Transcript Document

Radiation Treatment
Capital Investment Strategy
COORT Presentation
Success of Previous Capital Investment Strategies
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Historically CCO has been very successful in the planning and
implementation of capital initiatives
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The first Capital Plan resulted in new facilities in Grand River, Peel and
Durham.
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The second Plan resulted in the construction of new facilities in
Newmarket, Barrie, Niagara and Algoma and redevelopment of the
existing Centres in Ottawa and Kingston.
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Investments in the development of cancer treatment facilities and
radiation equipment have taken the provincial number of radiation
treatment units from 65 in the year 2000 to 103 units in 2013.
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Investments in two portable treatment units created flexible treatment
spaces in Ottawa and Barrie. Ottawa facility redeployed to
Peterborough in 2013 and the Barrie facility will redeploy in 2015 to a
location to be determined.
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Capital Investment Strategy
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Purpose

Provide advice on the development of a Capital Investment Strategy for provincial
radiation treatment services compliant with CCO’s Provincial Radiation Treatment
Program’s Goals.
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The plan maximizes the use of existing investments in equipment and infrastructure
while ensuring the appropriate tools are in place to provide equitable access to quality
care.
Develop recommendations for:
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New Facilities and Equipment
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Radiation Equipment Replacement
Principles
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Improve access to care for cancer patients
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Keep pace with technology to ensure the delivery of quality care
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Ensure value for investments
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Minimize costs
10 year planning horizon
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Existing facilities
New Captial Funding
Required
MOHLTC Approved and Funded Equipment
Centre
Algoma
Kingston
Peel
Grand River
Hamilton
London
Durham
Sudbury
Thunder Bay
Niagara
Toronto - Odette
Ottawa
Toronto - PMH
Barrie
Southlake
Windsor
Mobile Bunker
Total
2005
0
4
0
4
11
8
0
5
2
0
13
8
16
0
0
3
2006
0
4
3
4
11
8
0
5
2
0
13
8
16
0
0
3
2007
0
4
4
4
11
8
3
5
2
0
13
9
16
1
0
3
2008
0
4
4
4
11
8
3
5
2
0
13
9
16
1
0
3
2009
0
4
6
4
11
8
4
5
2
0
13
9
16
1
0
3
2010
0
4
6
4
11
8
5
5
2
0
13
11
16
1
3
3
2011
0
4
6
4
11
9
6
5
2
0
13
12
16
1
3
3
74
77
83
83
86
92
95
2012
1
5
6
4
11
9
6
5
2
0
13
12
16
3
3
3
1
100
2013
1
5
6
4
11
9
6
5
2
3
13
12
16
3
3
3
1
103
Equip
Construct
Rooms
1
5
6
5
11
9
7
5
2
3
13
12
16
4
6
3
1
109
Equip
Swing
Rooms
1
6
6
6
12
10
8
6
3
4
13
13
17
4
6
3
1
119
Including portable bunker in Barrie and Ottawa’s room relocated to Peterborough
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Current MOHLTC equipment approvals result in 103 units
There are 6 rooms that were constructed with no funding for equipment
There are 10 rooms designated as swing bunkers to facilitate equipment
replacements
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Investments in Facilities – revised planning assumptions
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Multi-disciplinary provincial committee met to update capital planning
assumptions
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The revised planning assumptions result in the additional treatment machine
capacity to treat 3,371 patients per year
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Based on an average of 445 patients per treatment unit these new operating
parameters result in a reduced machine requirement of 7.5 treatment units.
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Investments in Facilities - Capacity
Note: Projected demand is driven by the 3% annual increased incidence of cancer and a small increase in RT Utilization
(Projected RT Utilization rate in 2020 of 42% (@.5%/annum) vs. CCO target of 48%)
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Machine timing based on requests in Business Plan and deployment timeframes of 12 to 16
months.
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To support growth in incidence of 3% per annum, with 103 machines in operation equates to
3 additional machines per year
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To provide capacity to increase utilisation rates by .5% per annum adds another 1.5 units per
annum
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A reduction in the improvements in utilisation rates from .5% to.3% results in a machine
requirement reduction of 5 machines by 2020.
Investments in Facilities – Demand/Capacity projections
Machine Requirements by Region
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Regional Distribution of Services based on current referral patterns adjusted for the introduction of
new centres in Niagara and Barrie
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Did not round up partial machines and would rely on referral shifts to compensate for capacity
gaps, assumes patients will travel to where capacity exists
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Gradual ramp up to 12 hours dependent upon availability of operating funds completed by 2015
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Equip existing rooms first, plan additional capacity beyond 2018 through construction of new
facilities in 4 regions
Radiation Equipment Replacement Fund
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CCO employs a Radiation Treatment and Related Equipment Replacement Strategy that
has been developed to:
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Provide maximum equipment uptime thus minimizing unforeseen interruptions in
patient care due to equipment failure
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Minimize product obsolescence such that patients and staff in Ontario benefit from
current technological innovation to improve throughput and patient outcomes.
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CCO through its annual provincial multi-disciplinary review process prioritizes all requests
for replacement grant funding based on criteria which consider; improved access to care,
quality, impacts on operating costs and the provincial context to allocate $29.5M in annual
funding
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Over the past the decade there had been a 50% increase in the number of treatment units
providing care to patients across the province. During this period there had not been any
increase in base funding to replace treatment units.
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Developed Alternative Approaches
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Implemented performance targets to ensure the grant funding is deployed in a timely manner to
maximize its benefit
Developed strategies and recommendations to improve the utilisation of limited funding
associated with radiation replacement funding.
• Extending Average Equipment Lifecycles
• Function of the Grant
• Value for Money
Implementation of updated strategies included the development of 5 year local radiation
replacement plans with each hospital to inform local capacity planning and fundraising
requirements
Implementation of new approaches and additional $31.5M in 2012/13 in one time funding closed
the gap between projected need and projected funding
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