Transcript Governing in Today’s Health System October 14, 2011

Healthy People. Excellent Care. One System.
Collaborative Governance in
North Simcoe Muskoka
November 2013
Robert Morton, Board Chair
NSM LHIN
Continuum of Collaboration
Formal and Whole
Agency
Collaboration
Informal and Local
Collaboration
Communication
Cooperation
• Individuals from
different
disciplines
talking together
• Providers
working jointly
on lower
priorities on a
case by case
basis
Coordination
Coalition
Integration
• Formalized joint
working group
• No sanctions for
non-compliance
• Joint structures
created with
willingness to
sacrifice some
autonomy
• Integration of
services, staffing
or initiatives
between health
system partners
locally or
system-wide
and across
sectors.
Collaboration – T, T, T.
The impact of Trust Building
http://www.actforyouth.net/youth_development/communities/collaboration.cfm
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Implementation Structure, 2013-2016
Lead Organizations for each ‘Areas of Focus’:
Health Service Provider Boards and LHIN Board
NSM LHIN Leadership Council
GBGH
CCAC/ILS
OSMH
Waypoint
RVH
CGMH
1. Complex &
Chronic Health
Needs
2. In Home &
Community
Capacity
3. Maternal Child
Health
4. Mental Health
& Addictions
5. Medicine
6. Surgery
Complex Continuing
Care
Alternate Level of
Care
Maternal and Child
Health Community of
Practice
Waypoint
Schedule1Beds to
community hospitals
LHIN-wide Critical
Care System
Chronic Disease
Prevention and
Management
Home First
Building Child &
Adolescent Capacity
LHIN-wide Integrated
Vascular Care
System
LHIN-wide
Musculoskeletal
Program
(Bone and Joint)
Community Crisis
Management
LHIN-wide
Emergency Care
System
Behavioral Support
System
LHIN
7. Communications
and Community
Engagement
Seniors Health
Strategy
LHIN
8. Governance
LHIN
9. Information
Communication
Technology/eHealth
LHIN
10. Integrated
Health Human
Resources
CCAC
11. System
Navigation
County of Simcoe
12. Transportation
Standardization of
Process and Policy
Information &
Referral
Inter-facility
Organizational
Development
Transitions of Care
Community
Workforce Planning
and Education
Recruitment and
Retention
Coordinating Councils for 12 ‘Areas of Focus’
Project Steering Committees for > 40 Projects
Boards, Councils & Project Steering Committees supported by:
• NSM LHIN Leadership Council - CEOs & Executive Directors (the Care Connections (CC) Steering Committee)
• CC Operations Committee ( the Chairs of 12 Coordinating Councils)
• CC Implementation Team (LHIN Staff as Liaisons for Councils and Project Steering Committees)
Our Successes to Date….to name a few
Chronic and Complex Health Needs
•
Complex Continuing Care – Implemented LHIN-wide Program / Bed Registry
Mental Health and Addictions
•
•
Redistribution of 31 Schedule 1 Adult beds from Waypoint – Voluntary Integration – acute
care beds to RVH (11) and GBGH (20 with redevelopment)
Development of a LHIN-wide Child and Adolescent MHA Program
Medicine
•
Development of a LHIN-wide Stroke Program (Integrated Acute/Rehab Model)
Surgery
•
Development of LHIN-wide Integrated Orthopedic Program
Information Communication Technology / eHealth
•
•
Hospital Report Manager (HRM) across all hospitals – reduction from 12 days to 30 minutes
E-prescribing
Governance
•
Established Council of Governors and CEOs to develop new governance model in an
integrated system
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Care Connections Governance Working Group,
Governance Vision in 2010/11
Purpose
Challenges
and issues
• Sustainable Governance model to support future design
• Minimal education, information-sharing, and relationships across the HSP community
• Lack of shared vision for the future
• Tension between existing organizational fiduciary responsibilities and future systemwide governance and oversight
Hospital Boards
Key
stakeholders
Long-term Care Boards
Community Boards
“A Network”
LHIN Board
• Facilitated networking of Boards to support the transformation and delivery of the
future health system
• Delivered through:
Strategies
• Clear and consistent communication and information-sharing protocols
• Effective governor engagement strategies
• Platform for Board to Board sharing and relationship building to create a foundation
for change
Accountability
- Organizational Level
ORGANIZATIONAL
BALANCED
SCORECARD
• describes strategy,
measures & targets
• guides execution
• information on
performance
Financial
Customer
Value Creating
Processes
Learning &
Growth Enablers
Dialogue &
Continuous Dynamic
Evaluation &
Learning
Accountability
Agreement for
CEO
Managerial
Accountability
Agreements
ACCOUNTABILITY
AGREEMENTS
• sets out what parts of the
scorecard each individual is
accountable for achieving &
the supports they need to be
successful.
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Accountability
- System Level
ORGANIZATIONAL
BALANCED
SCORECARD
• describes strategy,
measures & targets
• guides execution
• information on
performance
Financial
Customer
Value Creating
Processes
Learning &
Growth Enablers
SYSTEM BALANCED
SCORECARD
Financial
Customer
Value Creating
Processes
Learning &
Growth Enablers
Dialogue &
Continuous Dynamic
Evaluation &
Learning
• states the financial & customer
outcomes
• defines the strategic contribution of
the board
• helps manage the performance of
board / committees
• clarifies the strategic information the
board needs
Accountability
Agreement for
CEO
Managerial
Accountability
Agreements
ACCOUNTABILITY
AGREEMENTS
• sets out what parts of the scorecard
each individual is accountable for
achieving & the supports they need
to be successful.
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A Governance Model
Generative
Strategic
Fiduciary
Source: Jim Nininger, Conference Board of Canada
Trust
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North Simcoe Muskoka LHIN’s Governance Journey
June 2012
Care Connections Update
Governance Coordinating Council Role
Collaboration Continuum
November 2012
“Made in Ontario Solution”
Unique role for governing
bodies
June 2013
January 2013
Governance 101
Generative Governance
Health Links
Implications for governing
bodies
October 2013
Governance Leadership in System Transformation
Chairs only session – focused on sub-geography
Next Stage?
Local improvement plans
“Put back on the table of the boards not just a request, but an absolute sense of obligation, that learning who
does better and then doing at least that well is central to proper stewardship of health care. The buck stops in
the board room.” D. Berwick
System Governance: Finding the Balance
Board members
need to govern
on a broader
health system
level
Board members
need to focus on
their own
organization
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Questions?
Contact Information:
Bob Morton
[email protected]
www.nsmlhin.on.ca
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