VP Quarterly Report on Strategies

Q1– June 23, 2015

Robbie Peters, Vice President, Financial Services &

Chief Financial Officer

Vision: Healthy people, families and communities.

Portfolio Overview

• Finance– Accounting & Financial Reporting– Payroll & Benefits– Decision Support

• Facilities Management

• Materials Management

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Multi-year Strategic Plans VP is Leading on:

• Financial Sustainability Strategy Multi-year Plan

• Facilities Strategy Multi-year Plan

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Financial SustainabilityProvincial Outcome

2015-2016

• By March 31, 2017, Ongoing, as part of a multi-year budget strategy, the health system will bend the cost curve by achieving a balanced or surplus budget.

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Financial SustainabilityProvincial Targets

2015-2016

• All health system partner organizations will be in a balanced or surplus year-end financial position in 2015-16.

• Shared services activities will produce $10M net new savings in 2015-16

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Financial Sustainability – RQHR Results as of May 31, 2015

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Financial Sustainability – Shared Services Reported at PLT Wall

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• Carry forward of financial deficiencies of prior years• Continually exceeding budget by approximately 140 FTEs• High level of employee movement

• Reduced funding over last 5 years through efficiency targets in an effort to bend the provincial costs curve• In the range of $60 - $70 million

• Increasing population and demographic changes resulting in growing demand for services • Estimated cost of $70 million last 4 years

• Planned investments to respond to growing complex and changing environment • Physician leadership structure and service expansion• Sask. Healthcare Management System• 3sHealth shared service opportunities

Financial Sustainability RQHR Challenges

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• Board Approved Priority Areas- Quality and Safety - Patient Flow- Primary Health Care - Mental Health and Addictions

• Long-term Sustainable Initiatives RQHR continues to focus on developing a strong and sustainable foundation • 11 initiatives addressing $38 million deficiency• 5 initiatives of ETI steering committee (some overlap with

11 initiatives)

• Diligent Daily Management shared responsibility and accountability for all decision makers on daily decisions we make

Financial Sustainability Recap of Strategy Implementation

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Recap of regional focus to a 2015-16 balanced budget and reducing long-term cost structure

Priority focuses and preliminary targets to achieve a balanced budget in 2015-16

Regina Qu'Appelle Health Region

2015-16 Operating Budget

In $000's

2014-15P 2015-16B $ Change % Change

Preliminary Deficit ($13,921) ($38,269) ($24,348) 174.90%Regional focus to a 2015-16 balanced budget and reducing

long-term cost structure VP Responsible3sHealth and Other Contracts 2,500 PetersCost Savings from Reduced Surgical Volumes 8,000 GarrattReduction of VAC Beds if No Funding for Alternative use 1,300 RedenbachClinical Appropriateness 1,000 McCutcheonQuality & Safety Initiatives 1,000 SmaduPatient Flow / 95% Occupancy 1,000 NevilleImprove on Ambulatory Care Sensitive Condition Indicators 3,000 EarnshawReduce Orientation Costs by 20% * 1,300 HigginsReduce Sick Costs by 15% * 2,500 Higgins Reduce Overtime Premiums by 33% * 3,929 PetersWorkforce Optimization - 152 FTEs at avg, salary $85,000 ** 12,740 All

Revised Surplus (Deficit) $0

* Expected payback from daily management initiatives** Done through attrition, does not contemplate layoffs

1. Management Capacity

2. Accountability Frameworks

3. Master Roster Reviews

4. Overtime Deep Dive

5. Workforce Optimization

Reminder of Efficiencies Targets Initiatives (ETI) Steering Committee Focuses

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• Significant budget challenge ahead of us – creating a mechanism to monitor and report on success of the $38M deficit mitigation strategies and ETI work

• Monthly SLT and Finance/Business Manager budget meetings• Wall walk format• Trialing a virtual wall next week and will be rolled out widely when ready

– want to make this work visible to the organization and other stakeholders

• Continue to build on the themes of Accountability and Shared Responsibility throughout the organization

• Monthly meeting and virtual wall will also hold VPs accountable through monitoring and reporting of portfolio financial results, paid hours, service volumes, etc.

• Daily management by everyone is key to our success

• Continue to support and lead initiatives such as 3sHealth business cases

• Continued commitment to on-going continuous improvement work (lean, other)

• Exploring options to develop a temporary dedicated task team to address immediate financial challenges and operational outliers

Financial Sustainability Going Forward

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Financial Sustainability

Questions?

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Facilities Strategy Provincial Improvement Outcome

• By March 31, 2017, all infrastructures (IT, equipment & facilities) will integrate with Provincial strategic priorities, be delivered with a Provincial plan and adhere to Provincial strategic work.

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Facilities Strategy Provincial Improvement Targets

• By March 31, 2016, have delivered results on 3 high impact capital areas that address high risk for critical failure using alternative funding/delivery options.

• By March 31, 2016, common criteria and options for investing are used to vet all capital investments.

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Provincial Model - Infrastructure

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Provincial Deliverables - Infrastructure

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Provincial Timeline - Infrastructure

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• Lack of Regional involvement in provincial strategy and targets development and related action plans

• Improvements needed in developing RQHR specific facilities outcomes and targets which link to provincial and other RQHR strategies

• Traditionally focusing on upcoming priorities for the department

• Initiating work with KPO and SPBIU to further develop a comprehensive strategy plan for Facilities Management

• Significant facility infrastructure deficiencies identified across the province requiring significant sustained investment

• Minimal annual funding to address deficiencies and no multi year funding commitments

Facilities Strategy RQHR Challenges

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Immediate to Short-Term:

•Working with KPO and SPBIU to enhance overall strategy and action plans

•Development of comprehensive capital plan to address most critical areas over the next 3 years and beyond including:

• Optimization of annual capital funding to address greatest operational risks while maximizing ROI ($5.3 million for 2015-16)

• Advancing major capital renewal of critical electrical systems at PH and RGH and energy upgrades at PH and WRC

• Advancing renewal and building capacity of residential, primary care and community infrastructure

•Planning workshop in the next quarter with Board/SLT and other stakeholders to develop an action plan to advance the most critical areas identified above

Facilities Management Going Forward

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Immediate to Short-Term (continued):

•Department restructuring to better respond to organizational operational and capital project requirements, risk mitigation and maximizing return on investments for limited dollars available to us, and capitalizing on market opportunities

•Developing / enhancing policies and procedures on space planning, utilization and alterations

Longer-term:

•Taking a longer term outlook on aligning our facilities, property and infrastructure management to  optimally sustain, critically enhance and strategically support change and innovation to increasing demands of better health care for our communities

Facilities Management Going Forward

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Facilities Strategy

Questions?

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