QHC proposes solutions to funding gap

Quinte Health Care (QHC) has announced a series of proposed solutions that may help to close its anticipated funding gap for the fiscal year starting April 1.

Some of the more significant changes in the plan will affect administration and non-clinical areas; the number and type of inpatient beds at the three southern QHC hospitals; outpatient physiotherapy and lab services.

QHC is now gathering input from physicians, staff, unions and communities to refine the solutions, make final decisions and then develop implementation plans.

“There were many creative ideas that have come forward from across the organization, some of which are very easy changes that would create financial efficiencies without impacting patients or staff, while other changes will be much tougher,” said Mary Clare  Egberts, QHC President & CEO. “However, given the provincial deficit, we know that hospitals like ours must receive funding decreases and we cannot maintain the status quo.”

QHC announced in fall 2012 that the anticipated financial gap between expected revenues and expenses could be as high as $10 million for its fiscal year that starts April 1, and could climb by an additional $5 million in future years. This is driven primarily by a change to the hospital funding formula which will lead to substantial decreases in QHC’s funding for the foreseeable future. QHC’s Board expects the hospital to operate within a balanced budget and the Local Health Integration Network is required by law to ensure that all hospitals balance.

“To address these funding changes, hospitals like ours must focus more on the complex cases, difficult surgeries and most critically ill patients that truly require hospital-based care,” said Egberts. “Other health care providers will perform services that people are accustomed to receiving in a hospital. Over the coming years, we expect to see a dramatic shift in Ontario of where services are provided and how people access care.”

Egberts added that in the long-term, the new funding model will be beneficial for patients and taxpayers and create sustainability for Ontario’s health care system. “However, we recognize that change is always difficult in the short-term, especially when we are used to a certain funding level and our communities are used to certain services delivered at hospitals.”

BACKGROUNDER
Proposed Solutions for Closing the Funding Gap
January 10, 2013

Between late-November 2012 and early January 2013, QHC managers and directors, with input from some physician leaders, developed a list of proposed solutions to address the funding gap. QHC is now starting the consultation process with its staff, physicians, unions, health care partners and communities.
The proposed solutions are organized under six key goals: to continue to enhance the quality of care; to ensure patients are receiving their care in the right place, from the right care provider; to ensure the services we deliver are meeting the health care needs of the patients in this region, within our available resources; to make QHC as efficient as possible; and to maximize our revenue streams.
1. Continue to enhance the quality of care
– Implement standardized care plans/clinical pathways
– Cohort some patient types across QHC (e.g., stroke patients)
– Increase the number of rehabilitation beds and reduce the number of complex continuing care beds
– Create better integration with community services (e.g., palliative)
– Move to more seven day/week therapies and support services

2. Ensure patients are receiving their care in the right place, from the right care provider
– Make more efficient use of all inpatient beds, which will allow QHC to reduce the number of beds at BGH, TMH and PECMH without reducing the inpatient services provided. This would be accomplished by:
o Reducing the number of patients who are waiting in hospitals for a more
appropriate placement in the community, focused on palliative and
cognitively challenged patients o Implementing standardized care plans (clinical pathways) and discharge planning
o Creating a surgical short stay unit and Acute Medicine rapid assessment
unit
– The reduction in inpatient beds at PECMH would mean that QHC could no longer staff the obstetrics program at that hospital and in the future all deliveries would need to be consolidated at BGH
– Divert less urgent patients away from the ERs

3. Ensure the services we deliver are meeting the health care needs of the
patients in this region, within our available resources
– Eliminate remaining outpatient physiotherapy and divert resources to more
inpatient physiotherapy
– Transition TMH lab to point-of-care testing
– Divert some of the remaining outpatient lab services to the community
– Consolidate all endoscopy at BGH once new ORs open

4. Make QHC as efficient as possible
– Find efficiencies in the management and administrative support structure
– Review current contracted services
– Reduce waste in office supply, printing, delivery, food, drugs
– Consolidate existing BGH ambulatory clinics in same physical space, sharing resources as possible
– Increase the use of telemedicine

5. Maximize our revenue streams
– Maximize preferred accommodation
– Maximize non-OHIP revenues
– Franchise opportunity, retail services, etc.