Canadian Centre for Healthcare Facilities

Operational Readiness Planning and Keys to

Success

John Wieser, Senior Principal, Stantec

Jackie Charko, Director Project Management Office, Halton Healthcare

Donna Rothwell, Principal, Stantec

November 29, 2016

 Agenda

1. What is Operational Readiness and Activation

Planning?

2. Oakville Trafalgar Memorial Hospital -

Operational Readiness Experience

3. Doing It Again – The Milton District Hospital

Current Experience

2 © Stantec Consulting Ltd. 2016

 The project question that helped start it all (circa 2005):

What could the Hospital possibly

be doing any earlier than 3
months before moving, that
requires time and resources?

3 © Stantec Consulting Ltd. 2016

 1 What Is Operational Readiness and Activation
Planning?

4 © Stantec Consulting Ltd. 2016

 Capital Projects Enable Healthcare Transformation

Transformation Success is
Facility
the Sum of Three Parts
Operations
Ready facility &
+ Ready operations
Individuals
+ Ready individuals_____
= Transformation Success
5 © Stantec Consulting Ltd. 2016
 Operational Readiness & Activation Planning

Process to prepare for and activate a facility in a

timely, safe, and cost-effective manner – soft side
of project
Operations
Connects readiness of operations, individuals and
facility
&
Individuals
Means to enable organizational transformation

6 © Stantec Consulting Ltd. 2016

 Operational Readiness Deals with Transforming the Soft Stuff…

Today… …Tomorrow
Operational Vision Change Management
Change Mgmt

Opening Opening
New Service Delivery Model and Process Changes

Financial Planning Licenses

Day Technology and Clinical Systems

IT / Systems Day
Competencies, Skills Mix, Roles, Staffing Models
Vision Recruiting & Hiring Orientation Operations
Policies and Procedures Communications

Planning and Design Equipment

Construction and Commissioning
IT Infrastructure Facility/ Plant Management

7 © Stantec Consulting Ltd. 2016 Physical Move

 Success defined for an Operationally Ready Hospital

“An organization that is operationally ready

has…
o the right people,
o with the right training and policies,
o in the right numbers,
o at the right place,
o with the right equipment and technology and,
o with the right attitude,

…. generating an exceptional and sustainable patient, family

and staff experience.”
8 © Stantec Consulting Ltd. 2016
Operational Readiness and
Activation Planning

How to be Successful
 Must Haves and Lessons to be Successful

• Insights drawn from over 30 projects

• 4 common “must haves”

Leader
ship Vision
• Effective blend of:
– project management practices Planning Framework
or Roadmap
– change management principles

Integrating Structures and Tools

Empowered Teams

10 © Stantec Consulting Ltd. 2016

 Must Have – Leadership Vision and Support

• Start with Ops Readiness Leadership Charter

– aligns expectations
– links to Corporate Strategy Leader
– defines governance ship Vision
– sets out success criteria

• Recognition its actual work

• Focus on operational change not just construction

• Inspires leadership to lead!

11 © Stantec Consulting Ltd. 2016

 Must Have – Planning Framework to Follow

• Road-map for the journey = answers where are we headed

and why?

• Manage like a project = predictability; reduced risk Leader

ship Vision
• Enables early change = early wins; maintain momentum,
reduced Opening Day risk Planning Framework
or Roadmap
• Support resources/ backfill plan = business case for
Ministry transition funding support

Engage leadership Identify the degree

Determine “what Build a plan and Implement and
& define project of change (current
needs to get done” stress test it monitor progress
expectations vs. future)

12 © Stantec Consulting Ltd. 2016

 Must Have – Structures and Tools to Enable the Work

• Integrating structures (leverage existing wherever possible):

– Steering Committee (direction/ oversight)
– Project Council (sharing forum) Leader
– Multi-disciplinary Planning Groups (solving issues) ship Vision
– PMO (support Programs and Services)
Planning Framework
or Roadmap
• “Day-in-the-life” simulations prior to move

• Educational forums to share lessons along theIntegrating Structures and Tools

way

13 © Stantec Consulting Ltd. 2016

 Must Have – Structures and Tools to Enable the Work

• Variety of tools for planning and communicating:

– Opening Day Views

Leader
– current-future state Change Map
ship Vision
– individual Program Work Plans
Planning Framework
– red-yellow-green Status Dashboard or Roadmap
– Operational Risk Register
– day-by-day Start-up/ Burn-In Plan Integrating Structures and Tools

– Opening Day Readiness Checklist

14 © Stantec Consulting Ltd. 2016

 Must Have – Teams Empowered & Accountable for Outcomes

• Engaged and inspired leaders to build resiliency

• Maintain existing operational accountabilities

Leader
• Break down silos: ship Vision
– Ops Readiness Leads for each Program
– Multi-disciplinary Planning Groups Planning Framework
– Physician “champions” or Roadmap

• Designated IT Lead
Integrating Structures and Tools
• Super-users and train-the-trainers
Empowered Teams

15 © Stantec Consulting Ltd. 2016

Operational Readiness and
Activation Planning

Putting it Into Practice

 Halton Healthcare's Capital Project Trifecta Today

17 © Stantec Consulting Ltd. 2016

 2 Oakville Trafalgar Memorial Hospital

Operational Readiness Experience

18 © Halton Healthcare Services Corporation 2015

 Operational Readiness - Planning A Must

•Roadmap for operational readiness

•Shifts focus from construction to operations
•Standardized planning process
•Continuation of safe, quality patient care
•Implement early to mitigate risk
•Track & monitor progress
•Plan & track costs

19 © Halton Healthcare Services November 2016

 Framework Foundation

Change
Management

Project Flow
Map

Project Management
Principles

20
© Halton Healthcare Services November 2016
 Framework Foundation

Shared Speed Critical Mass

Understanding

Opening
Start Day View Budget PMO Implement Evaluate Close
Project Charter

Initiating Planning Executing Monitoring Closing

21 © Halton Healthcare Services November 2016

22
© Halton Healthcare Services November 2016
23
© Halton Healthcare Services November 2016
 Seven Tactical Elements

24
© Halton Healthcare Services November 2016
 Framework Attributes

•Based on change management model

•Integrates project management discipline

•Scalable to project size

•Modular components

•Adaptable to project complexity

•Risk mitigation

•Comprehensive
•Innovative
25
© Halton Healthcare Services November 2016
 Building in
Operational Readiness
~Tools & Templates~

26
 Framework Tools &
Templates
Functional
Program Project
Charter Council Functional
WorkPlans Planning Program Lessons
Enterprise – Groups Status Reports Learned
Risk Registry
wide Charter SharePoint Executive Evaluations
Budget
Opening Day Information Summary Indicators/
Change
Views Needs List Status Report Metrics
Management
Gap Analysis Master Budget/ POE Report
Toolkit
Change Heat Schedule Resource Presentations
Workforce
Map Tracking & Journals
Planning

Initiating Planning Executing Monitoring Closing

27 © Halton Healthcare Services November 2016

 Framework Tools & Templates

Initiating

•Enterprise-wide Charter
•Opening day view
•Program gap analysis
•Change Heat Map

2828 © Halton Healthcare Services November 2016

Opening Day View (ODV)
• Based on 7 tactical elements
• 2 formats (Clinical and Support)
• Each program/department completed and presented to others

© Halton Healthcare Services November 2016

Change Heat Maps - Purpose

• Provides a visual representation of scope of change in an

area/initiative
Should be done for entire life of project
• Identify areas of higher‐risk due to the complexity or magnitude
of change
• Identify areas to focus support resources
• To monitor and maintain the priority of a project relative to other
competing projects and established timelines
• Programs/Projects want to be red!!!

30
© Halton Healthcare Services November 2016
 Change Heat Map Legend

High (affects are enterprise-

wide)

Minimal Multiple
change/complexity; and if Some change/complexity; changes/complexity; and
not done well, impact will and if not done well, if not done well, impact
be high (3) impact will be high (6) will be high (9)
(what does it affect)

um (affects multiple
departments)

31
© Halton Healthcare Services November 2016
 Change Heat Map – Program Example
Program Financial People Process Technology & Facility
Operatio Total
Equipment nal Score
Commun
ications
FP Department / Scope of System- New Volumes Operatio Major Major New Major IT Major Major Operatio  
Program Service Wide Model of nal Staffing Training Processe Changes Equipme Space nal
Changes Care/ Financial Changes Needs s/ nt Adaptati Commun
(impacts Service Impacts Process Changes ons ication
other Re- Changes
sites or engineeri
LHIN) ng

2 2 6 4 4 6 6 6 4 2 3 4 49

Potential
increase
Redesign
in
New new
volumes
Maternal Child LBRP, processes
due to Change in Communi
Program (incl scope of Midwifery, based on
12 new Slight job Retrain all cation Uncertaint
Inpatient service Paed new model New fetal No new New
Paediatrics) building, increase descriptio staff on internally y of
consistent   short stay and monitorin equipmen geographi
however in funding ns due to new primarily potential
with in ED, accommo g system t c layout
population required LDR model and to volumes
current Physician dation of
growth in model offices
on call location of
MDH
planning office
greater
spaces
than in
Oakville
32
© Halton Healthcare Services November 2016
 Change Heat Map – Enterprise View
Program Financial People Process Technology & Equipment Facility Operational Total Score
Communications

FP Department / Program Scope of Service System-Wide New Model of Volumes Operational Major Staffing Major Training New Processes / Major IT Changes Major Equipment Major Space Operational  
Changes Care/ Service Financial Impacts Changes Needs Process Re- Changes Adaptations Communication
(impacts other engineering/Proc Changes
sites or LHIN) ess Improvement
(Lean)

6 6 6 6 9 6 6 4 4 2 6 4 65
Adult and Child/ Adolescent
Adult unit now has
Mental Health Program - New PICU, new New PICU, new 7 additional beds in MH unit in ED, new Confirm criteria and
1,2,8,9 Integration with ED, 2 units. Structured Communication New and potentially
Inpatient/Outpatient day hospital, day hospital, Child and Adult New budgets for day hospital and hand-off process in May have new
Paeds and LHIN New training New equipment list plan for deployment with external expanded
Services expanded mental expanded mental Mental Health. Also new programs PICU. Investigate between ED and security system
initiatives of patients and staff partners and PR programs
health hours in ED health hours in ED new PICU. use of PALS crisis MH.
required.

4 4 4 6 4 6 6 4 4 2 6 9 59

Coordination with Expanded dialysis

Chronic Disease Communicate inter-
Expanded dialysis Dorval site and Potential change to Integration of Require training model and
Management - Nephrology, Increased dialysis Plan improvements clinic hours of
3,6 volumes and potential changes Potential changes ORN funding Dorval staff. and orientation of Confirm ORN New dialysis integration with
Diabetes, Health Promotion stations from 24 to on registration and Dorval site will join operation. Develop
confirm scope of to dialysis service to dialysis service model. Assuming Staffing model to currently off-site reporting machines requiring Chronic Disease
and Disease Prevention 33 requires phasing scheduling main NOH campus patient
service of mobile delivery from ORN. model from ORN status quo volumes match ORN staff who will be requirements training Management
approach processes communication
diabetes team Diabetes service for others funding integrated at NOH through LHIN
plan re: move
consolidation initiatives

9 9 9 6 9 9 9 6 9 6 6 9 96

New Processes /
Cancer Clinic-new All net new
Medical Day Care and New budget Process Re- New software,
4 service and Impact to support volumes for Cancer New staff and Develop new Net new program
Cancer Clinic New model of care required, however engineering/Proces reporting
Medical Day will services (Rx, Lab, Care. Medical Day alignment of New training New equipment New space communications for Cancer Clinic
for HHS supported through s Improvement requirements
undergo multiple DI, ED inpt, etc) needs to align existing and protocols and consolidations
CCO (Lean); external (CCO, etc)
changes volumes
radiation therapy

6 2 4 6 6 6 6 6 6 6 6 6 66

Communicate inter-
New clinics and
Identify skill set Centralized clinic hours of
Confirm service consider current
Medical/Surgical Clinics requirement for process for operation. Develop
5 New clinics - delivery from demographics to Staff integration New clinics
and Procedures Budgets for new each clinic, registration and use EMR, Registration, New space and OR patient
neurosurgery and   specialists and project volumes. plan for adjacent New equipment (Neurosurgery and
clinics however generally of kiosks. Confirm OR Manager block scheduling communication
wound family MDs with Assuming current clinics Wound)
easy to recruit to patient observation plan re: move.
special privileges volumes upon
positions process Physician block
opening
scheduling

6 3 6 4 4 4 4 3 4 6 6 4 54

Internal process
Confirm scope of Potential increase Staffing plan for Training for new review to identify
Outpatient Rehabilitation Potential changes Communication
7 service for Hands in volumes for new programs and programs. potential Dorval Staff to potentially
Services from the LHIN New services such New budgets with internal and
Clinic, pool Hands, Geriatric, recruitment to Registration clerks opportunities for EMR New therapy pool move, therapy expanded
regarding Central as pool program required external
program, outreach Physiatry and Step begin early enough to be cross - improvements (e.g. room planning programs
Intake Process stakeholders
services Up for training trained referral process to
day treatment)

6 6 4 6 4 4 4 6 4 3 6 4 57

Opportunity to
Additional palliative
Potentially Higher acuity improve e-referral
Complex Continuing Care beds, and potential 8 additional Budget for Impacted by new
33
10, 14 Possible impacted by new Additional staffing patients mean process, ADU Expanded program
and Inpatient Rehab higher acuity of palliative care beds additional CCC E-referral, New geographic shared space -
regionalization of space design and and patterns for appropriate training implementation, New equipment list and integration of
patients (i.e.
the CCC program larger scope of
transferred from beds and confirm
palliative beds of staff skill mix Dining Room © Halton
WanderguardHealthcare Services layoutNovember 2016
currently teams are
teams
Change Heat Map – Program Ranking

Functional Program Total Score Functional Program Total Score

Medical Day Care and Cancer Clinic 96
Maternal Child Program (incl Inpatient Paediatrics) 49
ICT Applications 79
Pathology and Laboratory 74 Biomedical Engineering 48
Pharmacy 72
Business Development 66 Organizational Learning & Professional Practice Development 47
Patient Registration (ER and Admitting) and Clinical
Diagnostic Services - Cardio respiratory, DI, Neurophysiology, Information Services 40
Specimen Collection Services 66
Public Areas - Public Relations 39
Medical/Surgical Clinics and Procedures 66
Finance, Decision Support 35
Surgical Services - Surgical Day Care, Surgical Suite (OR,
PACU), Ambulatory Proc Unit 66 Infection Prevention and Control 35
Adult and Child/ Adolescent Mental Health Program - Materials Management 35
Inpatient/Outpatient Services 65
Emergency (including Observation Unit) 64 Medical Devices Processing (Central Sterile Processing) 35
Admin- Redevelopment Administration 34
Chronic Disease Management - Nephrology, Diabetes, Health
Promotion and Disease Prevention 59 Environmental Services - Administrative Centre 33
Facility Maintenance 59 Admin- Program Administration 31
Complex Continuing Care and Inpatient Rehab 57 Spiritual Care 31
Food Services 56 Public Areas - Library 29
Critical Care Unit 55 Admin- Quality, Risk and Patient Relations 25
Human Resources 55 Diagnostic Services - Cardio respiratory 25
Medical/Surgical Units 55 Public Areas - General 24
Admin - Professional Staff (Physicians) 54
Public Areas - Patient Discharge Centre 24
Outpatient Rehabilitation Services 54
Admin- Corporate Administration 22
Parking, Grounds and Security 53
Housekeeping and Linen Services 50 Foundation 17

34 Volunteer Services 50
© Halton Healthcare Services November 2016
Change Heat Map Uses

• Statusing frequency (total score)

– Red – monthly
– Yellow – bi monthly
– Green - quarterly
• Funding support (total score)
• Process/Greenbelt training candidates (Process column)
• Workforce planning and change management (People column)
• Training & Orientation (People, process and Technology & equipment columns)
• Risk Registry (all columns e.g. people column for HR risks)

© Halton Healthcare Services November 2016

 Framework Tools & Templates

Planning

•Functional Program Charter

•Functional Program work plans
•Risk registry
•Budget Template
•Change Management Toolkit
•Workforce planning tools

3636 © Halton Healthcare Services November 2016

 Workplans – Flexible to individual styles

Workplans need to be
embraced by the
individuals who are
managing them
– Georgetown ED –
~600+ lines
– Georgetown DI –
~ 300 lines

37
© Halton Healthcare Services November 2016
 Workplans – Need to be user friendly

Workplans- use of sophisticated

software programs are not
necessary; chose the system that
accomplishes and supports what
you need
38
© Halton Healthcare Services November 2016
Risk Registry
• Based on 7 tactical elements + others (governance, external, etc)
– Business owner for each element/section
• Gathered top 3-5 risks of each program before workshop
• Discussed risks and mitigation plans in workshop
• Monitored monthly with external consultant

© Halton Healthcare Services November 2016

© Halton Healthcare Services November 2016
 Framework Tools & Templates
Executing

•Project Council – Terms of Reference

•Planning Groups – Terms of Reference
•SharePoint; communications & documents
•Information Needs List template
•Master Schedule template
•Training and education plan
•Orientation Checklist
•Purge/Move Plans
•Lessons Learned

41 41 © Halton Healthcare Services November 2016

 Project Council – Terms of Reference
• Monthly to bi-Monthly meeting with all Program/Department
Directors
• Objective - established to advise, recommend, monitor and
share information with respect to the Program/Department
Operational Readiness work
• Co-Chairs – PMO Director
& COO Transitions
• Reports to Ops Readiness
Steering Committee (ORSC)

42 © Halton Healthcare Services November 2016

Project Council Examples

• Model of care/service changes

• New processes
• ICT Project launches and updates
• Risk monitoring
• Celebrations and thanks (e.g. greenbelt certificates)

© Halton Healthcare Services November 2016

 Planning Groups
• Various individuals brought together
to focus on a specific topic with
respect to the specific project
• Objective of group is specific to
focus area
• Monthly or bi-weekly meetings
• Chaired by most appropriate
business owner

44 © Halton Healthcare Services November 2016

 Planning groups
• Communications • Parking Services
• HR Workforce Planning • Cancer Clinic
• Transportation (Portering, pneumatic • Access & Control
tube, etc) • Orientation & Training
• BMWV (Volumes/service mapping, • Wayfinding & Signage
Model of Care, Budget & Workforce • ICT projects (various)
Design)
• Chart Management
• Emergency Preparedness and Response
• Celebrations & Closing Ceremony
• Public Spaces
• Move Planning & Coverage
• Supply Flow
• Purge & Preserve
• Chart Management
• Documents
• Core Clinical Workflow Design
• Tobacco free Site
45
© Halton Healthcare Services November 2016
 Planning Group – Core Clinical Workflow Redesign
• Purpose:
– to investigate, identify, discuss, and recommend changes in core clinical
processes and procedures and the impact on interdependencies and policies
resulting from the new floor plate, size and configuration of the new Hospital

• Membership:
– COO – OTMH (chair)
‾ Ad hoc cross organizational team members, e.g.
– Chief Nursing Officer IPCS, Food Services, Pharmacy, Biomed,
– Director, PMO Volunteers, etc. as required
– PMO Lead – Senior Project Manager, ‾ Program Leads (as required by scope of group)
Process Design & Improvement ‾ Physician representatives, where appropriate
– Clinical Directors (Medical, Surgical and Maternal ‾ External stakeholders as appropriate (including
Child, Emergency patient/family representation or other service
recipients/providers)
– Patient flow representation
– Registration representation
– Environmental Services representation
© Halton Healthcare Services November 2016
Process Portfolio
• Hired Sr. Project Manager to support portfolio and projects
• Established Vendor of Record
– Focus on complicated/political projects

• Conducted Lean Greenbelt training

– Included classroom, exam and project
– Ended up having 4 cohorts
– Training 110 staff to lean processes
– ~ 60 projects related to Ops Readiness

– Enabled staff to solve problems and continue process

improvements today
© Halton Healthcare Services November 2016
 © Halton Healthcare Services November 2016

Projects-At-A-Glance: Month of April

Reporting Period: March 9th to April 3rd

Apr 15
Mar’1

Mar’1

Phase
Phase

Apr,
# Process Improvement Projects # Process Improvement Projects

15
5

5
a
1 Pod Prototype: 4E, 4W, 2E G G E 10 Std. of Nursing Shift Routines G G P

o
2 Pod Prototype: 2C and 4C G G E 11 Greenbelt Training G G E

b
3 Shared Reg Model: DI & Fracture Clinic G G P 12 Lean Leadership Training G G E

h l e
13 Mat Child: Postpartum Paeds Flow G G P

s
Shared Reg Model: Nuc Med, Cardio Resp &
4 -- G P

p
Pacemaker Clinic **

a
14 Mat Child: Prenatal and Endocrine Clinic G G P
5 Shared Reg Model: OR & APU G G P -- G P

D am
15 Mat Child: PEPC Clinic**

Shared Reg Model: Eye Clinic, PAC, Med-Surg HR and Occ Health – Short Term
6 G G P 16
Disability/Employment Insurance Y G P
Clinics, PEPC, Geri Clinic

x Y Y P
7 ED NOH Registration & Admission Process ** -- G P 17 HR & Occ Health – Employee Support Program

E
Mental Health: 2-Team Model Simulation on 5C
8 OR and MDR G G E 18
** -- G P
9 APU: GI G G E
** Projects added this month

G Y R C P Planning L Lean Event E Executing

On Track At Risk Critical Complete
 Pod Prototype Project
To help prepare for changes to the physical layout
Pod prototype simulates the decentralized environment of the inpatient units at the
new Oakville hospital:
• 36 beds units comprised of 3 - 12 bed “pods”

• Positive response:
– Number of call bells decreased
– Noise level at team stations decreased
– Positive physician response

Published in Healthcare Quarterly – Volume 19 No1 - Decentralizing the Team Station: Simulation before Reality as a Best-
Practice Approach; Jackie Charko, Alice Geertsen, Patrick O’Brien, Wendy Rouse, Ammarah Shahid and Denise Hardenne
49
© Halton Healthcare Services November 2016
The Pod Design

Team
Station
Pod #3

Team Team
Station Station
Pod #2 Team Team
Station Pod #2
Station Central
Pod #1 Pod #3 Station

Team
Station
Pod #1

© Halton Healthcare Services November 2016

Pod Prototype- Spaghetti Maps

BEFORE PODS

AFTER PODS

© Halton Healthcare Services November 2016 51

 Framework Tools & Templates

Monitoring

•Status Reports
•Quality Reporting
•Due Diligence Checklist
•Master Schedule template
•Information Needs List template

5252 © Halton Healthcare Services November 2016

 Tracking & Monitoring
Target Audience Purpose Report Frequency
High Level update on each Monthly
Capital Planning Functional Program =
Steering Committee Executive Summary

Review & discussion of

Operational Readiness Executive Summary Monthly
Steering Committee
Stantec Monthly
Compile Functional
PMO Program Status Reports

Work Plan progress status

Functional Program Issues - logged and
Monthly to
Status Reports identified; escalated as Quarterly
required
53 © Halton Healthcare Services November 2016
 Status Reporting Process
Updated Oct 8, 2013
Executive Dashboard
Italics = complete/closed
  Previous Overall Status Colour     Current Status Colour      
WBS Task Name Task Lead Start Date End Date Major activities completed this period Issues /Barriers identified this Status Revised
(MM/DD/YYYY) (MM/DD/YYYY) period completion
date
(MM/DD/YYYY)

  FP# 24, 39 HUMAN RESOURCES, ENTERPRISE       Meetings held; decisions made; Interdependencies, barriers, Red -
Critical
 
LEARNING & CHANGE MANAGEMENT investigations and site visits conducted, etc assumptions, etc issues
may
impact
achieving
operation
al vision;

Yellow -
task at
risk

Green -
task on
track

24_1 ENTERPRISE-WIDE HUMAN RESOURCE PLAN              

(what you are doing for others)
24_2 Workforce Planning Strategy              
24_3 Create Workforce Planning Strategy for NOH Sharon Norris Jan-13 Jan-14 Initiated with Workforce Planning Group in April Timeline is being driven by BMW-V    
2013 Meets bi-weekly. Developed high level work process. As service levels and model of
plan - July 2013. Revisiting monthly. Workforce care work is completed, Finance and HR
Planning Specialist commenced September 3, 2013. meet with departments/programs to
Meeting weekly with Director of HR, Manager - HR work on budget and workforce planning.
Solutions, Manager - Talent Solutions and Manager G85
- HR Projects. Manager - Volunteer Services invited
to all meetings.

24_4 Develop and implement a plan to collect best practices from Sharon Norris Apr-13 Dec-13Site visits underway. Recent visits to Royal Victoria Importance of labour relations was    
external organizations Hospital, North York General Hospital and Niagara emphasized by RVH. As well, the need to
Health System. Information reviewed at Planning engage partner hospitals to reduce
Group meetings and filed in shared drive. concerns re: competing for resources.

24_5 Develop strategy for succession planning at NOH (by Dec 31, Sharon Norris Sep-13 Dec-14Currently reviewing the OHA's succession planning New process at HHS. Will require    
2013). Execute strategy by December 2014 program as a potential option for HHS. education and awareness.

  HOLDING 24_6 TO 24_25 FOR FUTURE ACTIONS              

                 
24_26 Workforce Planning NOH              
24_27 Workforce Planning Tools and Templates Ready confirmed Demetrios Nov-12 Dec-13Assessment of available tools completed in 2012.      
based on pilots. Software identified to capture data. Kalantzis/Carole Pilots conducted in Georgetown, Renal Dialysis and
Daniels Rehab Services. In July 2013, HR and Volunteer
Services collaborated to conduct a pilot in
Environmental Services - PALs and Helpers. Met
with Diagnostic Imaging at OTMH to do a
preliminary analysis of current workforce and risks.
Each pilot results in important knowledge
acquisition that will inform HR strategy and action
plans.

24_28 Determine process to implement workforce planning tools at Demetrios Jan-13 Dec-13Update as per 24_27 above. Excel spreadsheet      
NOH Kalantzis/Carole template developed to capture current and future
Daniels/Jennifer state, gaps and risks for BMW-V process. Will allow
Kustra for roll up of information.

24_29 Understand skill mix changes from each program after being Demetrios Jul-13 Dec-13Model of service discussions initiated. Volumes and model of care work    
advised of model of service Kalantzis/Carole underway Aug to Oct 2013.
Daniels

Program/Dept Status Reports

54 © Halton Healthcare Services November 2016 54
Planning Groups Dashboard

© Halton Healthcare Services November 2016

Quality Reporting

Focus changed to Operational

Readiness in 2013
-report on what ops readiness
changes were happening to
improve quality in their areas.
© Halton Healthcare Services November 2016
Reporting - Due Diligence to the Board

• Established Due Diligence checklist to ensure diligence was completed, or

close to completion, before major events/transitions
• Two types
1. substantial completion
-based on Project Agreement
2. opening day
-based on 7 tactical elements plus others

• Dedicated Board retreats specifically for due diligence

presentations/discussion

© Halton Healthcare Services November 2016

 Substantial Completion Due Diligence

- Included 3rd party attestations and presentations

- Indicated to Board which items were closed or still in-
progress
- Included risk/mitigation plans for items statued as yellow

© Halton Healthcare Services November 2016

 Substantial Completion
Due Diligence Checklist Summary
Activation Plan Category Checklist Completed In Recommend
Items Progress Proceeding to
Overall Substantial
Completion?
recommendation
Project Management 1 1 0 Yes
is(was) to "Proceed to Project Agreement (PA) 6 2 4 Yes
Substantial Financial / Regulatory / DAA 6 5 1 Yes
Completion” based Foundation 1 1 0 Yes
upon attestations Communication 1 1 0 Yes
from Due Diligence Commissioning 1 1 0 Yes
Leads. Equipment & Furnishings 2 1 1 Yes
ICT Systems 4 0 4 Yes
Operational Readiness 5 4 1 Yes
FM Services 5 1 4 Yes
Retail 1 1 0 Yes
Parking 1 1 0 Yes
Totals 34 19 15 Yes
© Halton Healthcare Services November 2016
 Opening Day Due Diligence
- Included 3rd party attestations (HCR, Stantec, etc)
- Included items still in progress
- Included risk/mitigation plans for items statued as yellow
- Included attestations signed by each program/department

© Halton Healthcare Services November 2016

 Opening Day Due Diligence
~Summary~
Activation Plan Category Checklist Completed In Progress Recommend Proceeding
Items to Opening Day?

Project Management 1 0 1 Yes

Program 2 2 0 Yes
Financial 2 2 0 Yes
People 6 6 0 Yes
Professional Staff 1 1 0 Yes
Process 3 3 0 Yes
Technology 4 4 0 Yes
Facility 7 4 3 Yes
Operational Yes
4 3 1
Communications
Totals 30 25 5 Yes

© Halton Healthcare Services November 2016

Attestation
-one per
Program

Program/
Department

© Halton Healthcare Services November 2016

 Framework Tools & Templates

Closing

•Lessons Learned
•Evaluations
•Program/Department Outcome Indicators/Metrics
•Post Occupancy Report

6363 © Halton Healthcare Services November 2016

Closing - Lessons Learned
•Monthly Georgetown reports to ORSC
•Quarterly PMO reports to ORSC
•Survey Monkey evaluations

© Halton Healthcare Services November 2016

Closing – Lessons Learned from Georgetown

© Halton Healthcare Services November 2016

 New Oakville Hospital ~ Lessons Learned
• Move day survey monkey completed December 2015
– Lesson learned:
• food is very important!
• Manage on-site resources (e.g. volunteers,
staff)

• World café lessons learned with key stakeholders

– Themes - Redevelopment, Facility Activation &
Operational Readiness

© Halton Healthcare Services November 2016

 3 Doing It Again

The Milton District Hospital Current Experience

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 MDH Unique Vision The vision of the project
is to “create with and
for the Community, a distinctive
centre of healthcare excellence that
provides, through the efficient use of
resources, the highest quality of clinical
patient-centred care to the
Community within an innovative
environment hat supports the
physical, mental emotional and
spiritual needs
68
 MDH Expansion Operational Readiness Timeline
– “Fast and Furious”

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 Building On Lessons Learned, MDH is…...

• Planning a consistent approach

• Accepting the complexity of change

• Realizing the limited time required to plan and implement

• Embracing ICT planning and collaboration as a critical success factor

• Identifying and adopting early enablers and work 0

• Increasing the frequency of monitoring progress

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 MDH Expansion – Opening Day Views and Tactical Elements
• Opening Day Views were developed and aligned based on the 7 tactical
elements of health care
• Provides clear and distinct objectives for each Program and Service to
guide Operational Readiness & Facility Activation

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 MDH Expansion – Gap Analysis and Change Map
– IT Integration and Collaboration
• ICT support, knowledge and expertise is essential to understand the impact of change
and identification of work plan tasks
• Early and ongoing engagement with ICT is imperative for project success
• ICT enablers can significantly impact process and flow

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 MDH – Gap Analysis and Heat Map
• Status frequency – meet all Programs every
month given the aggressive time frame -
identify issues early
• Funding support
• Workforce planning and change
management (People column)
• Training & Orientation (People, process
and Technology & equipment columns)
• Risk Registry (all columns e.g. people
column for HR risks)

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 MDH – Risk Register
• Utilized OTMH Risk Register as baseline
• Facilitated a “World Café” approach
• Each group rotated through stations to
identify MDH specific risks
• Emerging themes were identified
• Business Owner for each section
• Discussed risks and mitigation plans
• Monitored monthly at status meetings

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 MDH Expansion – Planning Groups

• Subject matter experts brought together

Aug 16

Sep 16

Oct 16
# Planning Group
to focus on a specific topic related to a
specific project Active
5.1 Training & Orientation & OD G G G

• Merged Planning Groups: 5.2 TBD (Volumes, Model of Care, Finance & Recruitment) N/A N/A N/A

5.3 Communications & Celebrations G G G

– Wayfinding and signage 5.4 Emergency Preparedness and Response G G G

– Whole building, wall space and public 5.5 Whole Building (public spaces, etc) (TBC) G G G
5.6 Medical Model of Care G G G
spaces 5.7 Supply Flow G G G
5.8 Portering and Transportation G G G
5.9 Access & Control G G G
5.10 Documents G G G
5.11 Parking G G G

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 MDH Expansion – Planning Groups

• OTMH Core Clinical Planning Group: to

investigate, identify, discuss and recommend
changes in core clinical processes, procedures, the
impact on interdependencies and policies
resulting from the new floor plate size and
configuration
• MDH created other groups:
– Day in the Life
– Shared Registration: DI and Fracture Clinic –
nuances at a small site – cross training of staff,
additional responsibilities

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 MDH Expansion – Early Implementation & Adoption

• At OTMH early implementation &

adoption meant this would occur on
one or two units – POD prototype
simulation

• MDH only one medical/surgical unit

that is moving

• ICT Visibility - MDH a smaller site

therefore implemented across the
entire site versus a focused area

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 MDH Unique Opportunities

• Based on OTMH and Georgetown lessons learned,

many opportunities have presented themselves to
continuously improve processes based on the “Fast
and Furious” timelines for the MDH Expansion!

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