Narrative and PIP Description Template

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2015-16 HAPS Narrative
Hospital Name: Click here to enter Hospital Name
Facility Number: Click here to enter the Facility Number.
SECTION 1- General Narrative
Planning Assumptions:


The hospitals HAPS forms include the assumptions used to construct the budget for fiscal 2015.
There is no need to duplicate those planning assumptions unless the assumptions are material
and you wish to highlight them to the LHIN. All other major planning assumptions not built into
the HAPS forms should be highlighted here
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The hospitals HAPS forms include the assumptions used to construct the budget for fiscal 2015.
All other planning assumptions built into the HAPS are included on the HAPS submission form.
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Health System:

The hospital’s role in the health system:
o Who is served and why
o How provincial and local priorities are met
o The determination of current and future services
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Who is served and why
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How provincial and local priorities are met
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The determination of current and future services
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Hospital Performance: Efficiency and Effectiveness:

Areas the hospital has identified that require the most improvement with regard to efficiency,
effectiveness, and performance
 Strategies planned and/or adopted to manage such desired improvements
 Where savings will be reinvested, if applicable
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Service Delivery
 Service changes proposed to improve the local health system and/or achieve a balanced
budget (with supporting justification) and the expected impact on patients/clients and costs
 Describe how health partner engagement will be/has been utilized in determining proposed
changes to ensure a sustainable system for the region
 Critical risks to success and mitigation/management plans to proposed changes
Choices made to achieve a balanced budget
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Health partner engagement
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Critical risks to success and mitigation/management plans
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Alignment and System Contributions
 Initiatives in place or to be implemented to contribute to the achievement of provincial and
LHIN priorities and contribute to a more integrated health system.
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Provincial and LHIN Priorities
Hospital initiatives to contribute towards the achievement of
(examples)
priorities
eHealth initiatives

Health Links Development

Participation in Health System

Funding Reform
Quality Improvement Plans

Senior Friendly Hospital Strategy /

Senior Friendly Improvement Plan
French Language Services Act

Other LHIN Initiatives
1. Initiative 1 (please describe)
2. Initiative 2
3. Initiative 3
4. Initiative 4
5. Initiative 5
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Risks

Key risks and mitigation strategies should include:
o Strategic
o Clinical
o Financial (including working capital)
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Strategic Risks
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Clinical Risks
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Financial Risks
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Quality
 Identify whether the submission reflects the quality improvement initiative and targets
included in the hospital’s annual QIPs
 Note specifically how the hospital will be achieving the best practice guidelines for the QBPs
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SECTION 2- Provincial Interest Program description
*HIV outpatient clinic/Infectious Disease Clinic Program Plan
(Applicable only to Hospitals who have dedicated funding for this service)
The purpose of this form is to provide an overview of the services you provide to people with HIV and
any changes that are occurring or you anticipate will occur in the clinic that may impact patient care.
These can be changes you anticipate will strengthen patient care or changes you anticipate may create
added challenges to providing patient care.
*Applicable only to Hospitals that administer this program.
Clinic name:
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Contact:
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Contact.
Email:
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Tel:
What percentage of your clinic time is devoted to providing services to people with HIV?
(###) ###-####
Enter % Here
1. Briefly describe the services you provide to people with HIV in your clinic:
a. Intake and assessment
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b. HIV treatment and care
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c. Allied health care:
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Social Worker
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Dietician
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Pharmacist
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Psychiatrist/Psychologist
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d. Sexual and reproductive health care
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e. Other
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2. a. Outline any significant changes to how these services will be delivered in the upcoming year (if any).
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b. What do you anticipate will be the impact of these changes?
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c. What will you do to mitigate any negative impacts on patient care from these changes?
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3. Describe any collaborative or shared care you participate in with other providers:
a. Other specialty medical care to respond to co-morbidities
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b. Primary care physicians managing HIV patients
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c. Community-based health and social services
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