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Financial sustainability – Getting to Green

30-Nov-2015

The Workforce Optimization Task Team

WOTT is tasked to help departments that are over budget figure out where the problem lies. Their job is to ask the questions, and use data to ensure the defined problem is in reality the true problem. 

Here are highlights of what they have been doing.  

September Financial Update:

(Oct 30, 2015 - Robbie Peters)

  • Year to date deficit to $3.86M
  • projecting a deficit ~ $1.4M higher than last year = ~ $16M
  • Most of the deficit is in the area of Salaries and Benefits.
  • “We do not have enough money in the bank to withstand running a deficit again this year”.


  • Budget Actual Variance
    Revenues $ 506,669,000 $ 511,393,000 $ 4,724,000 **
    Salaries and Benefits $ 325,850,000 $ 338,430,000 $ (12,580,000)
    Medical Remuneration $ 42,848,000 $ 43,741,000 $ (893,000)
    Operating Grants $ 34,660,000 $ 34,319,000 $ 341,000
    Medical Supplies $ 46,963,000 $ 44,028,000 $ 2,935,000
    Infrastructure $ 23,801,000 $ 23,425,000 $ 376,000
    Clinical & Operational Supports $ 25,020,000 $ 24,992,000 $ 27,000
    Admin & Other $ 7,545,000 $ 6,319,000 $ 1,226,000


    Where to start?

  • The problem is: Expenses > Budget
  • Cause?: Salaries are the largest contributor to expenses
  • Cause?: Unbudgeted paid hours and unbudgeted rate of pay/cost of the hours
  • Gemba?: Units with the largest negative salary variances.
  • Initial Findings - Contributing to Paid Hours:

    Rosters are not healthy and not within budget

    –Models of care based on historical vs. knowing the demand.

    –More guarantees of hours than required for baseline staffing.

    –Costly use of relief dollars (i.e. casuals vs. relief lines).

    Initial Findings - Contributing to Paid Hours:

    -Costly use of relief dollars (i.e. casuals vs. relief staff)

    -Casual availability

    -Replacing staff at premium pay

    - Replacing staff at a higher cost (i.e. RNs replacing Unit Clerks)

    Both: 

     - Variation in administrative role of managers (i.e. financial management, scheduling) and supports provided.

    - Various decision tools for relief/ OT in place. Not certain they are being used.

    Key Recommendations So Far:

    1. Ensure your roster aligns with your baseline needs and budget. Know the cost of your roster.
    2. Implement recommendations from the Master Roster Review (where applicable).
    3. Ensure rigorous daily management around staffing (confirm hours and cost of the hours are required to meet demand).

    Daily management

  • Develop Daily huddles
  • “How do we get todays work done today and be ready for tomorrow’s work – what is appropriate staffing today?
  • Make the work visual
  • Talk to KOTs/KPO.