Vancouver Coastal Health

Vancouver_Coastal_Health

Vancouver Coastal Health (VCH) is a publicly-funded health authority providing direct and contracted services in the Greater Vancouver area. With 23,000 staff and seven hospitals, they see nearly 1000 patients in their emergency departments each day, and conduct over 1500 elective surgeries each week.

Their focus on top quality care, better community health, workforce optimisation and efficient use of resources has made them a top healthcare performer in Canada.

In July 2009, VCH kicked off a CapPlan Theatre Flow pilot project at Richmond Hospital, to coincide with their neighbouring health authority, Fraser Health, who had a similar pilot underway at Burnaby Hospital.

Within weeks VCH began to see the power of CapPlan forecasting, and asked Emendo to work with them on special event planning to help ensure they would be able to cope with presumed increased demand during the Winter Olympics and Paralympics, which were to take place in Vancouver/Whistler during February and March 2010.

"We knew we would be seeing an influx of international athletes, spectators, media and dignitaries - for the Olympics as well as the Paralympics," said Duncan Campbell, VCH CFO. "We just didn't know exactly how it would impact our facilities and staff. With Vancouver in the world spotlight, we wanted to be sure there wouldn't be any surprises."

The Challenge

VCH provided data on completed inpatient nursing cases going back to April 2007, as well as the elective OR allocation plan for the first three months of 2010. Emendo specialists combined that data with research on major sports events such as the impact at Christchurch Hospital during the English Lions rugby tour in 2005, and then, using forecasting and simulation, were able to predict the impact on the local health system during such a major event. In Christchurch, the medical staff had geared up for a surge in admissions but in reality the surge didn't happen until the event was nearing completion, as people evidently delayed their treatments in order to enjoy the festivities.

The Solution

In May 2010 a review was released on the health and socioeconomic impacts of major mulit-sport events (1978 - 2008). It included 54 studies of "low quality" (due to bias risk and a lack of a comparison group) and determined the evidence was insufficent to confirm or refute expectations. Only five studies reported health related outcomes, these included suicide, paediatric health service demand, presentations of asthma in children and problems relating to illicit drug use.

Andrae Gaeth, Product Specialist at Emendo said, "For VCH, it was about firstly, creating a 'what if' scenario model to look at the different surgical elective sessions they were planning to run through the OR during the Olympics, as well as the types of patients going through those sessions which could then be used to predict the bed and staffing requirements of those patients. Secondly, it was about amalgamating that with forecasts of other non-surgical and non-elective patients into a single vision of total bed utilisation by area over a period of time. We were then able to predict the daily and weekly peaks and troughs in activity and enable the hospital to effectively manage them."

The Results
Before implementing the CapPlan system, the culture within the hospital was to never "close a bed". But when the pilot system forecasts turned out to be highly accurate, and earned the trust of the staff, it opened up new opportunities. Richmond hospital was able to safely close certain areas during periods of low demand to enable much needed capital renovations to the facility. It lead to a reconfiguration of the bed map, as well as combining the medicine and surgery nursing units to achieve efficiency saving.

"The forecasting was impressive. Just before Christmas we knew to expect a surge in demand, and it definitely eventuated. We were very full" quotes Director of Medicine Surgery Carol Surrow. VCH staff were able to identify bottlenecks in the system and prepare business rules ahead of time in order to deal with them. For example, they specified a set of criteria for gynaecology patients to be sent to the maternity ward for care instead.

"We are still tweaking the system to suit our precise needs, but staff are very excited to have a real time sytem which will be able to tell them exactly how many patients are in emergency or waiting for surgery" quotes Carolina Ferguson, Project Manager at VCH.

The CapPlan implementation is part of a larger focus on workforce optimisation and system investments. Duncan Campbell, VCH CFO said, "we are focused on our acute care hospital settings first, looking at high overtime units and following the money to find the biggest opportunities to roll out our optimisation program. We are about half way through implementation, having done the high impact areas, and we've saved about $30 million per annum. The organisation is focusing on providing reported information and training on how systems are used to help people make decisions. Change management, learning, and training behind the workforce optimisation are how we make this all work. It isn't just technology; it is a leadership commitment to building support mechanisms around frontline staff." (from Inside Healthcare Decemeber 2010)

 

If you would like to find out more about our technology solutions for healthcare, please contact us.