In Chapter 6, we argue that the dominant presence of women in daily hospital operations and at the frontline of patient care surpasses their representation on the senior management teams in hospitals located in Ontario.
However, a critical mass of more than 30 percent of women in the boardroom is associated with higher hospital performance by achieving better outcomes with fewer resources and improving public services while containing costs.
The average number of women on hospital boards throughout the LHIN is seven. Although more than three women are represented on boards in Ontario hospitals, the gender distribution appears to be consistent throughout the province with an average of 60 percent males to 40 percent females.
See Figure 6.1 for the average hospital board gender by LHIN in 2014.
Figure 6.1 Average hospital board gender by LHIN in 2014
6.2 Efficiency levels across Local Health Integration Network
The time series analysis is a predictive model that trends ASEPTE values from 2007 to 2017. Four of the 14 LHINs, Waterloo Wellington, Hamilton Niagara Haldimand Brant, Central West, and North Simcoe Muskoka, showed a projection of increased inefficiencies to 2017 with a positive trend line, which suggested increasing costs and inefficient operations. Negative trend lines are shown in 71 percent of LHINs. A negative trend line suggested reduction in costs and efficient operations.
See Figure 6.2 for the time series analysis of ASEPTE average values from 2007 to 2017.
Figure 6.2 The chart is a time series analysis of ASEPTE average values from 2007 to 2017—a predictive model of LHIN performance
6.3 Organizational performance
The targets set for quality measures may appear unrealistic or inefficiencies in the health care system exist. However, no significant movement exists to drastically reduce ASEPTE average values in 2010 to 2011 or to close the gap between LHIN performance and provincial and Canadian values.
Of the 126 acute care Ontario hospitals, 22 or 18 percent are positively trending in ASEPTE average values and are in close geographical proximity to each other. The hospitals are in highly populated communities and operate in LHINs region 3, 4, 5, and 12. In addition, several hospitals are major hubs that offer a variety services in areas of general teaching, 100 to 200 beds, cancer care, and rehabilitation. Other services include diagnostic and therapeutic care and specialized care. Loss of any service would be significant and could have a major effect on patient care in Ontario.
Some patients are traveling more than two hours to receive care from out of town rather than at their community hospitals. The MOHLTC and LHINs have an opportunity to normalize and course correct the imbalance in LHINs 3, 4, 5, and 12.
For the 82 percent of hospitals that are improving their trending negatively ASEPTE values, capacity to reach their annual targets is an indicator that change is slow and may take years or not at all. The MOHLTC has the opportunity to address the shortcomings by reassessing their strategic-based measurement goals with the LHINs.
Last, learning from Mississauga Halton LHIN of what they are doing right could be a model to follow.
Mississauga Halton LHIN of the Trillium Health Partners and Halton Health Care Services comprises six hospitals:
Trillium Health Partners:
1. Credit Valley Hospital
2. Mississauga Hospital
3. Queensway General Hospital
4. Georgetown Hospital
5. Milton District Hospital
6. Oakville-Trafalgar Memorial Hospital
Credit Valley Hospital
According to the Trillium Health Partners website1, before the merging of the Trillium Health Centre and the Credit Valley Hospital, it had one of the lowest ASEPTE value in the province (4.70), signifying a high level of efficiency. Further, the annual report for 2010 to 2011 showed the hospital contributed to a financial surplus of $7.9 million, which reflected efficient management of administrative costs and use of operational dollars. The ASEPTE values for Halton Health Care Services were 5.08 and Trillium Health Centre were 6.38.
Founded in 1970s, The Credit Valley Hospital located in Mississauga, Ontario, is a regional center of excellence in clinical genetics, renal, maternal–child care, and oncology. Core clinical programs include general internal medicine, perinatal surgery, emergency, mental health, rehabilitation, obstetrics and gynecology, pediatric, and cardiac services.
Several female board members were appointed as part of the board’s extensive discovery, due diligence, and strategic decision-making processes. Some female board members had attained distinguished careers as presidents or CEOs of their own companies and organizations. Further, they had knowledge and skills that included board experience, banking, human resources, service industry, consulting, information technology, quality, and organizational performance. CIHI acknowledged the amalgamation of the Credit Valley Hospital with the Trillium Health Partners showed better performance rates than previous.
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