Sharing resources 2018 FALL PCN STRATEGIC LEADERSHIP FORUM

Transcription

1 Sharing resources 2018 FALL PCN STRATEGIC LEADERSHIP FORUM

2 Presenter Disclosure Faculty: Micheline Nimmock & Yvette Penman Relationships with financial sponsors: No relationships to declare.

3 Sharing resources 3

4 YOUR PANEL SHARING RESOURCES Micheline Nimmock Executive Director, Highland PCN Yvette Penman Executive Director, Bow Valley PCN

5 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING >> 2. THE THINGS WE SHARE 3. THE STRUCTURE 4. THE SECRET TO SUCCESS 5. THE LESSONS LEARNED 6. THE SUMMARY, Q&A

6 1. THE CASE FOR SHARING STARTING THE CONVERSATION When PCNs share resources Conversations often start around common needs Opportunities can be identified during meetings (eg joint RFP, privacy officer) PCNs sometimes reach out to share Zone-wide sharing Task groups, Secretariat discussion Budget created annually and approved by EDs, expenses tracked Support from Zone admin, communications lead

7 1. THE CASE FOR SHARING ORGANIZATIONAL CHART CALGARY ZONE PCN COMMITTEE Working Groups CALGARY ZONE PCN COUNCIL Zone Support Team SECRETARIAT Ad-Hoc Committee CAAPAC Executive Directors PROVINCIAL MANDATE MEDICAL HOME SPECIALTY INTEGRATION SUPPORTED TRANSITIONS

8 1. THE CASE FOR SHARING PROJECTS, STRATEGIES PROVINCIAL MANDATE MEDICAL HOME SPECIALTY INTEGRATION SUPPORTED TRANSITIONS Opioid strategy Mental Health Deeper Dive Pop Health Leader group Pathways/ Education Find a Doctor Enhanced Transitions Quality improvement Specialist LINK Hospital Communication

9 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING 2. THE THINGS WE SHARE >> 3. THE STRUCTURE 4. THE SECRET TO SUCCESS 5. THE LESSONS LEARNED 6. THE SUMMARY, Q&A

10 2. THE THINGS WE SHARE WHEN PCNs WORK TOGETHER Resources: People Finance Manager Privacy Officer Evaluation Associate Resources: Other Policies, staff manuals RFP processes (e.g. auditors) Benefits packages Sharing of ideas

11 2. THE THINGS WE SHARE SHARING AS A ZONE Resources: People Zone Administration support Zone Communications Lead Discharge clerks in hospitals Resources: Other Find a Doctor website, materials Health Matters magazine Planning resources (co-chairs) Media training Collaborative learning events (e.g. Deeper Dive, pan-pcn clinician meetings)

12 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING 2. THE THINGS WE SHARE 3. THE STRUCTURE >> 4. THE SECRET TO SUCCESS 5. THE LESSONS LEARNED 6. THE SUMMARY, Q&A

13 3. THE STRUCTURE SHARING: HOW IT WORKS Panel determines payments Pan-PCN/Zonal budget developed each year to support joint initiatives, infrastructure needs Cost-sharing agreement updated following per-capita payments in April, October Invoices based on % of panel in Zone Expenditures tracked, invoiced back to individual PCNs by the lead PCN

14 3. THE STRUCTURE SHARING: HOW IT WORKS PCN-specific resources Several models used Lead PCN usually hires, responsible for performance management Lead organization initiates Service Agreement Other PCN or PCNs sign and budget for their portion of resource Lead organization invoices other PCNs, usually quarterly

15 3. THE STRUCTURE SHARING: HOW IT WORKS Pan-PCN/Zone resources Most costs incurred by lead PCN Lead PCN initiates service agreement with other PCNs (in development) Lead PCN invoices monthly, as per service agreement Expenditure approval usually by ED lead of task group Lead organization usually hires, manages day-to-day but there are exceptions

16 3. THE STRUCTURE SHARING: HOW IT WORKS Documentation PCN-specific service agreement Attestation agreement (for example, opioid grant expenses) Calgary Zone service agreement (between lead organization, other PCNs) Calgary Zone budget, cost share agreement and tracking Formal table, Terms of Reference for Executive Directors

17 3. THE STRUCTURE SHARING: HOW IT WORKS Budgeting Lead PCNs pay employee full amount, invoice other PCN(s) for salary, benefits, expenses If sharing PCN, we budget our portion, pay quarterly invoice Add FTE in budget Budget item called Pan-PCN expenses or similar Others attribute cost directly to item Many PCNs trying to reflect costs in Budget Plan Renewal and adding pan- PCN services in the plan directly

18 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING 2. THE THINGS WE SHARE 3. THE STRUCTURE 4. THE SECRET TO SUCCESS >> 5. THE LESSONS LEARNED 6. THE SUMMARY, Q&A

19 4. THE SECRET TO SUCCESS WHAT IT TAKES TO MAKE IT WORK Important elements Willingness, commitment on all sides Investment of time and trust (for example, ED meetings) A strong foundation for sharing for example, cost savings, efficiency Where there s strength in numbers for example, Specialist LINK When a pilot proves value and there s scope to scale, spread

20 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING 2. THE THINGS WE SHARE 3. THE STRUCTURE 4. THE SECRET TO SUCCESS 5. THE LESSONS LEARNED >> 6. THE SUMMARY, Q&A

21 5. LESSONS LEARNED SHARING OUR EXPERIENCES Challenges Investment of time, resources Cost of leading projects when benefits are shared What is equitable sharing? How much should each PCN contribute? Keeping up to date on shared activity while overseeing business plans, local demands Can lead to capacity challenges, especially during busy periods (AGM, business plan, annual report) or when sharing HR resources Many processes are built to serve local needs In Calgary we re still 7 separate businesses

22 5. LESSONS LEARNED SHARING OUR EXPERIENCES Opportunities System-wide improvements Improving access to patients for services or programs, physicians Cost savings (for example, Specialist LINK set to hit $1 million in savings) Strength of numbers can persuade partners to come forward, encourages collaboration Increases consistency and ease of understanding for patients, removes boundaries to care Structure, processes proven to be major facilitator for effective sharing

23 5. LESSONS LEARNED SHARING OUR EXPERIENCES Be clear up front re communications and accountabilities Spell out an agreement in writing re costs, process, roles and terms Ensure that staff understand the different roles and are clear re reporting Designate a lead PCN to employ staff and address general orientation, performance and any issues Ensure that the staff is oriented to each PCN Stay on top of invoicing, and Payments Set up regular communications mechanisms as needed

24 5. LESSONS LEARNED SHARING OUR EXPERIENCES Assume that the staff will figure out how to work with all PCNs Assume that all PCNs have the same needs and function similarly Create job descriptions that are too flexible Be unclear as to whom the person should report to Neglect to set up regular communications between the lead PCN and others Neglect to set up a contact person in each PCN for the new HR/System/vendor

25 OVERVIEW SHARING RESOURCES 1. THE CASE FOR SHARING 2. THE THINGS WE SHARE 3. THE STRUCTURE 4. THE SECRET TO SUCCESS 5. THE LESSONS LEARNED 6. THE SUMMARY, Q&A >>

26 5. SUMMARY, Q&A QUESTIONS