Oct 3, 2013

Dr. Susan Gillam, Chief Executive Officer of Western Health today outlined a series of initiatives that will improve operational efficiencies within the region’s health care facilities. The operational improvement initiatives Western Health will save $13.5 million annually through improved human resource practices and a reduction of approximately 147 full time equivalent positions. All reductions will be achieved through attrition and reduced hours for employees. No lay-offs will be required.

Dr. Susan Gillam, Chief Executive Officer of Western Health today outlined a series of initiatives that will improve operational efficiencies within the region’s health care facilities. The operational improvement initiatives Western Health will save $13.5 million annually through improved human resource practices and a reduction of approximately 147 full time equivalent positions. All reductions will be achieved through attrition and reduced hours for employees. No lay-offs will be required.

To date, Western Health has already achieved savings of $7.2 million and almost 50 per cent of the position reductions without any impacts on program delivery.

“The operational improvement initiatives announced today are the result of considerable analysis of our operations and will improve the overall efficiency and sustainability of the programs offered with our region,” said Dr. Gillam. “This process has been a thorough process that has involved collaboration across the organization and will ensure that our programs are delivered at a high level over the long-term.”

In June 2012, Western Health engaged Health Care Management Group to assist the organization in undertaking a benchmarking exercise to determine how it was performing in comparison to other like-sized health organizations in Canada. Through this process, Western Health identified areas where it was performing at a high level and other areas where it was underperforming versus its comparator organizations.

From this process, Western Health’s operational improvement initiatives will focus on improved human resource management and non-clinical areas throughout the region. Western Health will initiate changes to its human resource policies to allow for the better management of sick leave, constant care, and overtime, as well as adjustments to non-essential travel and coordination of supplies and inventory.

“Western Health will be monitoring the implementation of these initiatives to ensure that we are making progress in our performance and that quality and safety of our programs and services is maintained,” said Dr. Gillam. “I am also pleased that we are proceeding with these initiatives in a manner which has the least impact on our valued employees.”

More information about these initiatives is available on the Western Health website www.westernhealth.nl.ca.

Western Health is one of four regional health authorities in Newfoundland and Labrador employing 3218 dedicated employees and serving a population of 77,983 people. The authority has an annual operating budget of $330 million and offers a full continuum of health services including acute, long term care, community services, hospital care and Humberwood, a provincial inpatient addiction treatment centre, the Cervical Screening Initiatives Program and Western School of Nursing. Its geographic boundaries extend from Port aux Basques southeast to Francois, north to Bartlett’s Harbour, and north east to Jackson’s Arm.

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Media Contact:

Heidi Staeben-Simmons

Director of Communications

Western Health
709-637-5252

heidistaebensimmons@westernhealth.nl.ca

 

BACKGROUNDER:

About Western Health
Western Health’s geographical boundaries are from Port aux Basques southeast to Francois, northwest to Bartlett’s Harbour, and on the eastern boundary north to Jackson’s Arm. Within this geographical region, Western Health serves a population of approximately 77,983 residents.

Western Health provides a broad range of programs and services to the people of Western Newfoundland. These programs and services are based in community and facility settings. Western Health provides community based services from 23 office sites, community based medical services from 23 medical clinic sites; two hospitals: Sir Thomas Roddick Hospital in Stephenville and Western Memorial Regional Hospital in Corner Brook; four health centres: Dr. Charles L. LeGrow Health Centre in Port aux Basques, Bonne Bay Health Centre in Norris Point, Calder Health Centre in Burgeo and Rufus Guinchard Health Centre in Port Saunders; and two long term care centres: Corner Brook Long Term Care Centre in Corner Brook and Bay St. George Long Term Care Centre in Stephenville Crossing. Within its facilities, Western Health operates 276 acute care beds, and 464 long term care beds, as well as 40 enhanced assisted living beds for individuals with mild to moderate dementia.

Western Health accomplishes their mandate through six lines of business: promoting health and well-being; preventing illness and injury; providing supportive care; treating illness and injury; providing rehabilitative services; administering distinctive provincial programs. Programs and services that promote health and well-being include health promotion and health protection activities. Preventing illness and injury occurs through early intervention and use of the best possible information as with screening and injury prevention activities. Programs and services that provide supportive care include: community health nursing; community supportive services; maternal, child and family health; long term care and residential services; mental health and addictions. Programs and services that treat illness and injury are primary and secondary in nature and include ambulatory care, emergency, maternal, medical, paediatric and surgical services. Rehabilitation services such as physiotherapy, occupational therapy and speech-language are provided in community and facility settings. Western Health is also responsible for two provincial programs: the Cervical Screening Initiatives Program and the Inpatient Addictions Treatment Program. In addition, Western Health operates the Western Regional School of Nursing.

Western Health's regional office is located in Corner Brook. The organization employs over 3,200 staff and 160 physicians throughout the region.

Western Health has approximately 1,300 volunteers who assist in delivering a number of programs and services and special events within acute care, long term care and community, which enhance the quality of life for patients, residents, and clients.

Jobs in Health Care:
Western Health has approximately 3,218 employees.

The employees are also categorized by employment status:

Understanding Employee Types
In health care, jobs are classified by type. For example permanent, casual, temporary, and so on.

• Permanent
An employee who is hired for the long term; permanent employees “own” the position that they occupy and have the rights and benefits associated with their collective agreement or contract.

• Temporary
An employee who is hired for a specific period of time or for the purpose of performing specific work and their employment will end following the completion of that work; often a temporary employee is hired to replace a permanent employee who is absent from work.

• Part Time
An employee who is scheduled to work less than full time hours.

• Casual
An employee who works on an as needed basis; These employees have no obligation to accept work nor does the employer have an obligation to call in a that employee.

What is an FTE?
FTE stands for full time equivalent. FTE is a measure used by organizations not to count actual people but to count positions. It is a measure of the number of hours worked divided by the number of hours constituting full time. For example: 10 FTE’s might actually be 12 employees – 8 who work full time and 4 who work part time as a 0.5 FTE.

Will permanent employees lose their job as a result of this process?
There will be no lay-off of permanent employees.

What other human resource changes are taking place?
Through improved human resource management, permanent employees will see a reduction in overtime. As well, there will be an ongoing assessment of the use of overtime, sick leave, and sick leave relief by our management employees.


A new multi-purpose bridge video system has also been installed to reduce travel costs and a new e-learning system has been created to create a flexible on line learning environment for our staff and to help reduce the need for employees to be away from the work place to attend some education sessions.

What about temporary employees who work full time?
Temporary employees may see a reduction in their hours of work and contract renewals will be evaluated on a case-by-case basis upon their completion. Western Health is committed to minimizing the impact on all employees where ever possible.

Where is the breakdown of changes to the number of full time equivalent positions?
Western Health will reduce its workforce by 147 full time equivalent positions – of which 70 are already completed.

• 71 permanent full time equivalent positions will be reduced through attrition;
• 70 full time equivalent positions will be reduced through changes to better management of overtime, sick leave, and constant care;
• 22 full time equivalent positions that are currently vacant will not be filled; and
• 16 new positions will be created as a result of skill mix changes

Of the total positions, 20 full time equivalents are management positions.

What has Western Health already achieved?
Western Health has in progress to date a savings of $7.2 million for a total reduction of 70 full-time equivalent positions.

What is attrition?
Western Health will use attrition to achieve the identified reduction in full time equivalents. Attrition is a gradual, voluntary reduction of employees - through resignation and retirement - who are not replaced, resulting in an overall decrease in the size of the workforce.

Total: 147 FTEs

Corner Brook
FTEs - 94 (Completed/In-Progress: 50)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Realign support services
• Staffing level adjustments
• Realign management staff
• Supply and inventory management

Stephenville
FTEs - 17 (Completed/In-Progress: 6)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Realign support services
• Staffing level adjustments
• Close cafeteria – seek expressions of interest

Port Saunders
FTEs - 4 (Completed/In-Progress: 1)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Realign support services
• Staffing level adjustments

Port Aux Basques
FTEs - 8 (Completed/In-Progress: 3)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Realign support services
• Staffing level adjustments

Norris Point
FTEs - 4 (Completed/In-Progress: 1)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Realign support services
• Staffing level adjustments

Burgeo
FTEs - 4 (Completed/In-Progress: 1)
• Manage sick and other leave
• Reduce overtime and extra workload
• Realign of support services
• Staffing level adjustments

Stephenville Crossing
FTEs - 8 (Completed/In-Progress: 5)
• Manage sick and other leave
• Reduce overtime and extra workload
• Changes in scheduling practices
• Staffing level adjustments
• Realign support service
• Skill mix change

Regional
FTEs - 6 (Completed/In-Progress: 2)
• Management of sick and other leave
• Reduction of overtime and extra workload
• Management realignment

Rural ClinicsFTEs - 2 (Completed/In-Progress: 1)
• Management of sick and other leave
• Reduction of overtime and extra workload

Understanding the Benchmarking
Benchmarking is determining what and where improvements are required; analyzing how other organizations achieve high performance levels and using that information to improve performance.

Operational benchmarking is defined as determining what and where improvements are required; analyzing how other organizations achieve high performance levels; and, using that information to improve performance.

Through the process, Western Health was “benchmarked” against other similar health care organizations nationally, particularly in Ontario, to compare processes and expenses to determine whether Western Health is operating as efficiently as like organizations. It was not an operational review; it was an operational improvement process.To assist with the work, Western Health hired Health Care Management Group Inc., a management group that specializes in benchmarking and improvement processes. The goals of the work were:

• To compare operations with like operations who operate more efficiently
• To improve operating performance
• To move closer to being a top performer in operating efficiencies

How did the process work?
To initiate the benchmarking process, Western Health provided to Health Care Management Group its financial and statistical data relevant to such areas as finances, worked and paid hours and number of visits/encounters. That data was compared to that of other similar organizations and those that are considered top performers in the country. Starting in June 2012, the data comparisons were shared with the managers of all functional centres. Within the organization’s management information system (MIS), departments, programs and services are categorized into like areas that are called functional centres. The managers were asked to review the data to determine whether there were opportunities and/or initiatives that would bring their operations in line with the top ranked peer groups. Once the information was shared, Western Health representatives and Health Care Management met with managers to: review how their respective functional centres benchmarked; and evaluate the initiatives they had developed to improve their performance.

A good example: Constant Care
When patients are admitted to hospital they expect to be cared for all times during their stay. This is a fair and reasonable expectation. Our employees are dedicated to caring for our patients – that is our number one priority. The term “constant care” however, has to do with the amount of time a patient is under direct observation by a Western Health employee. Sometimes, to be safe, patients require more than routine observation. For example, a patient who is very confused, at risk for falling, or potentially a risk to themselves might require more attention. We call this close, cluster or constant care.

When a patient requires more than routine care, they may be under close, cluster or constant care.

• Close care means being checked on at least once every 15 to 30minutes.
• Patients in cluster care are usually on a unit or a ward where there is acare provider in the room with the group, at hand if needed, and ableto check on everyone - at least visually - by looking around the room.
• A patient getting constant care has one-on-one supervision; there is acare provider with them at all times. This type of care has to be medically warranted, and approval is required prior to someone receiving constant care.

What is being done to ensure constant care is provided more efficiently?
Over time, the number of patients on constant care has risen above national standards. What the benchmarking initiative has identified is that there is a need to better manage constant care and ensure that it is provided by the most appropriate health care professional.