Clinical & Systems Transformation project? What is the Clinical & Systems Transformation project? CST is a joint initiative of three health organizations - Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care. The project is designed to transform healthcare delivery systems and processes to improve the quality and consistency of the patient and caregiver experience. CST will support the HOs in establishing common clinical and process standards including work flows, order sets, clinical guidelines integrated plans of care and a common electronic health record. This clinical transformation will be supported by the implementation of a clinical information system that will replace aging existing systems. The project will be implemented in stages across Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care.

CST video: “If you could change one thing…” https://www.youtube.com/watch?v=KshRgQC2NCk

Strategic Directions PHSA Key Directions Even though each of our health organizations has its own approaches to care - they all link back to the MoH efforts to improve health care by framing its work around 3 overarching goals. Ministry of Health Strategic Context: The B.C. health sector, along with other heath sector jurisdictions, has framed its efforts to improve health care around three overarching goals (developed through the Institute of Health Improvement and known as the Triple Aim): Improving the health of populations; Improving the patient experience of care (including quality and satisfaction), to which B.C. has recognized the additional requirement of improving the experience of delivering care for providers and support staff as critical to patient-centered care built on efforts of those who deliver and support health services; and Reducing the per capita cost of health by focusing on quality (especially effectiveness and appropriateness) and the efficiency of health care delivery PHSA Key Directions 1. Improve quality outcomes and value for patients 2. Promoting healthier populations 3. Contributing to sustainable health care system

CST at a Glance (infographic) Even though each of our health organizations has its own approaches to care - they all link back to the MoH efforts to improve health care by framing its work around 3 overarching goals. Ministry of Health Strategic Context: The B.C. health sector, along with other heath sector jurisdictions, has framed its efforts to improve health care around three overarching goals (developed through the Institute of Health Improvement and known as the Triple Aim): Improving the health of populations; Improving the patient experience of care (including quality and satisfaction), to which B.C. has recognized the additional requirement of improving the experience of delivering care for providers and support staff as critical to patient-centered care built on efforts of those who deliver and support health services; and Reducing the per capita cost of health by focusing on quality (especially effectiveness and appropriateness) and the efficiency of health care delivery

Patient safety first Reduce errors and adverse events Right patient Right treatment Right transitions From timely access to information, to barcode scanning of medications, to better care planning, we're investing in a safer future.

Best way, every day Improve quality and consistency of care Reduce variability in care pathways Reduce inconsistency in documentation Reduce uncertainty Patients expect and deserve to have the same experiences, wherever and whenever they need our services. We are designing safe, efficient care pathways that reflect the latest evidence and will reduce unnecessary variations in care across our facilities and healthcare organizations. We are supporting a culture of continuous learning and quality improvement. Our caregivers will make decisions based on reliable, consistent clinical information, and patients can have confidence they are being cared for the best way, every day.

Face time, not chase time Improve the healthcare experience for patients and care teams More time to plan More time to care More time to assess When care teams have the information they need at their fingertips, it means more time for patients. Transitions across health care settings will be smoother; everyone will be on the same page. Care teams won’t have to ask the same questions over and over or repeat tests. Attention can be paid to the right things without impacting our productivity. Patients and families can be confident that care teams know their story, and can be informed partners in their care. Instead of chasing charts, care teams can focus on what’s important: the patient.

Draw on data Make better information available to improve decision-making, research and proactive care Improve decision-making Improve access to clinical data Improve system performance Fuller, richer information will give us a clearer picture of how we’re doing and where we can improve. We can proactively manage patient populations based on aggregate data. Data from today will be used to anticipate the needs of at-risk populations today, and benefit the patients of tomorrow – across health disciplines and organizations.

Strengthen our core Improve information system reliability and sustainability One login One system One record A healthy body needs a strong spine. Our healthcare system needs a strong technical backbone. Right now, we use over 200 systems and programs. Logging in, logging out, forgetting passwords: all this takes time away from patient care. Many of our outdated systems will be replaced with one clinical information system, which will connect with other key systems. This will improve the stability of the systems our clinicians are using, enable us to enhance their functionality, and reduce costs over the long term. It will make it easier to deliver quality care and improve the overall reliability and sustainability of the systems we count on.

CST Drivers and Goals Drivers Goals How we will measure our success The intention of this document is to provide a “definition of success” for the CST project. It outlines the key goals that, if achieved, will signify that the CST project has been successful. The framework is not intended to outline all possible intended outcomes of the project. There are other intended outcomes (clinical, system, and organizational) that are expected to emerge as the environment for achieving the key goals is created. These other outcomes will be detailed in the CST logic model, which will map how CST expects to achieve these goals. Drivers Goals Reduce medication-related adverse events Reduce non-medication related adverse events Patient safety first Improve delivery of evidence-based care Best way, everyday Reduce time to therapy Reduce non-value added activities Improve information sharing and participation with patients and families at transitions of care and care planning Face time, not chase time Inform health system management and quality improvement with better and more accessible data Improve availability of high quality and readily accessible data for research Enable proactive care for at-risk individuals and populations Draw on data Improve reliability/stability of the technical environment Reduce clinical information system maintenance costs Strengthening our core For questions and comments , please contact: Beth Snow Joyce Cheng Program Evaluation Lead Program Evaluation Business Analyst bsnow@cheos.ubc.ca Joyce.Cheng@vch.ca February 25, 2016 12

CST Governance Structure Project Board Clinical Steering Committee Steering Committee Data Decision Group Core Clinical and Operational Advisory Team Working groups

Health Organization CST Leadership Michael Long CST Owen Haley CST Paul Brownrigg VCH Dr. Nick Foster PHSA Yoel Robens-Paradise PHC Oliver Grüter-Andrew, IMITS Glen Copping VCH Acting Chief Transformation Officer Project Director Executive Sponsor Executive Sponsor Executive Sponsor Chief Information Officer Chief Financial Officer Dr. Alain Gagnon, PHSA Dr. Eric Grafstein VCH/PHC Barb Lawrie VCH Elizabeth Stanger VCH Vicky Crompton PHSA Grant McCullough PHC Chief Medical Information Officer Chief Medical Information Officer Chief Clinical Information Officer, VCH Executive Director CST Coastal Community of Care Executive Director & Transformation Lead Acting Director, Clinical Transformation

CST Project Website – CSTProject.ca