CAPHC – CPDSN NATIONAL SYMPOSIUM:CEO PERSPECTIVE

DATA ANALYTICS

• We need to use data to first improve care and then to help contain costs

• Clinical data, cost data and mixture of both• The amount of available data and reporting

requirements are increasing every month– Internal, provincial, national, international– So be sure to pick your battles!

DATA ANALYTICS

• Basic principles when using data– Patient safety and quality are top priorities– It takes a team to use the data properly– External benchmarking is often key to

engagement of staff– Form follows function

• Critical Care LHIN Name Total Percent Hamilton Niagara Haldimand Brant 1428 68.5% Waterloo Wellington 457 21.9% N/A 75 3.6% Mississauga Halton 54 2.6% North East 13 0.6% South West 13 0.6% Central West 12 0.6% Central East 9 0.4% Central 8 0.4% North Simcoe Muskoka 6 0.3% Toronto Central 5 0.2% North West 3 0.1% Erie St. Clair 2 0.1% Total 2,085 100.0%

68.5%

21.9%

3.6%

2.6% 0.6% 0.6% 0.6% 0.4% 0.4% 0.3% 0.2% 0.1%

Critical Care

Hamilton Niagara Haldimand Brant Waterloo Wellington

N/A Mississauga Halton

North East South West

Central West Central East

Central North Simcoe Muskoka

Toronto Central North West

The SEC index includes Low SES and the Ontario Marginalization Index’s Instability and Ethnicity measures

DATA ANALYTICS

• We need to use “big data” as we move more into population health initiatives– Taking an upstream approach to disease

prevention and management– Assessing models of care delivery outside of

our walls

MCH Approach to Reduce Admit Rate

Challenge: Unsustainable increase in admission through the Pediatric Emergency Department.

DATA: Admit Rate: Admits as a % of Visits - 10.1% (CIHI, 2015).

Absolute Values: Admits increased from 3,327 to 4,878 (CIHI, 2013-15)

46.6% increase above 2013 baseline

MCH Approach to Reduce Admit Rate

Goal: Determine what is the ideal admission rate for MCH utilizing CAPHC National Benchmarking?

Background: Emergency Department Visit volume ranged from ~1,000 - 76,000 per ED (CIHI, 2015) Canadian Pediatric Hospitals Average Admit Rate through the Emergency Department – 8.1% of total visits (CIHI, 2015)

MCH Approach to Reduce Admit Rate

Drilling Down:Hospitals with a similar range of ED visits (50,000/year) generated the following admit rates:

BC Children’s Hospital – 7.4%Stollery Children’s – 9.7%

Winnipeg Children’s – 7.2%McMaster Children’s – 10.3%

MCH Approach to Reduce Admit Rate

Goal 8% Target (2016) 9.5%

Action: Investigate alternatives to Admission to Reduce Admit Rate – upstream focus

1. Focused on 24hour admits and dischargesa) Launched an expanded wait at home practice to include our Ronald McDonald House for patients that meet criteria but live outside of our City.

MCH Approach to Reduce Admit Rate

2. Partnered with our Ambulatory Sub-Speciality Teams to improve the ED physician’s knowledge of complex patient’s medical history on arrival to the ED – upstream focus

a) Re-launched our patient alert card system

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MCH Approach to Reduce Admit Rate

3. Clustered long stay patients onto one Medical Unit to focus efforts on similar discharge barriers – downstream focus

a) Strengthen partnerships with community and home care providers

b) Explore the opportunity to expand care parameters in the community and/or home

Questions?