alberta health services

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Topics . AHS Organization, PrioritiesExecution of Successful changeOrganizing Analytics and Performance MgmtAnalytic Examples. Quick Facts. $11 Billion operating budget90,000 staff members7,200 physicians3.5 million Albertans served97 acute care hospitals; 5 psychiatric facilities9,000 acute care/sub-acute care beds19,000 long-term care/supportive living beds1,500 addiction/mental health beds7 urgent care centres.

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1. Alberta Health Services ‘Measure to Improve’ AHS Approach to Analytics and Performance Management

3. Quick Facts $11 Billion operating budget 90,000 staff members 7,200 physicians 3.5 million Albertans served 97 acute care hospitals; 5 psychiatric facilities 9,000 acute care/sub-acute care beds 19,000 long-term care/supportive living beds 1,500 addiction/mental health beds 7 urgent care centres AHS implemented a new organizational structure June 1, 2009 arranged in the following areas: Quality and Service Improvement Strategy and Performance Rural, Public & Community Health Finance Corporate Services Senior Physician Executive Clinical Support Services

4. Vision To become the best performing publicly funded health system in Canada Improving health for ALL Albertans

6. Strategic Improvement What How How are we doing

7. Alberta Health Services Measurement – Past

8. Alberta Health Services Measurement Plan Unite analytical/measurement resources across the province. Develop one data repository to meet multiple reporting needs. Develop a data governance structure and process Shift from largely administrative data to clinical and operational data Align measurement resources to clinical services – our core business. Collect data once, at the most granular level and use it for health services delivery management and external reporting requirements. Measure outcomes and activities/process and attach costs to activities

9. Things to consider when choosing an indicator Does it measure an important health issue? Actionable? Strategic: Someone is actioning it (accountable)? Relevant? Is it timely? Measurement Burden relative to value

11. Hybrid Model

12. Why Organize Analytics? Analytical Talent – need to organize analysts so that they are working “close to the business” on critical analytical initiatives while also keeping them “close to each other” for purposes of coordination, mutual learning and support.  Making both happen at once is the challenge. (How to Organize Analytical Talent, Analytics Magazine, Jan/Feb 2010) Interviews with dozens of executives and 700 analysts found that companies with a strong commitment to an analytical workforce are best served by greater centralization and coordination of analysts. (How to Organize Analytical Talent, Analytics Magazine, Jan/Feb 2010) Companies and organizations that compete on analytics don’t entrust the analytical activities to just one group within the company or to a collection of disparate employees across the organization. (Competing on Analytics, 2007)

13. Proposed New Functions Performance Management: Measures alignment of enterprise transformational initiatives with AHS strategic goals and the degree to which performance targets are being met Works with AHS decision makers to set performance targets, identify benchmarks and create a culture of accountability Operations Analytics: Simulation modelling, matching of capacity to demand to ensure acceptable patient flow across the continuum of care Health Economics & Forecasting: Cost per weighted patient methods and reporting, health service event costing, linking costs to outcomes Population Health Observatory: Population pathway modelling, analyses to understand the determinants of health and reduce inequities in the distribution of risk conditions across the province Clinical Networks Support: Will involve common approach for the networks to access analytic support, as well as standards for performance reporting deliverables

14. Significant Projects Utilization index for acute sector- Allocative and Technical - primary care /ASC/Day Surg/QI/EoL/ALC’s Programs, Populations and Pathways- priorities using CRG analysis Performance reporting dash boards, drill down Q&S, HR, Finance, Board VLAD’s

15. Method – Provincial Programs of Care - $ & CRG - KPI across - Population -Red Flag = - Evidence - Focus on Continuum Profiles Response Based Large - Evidence- - Sub-geography - Green = - Research/Lit Variation Based Sub-Population Share Model - Experts - KPI from AHS - Profile with - Amber = - HTA Clinical Networks other info e.g. monitor trend - Reallocation of & Experts Service Inventory, (up or down) Resources PH Surveillance - Design / etc. Re- design by Networks

17. VLADs Introduction to Alberta

18. A statistical monitoring tool which graphically displays clinical outcomes for selected clinical indicators with an alerting mechanism to identify pre-determined variation between a hospital and the province average What is a VLAD?

19. VLAD = Variable Life Adjusted Display A type of Statistical Process Control methodology A graphical tool that detects variation in patient outcomes Assist in identifying potential safety & quality issues & identifying excellent practice A systematic approach to quality improvement Doesn’t replace other quality tools 6 Quick VLAD Facts

20. Introduction of VLADs to AHS

21. How to make a VLAD

22. How is a level of variation detected? FLAG the VLAD plot touches the control limit indicates a certain level of variation prompts a review of patient charts NOTE: A flag does not indicate one case only is to be reviewed, it is cumulative – prior cases also for review How to make a VLAD

23. How to make a VLAD

24. VLAD Process – Flagged VLADs

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