Directors – October 9, 2013

Champlain 2

Employee Engagement

A heightened emotional connection that an employee feels for his or her organization, that influences him or her to exert greater discretionary effort to his or her work.

Conference Board of Canada

The ability to capture the heads, hearts and souls of your employees to instil an intrinsic desire and passion for excellence.

Gallup Organization

Champlain

• Employee Engagement

• Individual Outcomes

• Job

• Management Trusting Employees

• Organizational Outcomes

• Organizational Supports

• Performance Management

• Work Environment

3

Survey Structure

55 questions in 8 themes

5 supplemental questions

for Champlain CCAC

NRC Picker • New survey organization, new survey, new strict scoring approach

Champlain 4

Survey Response Rate

2008 2010 2013

68%

72%

76%

521 responses

Sector response rate average: 73%

Champlain 5

Overall Results by Theme

Theme Champlain

CCAC CCAC Sector

Champlain vs. Sector

National Acute

Average

National Non-Acute

average

Employee Engagement 57% 56% +1 58% 67%

Individual Outcomes 59% 56% +3 61% 66%

Job 72% 68% +4 66% 70%

Management Trusting Employees

55% 44% +11 - -

Organizational Outcomes 56% 55% +1 55% 63%

Organizational Supports 52% 48% +4 48% 58%

Performance Management 36% 33% +3 - -

Work Environment 67% 66% +1 60% 64%

Champlain 6

Engagement Theme

Champlain

CCAC

CCAC

Average

National

Acute

Average

National

Non-Acute

Average

Employee Engagement Theme 57% 55.8%

Proud to tell others I am part of

the organization 67% 65.7% 69% 76%

Values similar to organizations values 60% 61.4% 63% 70%

Organization inspires the best

job performance 48% 46.8% 48% 61%

Satisfaction with current job 73% 69.2% 71% 76%

Look forward to going to work 16% 17.9% 20% 40%

Rate CCAC as a place to work 77% 73.9% 75% 79%

Champlain

Our Highest Rankings

Champlain

Our Lowest Rankings

8

Champlain 9

Champlain specific questions

2013 2010

In my team, we have the opportunity to provide and receive feedback in order to improve quality and safety.

71%

My organization effectively balances the need for patient safety and the need for productivity.

56%

Overall, I think Champlain CCAC is heading in the right direction to achieve our strategic plan and our vision of Outstanding care in the Champlain region, every person, every day, every community.

59%

I am held accountable for my own performance. 90% 82%

I would feel comfortable raising an ethical concern. 79% 76%

Champlain 10

Major Trending 2010 to 2013 Reported by NRC Picker

Concept 2013 2010 2010 vs. 2013

Staff Health & Wellness 76% 51% +25%

Decision Input 53% 31% +22%

Ability to Take Initiative 70% 51% +19%

Trust 50% 31% +19%

Comment Themes

• Workload

• Rate of Change

• Work Environment

• Technology

‘How can your organization improve?’

Total Responses: 255

• Training

• Navigator

• Acting on Staff Feedback

Champlain

Communications • Increased presence of senior leaders in all offices/locations

• Organizational Communications Plan

• Conversations with Staff forum (strengthened)

Awareness and involvement of staff • Continue involvement of staff in decision-making and process improvements

• Increase staff engagement in planning, awareness of leadership activities, decisions, and follow-up.

Performance Management • Web-based performance management system

• Compliance and follow-through on Performance Agreements and Appraisals for all staff.

• Attendance Management Program

• Development on coaching/feedback skills, difficult conversations

• Manager presence: visibility & presence in person or virtually

Leadership and Direction • Increase presence, access and visibility to members of management team.

• Strategic alignment & communication via leadership meetings & coordinated internal communication.

12

2010 Action Plan Highlights

Champlain 13

Progress in critical areas from 2010 (as per NRC Picker)

Theme 2013 2010

Decision input 53% 31% +22%

Leadership – communication 63% 47% +16%

Leadership - Responsive 37% 33% +4%

Trust 50% 31% +19%

Trust and Ethics 55% 43% +12%

Performance management (poor performers managed) 28% 19% +9%

Performance management (excellent performance recognized) 43% 40% +3%

Performance management (I’m held accountable…) 90% 82% +8%

Champlain

Priority Areas

Work to improve these areas first Can trust this organization

Organization values work

Leaders trust employees

Rate opportunity to advance in career

Rate recognition for good work

Work to maintain these areas Rate opportunity to make improvements in work

Organization promotes staff health and wellness

Rate opportunity to take initiative

Rate ability to decide how to do work

Rate opportunity to use skills

Champlain

Step Detail Timeline

Initial Analysis

• OPSEU, CUPE, & Worklife Balance surveys • Results by data type (branch, job type,

group, team • Comments

August-September

2013

Communication, Consultation, Stakeholder

Analysis

• September Staff Conversations • Directors: business line data • Managers: team data • Manager/Team consultations & other focus

groups

September / October 2013

Final Action Planning

• Organizational • Functional Groups • Teams

November 2013

15

Next Steps

Champlain 16

Discussion

minutes board of directors meeting held october 9, 2013 head office boardroom...

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