balanced score card report review of august 2017 data
TRANSCRIPT
Balanced Score Card Report Review of August 2017 Data
Balanced Scorecard
Finance Patient Access
Quality
&
Safety
Human Resource
Management
Patient and Service User
Finance
Finance Report – August 2017
CUH Actual outturn YTD 2017
PAY and NONPAY Gross pay & non pay budget €237.3m (2016 :€228.4m)
Actual pay & non pay €246.3m (2016: €235.0m)
Actual Deficit €8.9m (-3.8%) (2016 :€6.6m/-2.9%)
Less Adjustments €5.3m
increase in Bad debts provision €2.4m
PCRS Drugs €1m
LRA Restoration unfunded €1.7m
Living out allowance €231k
Adjusted Deficit €3.6m(-1.54%) (2016 :€3.0m/-1%)
NB: increase in % deficit is due mainly to retraction of Budgets for Bowel Screening & Diabetic Retinopathy screening €0.4m
CUH –Pay & Non pay Budget Surplus/(Deficit) %
CUH – Patient Income Budget Surplus/Deficit %
7
CUH AGENCY WTE 2014-7
Jul-14 Sep-14 Dec-14 Jan-15 Mar-15 Jun-15 Sep-15 Dec-15 Jun-16 Aug-16 Sep16 Oct 16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17
Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual
Radiotherapist 9.40 4.00 4.87 2.78 0.95 0.9
Radiographer 0.09 0.05 0.06
Labs 12.04 13.40 11.0 12.19 1.0
Cardiac Techs 3.80 3.80 1.0
Physio 1.60 1.50
Pharmacy 2.00 1.00
Admin 23.40 9.08 9.36 14.1 9.3
Nursing 46.20 33.0 34.7 37.8 40.0 30.4 28.6 26.1 31.6 28.7 27.6 29.6 31.5 25.5 33.3 33.3 32.7 31.7 34.3 37.3 44.8 41.3
HCA 34.80 16.2 22.7 23.2 24.4 29.8 30.8 38.2 38.4 52.1 52.1 56.9 32.1 17.7 26.1 25.3 34.5 34.5 33.9 36.6 41.6 35.7
House-Keeping 10.40 0.16
Physics 4.30 2.6 1.6 1.09 0.92 0.75 0.66 0.46 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.23
Catering 3.00 8.5 2.0 2.7 1.8 6.9 3.9 0.9 1.2
Social Work 1.00 0.5
Occ Therapy 1.00 0.37
Dietician 0.50 0.3 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Medical 11.00 5.27 4.77 4.4 6.35 5.86 7.97 15.73
Consult 0.25 4.44 0 0.38 1.62 0.6 0.34 2.9 3.94
NCHD 2.47 5.13 6.7 2.99 2.84 1.87 1.82 2.83 2.94 2.15 2.34 1.54 0.8 1.18
164.5 99.7 91.1 98.26 84.7 74.6 71.9 81.4 76.75 92.20 88.23 91.70 69.89 46.9 63.05 63.26 71.37 69.95 71.88 76.4 91.1 83.12
CUH AGENCY COSTS €k 2015 - 2017
Acute Nursing Agency WTE 2015 to 2017
Acute HCA Agency WTE 2015 to 2017
CUH Average Nursing & HCA Agency WTE’s per Week 2015-17
10
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2016-17
11
CUH Nonpay-Budget v Actual YTD August 2017Budget Actual Variance Actual YTD 2016 Diff 2017-16
Medicines 20,909 22,787 -(1,878) 20,992 -(1,795)
Medical & Surgical 19,723 20,324 -(601) 19,069 -(1,255)
Blood 3,298 3,687 -(389) 3,502 -(185)
Medical Gases 278 298 -(20) 280 -(18)
Medical equipment 2,990 3,289 -(299) 3,085 -(204)
Radiology 3,671 3,957 -(286) 3,591 -(366)
Provisions 1,369 1,408 -(39) 1,330 -(77)
Catering 328 302 26 330 28
Cleaning/Waste 2,534 2,810 -(276) 2,545 -(265)
Laundry 1,220 1,227 -(7) 1,225 -(2)
Energy 2,052 2,096 -(44) 2,120 24
Bedding/ clothing 274 308 -(34) 299 -(9)
Furniture 122 165 -(43) 193 28
Pathology 6,967 7,003 -(36) 7,856 853
Maintenance /Grounds 487 602 -(115) 557 -(46)
Transport /staff travel 1,259 1,274 -(14) 1,399 125
Office expenses 1,311 1,459 -(147) 1,330 -(128)
Telecommunications 312 318 -(6) 270 -(48)
Computer 790 706 85 778 73
Administrative expenses 4,963 7,779 -(2,816) 5,024 -(2,756)
Staff recruitment/training 494 457 37 475 17
Miscellaneous 1,083 828 256 1,114 286
TOTAL NON-PAY 76,435 83,084 -(6,650) 77,363 -(5,721) Less Bad debts -855 -3,073 2,218 -848 2,225
NON-PAY excl Bad Debts 75,580 80,012 -(4,432) 76,515 -(3,496)
CUH Actual Non-pay expenditure €k August 2017 v
2016
CUH Bed Occupancy 2017 v 2016
147
145
139
151
128
130
120
123
125 124
115
111
114
120
126
118
121
102
111 110
115
113
111
114
110 111
107
117
100
110
120
130
140
150
160
Jan Feb Mar Apr May Jun Jul Aug Sep 12thOct
19thOct
26thOct
2ndNov
9thNov
16thNov
23rdNov
30thNov
7thDec
14thDec
21stDec
2016
2017
Patient Income 2015 –2017
15
C U H Ot her Income Y TD A ugust 2 0 17
Income B udget €k A ct ual €k V ariance €k
R ent al income 2 9 8 6 8 6 3 8 8
B equest s/ D onat ions 10 4 13 9 3 5
R esearch grant s 2 0 3 156 - ( 4 7)
C arpark 1,54 1 2 ,0 0 4 4 6 3
D rug rebat es / PC R S 6 ,12 1 7,3 0 9 1,18 8
M isc 10 4 8 3 - ( 2 1)
8 ,3 71 10 ,3 77 2 ,0 0 6
C U H R ecoupment s and R ef unds Y TD A ugust 2 0 17
Income B udget €k A ct ual €k V ariance €k
R ecoupment s Pay 6 12 759 14 7
R ef unds- Pay 116 8 9 - ( 2 7)
R ef unds- Ot her 16 1 8 5 - ( 76 )
U nclassif ied 13 6 14 2 5
1,0 2 5 1,0 74 4 9
CUH Debtor Days Consultant Claims August 2017
17
Cost Containment Initiatives update at 31/8/17
TARGET
JAN/FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC ACTUAL
1
Unrostered overtime-DIT 250 50 50 50 50 50
2
Reduction in Medical agency 300 30 30 30 30 30 30 30 30 30 30
153 99 53 -43 -45 117 -24 -4
3
Drug savings 0
4
Procurement (NDC) one-off & recurring (REVISED)
600 60 120 120 120 180
5
Reduce Waste costs 30 5 5 5 5 5 5
-65 -39 -26
6
Reduce Energy costs
30 5 5 5 5 5 5
14 7 7
7
Reduce Bad debts 0
8
Blood science savings
1,000 100 100 100 100 100 100 100 100 100 100
763 74 70 165 162 40 100 152
9
Additional cafe income 330 140 110 10 10 10 10 10 10 10 10
247 4 9 38 0 170 20 7
10
Recode Clinical trials expenditure 100 100
100 100
11
Recode Donated funds expend 200 200
TOTAL-Target 2,840 270 240 140 240 150 260 320 320 320 580
TOTAL- Actual 1,212 177 132 160 117 327 164 136
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MGH - Finance Report – August 2017
Mallow YTD August 2017 outturn
Gross pay & non pay budget €13.47m (2016:€13.4m)
Actual pay & non pay €13.86m (2016:€13.5m)
Actual deficit €387k (-3%)
Less Adjustments €321k
increase in Bad debts provision €225k
LRA Restoration unfunded €85k
living out allowance €11k
Adjusted deficit €66k (-0.5%) (2016:€87k/-0.7%)
Mallow Income Outturn
Income budget €2.38m (2016:€2.57m)
Actual Income €2.54m(2016:€2.42m)
Actual surplus €157k (7%) (2016:Deficit €150k/-6%)
BGH - Finance Report – August 2017
Bantry YTD August 2017 Outturn Gross pay & non pay budget €13.84m
Actual pay & non pay €14.31m
Actual deficit €468k (-3.4%)
– Less Adjustments €317k
– increase in Bad debts provision €77k
– St. Josephs ward €150k
– LRA Restoration unfunded €78k
– Living out allowance €10k
– Waiting list initiative €2k
Adjusted deficit €151k (-1.09%)
Bantry Income Outturn Income budget €2.4m
Actual Income €2.3m
Actual deficit €99k (-4%)
Patient Access – Emergency Department
CUH 30 Day Moving Average 2016 - 2017 (September 2017)
30 Day Moving Average (18th September 2017)
6 Hour PET & 8AM Trolley GAR per 100 ED Attends
PET Monthly Comparison (Non Admitted)
PET Monthly Comparison (Admitted)
Patient Experience Time >24 Hours
0
50
100
150
200
250
300
350
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 up to 13 Sept
320 316
264
328
85 98 68 89
79
PET >24 hours
>75 years >9 hour bed wait
0
50
100
150
200
250
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17
218 199 200
215
129 120
57
108 126
>75yrs Bed Wait >9 hrs (2017)
To 25th Sept
>14 Day Target Reduction
Project Flow Improving Patient’s Hospital Experience
Project Flow 2017
PF17 - Objectives
Phase 1 - By 10th July 2017
Achieve 30% reduction 30 day moving average
No Patient >75yrs wait >9 hours for a bed
No patient >24 hour PET
Non Admitted PET to 85 %
Phase 2 - By 31st December 2017
Achieve 50% reduction 30 day moving average
No patient >75yrs wait >9 hours for a bed
No patient PET >18 hours
Non Admitted PET to 95 %
Improved Whiteboard Participation
Processes around whiteboard good generally
Engagement of Medical Staff (team by team)
Planned Date of Discharge capture variable
Weekend update of boards
Information leaflet
Data protection issue to be resolved – cost €10k
Weekend Demand/Capacity Non Invasive Cardiology
Winter Plan Submission
Report average inpatient waiting time for echo / stress
Potential diagnostics as outpatient
– for discussion with Radiology
Communication of bi directional capacity
– Bulk text message to Medical Staff
– Whiteboard capture
Delegated discharge responsibility (for action)
Friday Specialty Handover (for action)
?? Weekend Discharge Registrar
Resource Dependant Initiatives Transitional Care (50 Beds in
Community)
Acute Beds (Ward 2A)
Operational HUB
Flow Coordinators
Regularisation of extra unstaffed beds
24/7 AMAU Service
ITU & HDU Capacity
Diagnostics
o Point of Care (H1N1, Ketones, Pregnancy testing)
o CT Scanning
o 7 Day Echocardiograph
Bed Management & Acute Floor Information Systems
Ambulatory Care Facilities / Surgical & Cardiac Assessment
Health & Social Care (Rehabilitation)
34
Patient Access - Outpatient Waiting Lists
Total Medical Patients to be seen by 15 Month Target (as of 22/09/2017) (202)
Total Surgical Patients to be seen by 15 Month Target (as of 22/09/2017) (3109)
Patients Currently Waiting Longer Than 12 Months (as of 22/09/2017) (4967)
Ophthalmology Waiting List Validation
Ophthalmology Return Waiting list validation
Consultant G.O.Connor E.O. Connell S.Fenton A.Cullinane Z.Idrees Total
Letters sent out 737 650 444 950 468 3249
Letters left to sent out 520 486 1006
Outcomes
Yes to Stay on w/l 528 230 312 678 319 2067
Request removal 25 14 12 37 11 99
RIP 4 4 8 6 22
Attended TCI 1 1 2
Query 8 2 6 7 4 27
Return Post 2 3 3 2 1 11
Diabetic Screening 16 8 14 24 17 79
No response to date 25/9/17 154 388 97 194 109 942
Patient Access - Inpatient Waiting List
Patients to be Treated by October 2017
Service Number to List by 13th
October 2017 Number with TCI +
Suspension Overall
Total
Cardiothoracic 5 5 0
General Surgery 86 4 82
Plastic Surgery 73 16 65
Urology 52 4 48
Vascular 13 0 13
Total 229 15 208
Urology Waiting List (48)
Plastic Surgery Waiting List (65)
General Surgery Waiting List (82)
Scope Waiting List (22/09/2017)
Quality & Safety
ALOS All Inpatients – July 2017 G
ALOS Medicine – July 2017
48
A
ALOS Surgery – July 2017
49
R
HIPE Coverage - Prior Month - % of cases entered into HIPE(A38)
G
Cancer KPI – Breast-Lung-Prostate January – August 2017
Risk Management – August KPI data
Serious Reportable Events reported CUH - 0
Serious Reportable Events reported MGH - 1
Medication Safety Incidents reported - 9
Complaints – 18 complaints raised in July with 6% closed within 30 day timeframe
New claims notified to hospital – 7
Risk Register
Risk Register updated in June– one new risk added
Updated Risk Register submitted to the Group
Quality and Safety Pressure Ulcer To Zero
Continue to roll out PUTZ initiative – ward 3B and ICU
SWARTZ Round
1st round held on12th September ( 2nd on 31st October)
Full Attendance
Very positive feedback
National Patient Satisfaction Survey
CUH – 53% response rate
Emerging theme is the Discharge Process
Workshop at Group level to review results of the survey
Staff Quality Survey Completed
Vision
Mission Statement
Quality and Safety
Purpose of Survey
Capture feedback from staff - what words best describe
Quality? What are the Quality Priorities?
Results
268 Responses
Who Responded
31% Nursing, 26% Allied Health, 24% Administration
10% Clinicians
Words that describe Quality
Safe, Effective, Patient Centred
54
Quality and Safety
Vision
Delivering Safe, Effective, Person-Centred care, Every time
Mission Statement
All CUH staff are committed to delivering the highest level of Quality Care achievable. We will work with you, our service users in enhancing services that are safe, clinically effective and delivered in a clean environment.
55
5 top priorities 20 additional priorities
Human Resource Management
CUH Sick Leave 2016 v 2017- CHANGE
4.65 4.59
4.53
3.913.39
4.27
3.78
3.773.94
4.04
4.08 4.984.77
3.84 3.924.22 4.17 3.9
3.65 3.98
0
2
4
6
Jan Feb Mar April May June July August Sept Oct Nov Dec
%
CUH – Total % Sick Leave 2016 v 2017
2016% 2017% % Target
40.7635.76
38.81
32.49
41.8
43.96 44.55 34.5537.35
31.14
28.89 44.1540.05
0
10
20
30
40
50
Au
g-1
6
Sep
-16
Oct-1
6
No
v-16
De
c-16
Jan
-17
Feb
-17
Ma
r-17
Ap
r-17
Ma
y-17
Jun
-17
Jul-1
7
Au
g-1
7WTE’s
CUH Long Term Sick Leave – WTE’s
EWTD Compliance –January - August 2017
Capital Projects Project Status
Paediatric Unit Phase 1 - build programme completed
Phase 2 – funding received – proceed to Design Stage
Radiation Oncology Unit
Builder commenced on site on Monday 20th February
Education and Training Centre Draft Statement of Need completed and discussion
ongoing with UCC
Meeting held with UCC
Blood Sciences Project
Design Team appointed
Infrastructural works are near completion
Oncology Service
Expansion of Day Unit – plan signed off – submitted
for Philanthropic funding (ACT)
Refurbishment of Ward 2D – capital funding in place
Medical Oncology Centre – developing Statement of
Need
Ophthalmology Transfer – Phase 2
Project group in place
Application for planning permission submitted
Tender Pack being prepared
Helipad
Meeting held with the IAA
Ground Level Helipad the agreed option
Key Issues
Implementation of SAP
Structured Overtime
Pay controls clearly working
Need for change in accounting for PCRS funded drugs
Bad Debts
PF17 working well
Challenge with complex discharges
Ophthalmology service risk
CAMHS
Pharmacy Review
Quality Strategy
National Quality Survey
Unscheduled Care Process
Day Surgery Unit
No outstanding third party hearings
INMO relations working well
Implementation of change programme in Catering/Housekeeping
Sick Leave Focus
HR recruitment workload
Grading of staff must be addressed
Finance Patient Access
Quality & Safety
Patient and Service User
Human Resource