(Revised January 2010)
Vision:
Doing the Right Thing, in the Right Place by the Right Care Provider, at the Right Time to
Promote a Positive Health Outcome
Purpose:
The purpose of the Clinical Resource Utilization Management Steering Committee (CRUM) is to monitor, review, evaluate and make recommendations to improve the use of clinical resources to best meet the needs of patients at all HHS hospitals and the Juravinski Cancer Centre, within the context of the LHIN and the broader health system.
Membership of the Clinical Resource Utilization Management Steering Committee will be:
Executive Vice President Corporate Affairs (Chair)
Executive Vice President Clinical Operations
Vice President Medical
Integrated Vice President Patient Services
Vice President, Professional Affairs and Chief Nursing Executive
President Juravinski Cancer Centre
President McMaster Children’s Hospital
Chair of the Medical Advisory Committee
Other Physician Representation
Clinical Program Directors
Director of Decision Support Services
Practice Chief Representative
Director, Quality, Patient Safety and Clinical Resource Management
Diagnostic Services Representative
Laboratory Services Representative
Pharmacy Services Representative
CCAC Representative
Ad-hoc members as issues arise

Accountability:
The Clinical Resource Utilization Management Steering Committee reports to the Executive Council.
Linkages:
Medical Advisory Committee
Clinical Executive Team
Pharmacy and Therapeutics
Professional Advisory Committee
Corporate Strategic and Operational Initiatives Steering/Working Groups
Ad-hoc Working Groups
General Responsibilities:
The general responsibilities of the Clinical Resource Utilization Management Steering Committee are: i.
Strategy development, corporate tactics and advice on execution related to clinical utilization and clinical resource allocation that aligns with external factors and partners; ii.
Policy development and approval; iii.
Monitoring of clinical utilization indicators and identification of opportunities for improvement related to clinical appropriateness and efficiency; iv.
Coordination and monitoring of corporate improvement initiatives related to clinical appropriateness and efficiency; v.
Development of strategies related to sustainability and monitoring of previous gains made in clinical utilization; vi.
Development and oversight of strategies related to spread and dissemination of improvement throughout the organization.
CRUM Terms of Reference 2

Specific Responsibilities:
Strategy and Tactics
1.
Recommend and prioritize corporate strategic areas of focus and activities to achieve the HHS vision, goals and objectives for clinical resource utilization management.
2.
Advise the Clinical and Executive Council on recommended tactics and actions to improve the utilization of clinical resources and clinical resource allocation.
3.
Advise the Clinical and Executive Council on any matters referred to CRUM by the same.
4.
Identify and create strategic partnerships with LHIN 4 members to improve patient flow through the health care system.
Policy
5.
Identify, develop and approve corporate policies related to clinical utilization and clinical resource allocation.
Monitor Clinical Utilization Indicators and Identify Opportunities for Improvement
6.
Monitor overall clinical utilization trends. Examples include:

HAPS Indicators

Hay Utilization Indicators,

Hay Clinical Indicators,

CIHI Data,

Census Data,

CPWC,

Over/under Utilization according to Funding Formula

Activity Data (census, patient days, weighted cases, ER visits, Surgical Cases, Outpatient visits),

Admission and discharge patterns and trends

Referral and consultation patterns and trends (Physician and other health professionals)

Resource consumption according to CMG

ALC Data,

Lab Utilization,

Diagnostic Imaging Utilization,

Pharmacy Utilization,

Medical Diagnostic Unit Utilization.
7.
Assist in the interpretation of results leading to identification of corporate issues and recurring themes that need to be addressed via policy or improvement initiatives.
CRUM Terms of Reference 3

Corporate Coordination and Monitoring of Improvements Initiatives
8.
Identify and ensure the coordination of all activities and initiatives for achieving the HHS vision, goals and objectives for clinical resource utilization. During this term of the committee, the main areas of focus with respect to clinical resource utilization are:

Patient Flow and Partnerships

Admission Avoidance, Stream-lined Bed Placement Process, Expedited Care Delivery,
Earlier Patient Discharge, Accelerated Post-Acute Transfer;

Practice (Appropriateness of Care) (e.g.
admissions, referrals, consults, diagnostics, surgeries and procedures, practice, lab tests and drugs);

Providers and Technology (e.g. scheduling, staffing, HPPD, skill mix, elective patient transport, therapeutic surfaces).
9.
Serve as the “multiple project integration team” to coordinate all strategic corporate and operational initiatives related to clinical utilization.
10.
Establish standing and special committees/working groups to fulfill the mandate of CRUM as necessary.
11.
Receive reports of any subcommittees or working groups of CRUM.
12.
Periodically review Program clinical utilization activities.
13.
Monitor utilization of best practice and suggest strategies for implementation of the same.
14.
Identify and eliminate barriers to successful achievement of HHS vision, goals and objectives for corporate clinical resource utilization management.
15.
Advocate for appropriate resources.
16.
Develop and monitor annual objectives ensuring alignment with the Corporate annual objectives
17.
Develop and monitor an annual work plan, including communication and education plans.
Sustainability
18.
Develop strategies to ensure gains made in clinical utilization are sustained within the operating line.
19.
Serve as a vehicle to monitor the results of previously accepted recommendations for improvement.
20.
Identify and advocate for necessary resources to sustain previous improvements.
Spread
21.
Develop strategies to promote dissemination and uptake of clinical utilization strategies throughout the organization.
22.
Identify strategies to share improvements with internal and external audiences (Networks, conferences).
23.
Develop and implement communication and education plans.
24.
Report activities and progress to the Executive Council, MAC and PAC.
CRUM Terms of Reference 4

Responsibilities of Committee members include:

To actively participate in discussions around the appropriate and efficient use of clinical resources from a corporate and systems perspective;

To offer ideas and perspectives to improve clinical utilization;

To serve as a vehicle to communicate and disseminate information discussed at the meeting to the organization at large and to the members respective programs and services;

To actively reflect and discuss the impact of issues and ideas on the members’ areas of line accountability and to action improvement ideas when applicable and able;

To participate in working groups as appropriate.
Term:
The effectiveness of the Committee will be evaluated every two years (September 2010). Consideration for disbanding of the Committee will take place following an evaluation of the achievement of objectives and a determination of whether there is a continuing need for the Committee.
Meetings:
A 120-minute meeting will be held every month or at the call of the Chair.
Minutes:
Minutes will be distributed to members including ex-officio members.
CRUM Terms of Reference 5