slide1
Download
Skip this Video
Download Presentation
David Levine President/CEO Montreal Regional Health Authority 2007

Loading in 2 Seconds...

play fullscreen
1 / 21

David Levine President/CEO Montreal Regional Health Authority 2007 - PowerPoint PPT Presentation


  • 111 Views
  • Uploaded on

Breakfast with the Chiefs Strategic Levers for a High-performing Health System Equity issues in funding and delivery : The Montreal Experience Toronto - April 17 2007. David Levine President/CEO Montreal Regional Health Authority 2007. Developing a High-Performing Health System in Quebec.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' David Levine President/CEO Montreal Regional Health Authority 2007' - archer


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Breakfast with the ChiefsStrategic Levers for a High-performing Health System Equity issues in funding and delivery : The Montreal ExperienceToronto - April 17 2007

David Levine

President/CEO

Montreal Regional Health Authority

2007

developing a high performing health system in quebec
Developing a High-Performing Health System in Quebec
  • History 1970-2004
  • The Reform

2.1 Objectives

2.2 Guiding principles

2.3 Structural changes

  • Strategic Levers

3.1 A managed care model

3.2 Primary care teams

3.3 Empowerment

3.4 Performance measures

3.5 Management contracts

3.6 Equity funding

3.7 Purchasing accessibility

  • Conclusion
developing a high performing health system in quebec1
Developing a High-Performing Health System in Quebec
  • History 1970-2004
      • 5 Canadian principles respected
      • Responsibility for the individual
      • Functioning in silos
      • A problem of continuity
      • A problem of accessibility
      • Repetition of services
      • Hard to move from one level of care to another
      • Performance undefined
      • Payment not linked to performance
developing a high performing health system in quebec2
Developing a High-Performing Health System in Quebec
  • The Reform

2.1 Objectives

        • Improve the health and will being of the population (specific mandates)
        • Bring services to the population

(equitable distribution of services)

        • Facilitate the use of services

(accessibility, continuity)

        • Manage care for vulnerable clientele
developing a high performing health system in quebec3
Developing a High-Performing Health System in Quebec

2.2 Guiding principal

  • Populational responsibility
    • Defined population
    • Responsible for the health well-being of that population
    • Responsible for the individuals health and well-being
  • Hierarchical provision of services
    • Regrouping primary care responsibility
    • Clearly refining secondary and tertiary services
    • Reference protocols and corridors of services
developing a high performing health system in quebec4
Developing a High-Performing Health System in Quebec

2.3 Structural changes

  • A new organization: Health and Social Services Centers (HSSC)
  • A new concept of integrated services through the creation of local services networks
  • Merger of hospitals, local community service center, long term care centers into a single institution
  • 12 HSSC in Montreal, 95 across Quebec
developing a high performing health system in quebec5
Developing a High-Performing Health System in Quebec

Population : 1,9 million

Budget : 5,2 billion $

Institutions : 97

Installations : 350

Medical clinics : 400

Employees : 90 000

MD specialists: 3 293

General practitioners: 2 223

Nurses: 21 700

Other professionals: 8 000

developing a high performing health system in quebec6
Developing a High-Performing Health System in Quebec

Mandate of a Health and Social Service Center

  • Manage and evaluate the health and well being of the population
  • Manage the use of services by the population
  • Manage the services offered by each HSSC
  • Develope a local network of care
developing a high performing health system in quebec7
Developing a High-Performing Health System in Quebec

Local territory

Social economy enterprises

Physicians

(FMG, AMC, medical clinics)

Community pharmacies

Health and Social ServicesCentres :

grouping of one or several CLSCSs, CHSLD, CHSGSs

Community organizations

Youth Centre

Noninstitutional resources

Rehabilitation centre

Other sectors:

education, municipal, justice, etc.

Hospitals that provide

specialized services

developing a high performing health system in quebec8
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.1 Managed care

        • Chronic care model
          • Chronic care protocal for each disease
          • Support patients self management
          • Multidisciplinary team approach
          • A seamless system
          • Decision tools
          • Information systems for developing registers ans insuring follow-up
          • Involvement of community resources
slide11

Survey of operational practice built

on the Chronic Care Model

  • Which is the most important practice?
    • Leadership
    • Accountability
    • Champions
    • Resources
    • Financial Incentives
    • Provider Feedback
    • Program Evaluation
    • Patient Action Plans
    • Patient Education
    • Guideline Training
    • Provider Alerts
    • AMR
    • Defined Care Path
    • Risk Stratification
    • Registry
    • Outreach and Follow-up
    • Inreach
    • Care Coordination
    • Team-Based Care
    • Cultural Competence

From Improving Chronic Illness Care

Ed Wagner, MD, Group Health Cooperative of Puget Sound

developing a high performing health system in quebec9
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.1 Managed care

        • Clinical components of a population based managed care model
          • A population health evaluation protocol
          • An individual evaluation protocol
          • Developing clinical protocols of care based of a chronic care model
          • Organization of care

- Into a multidisciplinary teams responsible

for a rostered population

- Corridors of service linking the providers of

care into a seamless system

developing a high performing health system in quebec10
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.1 Managed care

        • Restructuring care for a population based

care model

          • Restructuring nursing home care
          • Restructuring rehab care
          • Restructuring care for the intellectually handicaped
          • Restructuring mental health care
          • Restructuring laboratory services
developing a high performing health system in quebec11
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.2 A Primary care teams

          • Populational responsibility – Rostered clientel
          • Integration of primary care physicians specialists and health professionals into folly integrated multidisciplinary teams
          • Access to medical technology
          • Use of a manage care model
developing a high performing health system in quebec12
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.3Empowerment

        • On the determinants of health
        • On healthy living
        • On disease management
developing a high performing health system in quebec13
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.4 Performance measurement

        • Evaluation of population health
        • Evaluation of clinical performance of primary care teams (England quality outcome frame work)
        • Quality control of secondary and tertiary care
        • Measurement of efficiency add efficacy
developing a high performing health system in quebec14
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.5 Management contracts

          • Minisitry with the Agency
          • Agency with each institution
developing a high performing health system in quebec15
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.6 Principals of equity funding

      • Regional equity 221 $ million
      • Terretorial equity – Program funding

- Population based adjusted for age, sex, income,

education, cost of services, needs evaluation,

geography, state of health

- Redistribution of services : - dialysis

- chemotherapy

- rehab

- mental health

developing a high performing health system in quebec16
Developing a High-Performing Health System in Quebec
  • Strategic Levers

3.7 Puchasing acessibility

        • Primary care acessibility

- Family practice groups and integrated primary care teams

- Hours of operation add coverage

- Affiliated medical centers

        • Chirurgical acessibility
        • Diagnostic services
        • Regrouping lab services
        • Purchasing radiology services
        • Purchasing volume
developing a high performing health system in quebec17
Developing a High-Performing Health System in Quebec
  • Conclusion – The key ingredients
  • A population based managed care model
  • Multidisciplinary primary health care teams
  • Competition for provision of services
  • Management contracts
slide21

Thank You

ISBN 2-89510-223-6

Dépôt légal – Bibliothèque nationale du Québec, 2005

This document is available:

- At Service des technologies et de la diffusion de l’information

Phone (514) 286-6500

- On the Website of the Agency: www.santemontreal.qc.ca

ad