2011/12 budget and service plan enhances patient services while maintaining a balanced position

NHH has finalized its 2011/12 budget and service plan.

Hospital funding for the coming year, commencing April 1st, is yet to be confirmed by the Central East Local Health Integration Network (CE LHIN). Hospital sector funding is expected to be released in June or July. However, in order to meet the CE LHIN’s requirements to submit a balanced operating budget and sign an amended Hospital Service Accountability Agreement by March 31st, the hospital Board approved a budget based on reasonable assumptions. In the event that LHIN and provincial funding is lower than budget assumptions, then the plan will need to be revisited.

Approved by the CE LHIN and the NHH Boards, the plan builds on a number of the significant service achievements completed in the past year, including the Alternative Level of Care (ALC) Strategy. Now well under way, the ALC Strategy has brought to NHH the March 1st opening of the new Restorative Care program, the addition of enhanced therapies and supports, and the introduction of a new Hospital Elder Life Program.

Another significant achievement of the past year which the new plan will continue to support is the short wait times for patient services. NHH offers some of the lowest wait times in the province for services such as cataract surgery and diagnostic imaging (MRI, CT), while process improvements implemented in the Emergency Department (ED) are resulting in ED treatment times that are at or better than the provincial target. In the area of infection control NHH’s rates of hospital-acquired infections are consistently holding steady at zero.

Provincial expectations for quality and safety in hospitals continue to increase, with the past year’s most notable examples being the introduction of the Excellent Care for All Act (ECFAA) and changes to the Regulated Health Professions Act.

ECFAA, which came into law in June 2010, seeks to further promote high quality patientcentred care in Ontario by strengthening the health care sector’s organizational focus and accountabilities. Effective April 1, all hospitals in Ontario will be required to prepare Quality Improvement Plans (QIPs) and publicly post them on their websites. The QIPs

identify specific quality improvement initiatives and performance targets aimed at safety, effectiveness, access and patient-centredness.

Changes to the Regulated Health Professions Act emphasize the expanded scope of practice for health care practitioners and the need for a collaborative, interdisciplinary approach to care delivery.

The 2011/12 plan ensures NHH takes advantage of these new expectations and keeps pace with leading practices.

Highlights of the 2011/12 plan

Numerous changes to enhance quality and safety of patient care are included through the reallocation of dollars within existing budget lines, namely:

• enhancement of nursing coverage in acute care to reflect patient acuity; and
• introduction of Practice Leader nursing positions and a Patient Care Manager to enhance interprofessional collaboration, support staff to work to the full scope of their professional practice and reduce clinical management span of control.

Based on key financial measures, NHH is a very efficient hospital. The 2011/12 plan maintains NHH’s commitment to remain cost effective without jeopardizing the quality or safety of patient services. The following changes are included in the plan:

• elimination of the Director, Materials Management and Food Services role by reorganizing the management structure;
• continuation of supply chain improvements achieved in the past two years, including a new initiative to implement a just-in-time inventory system;
• quality and practice review for Inpatient Rehabilitation, using LEAN and interprofessional practice, to further build on process improvements learned through the establishment of the new Restorative Care program;
• energy and waste audits; and
• process improvements in discharge planning, resulting in the elimination of the discharge planner position as new inter-professional discharge supports and tools come on stream.

The 2011/12 plan will also advance NHH’s focus on the development of collaborative networks to improve local patient care. Of note in the 2011/12 plan are steps to:

• participate in the LHIN-wide Clinical Service Plan for post-acute care;
• further strengthen local mental health services through increased collaboration with Ontario Shores Centre for Mental Health Sciences;
• expand NHH’s chemotherapy services with support from regional partners;
• implement the regional dialysis strategic plan; and
• pursue opportunities with the proposed Northumberland Family Health Team, once established.

On the issue of LHIN-wide post-acute care bed planning, NHH Board Chair John Hudson emphasized that the NHH Board has reaffirmed its position from last year that changes in hospital services or beds are contingent in having alternative providers or capacity available in the west Northumberland community. In particular, Mr. Hudson emphasized: “The Board reaffirms its 2010/11 service plan to divest the interim beds under the condition that the CE LHIN secures alternative bed capacity in the west Northumberland community.”

Robert Biron, NHH President and CEO, said: “This plan, which requires no service reductions, permits our hospital to maintain the required balanced operating position while introducing further improvements to enhance patient access, coordination and safety.”