Presentation Transcript

1. Implementing a Single Statewide Pathology ServiceKey ChallengesKeys to Success Professor Ruth Salom August 29, 2013
2. The Journey : SA Pathology 2008 – 2012 2008 – 2012: Inaugural Executive Director, SA Pathology 17 hospital laboratories; 2000 staff; $280M budget; comprehensive pathology services; selected clinical services; research & teaching 2012 – current: KPMG: Director NAT Health and Human Services Melbourne Health: Non-Executive Director Monash University: Professor
3. The Journey : SA Pathology 2008 – 2012 2008 - SA Government Proclaimed the formation of SA Pathology, a Single StatewidePathology Service Mandated Project Quality Key Performance Indicators Restructure from existing budget  Budget savings of $1.5M in the first year  2012: > $30M recurrent savings  Retain private market share 33%  2012: 37.5% 60% of staff are satisfied with the transition process  85% @ 12 months  Hospital CEOsand clinicians are satisfied with the new service with fee reduction from 100% MBS to 85% MBS Fee for service established for CMBS and NCMBS across all hospitals 
4. The Journey : SA Pathology 2008 – 2012
5. The Journey : Major Initiatives Resulting in Productivity Gains
6. The Journey: Organisational Restructure Executive Director ClinicalGovernance CorporateGovernance ServiceDirectorates ResearchGovernance Business and Governance Director Commercial Contracts and Proposal Management Director Laboratory Operations Director ICT Director Business Change Director Marketing and Communications Director Deputy Director Chief Pathologist Chief Scientist Research Director Automated Laboratory Chemical Pathology Cytopathology Genetics & Molecular Pathology Haematology Immunology Microbiology & Infectious Diseases Regional Services Surgical Pathology
7. TQEH LYELL M MODBURY FMC WCH WCH RAH RAH FMC LMH TQEH The Journey: Organisational Restructure Discipline leadership across the state, not site based. HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR Mod HEAD OF DEPT/ LAB MGR HEAD OF DEPT/ LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR HEAD OF DEPT / LAB MGR LAB MGR X 13 REGIONAL LABS LAB MGR X 13 REGIONAL LABS
8. Key challenge 1 : Negative feelings / feedback by impacted staff At start of the process - most enthused As the project progresses -negative feelings Staff impacted...either by a direct challenge to their employment or to the way that they have been used to working. Key to Success CE / Ministerial support. Well informed stakeholders. Planning for negative impact. “ make sure that you go up the ladders and don’t slide down the snakes
9. Key challenge 2 : Governance of Multiple projects during the transformation Key to Success Established an effective Project Management Office. Maintained a strong management group Met regularly and signed off recommendations All projects governed by the ‘Quality Lens’ “ make sure that you go up the ladders and don’t slide down the snakes
10. Key challenge 2 : Governance of Multiple projects during the transformation Note: (a) [...]. Source: [...]. SA PATHOLOGY MANAGEMENT GROUP 2012
11. Key challenge 2 : Governance of multiple projects during the transformation Quality Reporting Established across the State
12. Key challenge 3: Implementation of Uniformity, Transparency and Equity Key to Success Extensive due diligence of current state processes in order to: Establish one common and transparent pathologist private practice arrangement across the organisation Establish organisational structure that is equitable across the organisation Establish common test nomenclature and cost structure for all hospitals Capture all costs relating to pathology in a uniform way (including overheads) “ make sure that you go up the ladders and don’t slide down the snakes
13. Key challenge 4: The Transformation Process to a Single State Service Key to Success Speed of implementation (< 6/12) Advertised / Matched roles not individuals to grades and job requirements, appointed the best Built specifications that defined the service need rather than favoured a particular technology or discipline Identified the real-estate required to host the service through a transparent process. “ make sure that you go up the ladders and don’t slide down the snakes
14. Key challenge 5: Stakeholder Management Key to Success Engaged with all stakeholders (including staff, customers, unions, government etc) Communicated widely and regularly with all groups. newsletters, website, road-shows engaged with representatives of the new groups / unions / clinicians etc. Celebrated achievements / milestones “ make sure that you go up the ladders and don’t slide down the snakes
15. Our Research
16. National & International Benchmarking of Government Pathology Integration......................Little Information Available
17. The integration challengeMore than two thirds of North American private deals fail to deliver value Findings from KPMG’s global 2011 mergers and acquisitions survey: “A new Dawn” Less than 1/3 of deals enhance value What would companies do differently next time? 31% Better due diligence and planning Enhance value 30% Faster implementation and integration Value neutral 39% More attention to HR and culture matters Reduce value
18. Measuring Success of Public Pathology Consolidation ....Pre and Post integration Key Performance Indicators
19. An amazing journey.........
20. Q & A THANK YOU
21. Key Achievements for each Stakeholders: Patients / Clinicians / Hospitals Standardised processes ; Improved Quality Systems – Q Pulse / ISO introduced / State quality reports; Decreased pathology cost to Local Health Networks; Maintained bulk billing for South Australian population through competing in the private pathology market sector; introduced state based registrar training in AP & Haem The State >$30M recurrent savings ; increased productivity; Increased private pathology market share / revenue; Commercialised IP with net worth to state of $90M; gifts given to charity The Staff Additional 1/52 leave for 24/7 lab staff, Training & Travel Fund, Uniformity of Classifications , Improved Staff Career Progression, Established Staff Common Room / Cafe / Improved Lab Facilities Research & Education Establishment of Centre of Cancer Biology; (2012: $17.2M in competitive grants); Establishment of Genomics Facility; Improved IP&CManagement, Improved researcher salaries