ppx january 2016 le
TRANSCRIPT
Operational Capacity Analysis to Support
Healthcare Outcomes
for Veterans
(or the unintended effects of asking simple questions…)
PERFORMANCE AND PLANNING EXCHANGE (PPX)
January 26, 2016
1
Presentation Outline
• About VAC
• Context
• Scope of work
• Samples
• Future steps
2
About VAC
• VAC = Department of Veterans Affairs, Veterans Review and Appeals
Board, Ombudsman
• Responsibility for pensions/benefits and services for war veterans, retired
and still-serving members of the Canadian Forces and Royal Canadian
Mounted Police, their families, as well as some civilians.
• 3555 personnel
• 4 Branches ( Service Delivery, Strategic Policy and Commemoration,
Strategic Oversight and Communications, Human Resources and
Corporate Services)
3
Service Delivery
• 4 Divisions Field Operations (District Offices and client services), Central
Operations (Adjudications), Program Management (Treatment and
Benefits), Health Professionals)
• 1550 personnel
4
Total Department Workforce Service Delivery Workforce
5SERVICE DELIVERY NETWORK
Health Professionals Division
• Admin Staff (6)
• Field Staff
– Medical Officers (41)
– Nurses (55)
– Occupational Therapists ( 60-all contractors)
• Directorate of Mental Health (23)
– Psychologists
– Social Workers
– Other occupations
6
HPD Context
• New Health Professionals
Division formed in 2012
• New DG Fall 2014
• New Departmental Strategy
• New DM, New Min VA
• Performance Measurement
7
VAC PAA (2015-16)
Scope of HPD Workload Project
• Inventory activities
– (what are we doing?)
• Workload analysis
– (how busy are we?)
• Logic Model
– (are we doing the right things?)
• Performance Measurement framework
– ( are we achieving the right outcomes?)
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Inventory of HPD activities
Workload Analysis – Data Collection
Workload Analysis – Data Comparisons and Validation
Activity Flow (Inputs to Outputs)
Nurses OTs
Workload Analysis Forecasting Model / Tool
Workload Analysis Forecasting Model / Tool
Workload Analysis Forecasting Model / Tool
Workload Analysis Forecasting Model / Tool
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Summary and Analysis of Capacity/Utilization Results
• Workloads can vary significantly from region to region
• Activities can vary significantly from province to province
• Analysis of “outliers” provides potential opportunities for process
improvement
• HPD staff continue to go “above and beyond” to help meet
Healthcare Outcomes for Veterans
HPD Engagement
HPD Support to Strategic Outcome 1
HPD Support Various PMF IndicatorsHPD Engagement
HPD Support Various Program Performance Measurement Strategies
Linking Activities and Outputs to Outcomes and Performance
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Benefits and Lessons Learned
• Validation
• Information for decision making
• Communication
• Need to implement and sustain
Next Steps
• Validate workload nationwide ( all offices)
• Extract workload volumes from existing databases
• Deploy scenario-playing model nationwide
• Report and forecast
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Costing Centre of ExpertiseCosting Benchmarking Framework
Planning & Performance Exchange Learning Event
Operational Costing & Capacity Management: Their Links to Planning, Performance, and Efficiency
January 26, 2016
1
2
Purpose
• Background
• High level findings
• Cost Factors Manual
3
CCE Major Activities
The CCE proactively supports:• Deputy Head and CFO accountabilities
• Program Sectors as the primary performers of the TBS challenge function
• The current roles and responsibilities of EMS
Key activities of the CCE include:• Supporting an enhanced diligence function within TBS for
consideration of funding requests
• Supporting “deep dives” and “horizontal reviews”
• Developing strategies for provision of training on cost containment and cost estimation for TBS program sector analysts
• Developing policy and guidance on cost estimation, cost containment, and the management of user fees
• Rolling out guidance on CFO attestation and provision of support to departments
Developing a cost factors manual to inform and
support resourcing decisions
4
Cost Factors Manual
• Is it possible to estimate incremental resource requirements for new initiatives?
• Can the Treasury Board assess the reasonableness of funding requests?
• Can we determine which metrics (cost factors) fairly represent efficiency in Internal Services?
5
Work to Date
Approach:
• Attempt to establish standard cost factors for comparable organizations
CCE went to work:
• What are other jurisdictions doing with their “internal services”?
• What are appropriate cost drivers for the different functions in internal services?
6
Open Data
Hypothesis being tested:
• Without adding to the reporting burden of organizations, what can we find out from publically available data?
Organizations have attested to this data and it has been tabled in Parliament:
• RPP, Public Accounts and DPR
7
Proof of Concept
Key Assumptions and Limitations:
• Expenditure was used as proxy for cost and capacity
• The IS Program was analyzed in the aggregate, not by sub-category of internal services
• IS Program effectiveness was not considered
Scope:
• Analysed the data for the following fiscal years:• 2010-11
• 2011-12
• 2012-13
• 2013-14
Ongoing evolution of approach
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Clustering of Organizations
Preliminary Analysis:
• Size on its own may not be sufficient to explain fluctuations in IS expenditures; other factors must be considered to measure the complexity
• Type of activities performed (i.e. G&C and Capital) and the amount of resources dedicated to specific types of activities impact IS expenditures, as does the geographic reach (number of regions with employees)
o However Capital expenditures have limited publically available data
Organizational context is key to understanding the whole story!
9
Hypothetical Clustering of Organizations
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What to measure?
• Analyze the behaviour of expenditures in groups of “like” organizations (or internally between programs) based on Cost Estimating Relationships
• One measure does not “tell the whole story”, multiple measures are needed to give a better understanding of an organization
• Based on preliminary analysis of publicly available data, 3 cost factors are being tested to see how they “tell the story”:
1) IS Program FTEs/All Other Programs FTEs
2) IS Program Gross Voted Operating Expenditures/ All Other Programs Gross Voted Operating Expenditures
3) IS Program Gross Voted Operating Expenditures/ Total Organizational FTEs
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Conceptual model
• Using cost factors and a proxy measure for capacity, is it possible to estimate additional resources required?
• Analytical grids allow decision makers to gauge the reasonableness of funding requests by allowing the comparison of “like” organizations
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Common Data and Clusters
• Our work to group organizations into appropriate clusters will enable:
o Reasonableness testing for Internal Services by providing a range of existing expenditures for similar organizations
o EMS can leverage these same cost factors and clustering methodology to measure performance
Common
Data Points
Clustering(size and
complexity)Performance Measures
(Efficiency and Effectiveness):
• Internal Services
• Transfer Payment Programs
• External Services
Reasonableness Measures for
expenditures and FTEs:
• Internal Services Program
• IS by function
• Type of G&C or Program
Collect data and analyse
Standardize Treatment
and Context
Review Results
Continuous Improvement
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Similar but different
• EMS could leverage and evaluate the work by the CCE to consider the clustering and cost factors to look at efficiency metrics
• CCE is leveraging the EMS work on efficiency metrics and program tagging.
Thus far, common data can be leveraged by both and will not cause undue reporting burden to organizations.
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Contact Information
Greg Steele
A/Director Costing Policy
Office of the Controller General, Treasury Board of Canada Secretariat
Government of [email protected]
Tel: 613-697-0863 / TTY: 613-957-9090
Directeur par intérim sur l’établissement des coûts,
Bureau du contrôleur général, Secrétariat du Conseil du Trésor du Canada
Gouvernement du [email protected]
Tél. : 613-697-0863 / ATS : 613-957-9090
Operational Costing and
Capacity Management
CBSA’s Cost Factor Manual
PERFORMANCE AND PLANNING EXCHANGE
(PPX)
January 26, 2016
Outline
• Context
• CBSA Cost Factor Manual
• The Step-variable approach applied
• Sample data extracts
• "Demo"
2
GoC Context
• TB President has been directed to
ensure more oversight on costing
and to ground decisions on
“best available information”
• TBS moving forward on
– Step-variable approach
– Benchmarking of internal services
costing / comparative data
– Internal Service efficiency and
performance indicators being
introduced
• CBSA proactively moving forward
with costing centre of expertise to
strengthen costing and implement /
apply step-variable approach
CBSA Context
• Like other departments, CBSA
facing a tight fiscal environment,
with significant pressure to
justify resourcing needs
with evidence
• In 2014, at the direction of the Deputy, the Agency initiated a
“Tooth-to-Tail” (TTT) analysis of Agency front-line versus internal
services resources
• The TTT architecture and data set was then transformed and
expanded to incorporate core front-line operational activities and
associated volumetrics to lay the foundation for the Agency’s
Cost Factor Manual (CFM)4
A A1-1 Front-line Program-Service Delivery Risk Assessment 1 Intelligence in the regions
A A1-2 Front-line Program-Service Delivery Risk Assessment 2 Security Screening
A A1-3 Front-line Program-Service Delivery Risk Assessment 3 Targeting
A A2-1 Front-line Program-Service Delivery Secure and Trusted Partnership 1 Trusted traveller … in the regions
A A2-2 Front-line Program-Service Delivery Secure and Trusted Partnership 2 Trusted trader … in the regions
A A3-1 Front-line Program-Service Delivery Admissibility determination 1 Front-line Ops - Traveller
CBSA CFM Objectives
• Improve accuracy, reliability and quality of Agency financial data
• Link data to core program volumetrics to enable stepped variable
costing in accordance with TBS / OCG costing directions
• Comply with TBS / OCG Internal Services costing guidance
• Create foundational data set to determine unit cost standards across
all common functions
• Strengthen rigour and quality of financial advice into budget allocation
decision making
5
The CFM – What Precisely Is it?• The CFM is a strategic resource management, costing, and management accounting
tool designed to support program analysis and resourcing decision-making
• It is essentially an off-line, enterprise data warehouse that links
– Financial expenditure data, to
– Program volumetric data,
– At the PoE level of analysis (in the regions), and
– At the Directorate level of analysis (at HQ).
• The scope of the database includes:
– Expenditure data, based on CAS, manually adjusted and validated by business owners
through multiple iterations since 2013
– Linkages to all financial data in the coding block, including Cost Centre data, Program Activity
data, Activity Type data, GL, Fund Code, etc
– Linkages to program volume data from core systems / data cubes, including ACROSS,
CRMS,G11, FOSS, ICES, etc..)
• As it contains manually adjusted financial data, it is not and should not be used for
system of record financial accounting requirements.
6
• The CFM architecture captures expenditures on multiple analytical levels,
through a series of data tags, including:
– “Tooth-to-Tail”, which captures
• Front-line Program Delivery, distinct from
• Direct Support to Front-line Program Delivery, distinct from
• Internal Services (in accordance with TBS guidance on coding for internal services)
– CBSA program architecture, specifically wrt
• The Agency’s current PAA, approved by TB Ministers in 2010, as distinct from
• The Agency’s new PAA, as approved by EC October 22, 2015
• The CFM is comprised of three main costing components:
– Regional Data
– Headquarters Data
– Costing by application
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The CFM – What Precisely Is it?
Key Principles / Methodology
• CFM Key principles
– Account for 100% of expenditures
– No double counting
– Balance to public accounts / system of record
• To build / update the database, the data is pulled from source
systems and adjusted based on the attribution formulas that
have been validated over the past 2 years
– Mapped by POE/division to enable the alignment of resources and volumes
– Resources and volumes are attributed by function based on the CFM
architecture
– The data is then compared by “cluster” to further validate the allocation /
attributions by function at the most granular level (to identify anomolies /
variances and challenge the attributions and enable further refinement of
the quality of the data)
8
Using the CFMThe Agency is looking to use the CFM as a core analytical tool for
costing and resource allocation. Uses include:
• Costing for TB submissions
• Stepped-variable approach for budget allocations / resource management
decision-making
• Tool for targeted reviews (e.g. OT)
• Identification and assessment of variances in unit costs within a program
and between PoE
• Development of efficiency indicators for the new Agency
Performance Measurement framework
• X-walk for implementation of a new PAA
• Mapping of data pathways for the Agency Enterprise Data Warehouse
• Engaging the financial and program analyst user community to proto-type
business requirements and functionality for future reporting tools
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• However, unlike true variable costs that vary directly with the level of activity; the stepped-variable approach
incurs increases at certain discrete points that involve changes in the number of FTEs required at the POE.
• Once we get to large POEs, the costs become truly variable depending on volumes.
Step-Variable Approach
Large
Tota
l Cos
t ($)
Small POEs
Small/Medium
Medium
Number of POEs :107Travellers : 4,463,023Commercial Releases: 319,065
Number of POEs: 28Travellers: 18,276,980Commercial Releases: 1,632,462
Number of POEs: 37Travellers : 5,647,045Commercial Releases: 2,009,161
Number of POEs: 20Travellers: 68,250,348Commercial Releases: 10,721,106
CFM Visualization ToolPrograms Branch – 2014-15
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(under development)
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Costing Centre of Expertise: Mandate
Vision:
• CBSA recognized as one of the best in costing in government
Mandate:
• Build and implement a fully integrated costing capability that strengthens the
Agency’s ability to deliver value-for-money across programs
Role / Position within Comptrollership:
• Centralized unit providing specialised cost estimation services
• Services to include:
– A core costing capability
– Capacity building, guidance and training to FMAs (targeting FI-02s and FI-03s)
– Costing tools for FMAs, to support their work
– Enterprise costing (I.e. CBSA costing template, IS costing model, SAF etc…)
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Demo
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Next Steps
• Confirm scope and limitations on use of CFM data
• Use CFM as an input factor in budget allocation decision-making
• Deploy visualization tool and directions and scope and limitations to
financial and program analyst community
• Use tool to support engagement and proto-typing of functionality desired
from user community in support of Enterprise Data Warehouse
• Continue to build a more accurate historical dataset by incorporating
periodic updates (until enterprise data warehouse is complete)
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