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Quinte improves multi-hospital budgeting process with automation

With provincial ministries of health moving towards patient-centric, procedure-based funding, Quinte Health Care, with sites in Belleville, Trenton, Picton, and North Hastings, Ont., wanted to achieve finer control of an increasingly complex budgeting process.

QHC’s finance division has the complicated task of managing budgets for 250 diverse departments across four hospitals. The finance team knew it would need to tackle more complex budgeting demands than ever before, and did not know if its existing approach was up to the challenge.

“Previously, we relied on spreadsheets for budgeting – 250 of these to be exact,” said Angela Abram, director of financial systems at QHC. “Each of these spreadsheets needed to be manually pre-populated, submitted and consolidated, a timeconsuming and error-prone process. We found that our financial analysts were spending more time making the budgeting process work than on analysis.”

Abram added that, “We ran the risk of overlooking departments that were underor over-resourced, potentially missing opportunities to enhance patient care.”

The team set out to define the goals for a new budgeting solution, working closely with a large stakeholder group within the organization to understand how to ensure rapid uptake and maximum benefit to all.

Brad Harrington, vice president and chief financial officer at QHC, said, “We released an RFP that outlined our goals: a high adoption rate, complex staff budgeting logic, the ability to drill down to all levels of very detailed budgets and a customized work flow that would help us track budgets and formalize the approval process.”

Canrock Solutions won the public procurement process with their Canrock Performance Management Solution for Hospitals and Healthcare Providers, which incorporates IBM Cognos Express software.

Administering the cure: QHC tasked Canrock Solutions with deploying the solution in time for the organization’s next budgeting cycle – a very tight deadline. Barry Hillier, director of information systems and knowledge management at QHC said, “We did not make it easy for Canrock. We asked them to get the solution up and running within just two and a half months – a month less than they would have preferred. To their credit, Canrock delivered not only the required solution within the allotted time, but added some nice-to-have features we were not expecting.”

At a high level, the solution is based on two parts: A central engine (OLAP database) where all the calculations and logic are defined, and a web-based user friendly interface where users input data and view reports. Data are stored centrally and calculations are applied to generate instant results for users.

The solution also comes with a workflow engine that requires managers and reviewers to sign off, thereby promoting full accountability throughout the budgeting process.

Budget participants and reviewers can now get instant financial and non-financial reports at the cost-center or roll-up level while they work on the budget. For example, when users change the staff schedule, they can see the impact on the financial budget as well as FTEs. Such instant feedback was not possible before, especially at rolled up levels.

Moreover, management was not able to drill down on variances and understand their source by department, as reporting was very inflexible. Managers can now drill down on costs by department and account and make appropriate recommendations.

Canrock Solutions supported QHC with in-depth training and support for users, ensuring rapid uptake of the new approach to budgeting at the organization. In place of spreadsheets, QHC now relies on a web-based solution that offers managers unprecedented control over the budgets that they work on.

Abram says, “By investing time in bringing managers along with us on this journey, we have succeeded in showing them the true benefits of the Canrock and Cognos solution. The buy-in has been tremendous, and the feedback extremely positive.”

Healthier outlook: Automating key parts of the budgeting process, the solution helps QHC’s finance team work more efficiently and contributes to a lower level of risk.

“Previously, implementing an organization-wide change to our underlying budgeting assumptions meant making changes to spreadsheets one-by-one, which could take a few analysts more than a day,” said Abram. “Now, a single person can affect the change in just a few minutes. Removing the human element from this kind of work also hugely reduces the risk of error, allowing us to be confident in the accuracy of our budgets.”

The solution enables greater visibility and granularity of budgets across the organization, driving better allocation of resources. A new formalized approvals process introduces unprecedented accountability around budgeting decisions. “IBM Cognos software enables us to drill down deep within budgets, eliminating any ambiguity around expected expenditure,” said Harrington. “Armed with this sort of insight, we can make complex decisions like staffing changes supported by accurate data and calculations. And because we know exactly who has signed off what, we can spot opportunities to challenge leaders to work more efficiently.”

Moving faster: QHC is already seeing the impact of the Canrock and IBM solution on the time needed to create annual budgets. “We succeeded in finalizing this year’s budget two weeks ahead of time, even though we were implementing and training users on a brand-new system,” said Abram. “In the future, we expect even bigger time savings, as users get more familiar with the solution.”

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