2011-12 statement of...

Department of Health

2013-14 Statement of Priorities Agreement between Minister for Health and Mercy Public Hospitals Inc

Mercy Public Hospitals Inc

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 5 Strategic priorities 7

Part B: Performance priorities 12 Financial performance 12 Access performance 12 Service performance 13

Part C: Activity and funding 14

Part D: 15

Accountability and funding requirements 16

Signature 16



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 Our Mission To follow Jesus Christ in his mission of mercy through the delivery of health, aged care and community services. Our Vision To build an enduring capacity and passion to serve those with special needs. Our Values Our values are central to everything that we do, these are:

• Compassion - being present for others at their time of need.

• Hospitality - we welcome people with warmth and offer comfort.

• Respect - we respect the sacredness of the gift of life. Each person is valued and treated with justice, dignity and integrity.

• Innovation - we strive to create a dynamic environment, which encourages creativity and diversity.

• Stewardship - to build and strengthen the ministry and all resources entrusted to us.

• Teamwork - we will work together to progress the mission of mercy.

Service profile

Mercy Public Hospitals Inc was established in 1986 by the Sisters of Mercy, and is listed in Schedule 2 (Denominational Hospitals) of the Victorian Health Services Act 1988. Services provided in agreement with the state are delivered in line with the ethos of the Sisters of Mercy. Mercy Public Hospitals Inc is part of Mercy Health, a Catholic community benefit organisation that operates public hospitals, aged care and home care services. As a Catholic health care provider we believe in the sacredness and dignity of each person at every stage of life and are committed to providing compassionate care to all people, regardless of culture or religion. The professional, holistic care we give is guided by our values of compassion, hospitality and respect.

Mercy Public Hospitals Inc operates a number of distinctly different services namely Mercy Hospital for Women, Werribee Mercy Hospital, Mercy Mental Health and Mercy Health O’Connell Family Centre. Mercy Public Hospitals Inc provides acute care, subacute care, specialist women’s and babies’ care, mental health, early parenting, palliative care and community based services.

These services are under a single management structure and in many cases share a number of supports and resources. As an organisation we are committed to working collaboratively with the Government and other stakeholders in advocating and responding to the health needs of our community.



Key priorities for 2013/14 include: • Consolidate the program model of service delivery across Mercy Public Hospitals Inc

• Prepare for accreditation against national standards, scheduled for August 2014

• Continue workforce reform efforts, particularly the transition from fee for service doctors to staff specialists and an increase in the number of junior medical staff at Werribee Mercy Hospital

• Establish additional formal arrangements for transfer of high acuity patients from Werribee Mercy Hospital to other hospitals including tertiary services

• Work with Western Health and Djerriwarrh Health to create a regional service plan for the West

• Complete Stage 1A of the Werribee Mercy Hospital masterplan, including opening 20 subacute beds

• Continue to plan for critical care services at Werribee Mercy Hospital

• Increase the number of births at Werribee Mercy Hospital by 20%

• Work with universities to increase academic profile, which will encompass clinical research and the training of health care professionals at Werribee Mercy Hospital

• Work with Western Health to plan and commence construction of additional acute mental health beds at the former Banksia Unit at Western Health’s Footscray campus.

• Continue planning and commence construction of Stage 1D of the Werribee Mercy Hospital masterplan (new mental health inpatient unit)

• Complete the clinical training facility funded by HWA, Victoria University and Australian Catholic University.

• Advocate for funding for the next stage of the Werribee Mercy Hospital masterplan

• Implement maternity group practice at Mercy Hospital for Women in line with contemporary, evidence based best practice models

• Complete facility masterplanning for Mercy Health O’Connell Family Centre

• Continue to advance care in perinatal mental health, in keeping with Mercy Health’s commitment to advancing coordinated improvements in ante and postnatal services to women and families experiencing low prevalence mental health disorders.

• Implement “Mercy Perinatal” initiative to improve clinical service, training and education

Strategic planning

Mercy Health’s strategic plan [2013 – 2017], incorporating Mercy Public Hospitals Inc, can be read at http://www.mercy.com.au/About_Us/Our_Organisation/.

http://www.mercy.com.au/About_Us/Our_Organisation/



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

In 2013-14 Mercy Public Hospitals Inc 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 preferences for future treatment and care enacted.

Advance care planning policy and procedure developed and implemented across Mercy Public Hospitals Inc Work with external agencies to improve communication of advance care plans from community to hospital settings

Configure and distribute services to address the health needs of the local population.

Increase the number of births at Werribee Mercy Hospital by 20% supported by increases in special care nursery and theatre Further develop gynaecology services at Werribee Mercy Hospital

Further develop ambulatory services at Werribee Mercy Hospital Work on processes and protocols for identifying and managing the acute deteriorating patient at Werribee Mercy Hospital Work with the Department of Health to develop an implementation plan for a critical care unit at Werribee Mercy Hospital

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

Create a regional service plan (Werribee Mercy Hospital) with Western Health and Djerriwarrh Health

Improving every Victorian’s health status and experiences

Improve thirty-day unplanned readmission rates.

Implement improved discharge planning processes and communication

Improve health literacy and support informed choice by responding to the health information needs of service users

Increase the use of interpreters at Werribee Mercy Hospital




Implement the “consumer tick” (consumer reviewed) process for all health information developed and issued by the health service

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

Implement the maternity group practice model of care at Mercy Hospital for Women

Implement the residential aged care in-reach program at Werribee Mercy Hospital

Design and implement an integrated model of care for the new subacute beds at Werribee Mercy Hospital Complete gap analysis of maternal and early family mental health services with support from Mercy Health Foundation Review and refine strategies to improve the timeliness of transfer of mental health patients from the emergency department to an inpatient bed Complete feasibility study for providing pasteurised donor breastmilk to other tertiary NICUs in Victoria

Ensure service coordination, discharge planning and referral processes support effective care transition.

Participate in the transitions project with Health West and Western Health to support coordinated healthcare delivery to Aboriginal patients

Use consumer feedback to improve person and family centred care, and patient experience.

Expand role of the Community Advisory Committee and panel community advisors to include feedback on service change and delivery

Expanding service, workforce and system capacity

Build workforce capability and sustainability by supporting formal and informal clinical education and training for staff and health students, in particular inter- professional learning

Appoint a General Manager Learning and implement education and learning plan across Mercy Public Hospitals Inc




Develop renewed structure for allied health that supports clinical education.

Provide resources to support allied health professional education for both staff and students

Implement “Mercy Perinatal” initiative to improve clinical service, training and education

Optimise workforce productivity through identification and implementation of workforce models that enhance individual and team capacity and support flexibility.

Appoint Anaesthetic Head of Unit at Werribee Mercy Hospital, who will review staffing model Continue with medical workforce reform and the transition from fee for service to staff specialist model at Werribee Mercy Hospital Complete and implement findings from the Victorian Allied Health Assistant Project Develop multidisciplinary workforce model to enhance outcomes for subacute patients at Werribee Mercy Hospital

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

Work with Department of Health and Western Health to plan and commence construction for the acute mental health and psychiatric assessment and planning beds in the former Banksia Unit at Western Health’s Footscray campus Work with the Department of Health on the capital improvements required for a critical care unit at Werribee Mercy Hospital Work with Department of Health to complete Stage 1A (subacute) at Werribee Mercy Hospital




Work with Department of Health to plan and commence construction of Stage 1D (inpatient mental health expansion) at Werribee Mercy Hospital Work with Department of Health to finalise the relocation the Saltwater Clinic (mental health outpatient clinics) Complete construction of the HWA funded clinical training facility at Werribee Mercy Hospital

Complete facility planning for Mercy Health O’Connell Family Centre Work with Department of Health to advocate for the financial commitment to progress Werribee Mercy Hospital’s masterplan

Implement the Credentialling and Scope of Practice policy and ‘Partnering for Performance’ framework for senior clinicians.

Implement current credentialling and scope of practice policy at Werribee Mercy Hospital. Make improvements to the Partnering for Performance process across Mercy Public Hospitals Inc

Increasing the system’s financial sustainability and productivity

Reduce variation in health service administrative costs.

Undertake agreed projects where appropriate and share learnings across system

Identify opportunities for efficiency and better value service delivery.

Complete NHS Productive Series projects

Implementing continuous improvements and innovation

Develop and implement improvement strategies that optimise access, patient flow, system coordination and the quality and safety of hospital services.

Develop and implement standardised access, patient flow and escalation policy and procedures across Mercy Public Hospitals Inc

Establish a day of surgery admission unit at Werribee Mercy Hospital




Implement project with University of Notre Dame for medical students to regularly audit antiobiotic use at Werribee Mercy Hospital and benchmark with best practice

Support change and innovation in practice where it is proven to deliver more effective and efficient health care.

Review inpatient mental health model of care along with new building design at Werribee Mercy Hospital

Increasing accountability & transparency

Prepare for commencement of proposed new mental health legislation in 2014

Work with the Department of health’s MH, D & R MHA Implementation Project Team to review and update mental health policies, procedures and clinical practice guidelines to deliver at least minimum level of operational readiness to meet statutory requirements

Prepare for the National Safety and Quality Health Service Standards, as applicable.

Complete gap analysis and implement changes in preparation for accreditation in August 2014

Ensure that gender sensitivity and women's safety are key in the delivery of mental health and alcohol and drug services.

Make improvements to Psychiatric Unit (nurse call, individual swipe access, sensory room and gender courtyards) to improve gender safety

Improving utilisation of e-health and communications technology.

Trial, implement and evaluate strategies that use e-health as an enabler of better patient care.

Develop requirements and request for proposal documentation for implementation of an electronic medical records system Implement required ICT infrastructure in support of Werribee Mercy Hospital expansion Implement variety of information portals on MercyNet to support hospital staff (eg, QA, Training, FOI) Implement clinical handover tool across Mercy Public Hospitals Inc

Implement theatre and emergency department performance reporting through data warehouse



Part B: Performance priorities Financial performance Key performance indicator Target

Operating result

Annual operating result ($m) 1.00

WIES (1) activity performance

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

Cash management

Creditors < 60 days

Debtors < 60 days

Access performance Key performance indicator Target

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) 600

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. Includes only competitive elective

surgery initiatives that have been allocated at the time of signing of this agreement.



Service performance Key performance indicator Target

Elective surgery (1)

Number of patients admitted from the elective surgery waiting list – quarter 1 1,150




Critical care Neonatal ICU Number of days below the agreed standard and flexible operating capacity (2) 0

Quality and safety

Health service 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 (3) < 2/10,000

Victorian Patient Satisfaction Monitor: (OCI) (4) (July to December 2013) 73

Consumer Participation Indicator (5) (July to December 2013) 75 Victorian Hospital Experience Measurement Instrument (6)

(January to June 2014) 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) Includes only competitive elective surgery initiatives that have been allocated at the time of signing of this agreement. (2) The standard operating capacity and flex capacity is 20 – 22. (3) SAB is staphylococcus aureus bacteraemia. (4) The target for the Victorian Patient Satisfaction Monitor is the Overall Care Index (OCI) which comprises six categories. (5) The Consumer Participation Indicator is a category of the Victorian Patient Satisfaction Monitor. (6) 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 31,337 $133,120 WIES Private 5,192 $16,764 WIES (Public and Private) 36,329 $149,034

WIES DVA 174 $756 WIES TAC 1 $4

WIES TOTAL 36,704 $150,643

Acute non-admitted Emergency Services $13,638

Specialist Clinics $25,133

Subacute & Nonacute Admitted Rehab Public 2,656 $1,254 Rehab Private 300 $132 GEM Public 2,287 $1,079 GEM Private 300 $132 Palliative Care Public 4,864 $2,296 Palliative Care DVA 88 $50 Transition Care - Beddays 2,190 $318 Transition Care - Homeday 1,460 $73 Subacute & Nonacute Other Other specified funding $902

Subacute non-admitted Health Independence Program $2,836

Health Independence Program - DVA $22

Mental Health and Drug Services Mental Health Inpatient 13,751 $9,020 Mental Health Ambulatory 43,600 $13,060 Mental Health Service System Capacity $902

Mental Health Subacute 10,958 $4,255 Drug Services $125

Primary Health Community Health / Primary Care Programs 609 $59 Community Health Other $16

Other Other specified funding $4,795

Total Funding $230,738



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 53,724 203,270,837 34.47% Other Funding 21,196,775 Total 224,467,612

If the Commonwealth government returns funding of $99.5 million this financial year, Mercy Public Hospitals budget will increase by $2.75 million. Note:

• Provisional Commonwealth Contribution Percentage is subject to change following state-wide adjustments (i.e. cross border patient flows).

• Activity loadings are included in the Estimated National Weighted Activity Units (i.e. Paediatric, Indigenous, Remoteness, Intensive Care Unit, Private Patient Service Adjustment, and Private Patient Accommodation Adjustment).

2011-12 statement of...

Documents