1. 2009 CEO Forum Kananaskis, Alberta Alan R. Hudson, OC, FRCSC February 16, 2009

2. Cataract Surgery Wait Time Trend

3. Benchmark vs. Targets

4. Hip Replacement Surgery Wait Time Trend

5. Cataract Surgery Wait Times – LHIN Variation

6. Note: Based on priority level 4 targets. Current State (December 2008) - % of cases completed within target

7. June 2007 Cardiac Cancer Hip and Knee Replacements Cataract MRI and CT Scans March 2008 Ophthalmic Surgery Orthopaedic Surgery General Surgery Paediatric Surgery Pilot 2008/09 Neurosurgery Vascular Surgery Otolaryngic Surgery Ob/Gyn Surgery Thoracic Surgery Urologic Surgery Plastics/Reconstruction Oral Surgery Paediatric Surgery WTIS Phase 1-3 81 WT funded hospitals Surgeons: 1,700 Total cases 2006/07: 1,301,069 Total MRI and CT scans (2006/07): 1.2 million WTIS Adult Group 2 Expansion ~74 WT funded hospitals (surgery only) Cumulative surgeons: ~3,350 Total cumulative cases 2008/09: ~2,225,000 IMPLEMENTED WTIS Adult Group 1 Expansion 74 WT funded hospitals (surgery only) Cumulative surgeons: 2,600 Total cumulative cases 2007/08: 1,610,000 Paediatric (Pilot) London Health Sciences Centre and St. Joseph’s Health Care (London) All paediatric surgical procedures Progress Developing Ontario’s Wait Time Information System

8. Progress to Date

9. Principles 1.Accountability 2.Transparency – D.C.C. – public reporting 3.I.T. 4.Expert panels 5.Political will 6.Pay for performance (money, data and embarrassment)

10. Pay for Performance P 4 P $

11. Unintended Consequences I.C.E.S. CIHI General Surgery

12. The infrastructure and resources to reduce demand and increase supply cannot be put in place overnight, therefore, efforts must start early and will take time to show results The ER Strategy calls for System-wide Improvements  ‚   ‚  Increasing Supply of Services Improving Processes within the ER Reducing Demand for Services OR H H  ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚  ER  ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚   ‚  ED ER ‚‚    ‚   ‚ ‚ ‚ ‚  ‚   ‚ ‚ ‚   ‚  ‚‚   ‚  ‚    ‚‚    ‚   ‚ ‚ ‚ ‚ ‚ ‚  ‚   ‚   ‚ ‚ ‚ ‚ ‚   ‚  ‚  ‚‚‚‚   ‚  ‚  ‚‚    Home Rehabilitation ‚ Long Term Care Long Term Care ‚ Alternate Levels of Care Home Community and home-based services Rehabilitation ‚ Long Term Care Long Term Care ‚ Alternate Levels of Care Complex and Continuing Care ‚ Reducing ER Wait Times and Improving Public Satisfaction can only be achieved by making improvements across the entire system Therefore, accountability for improvement must rest with Hospital Boards and CEOs, LHIN Boards and CEOs and community partners such as CCACs Aging at Home Family Health Care for All Chronic Disease Prevention and Management (Diabetes) Mental Health and Addiction Aging at Home (ALC) High Growth Hospital Funding Emergency Room Strategy HHR - Emergency Department Coverage

13. Future eHealth Ontario $2.4 Diabetes ePrescribing E.H.R. LHIN accountability for program integration tracked and managed quarterly Emphasis now on transparent reporting of RESULTS, e.g. post op improvement and QUALITY results tracked over time Customer satisfaction R.O.I. = results + quality $

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