Transcript Clalit Health Services Group

Clalit Health Services Group
Israel’s Leading Health Care Organization
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Israel - Population Profile
Heterogeneous population
• 7.7 million residents
• 1.4 million Arabs (84% Moslems)
• 1 million new immigrants from former Soviet Union since late 1980’s
• Young population (10% aged 65+ , OECD* Countries = 14.1%)
Outcome comparable to international average
• Life expectancy : M- 79.7 , F-83.5 (OECD* countries = M-76.5, F-82.1)
• Infant mortality : 5.1 per 1000 live births (OECD countries = 6.1)
*OECD = statistics provided by Organization for Economic Cooperation Development
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Relative Economic Efficiency
Israel spends less - yet its citizens live longer
Total Expenditure on Health
(% of GDP)
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OECD Report 2011
Life Expectancy Females
Life Expectancy Males
Clalit Health Services
• Established in 1911
• Today there are over 4 million insured
• 54% of market share
• Elderly (65+) - 70% market share , 0.5 million
• Arab Population - 73% market share, 1 million
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Clalit Vision and Core Values
Clalit is dedicated to a healthy Israel:
“We are committed to health through prevention of illness,
promotion of healthy lifestyle, quality care and attention
to the special needs of the patient and his/her family”
Core Values:
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Respect for each individual
Contribution to the community
Professionalism and excellence
Humility
Integrity
Dedication
COMPTROLLER
Director General
LEGAL ADVISOR
DIRECTOR ‘s
ASSISTANT
OMBUDSMAN
SUBSIDIARIES
SPOKESMAN
HEALTH INSURANCE
ALIGNMENT
CHIEF
CHIEF
HOSPITAL
COMMUNITY
LOGISTICS &
FINANCE
SERVICE &
HR
NURSE
PHYSICIAN
DIVISION
DIVISION
INFRASTRUCTURE
DIVISION
MARKETING
DIVISION
DIVISION
HOSPITALS
SOUTH DISTRICT
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DISTRICTS
DIVISION
A Fully Integrated Community-Hospital System
Primary Care at the Heart of the System
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Management Strategy
Promoting Patient
Experience
Decentralization and
Self-management
Clinics
Hospital Departments
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Monitoring Quality of Care
Through Quality Indicators
Comprehensive Care
Programs for
Patients at Risk
Community Clinics’ Computerized Medical Record
• Cumulative Patient Visit Data (Diagnoses, Markers, Prescriptions,
Lab results, Specialty Consulting Visit Report, etc… )
• Decision Support Tools (Patient Lists, Good Medical Practice,
Drug Interaction)
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Prevention and Early Detection
• Screening
• Breast cancer- Mammography (Ages: 50-74 - every 2 years)
• Colon cancer - Occult Blood (Ages: 50-74 - every year)
• Cervical cancer- Pap Smear (Ages: 35-54 - every 3 years)
• Promoting Wellness
• Behavioral factors
• Focus by topic (ie: smoking, physical activity, nutrition)
• Target groups
• Influence consensus and public opinion
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The Only Health Organization in Israel that Runs its Own Public Hospitals
• Community outreach
• National centers of excellence
• Children’s hospital
• Comprehensive cancer center
• Organ transplant center
• Rehabilitation centers
All general hospitals are accredited by the JCI
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Clalit Hospital Statistics
2.2 beds per
1,000
population
400,000
admissions
1,900,000
hospital days
900,000
emergency visits
Hospital stay –
average 4.1 days
17,000 staff
5,500 beds
3,000 open
heart surgeries
900 cranial
surgeries
2,000,000
outpatient
visits
170
transplants
40,000 births
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19,000
catheterizations
Organizational Operations Management
Strategic Map for Hospitals
Customer Experience
30%
Clinical Quality & Excellence
30%
Balanced Finances
15%
Media
Surgical Depts.
ER Customer Service
Teaching & Academics
Clinical Indices
Controlled Budget
Local Image
Ombudsman
Hospitalization
Customer Satisfaction
Risk Management
Quality Tests
Combined Financial
Index
Outpatient Clinics
Queue for Common
Procedures
Telephone Answering
Complaints about staff
attitudes
Non-Basket Activities
Weighted Outputs
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Internal Customer Survey
Employee Satisfaction
Employee Systems
Maintenance
Infrastructure
Logistics
Human Resources
10%
Interns Satisfaction
OR Utilization
Internal Processes
Operational Efficiency & Excellence
10%
External Income Growth
Strategic Goals
Image
5%
Clinical Quality Indicators at Clalit Hospitals
• Based on pre-defined criteria:
– evidence-based, potential for improvement, validity, potential harm
vs. benefit, size of target population, JCI accreditation requirements
• Process and outcome indicators
• Uniform numerical goals and weights that create a combined compound
score for quality
• Some measures are built on self-reporting
following review of medical records,
with external audit of the data
Clinical Quality Indicators at Clalit Hospitals: examples
• Pressure sores acquired during admission
• Falls / falls with injury
• PCI done within 90 minutes for ST-elevation MI
• Medications at discharge following acute MI
• Antibiotics given within 6 hours for community-acquired pneumonia
• Hip fracture operated within 48 hours
• Laparoscopic cholecystectomy converted to an open procedure
• Extended length of stay following colectomy for cancer
Service Standards Definition the basis of goals and grades in the hospitals
• ER length of stay
• Outpatient queue length
• Appointment cancellation rate at outpatient clinic
• Percentage of phone-calls answered at the hospital
• Speed of telephone answering in the hospital
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Service Standards Definition the basis of goals and grades in the hospitals
• Waiting time for outpatient doctor
• Rate of first customer delays.
• Surgery queue length
• Customer satisfaction- ER, inpatients and outpatient clinics
• Customer satisfaction – general hospital services
• Number of complaints about telephone and staff attitude per 100 beds
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2011 - Clalit’s Hospitals
• EMR pilots completed
• PACS deployed throughout the organization
• Quality parameters in focus
• Accreditation of all general hospitals
• “Excellence units” concept developed
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2011 - Clalit’s Hospitals
• Emphasis on ER service
• Dealing with waiting lists
• Improving oncology services
• Increasing income: medical tourism, Palestinians
• Special attention to shortage of doctors and nurses
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Clalit Steps Ahead
• Patient care and risk management: “Ask Me 3”, safety rounds,
controlling health care associated infections
• EMR deployment in 300 hospital departments
• Emphasis on the periphery
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Clalit Steps Ahead
• Purchase of new technologies (CT, MRI, PET-CT, Robots)
• Renovations and constructions
• Promoting research and collaboration
• Advancing patient experience
• Departmental budget
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Creating an “American Friends” Group for Clalit
Goals:
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To promote collaborative research
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To further institutional cooperation with hospitals, universities and
research institutions
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Supplement government funding
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building and renovation of clinics, institutes and hospitals
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unfunded needs of the elderly, lower income populations and those
living in Israel’s periphery
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Purchase of new technologies
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Introduction of electronic medical records
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