British Columbia innovation bends health cost curve, reduces wait times
B.C.’s use of lean techniques across the health-care system is significantly reducing patient wait times, increasing efficiency and creating the potential to save millions of dollars that will be directed back into patient care.
The Lean in British Columbia’s Health Sector Annual Report 2010-11 details the work underway across the health system to increase productivity and efficiency and reduce costs. With more than 125 lean events held by health authorities in the past year, the report focuses on seven case studies, which provide concrete examples of how patients in every region of the province are benefiting.
Highlights of the report include:
- In the Provincial Health Services Authority’s Provincial Specialized Eating Disorders program for children and adolescents, wait times from referral to assessment have been reduced from 66 to 8.5 days, and wait times from assessment to first treatment have been reduced from 48 to 8.5 days.
- In addition, the program has created two care pathways to better support eating disorder patients.
- In Northern Health, the lead time from when patients are referred through the Prince George Home and Community Care office until they receive long-term care home support services has been reduced from an average of 68 days to 14 days.
- In Vancouver Island Health Authority, acute care bed days have been reduced from 7.4 to 3.9 days for patients designated to move from the Nanaimo Regional General Hospital to a residential care facility with rehabilitation services.
- In Fraser Health, Surrey breast cancer patients are now offered three diagnostic tests (imaging, cytology and physical examination) during a single visit to the Jim Pattison Outpatient Care and Surgery Centre, with the intent to reduce time to diagnosis.
- At B.C. Children’s Hospital, the elimination of 2,160 unnecessary blood tests represents better care for patients and is estimated to lead to cost reductions of $32,400 per year.
- In Vancouver Coastal Health, modifications made to the Early Intervention and Rehabilitation Program for disability management have led to a reduction in absence duration, and a reduction in long-term disability claims, which is estimated to produce savings for Vancouver Coastal Health of $17.6 million (amortized from 2010 until 2020).
- More than 60 modifications have been made to processes in the pre-surgical screening/operating room booking processes at Kelowna General Hospital in order to make the journey more patient and family-centred, and more efficient.
The lean approach follows a patient’s journey through the system to identify steps that benefit patient care in order to eliminate “waste” or those steps that add no value. Examples of waste in health care might include duplicate tests, patient waits and underutilization of staff skills and knowledge.
Once wasteful activities are identified and removed, remaining steps are made more efficient and integrated so that services flow as smoothly as possible. A focus of lean is continuous improvement so the cycle is repeated, helping the processes become more and more streamlined.
The use of lean techniques is just one way that the Province is turning to innovation to ensure a high-quality and cost-effective health-care system. In 2009, Health Shared Services BC launched a shared services program, leveraging their buying power, consolidating supply chains, and working together to increase efficiency and improve outcomes. Projected savings are expected to reach $200 million by 2014.
While recognizing the need to build on innovations and efficiencies, Budget 2012 honours the commitment to protect health care, and in 2014-15 the ministry’s budget will be $1.5 billion higher than it is today.
Minister of Health Michael de Jong –
“With health costs continuing to rise, looking for ways to cut “waste” in the system and increase efficiency makes sense if we want to ensure a system that continues to provide excellent care in the long term. Thanks to Lean techniques, we are helping to provide better value for public dollars, and patients across the province are benefiting from shortened wait times and more streamlined care.”
The Lean in British Columbia’s Health Sector Annual Report 2010-11 can be found online at: www.health.gov.bc.ca/library/publications/
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