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Strategic Clinical Networks & Clinical Care Pathways: Creating & Managing Quality in Alberta Health Services CEO Forum Feb 6, 2013 Montreal Dr Tom Noseworthy.

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Presentation on theme: "Strategic Clinical Networks & Clinical Care Pathways: Creating & Managing Quality in Alberta Health Services CEO Forum Feb 6, 2013 Montreal Dr Tom Noseworthy."— Presentation transcript:

1 Strategic Clinical Networks & Clinical Care Pathways: Creating & Managing Quality in Alberta Health Services CEO Forum Feb 6, 2013 Montreal Dr Tom Noseworthy

2 Alberta Health Services
One health care delivery system for an entire Province The ‘third way’ in Canada Largest health care system in Canada- 3.7 million people Budget $12B, 100,000 employees, 7500 doctors Formed in 2008, 5 Zones added in 2010, Networks in 2012 Nine clinical networks launched to date Up to six more planned We aspire to being the best in Canada

3 How will the Provincial Clinical Mandate of AHS be Accomplished?
Strategic Clinical Networks Clinically-led change Performance measurement, research & best evidence drive practice Clinical care pathways Clinical variance management & peer review

4 Goals of Clinical Networks?
Achieve the best outcomes Practice the highest quality of clinical care Seek the greatest value from resources used Engage clinicians in all aspects of this work

5 Why Clinical Networks? Networks are positive ways for all partners along a broad continuum to be involved in planning & improving care & service delivery Networks have been shown to be an effective mechanism to ensure collaboration, joint decision-making and shared learning Networks are a proven model to promote the use/uptake of clinical experience, knowledge and evidence-based clinical pathways to reduce clinical variation & improve care

6 What are Strategic Clinical Networks (SCNs)?
Collaborative clinical teams with a provincial strategic mandate to improve quality & outcomes Led by clinicians, driven by clinical needs, focused on outcomes & based on best evidence Comprised of an all-inclusive membership, with 25 core members (community & specialty clinicians, patients, policy-makers, researchers) & leadership (0.5 Senior Medical Director, 0.5 Strategy Vice-President & 0.3 Scientific Director)

7 Scope encompasses entire continuum of care
How do SCNs Work? Broad mandate: Specific populations: seniors, women's health, children High impact: cardiovascular disease & stroke High burden: diabetes, obesity & nutrition, amh Scope encompasses entire continuum of care From population health & prevention to primary care to acute care to chronic disease management to palliation Projects & activities aligned with AH & AHS, priority-setting integrated with & into organizational decision-making Resourced & supported to improve clinical outcomes

8 Planned Support & Resources for Each SCN
Dedicated Business Intelligence Unit Project management, clinical analytics, case costing, quality improvement, pathway development, patient safety, knowledge management, health technology assessment Embedded research capability and expertise Education & skills development for leaders Funding including: Seed money for innovation, initiatives, and research Remuneration of core members Opportunities to retain savings that are realized

9 First Six SCNs (June 12/12) Addiction and Mental Health
Bone and Joint Health Cancer Care Cardiovascular Health and Stroke Obesity, Diabetes and Nutrition Seniors’ Health

10 Next Six SCNs (Fiscal 2013) Population Health and Health Promotion
Primary Care & Chronic Disease Management Maternal Health Newborn, Child, and Youth Health Neurological Disease, ENT, and Vision Complex Medicine (GI, Kidney & Respiratory)

11 Operational Clinical Networks
Similar to SCNs Provincial, clinically led teams Similar infrastructure & resources Differ from SCNs Responsible across populations Operationally focused Social determinants/ EOL agenda not required in projects

12 Three Operational Clinical Networks (Jan13)
Critical Care Emergency Services Surgical Services

13 Obesity, Diabetes & Nutrition Addiction & Mental Health
Snapshot of all 12 SCN ( & 3 OCN Projects) ** 9/15 new projects are ready to initiate by January 31, 2013 Cardiovascular Health and Stroke SCN Obesity, Diabetes & Nutrition SCN Seniors’ Health SCN Bone & Joint SCN Cancer SCN Addiction & Mental Health SCN Surgery OCN Emergency OCN Critical Care OCN Insulin Pump criteria** Fragility & Stability - Hip Fracture Rx and Prevention** ART E-referral** Depression Pathway aCATS** TBD TBD Vascular Risk Reduction C-CHANGE** Inappropriate use of antipsychotics** Rural Stroke Program** Enhancing recovery after surgery** Elder Friendly Care** Hip & Knee 5 year Plan Lung Cancer Safe Surgery Checklist** 3 avoid risks for AHS 4 equally high value 4 with some external funding 1 aligned with IHHP concept 3 Placeholders for SCN/OCN Equity 2 Mature Tier 1: in flight


15 CV&S: Rural Stroke Action Plan
Project Scope: Create standards and clear definition of rural stroke unit care Implement early supported discharge (ESD) & enhanced stroke unit care in 5 small stroke centres Implement enhancements to stroke unit care for 10 rural primary stroke centres Project Financials: Q4 (12/13): $ 141,964 13/14: $1,745,950 TOTAL Project: $2,873,594 Benefits to be Realized: Short term – Jan 31/ 13 – Mar 31 /14 ESD implemented in 5 small centres serving100 patients 26% reduction in length of stay; 3 persons avoid nursing home care; 1 life saved Long term– year window 214 new patients per year receive ESD and over 1000 new patients per year receiving full stroke unit services; 23 lives saved/year; 17 patients avoid nursing homes after stroke/year Reduction in length of stay of over 20% System Impact: Acute care Transition management Long term care

16 CV&S: Vascular Risk Reduction
Project Scope: Opportunity to lead country in OHS screening for vulnerable populations & impact lifestyle changes in patients with vascular risk through: Screening & early management to increase early diagnosis & treatment of disease – done in community pharmacies across Alberta & 1 designated worksite (TBD) Reduction in morbidity & mortality by: C-CHANGE adoption in primary care, community pharmacies and worksite (s) TBD Target vulnerable populations Integrate & enhance risk reduction clinics across system Project Financials: Q4 -12/13: $ ,557 13/14: $1,182,228 TOTAL AHS COST: $1,226,228 Partner contributions (TBD): Alberta Health – C-CHANGE roll out (see next slide) * budget TBD for TOPS Pharmacies / worksite – provide program delivery & budget to support operations within their setting (TBD) Benefits to be Realized: Short term – Jan 31/ 13 – Mar 31 /14 % increase in screening rates in 2000 physician practices across Alberta >6000 screened in community pharmacies & worksite (>20% in areas of high vulnerability) Long term – year window 10% reduction in smoking rate 80% who are screened meet target for BP, LDL-C System Impact : Prevention – primary and secondary Ambulatory care, primary care, community, industry Integrated approach Pan SCN initiative ODN, AMH, Cancer

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