The Need for An Operational Review

Hôpital régional de Sudbury Regional Hospital (HRSRH) was established in June 1997 and received the programs and services of the former Sudbury General, Sudbury Memorial and Sudbury Laurentian Hospitals. HRSRH is carrying out HSRC-directed capital redevelopment to accommodate all hospital services on the Laurentian site. In the fall of 2000, the hospital requested an operational review in response to five years of operating deficits, an increasingly significant working capital deficit, and significant cost overruns on the capital redevelopment project.

The Scope of the Operational Review Project

The Ministry of Health and Long-Term Care (MoHLTC) and HRSRH initiated this operational review in January of 2002 to better understand the issues faced by HRSRH and the steps to be taken by the HRSRH to improve performance, to achieve a positive financial position and realize its capital redevelopment consistent with MoHLTC approvals based on HSRC directions. The project is expected to :

• result in an objective analysis of governance, management and medical staff structures, decision-making and communication processes at HRSRH and to identify recommendations for strengthening the same;
• identify factors impacting on HRSRH’s financial situation and develop a plan for the HRSRH to achieve balanced financial position;
• identify strategies to improve clinical utilization;
• identify the impact of restructuring and the operation of multi-site locations on financial and clinical objectives, efficiencies and improvements, including that which can be realized in the shorter term while on multi-sites and in the longer term on a single site;
• review capital project management and identify options to complete the capital project within a realistic timeframe that consider the impact on operations and funding; and
• provide a recovery plan and an implementation plan for HRSRH to address these issues to ensure HRSRH can achieve necessary operational improvements and a balanced financial position according to a specified timetable.

The Operational Review Process

This following report summarizes the methods, findings and recommendations of the Operational Review consultants. The review included extensive and rigorous data collection and analysis, comparative benchmarking of HRSRH to peer hospitals, departmental reviews, surveys, interviews and focus groups involving HRSRH staff and other community stakeholders. A great deal of the project work was supported by three working groups comprised of MoHLTC and HRSRH staff, the consultants and their expert advisors :

• A Financial Working Group supported the detailed review of financial management and condition, as well as the selection of a cohort of hospitals and the resulting detailed benchmarking analysis of HRSRH departmental efficiency;
• A Clinical Working Group supported the implementation of a retrospective and a concurrent review of clinical utilization opportunities, a comparative benchmarking analysis of HRSRH clinical efficiency, as well as an analysis of HRSRH referral pattern trends, market share and population utilization; and
• A Capital Working Group supported the review of the capital project, and the development of options for completing the capital project and their evaluation.

The progress, findings and recommendations of the working groups, as well as the consultants’ review of governance, management and medical staff were overseen and scrutinized by a Steering Committee with representation from HRSRH and MoHLTC.

The HRSRH and the MoHLTC are currently working together, using these findings and recommendations, to develop a recovery and implementation plan. While there is still significant work to be done to ensure that HRSRH achieves a balanced operating budget, improves its working capital position, and completes its capital project, the consultants would like to acknowledge the dedication, hard work, and commitment of the many HRSRH and MoHLTC staff, as well as other community stakeholders that have participated in the Operational Review.

Note that there is an error on page 13 of the Report. The Sudbury Regional Hospital currently has 24 psychiatry beds in operation with no recommendation for bed reduction in this area.

EXECUTIVE SUMMARY Operational Review of Hôpital régional de Sudbury Regional Hospital : Executive Summary 18 pages / 226 K / PDF format

REPORT Operational Review of Hôpital régional de Sudbury Regional Hospital : Final Report 306 pages / 3.6 Mb / PDF format

APPENDICES Operational Review of Hôpital régional de Sudbury Regional Hospital : Appendices 143 pages / 1.2 Mb / PDF format

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November 1, 2002