​As promised last week, the next few editions of ​ Looking Ahead will focus on an update on our plans and areas of focus for 2016/17. As a reminder, our areas of focus are:

  • Purpose, Values and Principles & Strategy 
  • Clinical Optimization
  • Safety Transformation
  • Patient Experience
  • UHN Team Engagement (formerly known as Staff Engagement)
  • IT Transformation
  • Michener Integration
  • Research and Innovation

Today is a look at Clinical Optimization, and more specifically, clinical operations and the work necessary to balance our budget in 2015-16, the fiscal year which ends March 31 and 2016-17 – the year ahead.​

Many of you have been in healthcare for some time and have experienced years when funding for hospitals has increased and other years when it has been necessary to restrict spending and ensure that we are using existing resources to the maximum benefit for patients.  UHN has always balanced its budget, which has provided stability and the ability to take advantage of many opportunities over the years.  This year and next will be no different in terms of that goal and focus, although there's also no getting away from the fact that this time is especially challenging and will require the best efforts of everyone at UHN. 

We have very specific approaches to cost reduction this year.  They are:

  • Holding to budgeted volumes and no growth unless there are funds allocated to the growth
  • A reduction in our inpatient capacity and the capacity in our ORs to match the budgeted volumes
  • Continued focus on finding suitable placements for the approximately 160 Alternate Level of Care patients in our acute beds.  This will involve working with community agencies and support from the TC-LHIN and as we tackle this work, we will create a Transitional Care unit with an appropriate staffing mix.
  • As we reduce to budgeted volumes, we anticipate a decrease in the demand for medical imaging and laboratory medicine.  These areas will also reduce care to budgeted volumes in some highly specialized areas
  • We have also established a Utilization Committee to examine potential areas where UHN can optimize the use of existing resources. 
  • In response to opportunities pointed out by many of you, we will undertake a focused examination of supply chain policies and practices throughout the organization.

In taking all of these steps, I know that we will see longer waits for some procedures and that some patients will be admitted to our Emergency Departments for longer periods of time.  As I'm sure you can imagine, we have made sure that both the TC-LHIN and the Ministry of Health and Long-Term Care are aware of our plans and the fact that this will be difficult to manage in a period when demand for our services is at an all-time high.

In speaking with my colleagues at other hospitals, it is clear that the pressure on the system is building and that all hospitals are experiencing a growth in volumes, rising costs in drugs, supplies and labour in an environment where there has been no additional revenue. What this is going to require of all of us is an examination of everything that we do to find simpler, smarter and safer ways of providing care. This requires comfort with change, the ability to challenge the way we have always done things and the forging of new relationships with other hospitals and community agencies. I am confident that UHN will rise to this challenge and that we will find new and more efficient ways of caring for our patients while delivering the very best of care.

I'll conclude on this goal by saying that I appreciate the efforts of everyone at UHN to help with this work.  The people of UHN are our most valuable asset and Emma Pavlov, our Executive Vice President – Human Resources, Organizational Development and Michener Operations, has let me know that in an organization this size she is confident that we will be able to move people within the organization and minimize job loss.


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