1. Hospital Service Accountability Agreements: Schedules & Indicators
Fiscal 2017/18
Presented in Fall 2016

2. Agenda Context HSAA Organizational Structure
Changes to HSAA Schedules for
HSAA Indicator Work Group
Provincial HSAA Indicator Slate
Next Steps
Questions
Appendix A: HSAA Indicator Work Group Membership
Appendix B: HSAA Planning & Schedules Work Group Membership

3. Context HSAA Schedules and Indicators
The HSAA Template Agreement is envisioned to be a multi-year agreement established through consultative stakeholder meetings between the LHINs, hospitals, the OHA and MOHLTC. The Schedules content will be negotiated annually.
It is intended that the current HSAA will be extended an additional year, with an expiration date of March 31, 2018.
This presentation will focus on the status of the schedules and provincial indicators for 2017/18.

4. HSAA Organizational Structure Creating an ownership framework
Hospitals
(OHA)
HSAA Steering Committee
HSAA Planning & Schedules
Work Group
SRI Reports Work Group
HSAA Indicator
LHINs

5. Creating an ownership framework
The HSAA Indicators Work Group is co-led by Eric Partington, Senior Director, Champlain LHIN, and Imtiaz Daniel, Director, Financial Analytics and System Performance, Ontario Hospital Association.
The HSAA Planning & Schedules Work Group is co-led by Jeff Kwan, Director, Financial Health & Accountability, North Simcoe Muskoka LHIN, and May Chang, Executive Vice President and Chief Administrative Officer, Markham Stouffville Hospital.

6. Changes to HSAA Schedules for 2017-18
Schedule A (Funding)
Under Wait Time Strategy Service (Section 3), incremental funding has been removed to reflect the current approach, which reflects allocation through base funding only.
Under Quality Based Procedures (Section 2), the list of QBPs has been updated to reflect the refined list of QBPs noted in the HAPS Guidelines.

7. HSAA Indicator Work Group
The HSAA Indicators Work Group (IWG) is comprised of representation from involved hospital, LHIN and MOHLTC leaders with backgrounds in program delivery, performance improvement and finance (see Appendix A for membership list).
The core deliverables of the HSAA Indicators Work Group were to:
Review current indicators to ensure continued alignment with pan-LHIN system imperatives
Update technical specifications and target setting guidelines as required
Develop other communication and education materials as needed

8. Provincial HSAA Indicator Slate
With the tabled proposed legislation (the Patients First Act) in the Legislative Assembly as of the fall, the LHINs have agreed to maintain the 2016/17 SAA provincial indicator slates for 2017/18.
However, LHINs will reserve the right to amend LHIN-specific (i.e., local) indicators / obligations and/or to make any changes as required by law, policy, statute or Ministry direction.
As such, no changes will be introduced to the provincial HSAA indicator slate for 2017/18.

9. Performance Indicators
Performance indicators will remain as:
90th Percentile Emergency Department (ED) Length of Stay for Complex Patients
90th Percentile ED Length of Stay for Minor/Uncomplicated Patients
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Hip Replacements
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Knee Replacements
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for MRI
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for CT scans
Rate of Hospital Acquired Cases of Clostridium Difficile Infections
Readmissions to Own Facility Within 30 Days for Selected HBAM Inpatient Grouper (HIG) Conditions
Current Ratio
Total Margin (all sector)
ALC Rate

10. Explanatory Indicators
Explanatory indicators will remain as:
Percent of Stroke/TIA Patients Admitted to a Stroke Unit During Their Inpatient Stay
Hospital Standardized Mortality Ratio
Rate of Ventilator-Associated Pneumonia
Rate of Central Line Infection
Rate of Hospital Acquired Cases of Methicillin Resistant Staphylococcus Aureus
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cancer Surgery
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cardiac By-Pass Surgery
Percent of Priority 2, 3 and 4 Cases Completed within Access Targets for Cataract Surgery
Total Margin (Hospital Sector Only)
Adjusted Working Funds / Total Revenue %

11. Explanatory Indicators (cont’d)
Percentage of ALC Days
Repeat Unscheduled Emergency Visits within 30 days for Mental Health Conditions
Repeat Unscheduled Emergency Visits within 30 days for Substance Abuse Conditions

12. Next Steps The HSAA IWG will:
Liaise with external stakeholder groups as necessary to enhance understanding of, and continually improve upon, proposed and existing indicators for next cycle
Assess indicator set to ensure ideal alignment of hospital performance and accountabilities to system outcomes, as well as to other key work streams like Quality Improvement Plans
The HSAA P&S WG will:
Discuss members’ feedback about the HAPS and schedules materials and processes, and discuss any improvements for the following year

13. Please contact your local LHIN.
Questions?
Please contact your local LHIN.

14. Appendix A: Indicator Work Group Membership
Sector
Organization
Individual, Title
LHIN
Champlain LHIN
Eric Partington, Senior Director (Co-Chair)
OHA
Ontario Hospital Association
Imtiaz Daniel, Director (Co-Chair)
Hospital
Grey Bruce Health Services
Martin Mazza, CFO
Joseph Brant Hospital
Cheryl Williams, VP Patient Care Services and Chief Nurse Executive
Markham Stouffville Hospital
May Chang, Executive Vice President and Chief Administrative Officer
Sunnybrook Health Sciences Centre
Darren Gerson, Senior Director, Decision Support
St. Joseph’s Healthcare Hamilton
Jane Loncke, Director
MOHLTC
Ministry of Health and Long-Term Care
Nam Bains, Manager
Lauren Churcher, Senior Health Analyst
Thomas Custers, Manager
Domenic Della Ventura, Team Lead

15. Indicator Work Group Membership (cont’d)
Sector
Organization
Individual, Title
HQO
Health Quality Ontario
Gail Dobell, Director
LHIN
Central East LHIN
Marilee Suter, Lead, Decision Support
Champlain LHIN
Paul Caines, Senior Accountability Specialist
Hamilton Niagara Haldimand Brant LHIN
Iwona Bielska, Advisor
Toronto Central LHIN
Erin Scholl, Senior Consultant
Ranjeeta Wadhwani, Analyst

16. Appendix B: HSAA Planning & Schedules Work Group Membership
Sector
Organization
Individual, Title
LHIN
North Simcoe Muskoka LHIN
Jeff Kwan, Director, Financial Health & Accountability (Co-Chair)
Hospital
Markham Stouffville Hospital
May Chang, Executive Vice President and Chief Administrative Officer (Co-Chair)
Collingwood General & Marine Hospital
Michael Lacroix, Vice President, Corporate Services & CFO
North York General Hospital
Deepak Sharma, Director, Decision Support
St Michael’s Hospital
Tomi Nieminen, Director, Decision Support Services
Trillium Health Partners
Carol Vinette-Hancharyk, Director, Financial Strategy & Deputy Chief Financial Officer
MOHLTC
Ministry of Health and Long-Term Care
Maria van Dyk, Team Lead
OHA
Ontario Hospital Association
Imtiaz Daniel, Director, Financial Analytics and System Performance

17. Planning & Schedules Work Group Membership (cont’d)
Sector
Organization
Individual, Title
LHIN
Central LHIN
Jennifer Chiarcossi, Senior Business Analyst
Kelvin Luk, Business Analyst
South West LHIN
Scott Chambers, Team Lead
Mississauga Halton LHIN
Carrie Parkinson, Senior Lead
Andrew Wahab, Senior Lead of Funding and Allocation
North East LHIN
Marc Demers, Controller / Corporate Services Manager
North West LHIN
Kevin Holder, Senior Consultant
Toronto Central LHIN
Erin Scholl, Senior Consultant