Summary of Work Priorities in 2016-2017

The 2017-2018 year began on a positive note

In spite of a difficult context, marked by a major restructuring of the health and social services network and the departure of the institution’s president and executive director, we believe that we have achieved the internal transformation that was required, thanks to our teams, and put the MUHC back on a performance track. In summary, we have:

1. Brought the MUHC toward budget equilibrium

At the May 16th, 2017 meeting of the Board of Directors, the MUHC adopted a balanced budget for 2017-2018.

To restore budget equilibrium, the MUHC committed firmly and explicitly to put in place all the necessary optimization measures and to support them with rigorous oversight mechanisms that would make sure that the defined clinical and financial targets were met. The principal areas that will make our recent efforts sustainable are:

Performance: We chose a structured approach in order to establish our performance targets in relation to those of similar institutions. We worked tirelessly to implement the optimization measures. Several of these measures are already up and running, thus minimizing the projected deficit for 2016-2017. The implementation of a series of additional measures is also under way to allow the sustainability of our recovery plan.

Volumes of activities: The development of the budget recovery plan revealed that optimization on its own would not lead to budget equilibrium. We therefore asked for and obtained $13 million in additional financing to manage certain clinical activities (oncology, cardiology and interventional neuro radiology), as well as the higher volume of pediatric and adult emergency room visits. We thereby turned around a situation that was placing undue financial pressure on our organization.

2. Operating according to our clinical plan

Every effort has been made and we can now confirm that we are operating according to our clinical plan, which calls for an increase in the proportion of specialized and ultra-specialized patient care while patients requiring less complex care are transferred to network partners. As a first step, the number of beds went from 910 to 832. Thereafter, roughly 30 beds were closed permanently, to which are added seasonal bed closures, in order to respect authorized financing.

Since April 2016, the number of available beds has dropped to 798. However, patients requiring an alternate level of care (NSA) continue to occupy our acute-care beds while awaiting admission to another institution. Moreover, until such time as the regional transformation plan for patients requiring alternate care (NSA) is working effectively, the number of beds occupied by NSA patients will continue to affect the availability of beds. This chronic deficit of beds impacts not only the efficiency of operating rooms, the number of surgeries performed and the associated revenues, but also makes it harder to manage the flow of patients in the emergency department awaiting hospitalization or other patients needing to be transferred from another hospital to the MUHC for specialized care.

We are working very hard with our partner hospitals to transfer patients who require less complex care to them. The efforts made, however, don’t improve significantly the access to our beds for specialized and ultra-specialized care.

3. Put the emphasis on priority projects

At the time of its major optimization projects (GPOs), the MUHC had achieved budget equilibrium though not its full potential in certain sectors. That key aspect of transformation is now being tackled within the scope of the new priority projects:

  • A flexible manpower plan, including skill mix in Nursing and control mechanisms;
  • A centralized operating room booking system;
  • The optimization of operating rooms, including operating rules for physicians.

4. Pursued other initiatives

In parallel, we are continuing the following projects:

  • Optimization of patient-care trajectories, including the regional transformation plan for NSA patients;
  • Optimization of endoscopy units;
  • Implementation of the MUHC Optilab cluster within the network of biomedical laboratories;
  • Establishment of reference mechanisms for specialized care;
  • Contribution to the unified information system project;
  • Start of the most active phase of planning for the Lachine Hospital redevelopment project;
  • Re-launch of the redevelopment projects for the Montreal General Hospital and the Neuro;
  • Implementation of a new organizational structure for management, including a marked reduction in the number of managers;
  • Bringing information system positions under the MUHC banner;
  • Several moves: fertility clinic, administrative and research offices.

I would like to take this opportunity to thank you all for your contribution to our achievements. It is our wish that the progress and results achieved help re-establish the necessary trust between the MUHC and the Quebec Ministry of Health and Social Services. A clear sign of this would be seen as encouraging for all of our teams, which have invested of themselves in this transformation. From that point forward, the MUHC could refocus its efforts on achieving new mandates for specialized and ultra-specialized care in accordance with its mission as an academic health centre within the healthcare network.

 

Martine Alfonso
Interim President and Executive Director, MUHC