powerpoint: stephen duckett's "reflections on 20 eventful months"

Reflections on 20 eventful months

Alberta Health Services’ senior leadersDecember 6, 2010

Presented byDr. Stephen Duckett

Foundation President and Chief Executive Officer Alberta Health Services

2www.albertahealthservices.ca

Relative to other provinces, Alberta sits in the comparatively higher health expenditure per capita, lower health-adjusted life expectancy (both males and females) quadrant

1 Source: Statistics Canada. Table 102-0121 - Health-adjusted life expectancy, at birth, by sex, for all income groups, Canada and provinces, 2001, CANSIM.2 Adjusted for inflation using Alberta-specific CPI for Alberta and Canadian CPI applied across remaining provinces. Statistics Canada, CANSIM, table 326-0021. 3 Source: Canadian Institute for Health Information, National Health Expenditure Trends, 1975 – 2008 (Ottawa, Ont.: CIHI, 2008).4 Adjusted for Age and Gender differences in expenditure using the Indirect Method and weighting by All-Sector Expenditure in Alberta (2007/2008 Population-Based Funding Weights). Alberta’s weights were applied across all provinces.

Alberta(69.7, 2,563)

Newfoundland(70.2, 2,573)

Manitoba(70.4, 2,219)

Saskatchewan(70.2, 1,973)

Nova Scotia(70.1, 1,859)

British Columbia(71.2, 2,370)

Prince Edward Island(71.7, 2,041)

New Brunswick(70.9, 1,994)

Quebec(72.0, 2,061)

Ontario(70.1, 2,120)

Canada(70.8, 2,170)

1,600

1,800

2,000

2,200

2,400

2,600

2,800

69.0 69.5 70.0 70.5 71.0 71.5 72.0 72.5

Health-Adjusted Life Expectancy (HALE)1 vs. Constant (2002)2

Provincial Government Health Expenditure3 per Adjusted Capita4

for Females, by Province, for 2001

HALE

Exp

end

itu

re

Canada(68.3, 2,170)

Ontario(68.2, 2,120)

Quebec(69.0, 2,061)

New Brunswick(67.4, 1,994)

Prince Edward Island(67.3, 2,041)

British Columbia(68.9, 2,370)

Nova Scotia(66.5, 1,859)

Saskatchewan(67.3, 1,973)

Manitoba(66.7 2,219)

Newfoundland(68.4, 2,573)

Alberta(67.6, 2,563)

1,600

1,800

2,000

2,200

2,400

2,600

2,800

66.0 66.5 67.0 67.5 68.0 68.5 69.0 69.5 70.0 70.5

Health-Adjusted Life Expectancy (HALE)1 vs. Constant (2002)2

Provincial Government Health Expenditure3 per Adjusted Capita4

for Males by Province, for 2001

HALE

Exp

end

itu

re


Alberta cancer survival is marginally behind all-Canada for 3 of 4 most common cancers

91 88

60

12

9487

62

15

0

20

40

60

80

100

Prostate Breast Colorectal Lung

Su

rviv

al

Ra

tio

(%

)

Alberta Canada

Relative 5-Year Relative Age Standardized Survival Ratio for Cancer1

by Jurisdiction, for 2002 to 2004

1 Source: Canadian Cancer Registry database at Statistics


Alberta disinvested in Seniors Accommodation and Other Institutions relative to other provinces over last decade

1 Source: Statistics Canada, CANSIM, table 326-0021 and Catalogue nos. 62-001-X and 62-010-X.2 Source: Canadian Institute for Health Information, National Health Expenditure Trends, 1975 – 2008 (Ottawa, Ont.: CIHI, 2008).3 Adjusted Population is Weighted by All-Sector Expenditure by Age and Gender (2007/2008 Population-Based Funding Weights for Alberta). Alberta’s weights were applied across all provinces.


Emergency admission performance, Edmonton hospitals, 2000-2010 (3 month moving average)


Emergency admission performance, Calgary hospitals, 2000-2010 (3

month moving average)


Achievements

• Cooperation and sharing– Workplace engagement– Emergency access

• Procurement savings• ERM framework• Medical staff by-laws• Interprovincial equity

– Cervical screening example


Pap Test Coverage Rate in Screening Program Areas and Comparable Non-Program Areas (2006 - 2008)

Calgary Capital Palliser Chinook


Achievements - continued

• Security coverage• Electronic provincial drug formulary• Workforce• Activity based funding in long term care


Distribution of weighted cost per day, Alberta long term care facilities, 2009


Achievements - continued

• Contracting for services– Cataract example

• Intra-provincial coordination/cooperation• Reform of mental health services in Edmonton

– AHE• Five Year Funding Agreement


Life expectancy at birth* is shorter in lower socio-economic status neighbourhoods in the City of Edmonton compared to high status ones*2004-2006 combined mortality data

Source Alberta Municipal Affairs (Vital Statistics), Death Data 2004-2006

Exp

ecte

d Y

ears

of

Lif

e


Death rates* also differ between high and low socio-economic status neighbourhoods in Edmonton

*2002-2006 five year average age standardized all-cause, showing confidence intervals

Source Alberta Municipal Affairs (Vital Statistics), Death Data 2002-2006

Ra

te p

er

10

0,0

00


The multiple roles of the CEO

• Managing budget challenge• Getting the merger underway• Foundations• Transformation

• Teaching• Thinking about the long term


Making Medicare sustainable

The right person

enables

the right care

in the right setting

on time

every time


The last polarity slide

+vs

-vs

•Being part of really exciting transformation•Showing Canada the way on making Medicare sustainable•Working with really great people

•Stress ++++•External environment•Work-life balance

StayGo•Manner of going +++•Regrets about unfinished business (more needs to be done)

•Research and write•Consultancy (short trips only!)•Family time

Johnson, B Polarity management: identifying and managing unsolvable problems HRD Press 1996

powerpoint: stephen duckett's "reflections on 20 eventful months"

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