capio s:t gorans hospital - aventri · capio s:t görans’ business strategy 4 2015-04-13...
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Capio S:t Gorans Hospital Sofia Palmquist
Capio S:t Göran’s Hospital
• # 4 of 6 emergency
hospitals in Stockholm -
15 % market-share
• Service-area 330,000
patients
• 310 beds
• ~1,800 employees
• Private but publicly
financed
• Capio contract to 2022
EMERGENCY VISITS
OPERATIONCARE EPISODES
PLANNED VISITS
80,000 emergency visits:
• 30% by ambulance
• 31% admitted
29,000 inpatients
AVLOS:
• Acute: 3.4 dygn
• Planned: 2.1 dygn
141,000 consultancies
9,300 operations:
• 43% acute or ”semi-acute”
Clear goals for new contract period
• Improved quality and
patient safety
• Improved access, acute
and planned care
• Improve productivity with
good work environment
• Develop CStG to future
plan
In addition we have national and county goals
and participate in all relevant quality registers and
Capio S:t Görans’ business strategy
2015-04-13 4
Patient-flow
We deliver the care to the
patient needs
• What’s needed
• When needed
• As needed
Continuous improvement
Quality
• Correct the first time
– completed ASAP
• We solve the problems
and address the
underlying cause
Methods and tools
Values
Multi professional teams and standardisation
Everything we do create value
from a patient point of view
We make improvements
based on patient needs
Show respect for the individual
Businessplan 2015
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
Businessplan 2015
Improving quality outcomes
7
O
U
T
C
O
M
E
P
R
O
C
E
S
S
QPI
Follow up
- Activities to improve process - Responsibilities - Resources - Targets for activities and processes - Time line
Quality Plan
CROM PROM PREM
Quality report
- Activities done? - Process targets met?
Structured protocols enable visualization of
quality data
4/13/2015 8
Somatisk specialistvård
2009
2010
2011
2012
2013
CStG 96 % 95% 96% 99% 98%
DS 88 % 97% 95% 94% 90%
SÖS 87% 88% 92% 92% 87%
K 85% 88% 90% 91% 92%
STS 88 % 93 % 93% 93% 97%
NTS 89 % 88 % 95% 93% 96%
Result based quality indicators for Stockholm Acute Hospitals
CStG reach acute access targets Share of ER patients with door-to-door time under 4h
10
59
85
68
78
67
69
75
0 20 40 60 80 100
CStG
SLL average
Other
SLL
hospitals
CStG reach access targets for planned care
11
50,0%
60,0%
70,0%
80,0%
90,0%
100,0%
dec14nov14okt14sep14aug14jul14jun14maj14apr14mar14feb14jan14
Vårdgaranti Mottagning
CStG DS SöS K
50,0%
60,0%
70,0%
80,0%
90,0%
100,0%
dec14nov14okt14sep14aug14jul14jun14maj14apr14mar14feb14jan14
Vårdgaranti Behandling
CStG DS SöS K
Number of patients meeting waiting targets for consult >30 days
Number of patients meeting waiting targets for planned surgery/treatment >90 days
Businessplan 2015
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
Cooperation across organizational boundaries
Emergency patient flow
Before During hospital visit After
AE Rad Ward
Businessplan 2015
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
Continuous improvement from a patient
perspective
15
All employees are responsible for increasing
patient quality
We focus on patient value when
eliminating waste in the flow
We systematically improve the
quality in the patient flow
Value
Waste
Managers lead and coach employees in
our continuous improvement work
Involved patients active participants in their
own care and in developing care
Patient involvement in their own care
• Patient information
• Online quality publication
• MVK (National patient portal)
• Online national patient record
• Online patient booking
• Online health-declaration
• Information across the care-chain
• e-referrals
• National e-prescription
Patient involved in developing our care
• Patient feedback and visualization of feedback
• Patient participating in development workgroups
• Patient involved in analysis of risks and negative
events
Online patient tools – ”My care”
Online medical records
Online booking of appointments
Patient perceived quality 2014
808277
817880
0
20
40
60
80
100
Outpatient Inpatient
Nation Stockholm Capio S:t Gorans Hospital
Source: Swedish Institute for Quality Indicators, spring 2014
Businessplan 2015
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
Decentralized leadership a success factor Education based on business need – according to the Capio model
21
• All managers
• Six modules
• 12 days in total
First line managers with clear responsibility
for the business
Clear responsibility and authority Management training for all managers,
and key personnel
Employees
Finance Operations
Advanced
Step III
Intermediate
Step II
Basic
Step I
• For selected competent
and future leaders
• An integrated leadership
program
• 7 days
• Individual program for
advanced and competent
leaders
Roles and responsibilities
Manager Employee
• Introduce, lead and
follow up on continuous
improvement work
• Coach and motivate
employees
• Be present on the floor
• Two jobs – to give care
and to continuously
improve quality for the
patient
• Participate when trying
out new, improved ways
of working
• Correct the first time
around – completed
ASAP
Continued high employee satisfaction
4/13/2015 Source: Information from hospitals 2014
23
70
71
72
73
74
75
76
77
78
79
80
14 15 16 17 18 19 20 21 22 23
Days sick
Employee satisfaction
CStG
Capio S:t Görans Sjukhus
Other hospitals in Stockholm County (SLL)
Businessplan 2015
Improved
quality and
patient safety
Access for
acute and
cancer patients
Access for
patients with
planned care Goals:
Fo
cu
s a
reas 2
015
Develop CStG
to future plan
Improved
productivity
with good work
environment
2. Cooperation across organizational boundaries
3. Involve patients
4. Engaged employees
5. Develop IT, premises and other infrastructure
1. Improve working methods for improved quality
Continuous improvements
25
Steering through structured approach and
follow-ups
• CEO, CFO
• Department heads and first line
management
Weekly
Monthly
Quarterly
• Cross-functional coordination of
resource utilization and production
Objective Participants
• CEO, CFO, PD
• Department heads and controller
• Follow-up of production, productivity
and economic result
• CEO, CFO, CMO, HR, MD, Dep. CEO, PD
• Department Head, First-line management,
quality controller, business controller
• Follow-up of business plan, HR,
Patient safety, quality and satisfaction,
LEAN, Productivity and business,
Department specific initiatives
Daily • Multi professional care teams
• First line management
• Daily team meetings
• Feedback, divergence from standard
and risks
Steering through a structured approach and follow-up
Focus shifted towards real-time automatic information
Historic
information
Manual data
Real-time
information
Automated data
”Future”
information
Clinical decision
support
Warnings Quality data
• New quality
report
• New BI –
economic
reporting
• Daily team
meetings
• Improvement
boards
• Ward utilization
overview
• Statistics
from ER on
the intranet
27
Rubrik
• Text
–Text
• Text
– Text
County hospital quality benchmark shows that
CStG has good results on all dimensions…
…and we continue to use all available input to
continuously improve our hospital…
• Quality
• Patient satisfaction
• Employee satisfaction
• Access to care
• Productivity
Future Capio S:t Görans Hospital - 2018
