Agenda

1. Agenda

2. 2007 Reviewby David Dean, General Manager The Health Roundtable Limited2007 Annual Report Annual General Meeting 19 March 2008

3. An Innovation Clearinghouse • Share problems • Share solutions • Avoid reinventing wheels • “Seed” large scale projects • Provide CEO network Health Roundtable UHC IHI

4. 40 Organisational Members + RHIN76 Hospital Facilities + RHIN

5. H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  Health Roundtable Structure Health Service Organisational Members Organisational Members Nominate Personal Members Personal Members Elect Board of Directors Board Outsources Management Services with Biennial Contract Chappell Dean Network

6. Health Roundtable Board of Directors 2007

7. The Chappell Dean Support Team 2007

8. Overall Program for 2007

9. Overall Financial Results

10. Thanks to Our Corporate Sponsors in 2007!

11. Roundtable Meetings Patient Streaming Ambulatory Care Journeys Patient Safety Document Management Systems Multi-site Clinical Networking

12. Patient Streaming Models - Asklepios

13. Patient Streaming Models - Thunder

14. Improving Outpatient Journey – Diabetic Patients Example Patient receives an appointment date for initial assessment Patient referred by GP/ other Patient attends initial assessment Patient Attends for follow-up care 2 Weeks 5.3 Weeks 9.8 Weeks Time to 1st Appt Shortest: Vulcan, Hermes 4 weeks, Sirius & Poseidon 5 weeks Longest: around 14 weeks

15. Outpatient “Good Practice” Guidelines

16. Improving Patient Safety

17. Improving Patient Safety

18. Improving Patient SafetyHospital at Night – Good Practice Concepts

19. Document Management System Roundtable

20. Document Management System RoundtableBusiness Case Model Tutorial Discounted Cashflow

21. Multi-site Clinical NetworkingQuick Indicators of Multi-Site Network Integration

22. Multi-site Clinical Networking Models

23. Management Training

24. Lean Healthcare Program Design – 12 WeeksOver 100 Graduates by December 2007 Workshop One (2 days): Welcome and Introductions – Setting the Scene What is Lean Thinking? Why Lean in Healthcare? Seven Wastes Value Stream Mapping – Current State Starting your Value Stream Map 5 S Workshop Two (2 Days): Review Current State Maps Develop Future State Designing “Pull” Visual controls Standardisation Predicting Output Kanban Weekly Coaching Workshop Three (1 day): Report & Review Project Progress Extending and Expanding Projects Change Management Issues Next Steps Weekly Coaching

25. WHAT IS DIFFERENT ABOUT LEAN? ED LAB Theatre Ward Wait Wait Wait Wait Wait Main Focus on Improving Patient Journey Time by Reducing Waste between Silos

26. W W W Outpatient Process Referral Appointment Specialist Consult Clinic Reception 20 min 20 min 50 min 5 min 49 days 7 days 20 min Process Time: 95 min Delay Time: 80660 min

27. Lean Improvement Examples Canterbury:Reduce Radiology delays for Neurology patients Capital & Coast: Reduce delays for Diabetes OPD appointments Health Waikato: Decrease ALOS of T&A by 50% to 0.33 days Counties Manukau: Reduce ED Occupancy to <6 hrs for all general surgery patients Waitemata: Reduce patient waiting for their relatives to collect them Auckland:Reduce haematology and biochemistry specimen turnaround time SCGH:Eliminate neurosurgical cancellations due to ICU “bed blocks” NT:Reduce DNA rate of long-distance outpatient referrals Project summaries available on the website: www.healthroundtable.org

28. Benchmarking Activities Allied Health Clinical Costing Emergency Presentations Inpatient Casemix Key Performance Indicators Maternity Mental Health Staff Surveys

29. Updated Website Repository for All Datawww.healthroundtable.org

30. Participant Evaluations Provide Valuable Feedback

31. Operational Review – Improvements for 2008