2013-14 Statement of Priorities - Department of …docs2.health.vic.gov.au/docs/doc...To further...

Department of Health

2013-14 Statement of Priorities

Agreement between Minister for Health and Latrobe Regional Hospital

Latrobe Regional Hospital

Statement of Priorities 2013-14 2

Contents Background 3

Policy directions 3

Part A: Strategic overview 5

Mission statement 5

Service profile 5

Strategic planning 6

Strategic priorities 6

Part B: Performance priorities 8

Financial performance 8

Access performance 8

Service performance 9

Part C: Activity and funding 10

Part D 11

Accountability and funding requirements 12

Signature 12



Background Statements of Priorities (SoP) are key accountability agreements between Victorian public health services and the Minister for Health. The annual agreements facilitate delivery of or substantial progress towards the key shared objectives of financial viability, improved access and quality of service provision. The content and process for preparation and agreement of the annual Statement of Priorities is consistent with sections 65ZFA and 65ZFB of the Health Services Act 1988 (Vic).

Statements of Priorities are consistent with the public health services’ strategic plans and aligned to government policy directions and priorities.

A Statement of Priorities consists of four parts:

• Part A provides an overview of the service profile, strategic priorities and deliverables the health service will achieve in the year ahead.

• Part B lists the key financial, access and service performance priorities and agreed targets.

• Part C lists funding and associated activity.

• Part D forms the service agreement between each health service and the state of Victoria for the purposes of the National Health Reform Agreement (NHRA).

The mechanisms used by the Department of Health to formally monitor health service performance against the Statement of Priorities are outlined in the Victorian Health Service Performance Monitoring Framework 2013-14 Business Rules.

Policy directions The Victorian Health Priorities Framework 2012–2022 (VHPF) sets out the following 5 key outcomes the health system should strive to achieve by 2022:

• People are as healthy as they can be (optimal health status)

• People are managing their own health better

• People enjoy the best possible health care service outcomes

• Care is clinically effective and cost-effective and delivered in the most clinically effective and cost-effective service settings

• The health system is highly productive and health services are cost-effective and affordable

It also articulates seven priorities which reflect the Government’s policy ambition to build a strong health system for all Victorians. The focus is on:

• developing a system that is responsive to people’s needs

• improving every Victorian’s health status and experiences

• expanding service, workforce and system capacity

• increasing the system’s financial sustainability and productivity

• implementing continuous improvements and innovation

• increasing accountability and transparency

• making better use of e-health and communications technology

These priorities are fundamental to Part A of the SoP and require address by health services.



Government commitments

Victoria has long been a leader in driving efficient health services. The Government’s commitment to quality and efficiency will build an affordable health system for the long term ensuring that Victoria is well placed to address future challenges associated with a growing and ageing population, and greater rates of chronic and complex health conditions. In this context, the department will work with service partners to build a health system that is integrated and responsive to the changing needs of the community. Specific commitments made by the Government in 2013-14 relate to:

• Growing essential hospital services including capacity for critical care and elective surgery across the system

• Implementing mental health reforms, supporting mental health initiatives and growing mental health services

• Boosting alcohol and drug services, including alcohol prevention programs and specific alcohol and drug awareness campaigns

• Improving cardiovascular disease health outcomes and reducing readmission and disease progression rates through better management and support for people with chronic heart failure

• Training our future health workforce by providing additional clinical training positions for undergraduates, postgraduates and rural GP proceduralists

• Establishing a Health Innovation and Improvement Fund to support improvements in efficiency, quality, safety and patient centred care

• Implementing an infection prevention and control strategy to improve patient outcomes and reduce the cost burden of health associated infections in Victorian public health services

• Improving health outcomes for Aboriginal Victorians through the provision of culturally appropriate service options

• Increasing support for older people and younger people with a disability through the Home and Community Care (HACC) program to assist them to remain in their home

• Meeting the needs of refugees and asylum seekers through the provision of timely intervention and preventative care in primary care settings in high settlement areas of Victoria

• Improving health literacy about maternity care through the development of consumer information and piloting of a statewide parenting kit

• Increasing the availability of information for senior Victorians to support them to live independently in their own home for longer

• Boosting community health services, particularly in growth areas

• Reducing preventable disease in support of Victoria’s Healthy Together Community Strategy and via various public health initiatives

• Supporting telehealth projects that will improve co-ordination and care for patients, and support the delivery of care closer to where people live

• Supporting additional health capital projects and infrastructure improvements including the Werribee Mercy Hospital Mental Health expansion, The Waurn Ponds Community Hospital and Northern Hospital expansion



Part A: Strategic overview Mission statement � We will be a leading regional healthcare provider delivering timely, high quality, accessible,

integrated and responsive services to the Gippsland community.

CORE VALUES

� Patient-centred care, Working Together, Excellence, Integrity

STRATEGIC DIRECTION

� Enhance services available to the community

� Improving service models

� Improving quality

� Enabling people

� Developing the workforce

� Supporting education, training and research

� Developing infrastructure

� Developing partnerships

Service profile

PROFILE

� Fully integrated regional public health service located in Traralgon West

� Nine community mental health services across Gippsland

� Services include acute health, sub-acute, aged care and mental health

� Regional services including medical and radiation oncology, orthopaedics and mental health

� Serving a population of over 75,000 in the Latrobe Valley and over 260,000 across Gippsland

� 2013-14 Gross Operating Revenue approximately $185M

� Teaching hospital affiliated with Monash University

PRIORITIES

� Understand and address the health needs of the Gippsland population.

� Deliver accessible and quality healthcare that is relevant to the health needs of the Gippsland population.

� Ensure a sustainable health service.

� Continue to develop Latrobe Regional Hospital to meet the foreseeable future health needs of Gippsland.

� Over 2013-14, LRH will complete a number of capital projects including stage 2 of Gippsland Cancer Care Centre, Expansion of allied health department, new subacute ambulatory facility, additional mental health high dependency beds and a new mother baby unit.

� To further enhance provision of home based services, LRH will alter current arrangements for home based nursing and directly deliver nursing services for post acute care, hospital in the home and residential in-reach programs in 2013-14.



Strategic planning

Latrobe Regional Hospital Strategic Plan 2013 – 2018 is currently being finalised and, when completed, can be read at www.lrh.com.au

Strategic priorities The Victorian Government’s priorities and policy directions are outlined in the Victorian Health Priorities Framework 2012-2022.

In 2013-14 Latrobe Regional Hospital will contribute to the achievement of these priorities by:

Priority Action Deliverable

Developing a system that is responsive to people’s needs

• Implement formal advance care planning structures and processes that provide patients with opportunities to develop, review and have their expressed preference for future treatment and care enacted.

• Investigate the suitability of incorporating Advanced Care Planning with the Pathway for Improving the Care of the Dying.

• In partnership with other local providers apply existing service capability frameworks to maximise the use of available resources across the catchment

• Establishment of Mother-baby service at LRH.

• Establishment of an in-reach

residential program

Improving every Victorian’s health status and experiences

• Improve thirty-day unplanned readmission rates.

• Consider expansion of electronic discharge summaries to all local GP practices.

• Consider new models of care and more coordinated services to respond to the specific needs of people with priority clinical conditions.

• Complete Allied Health redesign which will identify opportunities for future models of care.

• Complete stage 2 of Gippsland Cancer Care Centre and plan for future services.

• Implementation of a clinical pathway with Central Gippsland Health Service for orthopaedic patients from pre-admission to rehabilitation.

• Optimise alternatives to hospital admission.

• In-reach residential care program implemented.

• Complete review and commence the delivery of a home based nursing service.



Expanding service, workforce and system capacity

• Support excellence in clinical training through productive engagement in clinical training networks and developing health education partnerships across the continuum of learning.

• In partnership with the Gippsland Clinical Training Network and Monash University School of Nursing establish student led primary clinic and enhance use of simulation teaching environments.

• Work collaboratively with the department on service and capital planning to develop service and system capacity

• Review of Masterplan

• Commence tender and construction of a four bed High Dependency unit.

• Complete construction of 4 additional Mental Health High Dependency beds

Increasing the system’s financial sustainability and productivity

• Reduce variation in health service administrative costs.

• Lead and contribute to the implementation of system improvements, partnerships and collaboration within the Gippsland region.

• Identify opportunities for efficiency and better value service delivery.

• Cooperative regional or sub-regional approach to pharmacy.

Implementing continuous improvements and innovation

• Develop and implement improvement strategies that better support patient flow and the quality and safety of hospital services.

• Introduce the Productive Operating Theatre and continue the rollout of the Productive Ward.

Increasing accountability & transparency

• Prepare for commencement of proposed new mental health legislation in 2014.

• Development of a strategic action plan by the Mental Health Services, incorporating an education and communication strategy, to enable the new legislation to be implemented in 2014.

• Implement systems that support streamlined approaches to clinical governance at all levels of the organisation.

• Integrate risk management systems with the National Safety and Quality Health Service Standards.

Improving utilisation of e-health and communications technology.

• Trial, implement and evaluate strategies that use ICT as an enabler of better patient care.

• Stage 2 of CHARM Chemotherapy Clinical Decision Support and Management software across five regional chemotherapy sites.



Part B: Performance priorities Financial performance

Key performance indicator Target

Operating result

Annual operating result ($m) $1.0m

WIES (1) activity performance

Percentage of WIES (public & private) performance to target 100

Cash management

Creditors < 60 days

Debtors < 60 days

Access performance


Emergency care

Percentage of ambulance transfers within 40 minutes 90

NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (July – December 2013) 75

NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (January – June 2014) 81

Number of patients with a length of stay in the emergency department greater than 24 hours 0

Percentage of Triage Category 1 emergency patients seen immediately 100

Percentage of Triage Category 1 to 5 emergency patients seen within clinically recommended times 80

Elective surgery

Percentage of Urgency Category 1 elective patients treated within 30 days 100

NEST - Percentage of Urgency Category 2 elective surgery patients treated within 90 days (July – December 2013) 80

NEST - Percentage of Urgency Category 2 elective surgery patients treated within 90 days (January – June 2014) 88

NEST - Percentage of Urgency Category 3 elective surgery patients treated within 365 days (July – December 2013) 94.5

NEST - Percentage of Urgency Category 3 elective surgery patients treated within 365 days (January – June 2014) 97

Number of patients on the elective surgery waiting list (2) 935

Number of Hospital Initiated Postponements (HiPs) per 100 scheduled admissions 8

(1) WIES is a Weighted Inlier Equivalent Separation. (2) The target shown is the number of patients on the elective surgery waiting list as at 30 June 2014.



Service performance


Elective surgery

Number of patients admitted from the elective surgery waiting list – quarter 1 1,311


Number of patients admitted from the elective surgery waiting list – quarter 3 993


Critical care

ICU Number of days below the agreed minimum operating capacity (1) 0

Quality and safety

Health service accreditation Full compliance

Residential aged care accreditation Full compliance

Cleaning standards Full compliance

Health care worker immunisation - influenza 75

Hospital acquired infection surveillance No outliers

Hand Hygiene (rate) 70

SAB rate per occupied bed days(2) < 2/10,000

Victorian Patient Satisfaction Monitor: (OCI) (3) (July to December 2013) 73

Consumer Participation Indicator (4) (July to December 2013) 75

Victorian Hospital Experience Measurement Instrument (5) (January to June 2014) Full compliance

People Matter Survey Full compliance

Maternity

Percentage of women offered prearranged postnatal care 100

Mental Health

28 day readmission rate 14

Post-discharge follow up rate 75

Seclusion rate per occupied bed days < 15/1,000

(1) The agreed minimum operating capacity is 5 ICU equivalents, increasing to 6 ICU equivalents from 1 October 2013.

(2) SAB is staphylococcus aureus bacteraemia.

(3) The target for the Victorian Patient Satisfaction Monitor is the Overall Care Index (OCI) which comprises six categories.

(4) The Consumer Participation Indicator is a category of the Victorian Patient Satisfaction Monitor.

(5) The Victorian Health Experience Measurement Instrument (VHEMI) will succeed the VPSM as the instrument for measuring patient experience.



Part C: Activity and funding Funding type Activity Budget ($'000) Acute Admitted

WIES Public 17,619 $76,748

WIES Private 1,148 $3,809

WIES (Public and Private) 18,767 $80,557

WIES DVA 306 $1,365

WIES TAC 96 $376

WIES TOTAL 19,169 $82,297

Acute non -admitted

Emergency Services $9,368

Specialist Clinics $4,932

Subacute & Nonacute Admitted

Rehab Public 12,969 $6,121

Rehab Private 814 $357

Rehab DVA 292 $167

GEM Public 6,958 $3,284

GEM Private 113 $50

GEM DVA 974 $556

Palliative Care Public 1,518 $716

Palliative Care DVA 87 $50

Transition Care - Beddays 8,395 $1,217

Transition Care - Homeday 6,935 $347

Subacute & Nonacute Other

Other specified funding $897

Subacute non -admitted

Victorian Artificial Limb Program $627

Health Independence Program $6,250

Health Independence Program - DVA $61

Mental Health and Drug Services

Mental Health Inpatient 15,598 $9,491

Mental Health Ambulatory 61,000 $22,453

Mental Health Residential 3,653 $343

Mental Health Service System Capacity $1,544

Mental Health Sub Acute 8,767 $3,473

Drug Services $125

Other

Other specified funding $3,973

Total Funding $158,700



Part D In 2012-13, the Commonwealth Government reduced funding to Victorian health services by $107 million. The Commonwealth Government decision to return funding of $107 million to Victorian hospitals and health services in 2012-13 was a one-off Commonwealth payment, leaving an ongoing Commonwealth shortfall in promised funding of $368 million over the next three years. In 2013-14, the impact is $99.5 million less than promised.

Period: 1 July 2013– 30 June 2014

Estimated

National Weighted Activity Units

Total Funding

Provisional Commonwealth

Percentage

Activity Based Funding 31,939 123,346,018 34.48%

Other Funding 29,226,151

Total 152,572,169

If the Commonwealth government returns funding of $99.5 million this financial year, Latrobe Regional Hospital budget will increase by $2.02 million.

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