1. A unique and comprehensive healthcare company in Norrtälje

2. TioHundra AB TioHundra was founded in 2006 Unique cooperation between Norrtälje Municipality and Stockholm County Council Made permanent 1 jan 2016

3. Norrtälje is rural The area covers 1/3 of Stockholm County 58 000 residents The population more than doubles during summer

4. Norrtälje’s demography, more frail elderly Age> 65 yearsOf which are > 80 years Norrtälje26 %6,2 % The rest of Stockholm15,4 %3,8 %

5. Sickness statistics, women and men, ages 16 - 64

6. Sickness statistics, women and men, ages 20 - 29

7. Diagnosis data, ongoing illness, women and men, all ages

8. 2015 County Council Assembly Stockholm County Council Local Council Norrtälje Council Purchaser, Public Authority: Health and Care Service Committee Health and Care Service Administration Owner of Tiohundra AB: Association of Local Authorities For Owner operations TioHundra AB Private health service providers SCC

9. From 1 January 2016 County Council Assembly Stockholm County Council Local Council Norrtälje council TioHundra AB Private Health Service providers Association of Local authorities Health and care service in Norrtälje -Owner of TioHundra AB -Purchaser -Public authority practitioners SCC

10. TioHundra AB Turnover 1.5 billion SEK 2 300 permanent employees 1 000 temporary & hourly employed The Local Council’s largest employer

11. TioHundra AB Operations: Norrtälje hospital Care and service homes Psychiatric operations Home care services Home healthcare Disablity support Habilitation Children, youth and families Primary health care Rehabilitation operations

12. T Management organisation TioHundra AB Children, youth, families, psychiatry & habilitation 1 Operations Manager Disabled support & service 1 Operations Manager Primary care, rehab & hospital 5 Operations Managers Care & service and care homes 1 Operations Manager Home care services & personal assistance 1 Operations Manager Managing Director Administrative Management, Physician 4 representatives

13. Organisation primary care, rehab and hospital Anesthesia Primary care Emergency room Wards 1, 2, 3, 4 Eyes Operation Operative specialists X-Ray Rehab in-out patient Ears nose & throat Intensive care ward Med/Geria tric specialists Clinical physiology Surgery Endoscopy OpsM 5 OpsM 1 OpsM 3 OpsM 2 OpsM 4 Admin. Children Clinic

14. TioHundra AB ”…develop new and integrated forms of activities to achieve greater effectiveness.” No one shall fall between the chairs.

15. Operative Plan Clear goals Focus care transitions Frail elderly Personal challenges

16. Operative Plan

17. Change management

18. Ten years with TioHundra

19. Best quality Healthcare Norrtälje hospital best in SCC: Quality indicator 2014 Halved door-to-needle time Short waiting period for hip patients 83 percent door-to-door <4hrs in Emergency Room Lowest DRG In SCC

20. Quick patient turnover at Norrtälje hospital Good cooperation with assistance department Cost effective care Quick patient turnover

21. Effective high quality care Improved results in quality measurement Person-centred nursing New working methods More secure medicine control in home care

22. Improvement work

23. Investing in frail elderly More secure health and social care for the elderly Fall prevention Elderly pathway in the Emergency room Satisfied customers

24. Good food achieves results ”From kitchen to table” Tasty and nutritious food, made from the start, served in pleasant surroundings More elderly are staisfied with their food

25. Focus area: medicine Investing in BPSD 70 percent reduction in sleeping and anxiety medicine Shorter night-fasting with evening snacks

26. All under the same roof in The family house Integrated health care chain for children, youth and families Cooperation benefits Together in the same house

27. Successful psychiatry organisation Dependant care specialist clinics, BUP and social psychiatry in the same operations area New forms of care Reduced inpatient care needs

28. Academic health centre Integrated node Investing in continued education Open seminars and lectures High student grades

29. Challenges Legal limitations Autonomous IT-system Ineffective hospital care Different principals and operators Low patient influence Financial restrictions

30. Invest in 1177.se – appointment bookings, internet journals etc. Involve the patients in their care - partnership Lift ”IT-maturity” – cooperate with Roslagens savings bank Integrate health and care services – same journal Which development projects will we invest in?