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Mid North Coast
Local Health District
Strategic Plan 2012-2016
July 2012
Reviewed January 2014
Mid North Coast Strategic Plan 2012-2016
Released July 2012
Reviewed January 2014
Further copies are available from:
Mid North Coast Local Health District Head Office PO Box 126 PORT MACQUARIE NSW 2444
http://mnclhd.health.nsw.gov.au/blog/2012/09/05/mnclhd-strategic-plan-2012-2016/
Mid North Coast Local Health District Strategic Plan 2012-2016
2
A Message from the Chair of the Board
The Governing Board is delighted to present the Mid North Coast Local Health District’s Strategic Plan 2012 – 2016.
We are extremely proud of our District and look forward to working closely with our communities and staff to achieve the Strategic Directions outlined in this Plan. The Governing Board is confident our Strategic Plan provides an excellent framework within which to further develop quality and safe health services for the communities we serve.
The Mid North Coast Local Health District’s (MNCLHD) Governing Board has worked to establish the Governance structure for the District in line with legislative and NSW Ministry of Health requirements. In doing so we have placed a strong emphasis on clinician and community engagement, and on ensuring our patients (and their carers and families) are at the centre of every decision we make.
The development of this Strategic Plan has been informed by consultations with the Governing Board, the MNCLHD’s Community Reference Group, Senior Executive Team, clinicians, managers and staff from across the District.
Our Vision: Quality and Excellence in Regional Healthcare
is underpinned by
Our CORE Values: Collaboration, Openness, Respect and Empowerment
The Governing Board, through the articulation and application of these CORE Values, will do all we can to build an organisational culture of tolerance and respect, as we work together to realise our vision of Quality and Excellence in Regional Health Care.
Introducing the Mid North Coast Local Health District (MNCLHD)
The MNCLHD covers a geographic area from Red Rock near Woolgoolga in the north to Passionfruit Creek in the south, and extending west to the Great Dividing Range where it shares a border with the Hunter New England Local Health District. It includes the Local Government Areas of Bellingen, Coffs Harbour, Nambucca, Kempsey and Port Macquarie-Hastings.
The Mid North Coast has one of the fastest growing and ageing populations within NSW. In 2012, we had some 3,000 staff providing a diverse range of services to a population of around 215,000.
Mid North Coast Local Health District Strategic Plan 2012-2016
3
Several of our population demographics are significantly different to State averages and present challenges for us in meeting current demand for health services. Future projections indicate that these challenges will persist.
State MNCLHD
Population growth 0.8% 1.35%
Over 65s population 14% 19%
Projected population growth
(2006 to 2016)
>55yrs 27.0%
>65yrs 32.4%
>55yrs 38.7%
>65yrs 42.2%
Aboriginal population 2.2% 4.3%
Socio-economic disadvantage 1003 Range 901 – 976
Over the next five years, MNCLHD will need to ensure planning and service provision is aligned to meeting the needs of our ageing and diverse population, whilst enhancing our out of hospital services.
Closer affiliations with our teaching partners will improve the supply of appropriately skilled and trained staff, and reduce our reliance on temporary, high cost labour.
Ensuring our hospitals and services are appropriately networked to meet our population needs whilst making the best use of our available resources to support our communities in clinically safe environments is at the forefront of our thinking. We aim to assure the future relevance and viability of our facilities and continue to provide appropriate services as close as possible to where people live.
Information about the health services we provide is available at:
www.health.nsw.gov.au/mnclhd/
The Governing Board understands there are services which are best accessed in major metropolitan tertiary facilities and we will make every effort to support those members of our communities and their carers who do need to travel to access the health services they need whether it be within or external to the District.
We thank all the clinicians, managers and staff who have given their time to ensure our first Strategic Plan provides the very best, relevant and achievable blue print for the future, as we work to support the health and wellbeing of our communities and staff.
We are committed to reviewing the Plan annually and invite your comments and recommendations for the Board’s future consideration. Your feedback can be emailed to:
mnclhdce-ea@ncahs.health.nsw.gov.au
Warren Grimshaw AM Chair – Governing Board Mid North Coast Local Health District
Mid North Coast Local Health District Strategic Plan 2012-2016
4
Mid North Coast Local Health District STRATEGIC DIRECTIONS 2012-2016
Vis
ion
Quality and Excellence in Regional Healthcare
Pri
ori
ty
Are
as
Community
Population Health
Service Access and
Patient Flow
Safety and Quality
Finance and
Management
People and Culture
St
rate
gic
Pri
ori
ties
Empower communities to engage as partners in health
Cooperate, collaborate and communicate with our partners
Improve health literacy in the community
Develop policies and programs to promote health across the lifespan
Close the gap
Provide comprehensive and coordinated care across all settings
Ensure current and future services best meet needs
Regional Reform Agenda
Ensure our focus is always on the patient
Provide effective, efficient, contemporary and acceptable services
Promote strategies to improve the patient experience
Focus on patient outcomes
Ensure clinical service provision is evidenced based and consistent with best practice
Improve equitable access to quality healthcare
Manage organisational risk
Use resources wisely
Promote and advocate for equity in funding
Work towards an effective transition to ABM
Ensure robust governance mechanisms are in place
Maximise and manage our capital share
Leadership in demonstrating better models of care
Promote an environment of mutual respect
Foster a culture of research, innovation and learning
Increase clinician engagement
Support the well-being of our staff
Foster a culture of leadership and development of our staff
Recruit and retain the staff we need
Collaboration Openness Respect Empowerment
CO
RE
Va
lues
Mid North Coast Local Health District Strategic Plan 2012-2016
5
PRIORITY AREA: COMMUNITY
Strategic Priorities Strategic Initiatives
Empower communities to engage as partners in health
Involve patients and carers in decisions about their health
Develop ways to communicate and engage with, and receive feedback from, communities about local health issues and service planning and in decisions that affect them
Build trust and relationships with local communities
Develop a communication strategy that keeps the community regularly and appropriately informed
Cooperate, collaborate and communicate with our partners
Coordinate and provide appropriate services in collaboration with government, non-government and community organisations
Work to identify and improve communication with partner organisations, e.g. Medicare Locals, Private sector and AMSs
Enhance partnerships with tertiary education institutions Improve health literacy in the community
Collaborate with other government and non-government organisations to develop and deliver health literacy programs
Increase community access to local health information
Mid North Coast Local Health District Strategic Plan 2012-2016
6
PRIORITY AREA: POPULATION HEALTH
Strategic Priorities Strategic Initiatives
Develop policies and programs to promote health across the lifespan
Develop and deliver programs that focus on child and family health
Develop and implement Strategic Plan to address needs of our aging populations
In alignment with state and national directions develop and deliver programs that focus on healthy ageing
Develop programs to improve health outcomes for vulnerable groups
Further develop chronic disease programs to improve management and health outcomes
Support and promote healthy environments Close the Gap
Improve Aboriginal Health by embedding Close the Gap, cultural respect and other initiatives across the District
Improve collaboration and partnerships with Aboriginal organisations and services across the LHD
Develop a targeted communication strategy with Aboriginal communities
Implement the Aboriginal Family Health Program
Increase Aboriginal employment to 4.3 per cent to match the District population
Develop targeted prevention programs for Aboriginal people e.g. smoking, physical activity
Implement key public health initiatives in partnership with Aboriginal communities
Develop and implement integrated models of chronic care for Aboriginal people
Improve the identification of Aboriginal and Torres Strait Islander people
Improve Aboriginal health data, and data management and reporting Provide comprehensive and coordinated care across all settings
Develop innovative ambulatory models of care
Use technology to enhance service delivery and outcomes
Ensure care planning considers the patient journey across the continuum of care
Ensure integrated, coordinated care and discharge planning are core to patient management Ensure current and future services best meet needs
Assess the needs of communities and ensure that the right services are provided in the right place
Develop a mechanism to identify future needs and reconfigure service requirements
Work with health related transport providers to improve transport options
Enhance the provision of outreach services across the District
Increase investment in alternative models (to hospital based services) of service delivery
Further develop a Network approach to service provision by encouraging collaboration and networking between all facilities within the District and Networks to enhance physical resources and services
Mid North Coast Local Health District Strategic Plan 2012-2016
7
PRIORITY AREA: SERVICE ACCESS AND PATIENT FLOW
Strategic Priorities Strategic Initiatives
Ensure our focus is always on the patient
Develop an organisational culture of patient centeredness
Develop and implement programs to support carers
Provide effective, efficient, contemporary, acceptable and appropriate services
Provide emergency care without delay (including National Emergency Access Target (NEAT))
Shorten waiting times for non-emergency care (including National Elective Surgery Targets (NEST))
Respond appropriately to advances in clinical technology
Improve medication use and safety
Improve access to allied health services
Expedite the transfer of acutely ill patients to the most appropriate facility in a timely manner
Develop and implement a strategy to reduce unplanned readmissions and potentially preventable hospital admissions
Improve the patient experience
Review the outcomes of patient and staff satisfaction surveys and develop action plans to address issues identified
Develop strategies to improve manager and clinician communication with patients and carers
Develop models of care for subacute patients
Recognise the role of the carer and implement strategies to assist their role
Improve nutritional care in inpatient settings
Improve IT infrastructure and continue implementation of electronic medical record
Focus on patient outcomes
Support services to develop relevant key performance indicators to measure patient outcomes
Take appropriate action in response to adverse outcomes
Develop adequate data systems to record and respond to patient outcomes
Mid North Coast Local Health District Strategic Plan 2012-2016
8
PRIORITY AREA: SAFETY AND QUALITY
Strategic Priorities Strategic Initiatives
Ensure clinical service provision is evidenced based and consistent with best practice
Develop, implement and monitor agreed models of best practice care
Maintain accreditation for the District
Reduce inappropriate variation in clinical practice
Continue and support local clinical improvement programs
Maintain and strengthen formal relationships with the Four Pillars (Bureau of Health Information, Agency for Clinical Innovation, Clinical Excellence Commission, Health Education and Training Institute)
Improve access to quality healthcare
Clarify the role and role delineation for MNCLHD services
Identify groups that have difficulty accessing health services and address barriers to access
Develop strategies to enhance infection prevention and control program
Monitor, measure and provide feedback on services provided and access to these services
Ensure facilities are well maintained and appropriate to support the services delivered Manage organisational risk
Embed the Enterprise-wide Risk Management Framework throughout the organisation
Service access and patient flow
Improve accesses to and expand mental health services
Mid North Coast Local Health District Strategic Plan 2012-2016
9
PRIORITY AREA: FINANCE AND MANAGEMENT
Strategic Priorities Strategic Initiatives
Use resources wisely
Set timely budgets and communicate outcomes
Critically evaluate outcomes of investment
Allocate resources based on population needs and in alignment with the Service Agreement
Improve transparency in financial management
Develop a District Environmental Sustainability Plan Promote and advocate for equity in funding
Advocate for an equitable share of funding for teaching and research
Work towards equity in resource allocation within the District
Communicate to the community our financial challenges and how we are tracking, ensuring that services not funded by Activity Based Management get a fair budget allocation
Lead the implementation of new models of care and work towards an effective transition to Activity Based Management
Develop and implement an Activity Based Management Plan that includes education and consultation with key stakeholders e.g. clinicians
Ensure robust governance mechanisms are in place
Align governance structures and processes to fulfil statutory obligations and ensure compliance with the NSW Ministry of Health Performance Framework
Ensure the right information is provided to the right person at the right time to inform appropriate and timely decision making
Maximise and manage our capital share
Complete master planning for all sites
Develop a District Asset Strategic Plan
Continue planning of redevelopment of Kempsey District Hospital
Advocate that capital share meets the need of the District
Maximise opportunities of new capital projects Use resources wisely
Continue to develop IT Strategic Plan
Mid North Coast Local Health District Strategic Plan 2012-2016
10
PRIORITY AREA: PEOPLE AND CULTURE
Strategic Priorities Strategic Initiatives
Promote an environment of mutual respect
Articulate organisational values and mandate behaviours that uphold the values
Engage in strategies that promote the LHD services and facilities to the community - e.g. hospital open days
Implement ‘Your Say’ (staff satisfaction survey) action plans Increase clinician engagement
Establish mechanisms for sharing information and engaging clinicians in decisions around services and service delivery
Provide appropriate support for clinicians for clinical supervision, education and training Ensure a safe and healthy environment
Foster shared accountability between managers and staff to promote staff safety and wellbeing
Support and promote professional development and ensure equity of access
Become a learning organisation to optimise the capability and capacity of our staff
Develop senior and middle management capabilities
Implement strategies to support career development and succession planning
Provide appropriate support for staff injured at work Recruit, retain and develop the staff we need
Action recruitment and retention strategies to meet organisational requirements
Develop and implement a workforce strategic plan in line with clinical service requirements
Collaborate with tertiary education providers to ensure that we have the workforce we need
Develop systems for credentialing, assessing professional competencies and providing clinical supervision
Engage with and recognise the value of volunteers Foster a culture of research and innovation
Develop and support a culture of research and innovation
Publish outcomes of clinical initiatives and research
Foster partnerships with local tertiary educational institutions to improve staff access to educational and research opportunities
Mid North Coast Local Health District Strategic Plan 2012-2016
11
2012/13 Measuring Performance
Our performance measures and targets are consistent with the Tier 1 and Tier 2 measures and targets in the District’s Service Agreement with the NSW Ministry of Health.
Performance Measures 2012/13 Targets
Tie
r 1
Pe
rfo
rman
ce M
ea
su
res
Will
gen
era
te a
perf
orm
ance c
oncern
when
the
Hea
lth
Serv
ice’s
perf
orm
ance
is o
uts
ide t
he t
ole
rance t
hre
shold
for
the a
pp
lica
ble
re
port
ing p
erio
d
Number Staphylococcus aureus bloodstream infections (SA-BSI) (per 10,000 occupied bed days)
2
Per cent Transfer of Care Time from Ambulance to ED < 30 minutes 90
Per cent ED patients admitted, referred or discharged within 4 hours of presentation: all patients
69 Jul-Dec 76 Jan-Jun
Number Category 1 overdue elective surgery patients 0
Number Category 2 overdue elective surgery patients 0
Number Category 3 overdue elective surgery patients 0
Per cent Category 1 elective surgery patients admitted within clinically appropriate time
96 Jul-Dec 100 Jan-Jun
Per cent Category 2 elective surgery patients admitted within clinically appropriate time
90 Jul–Dec 93 Jan-Jun
Per cent Category 3 elective surgery patients admitted within clinically appropriate time
92 Jul–Dec 95 Jan-Jun
Per cent Activity against purchased volume (%):
Acute Inpatient Services (Cost weighted Separations)
Acute Inpatient Services (NWAU)
Emergency Department Services (Cost weighted Attendances)
Emergency Department Services (NWAU)
42,140 40,579 92,476 10,376
Expenditure matched to budget (General Fund):
Per cent Year to Date
Per cent June projection
On budget or Favourable
On budget or Favourable
Revenue Matched to budget (General Fund):
Per cent Year to Date
Per cent June projection
On budget or Favourable
On budget or Favourable
Number Recurrent Trade Creditors > 45 days correct and ready for payment
0
Small Business Creditors >30 days from receipt of a correctly rendered invoice
0
Tie
r 2
Pe
rfo
rman
ce M
ea
su
res
Will
gen
era
te a
perf
orm
ance c
oncern
when
the
Hea
lth
Serv
ice’s
perf
orm
ance is o
uts
ide
the
to
lera
nce
thre
shold
for
more
tha
n o
ne r
eport
ing
peri
od
Number ICU Central Line Associated Bloodstream (CLAB) Infections (number)
0
Number Incorrect procedures: Operating Theatre - resulting in death or major loss of function
0
Per cent Mental Health: Unplanned readmission within 28 days 13
Number Presentations staying in ED >24 hours 0
Number Mental Health: Presentations staying in ED >24 hours 0
Per cent Mental Health: Acute Post-Discharge Community Care follow-up within seven days
70
Number Mental Health ambulatory (provider) contacts 67,463
Per cent Public Dental Weighted Occasions of Service against Target TBA
Number Connecting Care Program: people currently enrolled 1,491
Per cent centre-based children’s service sites adopting the Children’s Healthy Eating and Physical Activity Program in Early Childhood to agreed standard
TBA
Per cent primary school sites adopting the Children’s Healthy Eating and Physical Activity Program in Primary School to agreed standard
TBA
Number children 7-13 years who enrol in the Targeted Family Healthy Eating and Physical Activity Program (Number)
60
Per cent children 7-13 years who complete the Targeted Family Healthy Eating and Physical Activity Program (%)
85
Mid North Coast Local Health District Strategic Plan 2012-2016
12
2013/14 Measuring Performance Our performance measures and targets are consistent with the Tier 1 and Tier 2 measures and targets in the District’s Service Agreement with the NSW Ministry of Health.
Performance Measures 2012/13 Targets
Tie
r 1
Pe
rfo
rman
ce M
ea
su
res
Will
gen
era
te a
perf
orm
ance c
oncern
when
the
Hea
lth
Serv
ice’s
perf
orm
ance is
outs
ide th
e to
lera
nce thre
shold
for
the a
pp
lica
ble
repo
rtin
g p
eri
od
Number Staphylococcus aureus bloodstream infections (SA-BSI) (per 10,000 occupied bed days)
2
Per cent Transfer of Care Time from Ambulance to ED < 30 minutes 90
National Emergency Access Target (NEAT) - Per cent ED patients admitted, referred or discharged within 4 hours of presentation: all patients
71 Jul – Dec 81 Jan - Jun
National Elective Surgery Target (NEST) – Per cent Elective Surgery Patients Treated on Time Category 1 Category 2 Category 3
100
93 Jul – Dec 97 Jan – Jun 95 Jul – Dec 97 Jan – Jun
National Elective Surgery Target (NEST) – Average overdue waiting time (days) Category 1 Category 2 Category 3
0 at 31 Dec 20 at 31 Dec 65 at 31 Dec
Per cent Activity against purchased volume (%):
Acute Inpatient Services (NWAU)
Emergency Department Services (NWAU)
Sub and Non-Acute Inpatient Services (NWAU)
Non Admitted Patient Services – Tier 2 Clinic (NWAU)
48,143 10,454 2,759 4,461
Per cent against purchased volume %: Mental Health
Mental Health Inpatient Activity: Acute Inpatients (NWAU)
Mental Health Inpatient Activity: Non Acute Inpatients (NWAU)
3,281 832
Expenditure matched to budget (General Fund): Year to date (%) June projection (%)
On budget or Favourable
On budget or Favourable
Revenue Matched to budget (General Fund): Year to date (%) June projection (%)
On budget or Favourable
On budget or Favourable
Tie
r 2
Pe
rfo
rman
ce M
ea
su
res
Will
gen
era
te a
perf
orm
ance c
oncern
when
the
Health S
erv
ice’s
perf
orm
an
ce is o
uts
ide t
he
tole
rance thre
shold
for
more
tha
n o
ne r
eport
ing
perio
d
Number Recurrent Trade Creditors > 45 days correct and ready for payment ($) 0
Small Business Creditors >30 days from receipt of a correctly rendered invoice (%) 0
Number ICU Central Line Associated Bloodstream (CLAB) Infections (number) 0
Number Incorrect procedures: Operating Theatre - resulting in death or major loss of function
0
Mental Health: Acute readmission within 28 days (%) 13
Mental Health: Acute Post Discharge Community Care – follow up within seven days (%)
70
Presentations staying in ED>24 hours (number) 0
Mental Health: Presentations staying in ED >24 hours 0
Connecting Care Program: people currently enrolled 1972
Public dental baseline Dental Weighted Activity Units (DWAUs, % of Baseline target) 100
Per cent centre-based children’s service sites adopting the Children’s Healthy Eating and Physical Activity Program in Early Childhood to agreed standard
>50
Per cent primary school sites adopting the Children’s Healthy Eating and Physical Activity Program in Primary School to agreed standard
>50
Number children 7-13 years who enrol in the Targeted Family Healthy Eating and Physical Activity Program (Number)
180
Per cent children 7-13 years who complete the Targeted Family Healthy Eating and Physical Activity Program (%)
85
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