The focus of Saskatoon Health Region’s first 90-day cycle of breakthrough improvements has been patient flow. 90 Days of Innovation: Ready Every Day is all about ensuring that our patients, clients and residents move through our system seamlessly, that there is no backlog of people waiting for an inpatient bed, or being cared for in an inappropriate space.

This first 90-day cycle is due to wrap up in June.

So what’s next?

Dan Florizone, President and CEO of Saskatoon Health Region.

Dan Florizone, President and CEO of Saskatoon Health Region.

“Our next 90-day cycle will launch September 15,” Saskatoon Health Region President and CEO Dan Florizone said.  “And it will focus on safety.”

Though the entire scope of activity for the next 90-day cycle has not been finalized, at least two areas of focus are. One of those is the Hospital Standardized Mortality Ratio (HSMR). Tracked by the Canadian Institute for Health Information (CIHI), HSMR is an important measure that can be used to make improvements to patient safety and quality of care. Factors such as patient age, sex, diagnosis and admission status help determine HSMR in a manner that allows comparison between an individual hospital and the average Canadian experience. The ratio provides a starting point to identify areas for improvement to help reduce hospital deaths.

“Looking at those numbers will be a major thrust of the next 90-day cycle,” Florizone said.

The second area of focus is the Safety Alert System (SAS), and replicating that region-wide. The pilot SAS, which is a central intake line for all safety incidents and concerns, began at St. Paul’s Hospital in the spring of 2014.  The plan is to replicate this system not only in the three Saskatoon hospitals, but region-wide.

The third focus of the 90-day safety cycle is still up for discussion, Florizone said, but it will concern employee and staff safety.

Why the focus on safety?

“Safety is always our number one priority – not to be confused with the focus of our 90-day cycles, which are ‘must-do, can’t fail.’ Safety of patients, of staff – that’s always our first priority.”

The HSMR numbers for our hospitals, released late last year, showed areas of concern which were top of mind in the Region, Florizone explained.

Safety was also an area that physicians and surgeons very much wanted to tackle, he said.  The practitioner advisory committee and medical and surgical staff pushed for a safety focus.

“They want to take greater ownership of safety and quality, as they are feeling it’s the essence of their purpose as medical staff,” Florizone stated.

These three areas had all previously been identified as possible year-long breakthrough initiatives, Florizone explained, so some of the background work for them has already been done. The identified action steps will be incorporated into the new 90-day cycle.

Experience gained from the first 90-day cycle on patient flow will inform the second, Florizone indicated.

“We’ve learned a lot. Our experience from the first one tells us we need to spend 90 days preparing for the launch of the new cycle, to allow for sufficient collection of information and analysis,” Florizone noted. “After the launch, the improvements will start, and after the 90 days ends, we will follow the improvements made and ensure they are working.  Because of what we now know, it will be a more thoughtful period of preparation, then deployment, then follow-up.”

The teams have yet to be assigned for this upcoming cycle, but they will be led by senior leaders within the organization.

“I have a strong feeling that vice-president-led teams have been a positive of this first cycle, so we will be doing that again.  We haven’t decided how many VPs will be involved in the next cycle, or which ones will lead the teams. One exception is the HSMR team – that one will definitely have strong physician and surgeon leadership.”

Upcoming 90-Day Cycles• September 15, 2015: Safety• January, 2016: Seniors• Future possibilities include Children, Palliative Care, Complex Care, and Chronic Disease Management.

The third 90-day cycle will begin in January, and will focus on seniors and how they flow through our system.

“We will focus specifically on senior citizens, looking across the care continuum and at the public, private, municipal and regional services offered to them.  We are interested in making sure they are being provided with the right service at the right time in the right place, with our main emphasis on supporting ways to keep seniors as independent as possible within the community,” Florizone said.

This cycle will involve both rural and urban parts of the Region.

“I’m very interested in looking right across the care continuum and seeing where the gaps exist,” Florizone said. “We’re not limiting our work to our own services. We want to take a good, hard look at what’s available to seniors, from home care to enriched housing, from personal care homes to special care homes, and even fitness and recreation programs.”

Why seniors?

“It’s a big topic, and one long overdue. We wanted to really look at long term care, but in a more comprehensive way.  This will show us how age-friendly our communities and our Region really are,” Florizone said.

As for further 90-day cycles, senior leadership is continually looking ahead, and are developing a three- to five-year plan.  That plan will be put out for a catchball session in the weeks to come in order to gather staff feedback from across the Region. Areas being considered include Children, Palliative Care, Complex Care and Chronic Disease Management.

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