2015-16 strategic plan, business plan, and the supporting … · – 2015-16 business plan –...

2015-16

Strategic Plan, Business Plan, and the Supporting Operating Budget

Presentation to Board

March 31, 2015

wooddenni

Stamp

Objectives

• Board approval: – 2015-16 Business Plan – 2015-16 Operating Budget to support the one year

business plan – in principle pending final discussion with the Ministry

• Defer until provincial approval: – Multi-year Strategic Plan – will be finalized after

the Provincial Leadership Team meeting in April

Presentation Outline

Strategy and Business Plan

• Our Purpose • Strategic Hierarchy • Review of 2014-15 Successes • 2015-16 Provincial Strategies • RQHR Strategic Direction • 2015-16 RQHR Business Plan

Operating Budget to Support the Business Plan

• 2014-15 Financial Results • 2015-16 Ministry of Health

Funding Summary • 2015-16 Operating Budget to

Support the One Year Business Plan

• Factors Creating Financial Challenges

• Regional Focus to a 2015-16 Balanced Budget and Reducing Long-Term Cost Structure

Board Approval – Business Plan and Operating Budget

Our Purpose

Why we are here

Strategic Hierarchy

Government of Saskatchewan

Ministry of Health

Regina Qu’Appelle Health Region

Provincial Health System

Patient, Staff and Physician

Input

Review of 2014-15 Successes

• Significant progress towards achieving surgical wait time targets – Expect by March 31, 2015 approximately only 200 people will have waited

longer than 3 months for surgery • Primary Health Care Networks vision in place

– Ongoing Primary Health Care service realignment and redeployment of current resources

• Development and continued implementation of our Patient Flow Framework • Good progress on Mental Health and Addictions wait times • Improved incident resolution processes • Quality improvements

– Stop the line – Hand hygiene – WCB claims – Surgical Safety Check List – Surgical Infection Bundle

Review of 2014-15 Successes - Cont’d

• Sustained the success achieved in decreasing long term care patients waiting in acute care beds

• Reduction in Length of Stay in the Medicine Service Line • Reduced waiting times in diagnostic imaging • RQHR is committed to improving care using Lean tools and techniques, with

staff, physicians and patients changing how we design and deliver services so that patients and their families come first

• Establishment of Efficiencies Target Initiatives (ETI) working group – Initiatives that support the achievement of our expectations on focused

daily management and accountability

2015-16 Provincial Strategies

• Ministry and System Strategies – Hoshins (to be finalized in April):

o ED Waits and Patient Flow o Mental Health & Addictions

– Others: o Seniors o Infrastructure o Primary Health Care o Wait 1/ GP to Specialist o Appropriateness o Financial Sustainability o Culture of Safety

RQHR Strategic Direction

• RQHR Multi-year Strategic Plan includes: – Provincial Strategies (to be finalized in April):

o ED Waits and Patient Flow o Mental Health o Seniors o Infrastructure o Primary Health Care o Wait 1/ GP to Specialist o Appropriateness o Financial Sustainability o Culture of Safety

- RQHR Internally Identified Strategies o Patient Family Centered Care o Engagement o Academic and Research

RQHR Strategic Direction – Cont’d

• We are confident in the strategic direction we are taking as a province and organization

• Each strategy is led by a Vice President (VP) who is accountable for achieving the outcome

• Each strategy is supported by a multi-year plan • Each strategy is being monitored and reported out

quarterly • Funding restraint will slow the progress of multi-year plans

and delay achievements and could potentially result in a deterioration in our gains to date

• We have significant capital and infrastructure deficiencies (facilities, equipment and information technology systems) that could impede our ability to meet strategic, business plan and operating budget targets

2015-16 RQHR Business Plan

• 15-16 RQHR Business Plan (One-year Regional priorities):

– Continues to focus on: oQuality and Safety oPatient Flow (also a 15-16 provincial Hoshin) oPrimary Health Care

– Added one more focused area: oMental Health & Addictions (also a 15-16 provincial

Hoshin; to be confirmed in April)

• Focuses on the work of the Senior Leadership Team (SLT) – It includes regional work that SLT has to lead, monitor,

and report • Supports alignment across the RQHR

– It is supported by work plans at the portfolio, service line and unit level

• Focuses SLT support for daily management – Quality care, safe care, and financial sustainability

• Business plan can and will change during the year – When targets are met, initiatives can be replaced by

other work appropriate for SLT

2015-16 RQHR Business Plan – Cont’d

2015-16 Operating Budget to Support the One-Year Business Plan

2014-15 Financial Results

• February year to date deficit of $12.0M, representing 1.3% of year to date budget

• Projected year end deficit of $13.9M, representing 1.4% of annual budget

• 73.17% of our costs relate to compensation for staff and physicians (does not include affiliate staffing costs)

• $19.6M over budget in these areas, with overtime premiums, orientation and sick time accounting for $12.7M (see Appendix 1 for hours in these areas as a % of total paid hours)

• Offset by $7.2M in additional revenues, mainly from Ministry of Health

2014-15 Cost Breakdown by Expenditure Type

2014-15 Cost Breakdown by Service Area

2014-15 Breakdown of FTE’s by Union Affiliation

Provincial 2015-16 MoH Funding Summary

• Saskatchewan’s commitment to quality patient- and family-centred care continues, with a record $5.12 billion investment in health care in 2015-16.

• The health system continues to focus on building for the future, balanced with fiscal responsibility. We must all work together to ensure long-term sustainability of health care services by applying innovative approaches, being careful stewards of resources, and pursuing system efficiencies.

• This year’s budget supports targeted investments in priority areas, including seniors care, emergency department waits and major capital projects.

• The investment marks a $135 million, or 2.7 per cent, increase over last year’s health budget. Over the past eight years, the health care budget has increased by $1.7 billion or 49 per cent. This growth averages 5.1 per cent a year.

• RQHR represents a substantial portion of the provincial health system budget and we must contribute to financial sustainability initiatives

RQHR 2015-16 MoH Funding Summary

• Base funding increased by $36.2 million, which is 4.2% from prior year. Broken down as follows: – $24.1M for compensation transfers for CUPE contract, CBO

increases and SHEPP pension payments – $4.1M new program funding for seniors ($2.7M operating and

$1.4M capital) – $12.4M transfers to base from 2014-15 special funding – ($4.4M) program funding reduction for surgical initiative – No inflation or demographic funding

• The $2.7M operating dollars for seniors is the only incremental base funding for non-existing expenditures (representing a 0.03% increase)

RQHR 2015-16 MoH Funding Summary

• Targeted funding of approx. $6.8M for various initiatives

such as primary health care, emergency department waits and patient flow, and home first/quick response home care pilot

• Capital funding allocations have not been provided to us yet

2015-16 Operating Budget to Support the One Year Business Plan

• The operating budget is established to support achieving our one-year business plan and operational requirements for the coming year and is developed to link our outcomes to the funding we require to achieve this

• It supports our daily operations and the outcomes

established for the provincial health system

2015-16 Operating Budget to Support the One Year Business Plan

Regina Qu'Appelle Health Region

2015-16 Operating Budget

In $000's

2014-15P 2015-16B $ Change % Change

RevenueMinistry of Health Funding - Base 865,661 901,502 35,841 4.14%Ministry of Health Funding - Other 65,828 31,044 (34,784) -52.84%Other Gov't & Agency Revenue 26,000 25,513 (487) -1.87%Patient & Service Fees 24,700 24,108 (592) -2.40%Other Revenue 30,000 30,527 527 1.76%Total Revenue $1,012,189 $1,012,694 $505 0.05%

ExpensesSalaries & Benefits 663,690 684,107 20,417 3.08%Medical Remuneration 86,200 86,763 563 0.65%Operating Grants 68,500 69,111 611 0.89%Medical Supplies 94,450 97,173 2,723 2.88%Infrastructure 47,530 48,504 974 2.05%Clinical & Operational Supports 50,980 50,561 (419) -0.82%Admin & Other 14,760 14,744 (16) -0.11%Total Expenses $1,026,110 $1,050,963 $24,853 2.42%

Preliminary Deficit ($13,921) ($38,269) ($24,348) 174.90%

P - projected

B - budget

Factors Creating Financial Challenges

• Cumulative pressures carried forward from previous years, projecting deficit of $13.9M in current year, incurred deficits of $1.6M in 2014 and $19.7M in 2013

• A growing population with more people accessing our services • An aging population requiring more complex services • Increased volumes of procedures • No funding increases for inflation or demographic pressures for

2015-16 • Anticipated reduction in surgical volumes reducing funding of

$9.2M (associated resources/costs will take time to redeploy) • $2.7M in additional costs due to 2 additional stat holidays (this

will not occur again in 2016-17) • Efficiencies Targets Initiative working group not created until

mid-year and achieved minimal progress on meeting targets


• Increased costs of services due to population and demographic changes – RQHR region

• 7.9% increase from 2010-2014 in RQHR covered population, or 21,113 residents (see Appendix 2)

• Increase in costs of 7.25%, or $80.9M from 2010-2014 using healthcare costs per capita data from CIHI (see Appendix 3)

• RHAs account for roughly 69% of total health spending. So approximately $55.9M estimated increase in service delivery costs to RQHR over the 4 year period relating to population and demographic changes


• Increased costs of services due to population and demographic changes – South Sask. non-RQHR regions – Southern Saskatchewan Growth Increase of 10,125, resulting

in corresponding increase in service provision by RQHR for tertiary services

– Estimate of $8.3M in additional costs to RQHR for the increase in out of region inpatient volumes over the last 4 years (see Appendix 4)

– Increase in outpatient registrations of 31% between 2010-11 and 2013-14. Mostly due to increase in RQHR residents, but also a 13% increase noted in the number of registrations by residents of Southern Saskatchewan (see Appendix 5)


• Service volume increases in several areas over the last 5 years have contributed to the Region’s financial challenges (see Appendix 6 charts for selected volume data)

• Efficiency targets set by the Ministry of Health totalling

$57.7M over the last 4 years has put even more pressure on the Region

• A high level analysis of the population, demographic and efficiency target impacts, offset by new funding available for these factors identifies approximately $50.9M in potential costs that RQHR has absorbed in excess of funding available (next slide)

Estimate of Costs Absorbed From Population and

Demographic Changes and Efficiency Targets

2012 2013 2014 2015 Total

Population Change 1,545 3,572 8,633 7,363 21,113

Health Care Cost Increase (Total) $ 5,925,075 $ 13,698,620 $ 33,107,555 $ 28,237,105 $ 80,968,355

Region Cost Increase (69% of Total) $ 4,088,302 $ 9,452,048 $ 22,844,213 $ 19,483,602 $ 55,868,165

Increase for Out of Region Inpatient Volumes $ 2,515,500 $ 3,664,755 $ 2,116,296 $ 8,296,551

Amount of Cost Increase Absorbed $ 6,603,802 $ 13,116,803 $ 24,960,509 $ 19,483,602 $ 64,164,716

Inflation Funding $ 12,739,000 $ 13,404,000 $ 14,135,000 $ 13,172,000 $ 53,450,000

Funding Specific to Demographics for RQHR only $ 2,895,000 $ - $ 8,334,000 $ 6,296,000 $ 17,525,000

Funding Decrease for Ministry Efficiency Targets $ (8,812,000) $ (14,735,000) $ (15,600,000) $ (18,515,000) $ (57,662,000)

New funding available for inflation/demographics $ 6,822,000 $ (1,331,000) $ 6,869,000 $ 953,000 $ 13,313,000

Excess costs absorbed over funding available $ 218,198 $ (14,447,803) $ (18,091,509) $ (18,530,602) $ (50,851,716)

Regional focus to a 2015-16 balanced budget and reducing long-term cost

structure

• We started our budget process with an estimated deficit of $38.3 million

• Submitting a deficit budget is not an option

• Our target is a balanced operating budget or surplus


structure

• We must work within the Ministry of Health guidelines when addressing the budget deficiency, including: – Maximize possible reductions to administration (our admin

structure is already low when compared to others (see appendix 7)) – Minimize the impact to patients wherever possible – Minimize the reduction to services or access to patients (unless a

patient benefit will be realized; perhaps with service realignment or improved patient safety)

– Consider the impact to other services before allowing wait lists to increase

– Remove positions through attrition wherever possible – Only include the closure or conversion of facilities or other health

delivery sites if there is a patient benefit or if all other options have been exhausted


structure

Priority focuses and preliminary targets to achieve a balanced budget in 2015-16 Regina Qu'Appelle Health Region

2015-16 Operating BudgetIn $000's

2014-15P 2015-16B $ Change % Change

Preliminary Deficit ($13,921) ($38,269) ($24,348) 174.90%Regional focus to a 2015-16 balanced budget and reducing

long-term cost structure VP Responsible3sHealth and Other Contracts 2,500 PetersCost Savings from Reduced Surgical Volumes 8,000 GarrattReduction of VAC Beds if No Funding for Alternative use 1,300 RedenbachClinical Appropriateness 1,000 McCutcheonQuality & Safety Initiatives 1,000 SmaduPatient Flow / 95% Occupancy 1,000 NevilleImprove on Ambulatory Care Sensitive Condition Indicators 3,000 EarnshawReduce Orientation Costs by 20% * 1,300 HigginsReduce Sick Costs by 15% * 2,500 Higgins Reduce Overtime Premiums by 33% * 3,929 PetersWorkforce Optimization - 152 FTEs at avg, salary $85,000 ** 12,740 All

Revised Surplus (Deficit) $0

* Expected payback from daily management initiatives** Done through attrition, does not contemplate layoffs


structure

• Our staffing costs account for 73% of our total expenditures (not including affiliate organizations). In order to be successful, it is imperative that we are able to optimize our staffing levels and mix based on needs of our services, not maintaining to a certain arbitrary number of staff, while working within our employee collective bargaining agreements

• Rather than considering significant service changes, staff lay offs or facility closures, we are focusing on foundational long-term sustainable initiatives

• Our commitment to our staff is to achieve a balanced budget through attrition and not through lay offs


structure

• Key focus areas have been and will continue to be on initiatives associated with quality and safety (patients, physicians and staff), patient flow, primary health care and diligent daily management and accountability

• We will make impactful transformational changes through continuous improvement initiatives, using lean tools and techniques, while engaging with all stakeholders including physicians, front line staff and patients

• Transformational change requires all levels of the

organization to be involved, be accountable and share responsibility for achieving the outcomes and targets


structure

• We will continue to build on and communicate the themes of Accountability and Shared Responsibility throughout the organization, that was started in 2014-15

• Vice-Presidents have been assigned as leads on the various

initiatives identified for achieving financial goals and will be responsible for developing action plans and targets, and reporting mechanisms will be developed to monitor progress towards targets

Request for Board Approval

• THAT the RQRHA approve the – 2015-16 Business Plan – Direction for financial planning of the 2015-16

Operating Budget that supports the one year Business Plan noting that the Ministry has to approve our detailed budget by June 5th

• We will defer asking for approval of the strategic plan pending results of the provincial discussions in late April

Appendices

Appendix 1 Payroll Data Comparisons 2011 - 2015

2010-11 2011-12 2012-13 2013-14 2014-15P 1 YR % Change

4 Yr % Change

Total Paid Hours 14,376,804 14,716,822 15,132,081 15,246,607 15,609,275 2.38% 8.57% Overtime Hours 316,832 384,348 393,252 380,466 376,750 -0.98% 18.91% Overtime Hours as a % of Total Paid Hours 2.20% 2.61% 2.60% 2.50% 2.41% Orientation Hours 187,001 170,583 214,237 220,681 238,548 8.10% 27.57% Oreintation Hours as a % of Total Paid Hours 1.30% 1.16% 1.42% 1.45% 1.53% Sick Hours 645,970 644,401 663,558 656,376 682,200 3.93% 5.61% Sick Hours as a % of Total Paid Hours 4.49% 4.38% 4.39% 4.31% 4.37% Consecutive Weekends Worked 68,895 47,775 41,624 24,987 25,529 2.17% -62.95%

Consecutive Weekends Worked as a % of Total Paid Hours 0.48% 0.32% 0.28% 0.16% 0.16% Paid WCB Hours 99,417 115,542 98,612 93,661 85,605 -8.6% -13.89% Paid WCB Hours as a % of Total Paid Hours 0.69% 0.79% 0.65% 0.61% 0.55% NOTE: Decrease in Consecutive Weekend Worked Hours in 2013-14 was due to change in Collective Bargaining Agreement Language

Appendix 2 2010 – 2014 Covered Population - RHAs

2010 2011 2012 2013 2014

Total Change

2010-2014 % Change 2010-2014

Saskatoon HRA 318,503 318,102 323,938 336,405 346,362 27,859 8.7%

Keewatin Yatthe Regional Health Authority 10,588 12,032 12,001 12,217 12,312 1,724 16.3% Athabasca Health Authority 2,557 2,743 2,608 2,602 2,638 81 3.2% Regina Qu'Appelle 266,386 267,931 271,503 280,136 287,499 21,113 7.9% Sun Country Regional Health 55,144 56,529 56,890 58,644 59,984 4,840 8.8% Prairie North Regional 77,745 78,237 78,072 80,883 82,992 5,247 6.7% Mamawetan Churchill River 22,674 24,226 23,833 24,210 24,480 1,806 8.0% Prince Albert Parkland 79,237 80,000 79,926 81,513 82,578 3,341 4.2% Five Hills Regional Health 55,068 55,288 54,994 55,786 56,517 1,449 2.6% Heartland Regional Health 41,629 44,051 43,626 44,102 44,576 2,947 7.1% Sunrise Regional Health 56,807 58,113 57,678 59,007 59,551 2,744 4.8% Cypress Regional Health 44,302 44,526 43,982 44,761 45,394 1,092 2.5%

Kelsey Trail Regional Health 39,837 42,348 41,902 42,218 42,650 2,813 7.1%

Appendix 3 Cost Growth in RQHR's Covered Population

2010 to 2014 – excludes southern Saskatchewan

Age Groups 2010 Population 2014 Population Change *Cost per Capita $ Change % Change <1 3,390 3,704 314 $10,120 $3,184,865 9.28% 1 to 4 13,471 14,926 1,455 $1,825 $2,656,653 10.81% 5 to 9 15,130 17,817 26,86 $1,484 $3,986,454 17.75% 10 to 14 15,770 16,183 413 $1,607 $664,478 2.62% 15 to 19 18,100 17,145 -955 $2,062 $-1,970,097 -5.28% 20 to 24 20,165 20,792 627 $2,257 $1,415,974 3.11% 25 to 29 20,368 23,414 3,046 $2,597 $7,911,189 14.96% 30 to 34 19,004 22,438 3,433 $2,736 $9,394,658 18.07% 35 to 39 17,289 20,374 3,084 $2,682 $8,273,755 17.84% 40 to 44 17,200 18,399 1,198 $3,054 $3,660,677 6.97% 45 to 49 20,546 18,482 -2,064 $3,096 $- 6,390,423 -10.05% 50 to 54 19,724 20,843 1,119 $3,474 $3,889,838 5.68% 55 to 59 17,204 19,251 2,046 $4,162 $8,519,156 11.90% 60 to 64 13,639 15,511 1,871 $5,283 $9,888,508 13.72% 65 to 69 9,689 11,848 2,159 $7,044 $15,208,066 22.28% 70 to 74 7,796 8,335 538 $9,240 $4,975,925 6.91% 75 to 79 6,712 6,686 -25 $12,338 $-317,087 -0.38% 80 to 84 5,460 5,281 -178 $15,598 $-2,787,987 -3.27% 85 to 89 3,604 3,691 87 $23,312 $2,037,469 2.42% 90 to 94 1,610 1,773 163 $26,842 $4,382,225 10.14% 95 + 506 595 89 $26,842 $2,393,233 17.60% Total 266,386 287,498 211,12 $167,655 $80,977,532 7.24%

Appendix 4 In-patient Volumes –

S. Sask. Analysis

Inpatient Volumes & Cost – Notes:

• Data was abstracted from the Discharge Abstract Database for the last four fiscal years: 2010/11 – 2013/14. This reflects all discharges from RGH and PH for these index years where the patient’s health region of origin was Sun Country, Sunrise, Cypress or Five Hills RHA.

• Cost analysis was based on the resource intensity weight (RIW) for each case multiplied by CIHI’s cost per weighted case (CPWC) for that year (2010/11 = $5,995; 2011/12 = $6,230; 2012/13 = $6,458).

• Since data for CPWC in 2013/14 has not yet been released by CIHI an estimate was used for the projected CPWC in 2013/14. Based on the observation that the CPWC increased by 4% in each year the estimated CPWC in 2013/14 was projected to be $6,694.

Inpatient Volumes

A steady increase in the number of discharges was observed across the time period. Overall, the volume of discharges from acute care facilities increased by 13%.

The increase was fairly consistent across all Southern Saskatchewan health regions with the exception of Cypress where only a 3% volume increase was noted between 2010 and 2014. (fig 1.)

Appendix 4 (cont.) In-patient Volumes –

S. Sask. Analysis In-patient volumes (fig. 1) 2010/11 2011/12 2012/13 2013/14 change 2010-2014 %change 2010-2014 Sun Country Health Region

2676 2793 2882 3040 364 14%

Five Hills Health Region

1310 1356 1391 1492 182 14%

Cypress Health Region

570 518 553 585 15 3%

Sunrise Health Region

1701 1722 1778 1932 231 14%

Total S. Sask 6257 6389 6604 7049 792 13%

Inpatient Costs

Since this method of calculating patient costs relies on RIW, which is highly variable from patient to patient, the total costs of all patient stays in a single year may be affected by the presence of outlier patients (extremely high RIW and therefore higher costs). In order to account for this, the median inpatient cost per visit was also examined to confirm the presence of underlying trends.

Similar to inpatient volumes, the cost associated with service delivery to patient Southern Saskatchewan also increased by around 13% between 2010 and 2014. (fig 2.)

The largest increase in total costs for all visits between 2010 and 2014 was observed for Sun Country (19%).

The increases in the median cost per visit also confirmed this trend towards increasing costs over time associated with increase service volumes and annual increases in the cost of delivering care to these patients.

Appendix 4 (cont.) In-patient Volumes –

S. Sask. Analysis Summed Costs of Visits per Year by Southern Saskatchewan Health Regions 2010/11-2013/14

Health Region

2010/11 2011/12 2012/13 2013/14 change 2010-2014

%change 2010-2014

Sun Country Health Region

$23,510,774 $26,670,601 $28,047,270 $28,034,801 $4,524,027 19%


$16,293,562 $15,289,338 $16,089,575 $16,990,667 $697,105 4%


$6,374,772 $6,306,048 $6,724,227 $7,177,396 $802,624 13%


$19,460,941 $19,889,562 $20,959,233 $21,733,736 $2,272,795 12%

Total S. Sask

$65,640,049 $68,155,549 $71,820,304 $73,936,600 $8,296,551 13%

Median Cost of Inpatient Visit by Southern Saskatchewan Health Regions 2010/11-2013/14

Health Region 2010/11 2011/12 2012/13 2013/14 change 2010-2014 %change 2010-2014 Sun Country Health Region

$4,978 $5,281 $5,467 $5,917 $939 19%


$7,281 $7,114 $7,349 $7,730 $449 6%


$7,820 $7,882 $8,042 $8,078 $258 3%


$7,048 $7,419 $8,436 $8,418 $1,370 19%

Total S. Sask $27,127 $27,695 $29,293 $30,143 $3,016 11%

Appendix 5 Outpatient Visits – S. Sask. Analysis

Outpatient Visit Volumes N.B. These volumes reflect total visits (i.e., not individual clients) to outpatient clinics. This data currently excludes Active Client registrations. A total increase in outpatient registrations of 31% was noted between 2010/11 and 2013/14. Although the majority of this increase can be attributed to increased volume by RQHR residents, there was also a 13% increase noted in the number of registrations by residents of Southern Saskatchewan. The largest volume increases were noted for residents of Five Hills and Cypress.

Volume Change % ChangeHealth Region 2010-11 2011-12 2012-13 2013-14 2010-2014 2010-2014

All visits 254,751 277,126 292,040 333,298 78,547 31%RQHR residents 188,903 207,859 220,644 259,325 70,422 37%Sun Country 23,735 24,954 26,784 26,247 2,512 11%Sunrise 15,836 16,719 16,692 17,432 1,596 10%Five Hills 14,359 15,135 15,709 16,809 2,450 17%Cypress 4,083 4,516 4,583 4,794 711 17%All S. Sask Residents 58,013 61,324 63,768 65,282 7,269 13%

Prepared by RQHR Research & Performance Support

Appendix 6 Select Operating Data

Hospital Care Utilization 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

Admissions

34,123

34,549

35,281

36,595

37,564 10.08%

Average Daily Census

642.40

655.60

645.70

650.67

648.76 0.99%

Average Length of Stay (Days)

6.90

7.0

6.70

6.30

6.30 -8.70%

Births/Newborn Admissions

3,771

3,954

4,087

4,234

4,224 12.01%

Emergency Visits

106,755

108,900

110,000

107,033

112,964 5.82%

Radiology Procedures

117,704

116,755

111,065

112,164 -4.71%

Ultrasound Procedures

30,913

30,560

30,705

29,995

25,828 -16.45%

Mammography Procedures

7,284

6,925

7,728

7,819

6,124 -15.93%

Interventional Procedures

10,853

11,567

11,016

11,252

6,781 -37.52%

MRI Procedures

12,342

13,676

16,372

16,630

20,060 62.54%

CT Procedures

82,126

80,505

114,312

118,526

72,061 -12.26%

Nuclear Medicine Procedures

8,419

8,586

10,378

12,329

9,617 14.23% Bone Mineral Densitometry Procedures

4,849

4,185

4,380

4,262

4,158 -14.25%

Appendix 6 (cont.) Select Operating Data

Acute Care Surgery

2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

In-patient Surgery

10,163

10,665

10,754

11,904

11,821 16.31% Out-patient Surgery - operating room

11,520

12,109

12,478

14,711

14,395 24.96%

Total

21,683

22,774

23,232

26,615

26,216 20.91%

Laboratory Services

2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

Clinical Laboratory - Orders Placed

1,080,072

1,089,540

1,111,836

1,137,580 5.32% Clinical Laboratory - Tests Performed

3,555,074

3,662,535

3,783,155

3,952,096 11.17%

Surgical Pathology, Hematopathology and Autopsy - Case Count unknown

44,171

45,917

43,670 -1.13%

Cytopathology - Case Count unknown

71,053

60,148

58,495 -17.67%

Home Care Service Hours

2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

Number of Units (1 hour or 1 meal)

168,106

334,791

361,498

357,718

Total

168,106

334,791

361,498

357,718 - 112.79%

Appendix 6 (cont.) Select Operating Data

Regina Emergency Medical Services (EMS) 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015P % Change

Rural Responses

854

745

886

783 700 -17.99%

Out-of-Region

125

101

101

90 108 -13.60%

Inter-Facility

3,289

3,264

3,557

3,891 3,197 -2.78%

Urban Responses

13,879

14,222

14,579

14,214 15,255 9.92%

No-Transport Calls

5,451

5,432

5,747

5,833 5,767 5.79%

Total Calls

23,598

23,764

24,870

24,811 25,028 6.06%

Population & Public Health - # of Immunizations 2007-2008 2013-2014 2014-2015P % Change Number of Units (1 hour or 1 meal)

25,212

52,346

Total

25,212 -

-

52,346

- 107.62%

Appendix 7 Administrative Services

as a % of Total Expenses (CIHI)

2012 – 13 Data • RQHR – 2.86% • SK Avg – 4.29% • CDN Avg – 4.5%

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