Dawn Calder - Saskatchewan Health Authority | Regina … · Web viewBudget constraints are a real...

Q1 Report on StrategiesTable Handout and Discussion Guide

Answer Compilation

Table of ContentsDawn Calder (for Sue Neville)..................................................................................................................................................................................................................................... 4Carol Klassen.............................................................................................................................................................................................................................................................. 6JP Cullen (for Mike Higgins)........................................................................................................................................................................................................................................ 8Tamara Quine and Dona Braun (for Marlene Smadu)................................................................................................................................................................................................. 9Michael Redenbach................................................................................................................................................................................................................................................... 10Karen Earnshaw........................................................................................................................................................................................................................................................ 11Dr. McCutcheon......................................................................................................................................................................................................................................................... 12Sharon Garratt........................................................................................................................................................................................................................................................... 13Robbie Peters............................................................................................................................................................................................................................................................ 14

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Time Agenda ItemSession Notes

What encourages/excites you? What makes you nervous? What needs to be done differently? Other Comments12:30 CEO Introduction – Keith

Dewar� Getting started in 2-3 weeks� Patient Flow work being added� Stop talking about what you can’t

do, focus and deliver on what you can do

� Emphasis on clinical best practices in Q2

� Keith’s commitment to Lean methodology

� That you stated patient/family centred care as foundational

� Thinking about what we can do, not what we can’t do

� “Why we are here” definitions� Planning process� Doing little things right� Concentration on patient flow� Every small thing makes an

impact (re: alcohol swab)� Keith recognized that we need

basic infrastructure components in place

� Planning and reporting input/output framework

� Frontline managers are key to achieving financial sustainability

� With continued work at the management level, SLT continues to have trust we are doing our best to meet budget

� Focus of the region stays true� Always encouraging to hear Keith

speak. Its reassuring that our leader has a clear vision of where we’re going

� Commitment of all leaders in the org. moving towards targets

� Leaders driving personal agenda/projects vs. org. priorities

� Meeting expectations/service demands and current budget

� Sustaining quality of care with current budget

� Lack of progress on deficit� How we spend less money and

maintain quality patient/centred care and quality positive practice environment?

� Already been through the slash and burn process—it’s the worst way to go!

� Impact of financial constraints on service areas

� Continuous change� Short time frames� Budget landscape� Decreased resources makes it

challenging to manage ever increasing volumes

� Are we going to end up with a rebound surgical waitlist as a result of decreased ORs?

� We need to be serious about what we need to change in the next 4-6 weeks

� Keeping pace with last years’ paid hours

� Change needs to occur quickly; 3-4 months to change rosters

� Cost vs. Care

- Accountability for leaders, physicians, and staff

- Measure problems before working on them and focus on the “biggest bang” problems

- Give Keith longer to talk and slow down

- Focus on the “top 5” areas that are contributing to the deficit

- Do all employees understand the seriousness of the financial situation? They can have the greatest impact on decreased waste

- Do employees understand stewardship and do they care?

- Communicate the planning/reporting process to unit staff

- Reflect on the volume and paid hours

- Challenge frontline staff to get innovative (re: how can they contribute to decreasing the budget)

- Better PHC services- Control volumes (wait lists)- Asthma readmit work partnership- Empowering patients to have a

bigger voice- Diligent financial management- Listening to staff and managers- Suggestions as to how to manage

increased paid hours without laying people off

- Recruitment and retention to better manage staff time

- More details. Frontline managers

- Have a template for multi-year plans so they can all fit together and be separated and make sense at all levels

- For future Q Reports (lots of material, people leave, other attentions, etc.) maybe only half present, then they can talk about more achievements. Have the full Q Report available online.

- Do today’s work today. Don’t spend extra money to meet demand.

- What projects are flagged that cost money to save money? What should the whole group focus on to break the barriers to ensure prevention projects don’t become silo’d?

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� Possibility of layoffs for staff (never good for an organization)

� Budget constraints are a real concern and although we discuss resource allocation and appropriateness, the details of managing that with in-scope employees would better help me action those thoughts

� What is the KPOs role in reducing the deficit?

� Are we truly a 24/7 organization?� Possibility of losing

important/valuable care delivery for clients as we focus on driving out waste and work to limited resources

� Contradicting message at times from Ministry, CEO, SLT

� Government and ministry dictate from a philosophical position without considering the impact on the ground

� So we have to do everything but less of it?

� Increasing number of “stat” requests for support services

live in details. We need to know at a unit level what the 1, 2, 3, are.

- More interaction between disciplines

- Better balance to the “Betters”. Better Value is out of balance!

- Control the buying- Discussions with unions re:

vacancies and creative solutions- Engagement with RQHR vs.

engagement with your department/unit/co-workers/managers etc.

- Increase capacity of Lean methodology into service lines and drive down to the frontline staff to embed the principles. The hope would be to increase accountability and responsibility through the organization

- Incorporate new information into the work plan (i.e., accreditation, budget, flow, etc.)

- Volumes driven by physicians-

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What encourages/excites you? What makes you nervous? What needs to be done differently? Other Comments12:50

Dawn Calder (for Sue Neville)

� Patient Flow multi-year plan

� Making the data available (critical for physician engagement)

� Accountable Care Unit; knowing when teams discuss care

� FloCast great visual/easy for all to understand

� Patient Flow medicine example; needs clear and immediate corrective action

� Patients waiting less time in ER� Focused conversations: what

matters vs. what’s the matter� Family involvement in rounds� Data to measure and predict� Improving ED metrics� Emerging Flow metrics for

medicine units� Well-coordinated. Thoughtful

approach across functional areas. Flow team is building the framework and infrastructure required to advance this work

� Data/dashboards will be available� Great work to the Flow team!� Possibility of spreading the

Accountable Care Unit principles specifically the multidisciplinary rounds

� Patient Flow metrics; outcomes from the visioning session

� Decreased time for ANBs� We’re starting to get better� Length of stay in ED is trending

downwards� Improvement in trend line of

patient flow in ER

� D-Status accuracy (less than expected). Many units/people focus on “D”

� What are the balancing measures (i.e., patient wellness post discharge from acute service)

� Ensuring service line plans/work around flow is aligned with other multi-year and operational plans and not as standalone project work. I think this integration is key for imbedding and sustaining the work and culture around this

� Holding groups accountable� Triage will be ongoing work� Occupancy doesn’t equal flow.

Need less focus on occupancy and more emphasis on actual flow

� Nursing can only improve this so much, physician must be willing to change their current practices and write discharge orders the night before unless they round at 7am instead of 7pm—if this never changes we will never reach 80% discharge before 1100.

� Aggressive targets attached to ED waits

� Could get worse with the surgical slowdown

� A lot of flow issues seem to be physician driven

� Still don’t have funding for ACU� Gaps to achieve targets� Strategies to help improve

engagement would help

� Less talk, more walk� Corporate support areas absent

from visioning session (IT, HR, Facilities in particular) and from biweekly reports

� Need to share this info with units/staff

� Better use of analysis� Work needs to continue on new

metrics� Opportunity to have physicians

available for MDR to increase flow� Need to find a different place “to

meet” patients rather than ED� Thinking outside of the box and

recognizing that flow is a balance of internal and external factors

� Increased communication regarding how we are filling in gaps in patient flow

� Proactive vs. reactive approach� Enable processes to allow the use

of beds in other Regions� Think bigger. Involve all resources

to meet targets.

� I felt a gap at the visioning session. There is lots of focus on inpatient flow and PHC. There are other options to see some of the patients that come to emergency for consults. There could be a better place and time (e.g., early pregnancy clinic, ambulatory care for IVs, peds outpatients for children, etc.)

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� Improvements are being made and targets are being achieved

� Recognized provincially and nationally

� Good data� More action plans at the wall� Targets moved from red to green

recently� Data is visually easy to review

� Target still seems long for people to get a bed

� Discharge planning still needs work� Future improvements requiring

extra resources� Pushing patients out of ED so fast.

Focus on speed not accuracy or care. Does this increase costly readmissions?

� Changing metrics for supporting areas

� Ambitious goals needs organizational buy in

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Carol Klassen� IT/IM/Equipment

multi-year plan� Academic and

Research multi-year plan

� Reduced corrective maintenance in clinical engineering

� Simulation Lab and support� Use of Ennovation and SCM info

to provide real time patient flow metrics for medicine units

� Improvement in number of open work orders

� Gaining traction on research/academic agenda

� Good work!� Good progress on defining work

and plan in IT/IM� Good progress in HIMS� Will be helpful as you mentioned

to look at your progress and standard work

� Excellent work in eliminating clinical equipment downtime

� Vision and strategy looks very good

� Simulation centre is amazing� Strategic use of technology to

lead to safer care for patients� AIMS upgrade� Improvements in CES

preventative maintenance and decreased in failures/breakdowns

� FMU and Connect to Care initiative

� New RQHR website with better technology

� EHR discussions are exciting but taking too long to introduce

� Provincially standardized system

� IT/Clinical workload and capacity� Clarification on how you plan to

coordinate/obtain assistance from IHS regarding equipment needs/replacement

� Where is LTC in your plan?� Special Care Home guidelines;

Ombudsman Report; IT needs� Lack of provincial targets for IT/IM

infrastructure plan and planning� Transition to new ADT system

(timelines and ensuring standard work developed/deployed)

� Doesn’t seem that we have a concrete long term plan to address IT/IM/Equipment

� Lack of specific plan and strategy in place for research/academic areas

� Monetary constraints to implement IT upgrades/projects

� Access to information in a hybrid HIMS system. Increased chance of lost data and inability to access timely information

� Work needed to implement actual change

� Hospira pump rollout� Second campus in Regina� Number of work orders� Research concern re: demand on

lab services/lack of HR to support� Not always in attendance at events

(like ED Visioning Day). They impact so many things/projects

� All the areas of improvement

� Region standards for how IT/Clinical Engineering take on and support projects

� Evaluate LTC profile within the Region

� Consider a longer term IT/IM/Equip. plan (up to 20 years)

� Better integration of paper charts into health records. Increased risk to patient when the info can’t be accesses/does not travel with the patient

� Distribute patient info to PHC team� Staff need to be accountable for

how they use/treat equipment and the facilities

� Keep on top of research funding financials

� Need better ability to track data (e.g.. ventilation, etc.) to provide ability to see if our efforts are being effective

� What resources/tools/applications could be useful to units that other areas are using that people do not know about? Tell us about them!

� Lack of process to prioritize work� Hybrid health record� Engagement with improvement

projects. Did not participate in flow visioning session

� RPIW?� Provincial items taking a lot of time.

How can this be balanced?� Different/better transparency on

� Where are the medicine residents from Palliative Care listed or counted?

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� Increased use of clinical managers

� Prioritizing renewal of equipment process

� Working with HRF� Affiliation agreement with College

of Medicine

identifies IT/IM as a barrier on virtually every improvement project

� Number of internal/current projects causing a delay in future projects (i.e., physician order entry)

� Not a good balance between patient/client projects and business projects

� IT/IM touches everything. Much rework and wasted time are related to our technology not meeting our needs. Our progress often is stalled waiting for IT support in equipment and applications.

� Physician programs need to talk to our programs

� IT not being able to support our progress in a timely manner

choosing projects� Include related research academic

programs in your plan (e.g., clinical psych residency)

� Data = action� Better planning for end of life

schedules� Leverage provincial solution rather

than regional system development� Better PM schedules

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What encourages/excites you? What makes you nervous? What needs to be done differently? Other Comments

1:30

JP Cullen (for Mike Higgins)� Workplace Safety

multi-year plan� Employee

Engagement multi-year plan

� TLR audits� Span of control will be addressed� Self-serve run charts for

individual service areas and units� Sustaining gains of decreased

injuries� Increased participation in safety

training� More dialogue about staff safety

� Resources—who will complete the audits?

� Reality of it actually occurring� Manager capacity to be active

participants in all the endeavors targeted for improvement

� Length of time between engagement survey and informed action

� Targets not met� Span of control� Management capacity� Resources� Lack of progress with staff safety

� Should this be aligned better with, or integrated as part of, patient safety? Not understanding why this is a separate office dealing with each of these—duplication and misalignment

� Love the TLR audits� Engagement for managers� Accountability� Quicker response for high users of

sick time? Is it possible?� Address IT shortfall for training� Use PFCC as an example. Need to

break down the big concept of engagement into actionable items for HR and for the system leaders

� Post-injury huddle like a post-fall huddle

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2:05

Tamara Quine and Dona Braun (for Marlene Smadu)

� Patient- and Family-Centered Care multi-year plan

� Stop the Line multi-year plan

� Use of Driver Diagram shows some specific deliverables and actions for the problem

� Patients on interview panel� No harm by 2020� SHR Stop the Line (call centre)� Expansion of patient and family

advisory group� Design RPIW on Stop the Line

for equipment and supplies� Good work in both areas but lots

of heavy lifting� Family presence� Patients/families involved in all

committees across the region� Patients/families on interview

plans and Lean work� MDR at bedside� More patients at more planning

situations� Better transfusion consent� Better patient communication� Staff education� Appropriate patient signage� Love the culture shift!

� EMR progress is slow� Volume of work/rollout� Success largely depends on whole

org. engagement and consistency throughout application

� Staff education on PFCC—who will be responsible to deliver education?

� Slow development of Family Presence Policy across all services and units

� As Dona noted, culture shift for Stop the Line is integral but a huge challenge. Needs to be supported by overall policies including HR policies around harassment

� Increased time it will take to do MDRs at bedside; one more thing in an already change fatigued environment

� Timely disclosure of adverse events� Who is going to backfill care time?� 2017 goal is too broad so it doesn’t

translate into an accountable plan� Too many items in CAP. Need to

focus and prioritize� Taken too long to implement STL� Report at bedside should include

MRP. Will there be any accountability to ensure this happens?

� Deadline of March 2017 when our waitlists are 5-12 months now

� “Mission 0” by 2020� Targets for STL are not real. 100%

no hard will cost a lot of money.

� Don’t let “waiting for decisions” slow or stop the work

� Should Stop the Line/patient safety be closer aligned with workplace safety? It seems there is duplication and overlap

� Have been doing patient survey for months/years and now data is no longer collected and reported—why?

� Better transparency of defects� Be a strong advocate for these

initiatives to shift the culture� Focus on culture/engagement for

STL. Don’t waste so much time on readiness assessment and focus more on the engagement piece

� Find ways to support physicians so that representation on units for MDR is possible

� Continue messaging that occurrence and incident reporting is a good thing

� Include patient stories in areas where they can impact frontline workers (i.e., staff meetings)

� Medication error challenges

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2:25

Michael Redenbach� Seniors multi-year

plan� Mental Health &

Addictions multi-year plan

� VSM emphasis/desire� RPIWs not just thrown in� Anti-psychotic success� Quality of care vs. Quality of life� Tapping into all leader’s expertise� Focus on seniors and seniors

care/wellness� Keeping seniors in the

community as long as possible� Building on RPIWs development

and spread of standard work for post-fall huddles

� Improvements for residents as a result of decreased anti-psychotic drugs

� Daily visual management and distributed leadership in MH&A

� Odd message from Michael on the expectations we put on ourselves—we need to deselect

� Excited to see the impact of the work you are doing in MH&A

� Seniors friendly hospital� The NP at Pioneer Village� Community-based geriatrician� We are doing the best we

possible can for the people we serve (not because we are told to)

� Geriatric Program targeted funding

� LTC wait lists have decreased� Successful RPIWs� Partnership with CMHA� Balanced Care!

� Building infrastructure� Metrics for

guidelines/recommendations� System for tracking compliance with

program guidelines for Special Care Homes

� Integrated service planning is good but draws on staff for planning activities and is a concern

� Challenges with facilities in LTC and risk to staff and residents

� How to meet the guidelines of SCHA

� The condition at the LTC facilities—need to be safe and pleasant because it’s their home

� The number of mental health patients coming into the ER all the time (lacking outpatient supports)

� How will we prove that we are meeting guidelines?

� Quality of life in LTC

� Org. plans make for pressure on/in service line plans

� Elderly are most vulnerable so we need to change our attitudes and make them a priority. I was so happy to hear what you had to say about the work you’re doing with seniors

� More support for inpatient units that have mental health patients admitted for medical reasons

� Subsidize private care homes already present as they have more efficiencies and don’t need unionized staff

� Utilize down time in Home Care in LTC facilities for purposeful interactions

� Do more to make end of life better� Team up with the U of R. Psych

department is doing meaningful research into decreasing falls in seniors.

� Better incorporation and communication from LTC and acute centre teams

� What is the turn away profile and how can PHC link in to help get clients into MH&A services and how can PHC support mild and moderate cases?

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2:45 Karen Earnshaw� Primary Health Care

multi-year plan

� Physicians at Meadow� Huge amount of work/re-org

completed in Primary Health Care Network

� Progress on development and implementation of PHCN

� Great vision and progress in making changes and improvements

� Making progress� Care coordination at the system

level� Physician recruitment to Meadow� Everyday support for individuals

and communities� Have the right vision�

� Lots of change with concern for what that change has delivered

� Ensuring data/info flow is available to support the PHCN

� No overarching PHC strategy for the province from MOH

� Still have an acute focus—need to start integrating with master service plan and master facilities plan and start making the shift in where we focus

� Are the right people in place to address the needs of all patients?

� Change fatigues� Navigation, care coordination� ACSC worse than national average� Lots of patients still present to ED

that don’t have PHC team� Worst in Western Canada at

ambulatory admissions

� Focus on investments for change (eliminate wastes that don’t require investment)

� Need to invest to keep momentum and change culture and focus on PHC

� 2 of 6 chronic conditions are pulmonary, where are the RRTs? Redeploying RRTs from acute to PHC can decrease length of stay and readmission for COPD

� Possibility of having testing and diagnostics in the community to ease the burden on the ED

� Have PHC centres near/in hospitals for non-emergent clients

�

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2:55

Dr. McCutcheon� Wait 1/GP to

Specialist multi-year plan

� Appropriateness multi-year plan

� Physician Engagement multi-year plan

� Medicine Service Line multi-year plan

� Appropriateness potential� Dr. McCutcheon owned the

defects—“that is my problem� PPO development� Choosing Wisely follow-up by RQ

Lab and Physicians� Multi-faceted approach to “better

care made easier” in 2015-16� Good work overall� Appropriateness: interesting work

and the long term benefit could be huge savings

� Engagement: recognize internist burn out

� Developing PPOs to make Better Care easier

� ACU philosophy/work� MDR at bedside with family

present. Physicians participating in rounds as equal members

� Appropriateness of Care Program roles

� Review of lab/radiology practices� Provincial leadership on various

“studies” of appropriateness�

� How do we help physicians?� Old thinking that management is

against them—makes me nervous that it will never change

� Compliance related to use of these PPOs will determine the success of “better care made easier”

� MRI usage for spine issues. I thought Spine Pathway was to fix this?

� What are we doing in Regina?� Appropriateness platform and

work/engagement involved to make this happen

� Even with a heightened awareness of excessive spending, equates to no improvements

� ED volumes are up� Standardization of practices� PPOs vs. changing the

mindset/culture of physicians. PPOs actually cost more.

� Change name of “physician engagement” strategy

� Do we need to ensure that DHC plans are integrated with Q Reports either as separate work or as part of the broader work? (re: Dr. Jabs’ comments about not seeing her work represented).

� Enforce compliance� More stringent guidelines involving

diagnostics/lab orders� Start educating on appropriateness

during post-secondary schooling� Could start educating the

community differently (re: appropriateness)

� Taking population growth and increased spending into account, PPOs can potentially increase system spending because maybe not every patient with one diagnosis needs every test/procedure. PPOs could decrease critical thinking and individualized care

� Inappropriate MRI requests� Decision support tools� Meet GPs where they are in their

practices. Understand the value proposition between FFS, 6Ps, and RQHR systems for relationships, appropriateness, and outcomes.

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3:15 Sharon Garratt� Surgical Wait Times

outcome measure

� Great use of tracking system and data analysis to inform decision making

� Accountability for physicians� Decreased paid hours� Good tracking� Cost of OR was fabulous

� Improving health system means understanding drivers of surgical demand

� Day surgery space and staff� Increased waitlist due to slowdown� All the hard work that surgery has

done to decrease wait times being lost and wait times increasing

� IP/OP mix� Increase in ER surgeries� Risk of OR wait time increasing� Takes time to course correct� Curious about the rest of the

portfolio

- Communication plan – key messages so we are speaking same language to staff. Make connection to personal impact, sustainable healthcare, etc.

- Stager start time of slowdown- Steady state instead of peaks and

valleys- Stagger OR and IP beds- Plan vacated OR time- Case cost analysis- Volumes in private centres tracked

and displayed as a measure of our impact

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Robbie Peters� Financial

Sustainability multi-year plan

� Facilities multi-year plan

� Shared services - $10M savings� Focused on long term solutions

not stop gap measures� VP’s accountable to portfolio

results� “Virtual Wall” available to org.

and public� Return on investment decision

making� Frequent/weekly monitoring but

needs an emphasis on accountability

� Region reaching out to MOH for increased engagement

� Facilities management planning� Financial trend may not yet be

changing, however, good strategies/close monitoring will yield results

� Cost of lab services—great idea to raise awareness

� Accountability is shared… not just management but unions, physicians, staff, etc.

� 3sHealth savings� Lean improvement work� Comforting to hear we are not the

only district struggling financially� Long term sustainability initiatives� Capital planning� Savings on goods and services

contracts� Linen� Hold VPs accountable� Continue Lean work to decrease

waste

� Same deficit as last year� Number of involved parties (MOH,

3S, etc.)� No Facilities multi-year plan� $2B in facilities costs� Collaboration between MOH and

Region� Increase in population;

demographic changes; service pressures offset by efficiency savings/funding reduction

� Money needs to flow to RHAs who are providing services

� Initiatives have been identified but nothing has been done. No progress in management capacity or other initiatives.

� It has been mentioned before to stop talking and we need to see action from the Region on guidelines, framework, and standards… and accountability if people are not adhering to the guidelines

� Our hospitals and care facilities are old and they look dirty. Never any opportunities to get units painted, or floors waxed, or have the elevators working. How are we going to fix this?

� Issues with RPV/Grenfell� Surplus of FTE vs. increased

demand (will OT increase with the decrease in FTEs?)

� Q&S initiatives potentially contradict the loss of resources

� Conversion to provincial linen

� Physician accountability for financial impact

� Ministry not involving Robbie in strategy

� Finance has most pressure and least input/feedback

� Need movement on HR commitments and frameworks. I understand it’s a lot of work but instead of planning for years, just do it and PDCA it along the way

� Implement the task team idea to immediately investigate cost overruns when negative trends emerge

� Refurbish/major project to give a face lift and ongoing care to the physical environment

� Be mindful of how we manage the slowdown

� Leaders in RQHR know we’re in trouble but that doesn’t mean they have the knowledge/tools to influence change

� Better engagement/communication is required

� Leaders need to be given small targeted tasks that line up with a bigger plan on how to make changes

� How do we continue to drive out waste without staff available to support these events?

� Need to un-silo our thinking when looking at cost savings

� Attach costs to requested services� Find a way to move forward with

� To impact, support, and achieve financial accountability, management capacity is key and visibility on the units

� For EDC: I saw a draft policy for space management (policy and procedure) but it lacked rigor around standardization of space size

� Managers can only do so much. All the employees have to work towards saving money in all ways and understand stewardship. What people don’t think about is when we waste healthcare money, we are spending our own tax dollars!

� Employee engagement is a major factor for overtime, sick leave, churn, etc. and that is

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� Like the idea of cost to physicians. Maybe need to do this for supplies, too.

� Focus on 11 initiatives� Need to reach the frontline: “here

is our problem… $$M shortfall. What can you do?”… find the equivalent of “turn off the lights to help global warming” message.

(scrubs, etc.)� $70M to address population growth

in past 4 years. Even with the increased money, are outcomes any better?

� Details of how the FTEs continue to rise. Paid hours for what? Orientation? Extra staff? OT? Sick time?

� Are the 3sHealth savings projections real?

� 138 FTEs over prior year� Inability to meet balanced budget� Disconnect from province. Not

included in facilities plan.� There is no accountability for areas

over budget, OT, sick time, etc.� Nervous about everything. Long

term sustainability won’t help 15/16� Physicians don’t understand the

impact� Not clear information from the

Ministry�

pediatrics renovation� RQHR needs to be run like a

business. Financials need to be monitored monthly at unit level and corrective actions taken immediately if a unit is over budget

� Managers need to be supported to operate million dollar budgets efficiently and effectively. The region shouldn’t assume a good employee in a non-managerial role will automatically be able to operate a complex unit, including budget.

� Frontline staff needs to know about budget. Need a daily/weekly visual related to deficit

� Sustainable initiatives� Temporary task team� What are the initiatives that will

provide ROI to bottom line while improving patient experience and quality?

� How much can we save looking at equipment and supplies vs. more energy to HR management?

� Physician practices that drive costs� Engage medical section heads� Sometimes increasing tests will

decrease other costs (i.e., microbiology)

� Physician order entry� MI reports are double/triple run but

not utilized� No incentive to change if we don’t

take away paper� Education sessions (proactive vs.

reactive)� Instead of us reporting out on what

actions the organization is taking and expecting others to follow, get

something that won’t change overnight (nor are leaders in RQHR trained on how to impact this).

� Lean is necessary to reduce waste and ensure we are meeting demand given our resources but this is not going to translate to huge savings in the short run.

� Help me understand what the frontline managers can do to help the Region be successful

� How much would we save if every employee that didn’t need replacing took an additional 5 days of vacation and anyone who wanted to use their accrual vacation?

�

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the challenge down to the individual and what makes sense to them. (e.g., goal for everyone to take 1 less sick day this year than last year)

� Where does Robbie want/need us?� Collective bargaining� Can we have something on walls for

units that spend a lot for frontline employees (supply carts, ½ order slips, etc.) to help managers?

� What do we need to do to get the message across?

� Turn it into a challenge/contest. We are all competitive after all!

� Make it real for the frontline staff. 1 sick day = $x savings

� Clarify the core business� Deliver service that is needed it in

the way it is required to meet (adequately) patient needs (e.g., don’t exceed length of time as related to best practices)

� Managers on nursing units can make sick/LOA time more visible by making a chart to indicate who is off sick, who left, etc. to hold everyone more accountable. Include baseline staff and how many are actually working that day.

� Require employees to stay in their position for a defined minimum timeframe (hiring, training, etc.)

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Dawn Calder - Saskatchewan Health Authority | Regina … · Web viewBudget constraints are a real...

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