NLIS 5
February 24, 2005
(Health and Community Services)
 

Government releases best practices reviews of Western and Grenfell

In keeping with government�s commitment to openness and transparency, Health and Community Services Minister John Ottenheimer, along with regional chairs Larry Bradley, Labrador-Grenfell Regional Integrated Health Authority (RIHA) and Dr. Tony Genge, of the Western RIHA, today released the final reports of the Hay Best Practices Reviews of the Western Health Care Corporation and Grenfell Regional Health Services Board.

"Today we are fulfilling our commitment to a transparent process and releasing the findings so that every member of the public has complete access to the reports," said Minister Ottenheimer. "These reports will now serve as discussion documents as we engage the participation of our new CEOs and boards in planning for a balanced approach to the delivery of quality health services and greater financial stability in the RIHAs."

The Hay Health Care Consulting Group was contracted last spring at the request of both the Western Health Care Corporation and the Grenfell Regional Health Services Board, to determine the best way to meet the health needs of the regions within available resources. The final reports were submitted to the Department of Health and Community Services on February 10.

The two reports contain 270 recommendations covering themes of governance, medical services, operational efficiencies, utilization, access to services and finances. Collectively, the reports have identified close to $13 million in savings if the recommendations are fully implemented over the next three years.

Minister Ottenheimer has now asked the boards and CEOs of the new RIHAs to take the necessary time to assess the reports� findings, determine what is achievable and present implementation plans to government by the end of June 2005.

"We will need time to thoroughly evaluate all of the report�s recommendations before proceeding with any change," added Dr. Tony Genge, chair of the Western RIHA. "During our assessment we will continue to work with the full health care team to achieve success, with a commitment to delivering quality health services for the people of the Western region."

Patient safety and quality services will be given primary consideration, along with the need to balance the social and economic needs of the region in the development of future plans, Minister Ottenheimer noted, using primary health care as an example.

"The revitalization of our health services begins with improved primary health care in our province. Community clinics are an integral part of our primary health care system. Government does not plan to proceed with Hay�s recommendations affecting rural clinics at this time," stressed Minister Ottenheimer.

Larry Bradley, chair of the Labrador-Grenfell RIHA agreed. "The Labrador-Grenfell RIHA will use the Hay Report as a reference point for discussion. Any changes in the present delivery of health care will be guided by the principle of quality and safety for the people we serve."

Minister Ottenheimer thanked the board, management and staff of the Western Health Care Corporation and the Grenfell Regional Health Services Board for assisting Hay in completing the reports. Copies are available on-line at www.gov.nl.ca/health/publications.

In the coming weeks, the Western and Labrador-Grenfell RIHAs will outline a process for interested organizations, community leaders and staff to provide feedback on the reports� findings.

The Hay Health Care Consulting Group is part of the HayGroup, one of the world�s pre-eminent consulting firms focusing on improving organizational effectiveness. The firm previously completed a successful operational review of the Health Care Corporation of St. John�s, assisting the board in achieving $17.8 million in savings with minimal impact on staff and health consumers, and begin debt retirement payments over the last three fiscal years.

Media contact: Carolyn Chaplin, Communications, (709) 729-1377, 682-5093

BACKGROUNDER
Hay Best Practices Review - Western and Grenfell

At the request of the boards, the department engaged the Hay Health Care Consulting Group in spring 2004 to perform a comprehensive bench-marking review of all programs and services within the Western Health Care Corporation (WHCC) and the Grenfell Regional Health Services Board (GRHSB). The purpose was to identify operational and clinical efficiencies and develop multi-year financial recovery plans to achieve financial health in both regions.

Western Health Care Corporation
The existing WHCC provides hospital and nursing home services to 82,034 persons residing from Burgeo/Ramea on the South Coast to Bartlett�s Harbour on the Northern Peninsula and on the Eastern boundary North to Jackson�s Arm. WHCC operates two hospitals, four health centres, three nursing homes and medical clinics in a number of communities. The board�s 2003-04 gross expenditures were $157.3 million and the board had an accumulated operating deficit of $22.5 million to March 31, 2004.

Grenfell Regional Health Services Board
GRHSB is an integrated health board that provides hospital, nursing home, community and air transportation programs and services to 15,859 people residing in Northern Newfoundland and on the South Coast of Labrador. GRHSB operates one hospital, one nursing home, three health centres, four community clinics and community health offices in five locations. The board�s 2003-04 gross expenditures were $44.1 million and the board had an accumulated operating deficit of $3.4 million to March 31, 2004.

Key Findings of the Reports
The two reports contain 270 recommendations covering themes of governance, medical services, operational efficiencies, utilization, access to services and finances. Collectively, the reports have identified close to $13 million in savings if the recommendations are fully implemented over the next three years.

Key findings include:

• Boards should take more responsibility for the financial health of the regions by more aggressively pursuing opportunities to minimize costs, including reasonable restructuring of services.
• The executive teams should expand financial and statistical reporting to the board and identify potential corrective actions to deliver programs and services within available funds.
• The importance of nursing should be elevated within the regions. Nursing leaders should be appointed who have specific responsibilities for the professional practice of nursing at the senior executive team.
• Stronger orientation processes must be put in place to ensure board members understand decisions must reflect the health needs of the region, not individual communities.
• Processes should be put in place for reviewing and addressing quality of care issues in all sites within the regions.
• Utilization of hospitals by the Grenfell population is highest in the province and 46 per cent above the provincial average. Opportunities exist to reduce admissions and lengths of stay at the hospitals in St. Anthony, Corner Brook, Stephenville and Port aux Basques. In Western, there are potential savings of approximately $2 million. In Grenfell, there are potential savings of approximately $600,000.
• There may be over-utilization of select services in both regions. Utilization in Grenfell of orthopaedics is 64 per cent above provincial average; trauma is 70 per cent above provincial average; general medicine is 88 per cent above and the highest in the province. Utilization in Western of gynaecology is 57 per cent above the provincial average. The hysterectomy rate in Western is 63 per cent higher than the national average.
• The rate of avoidable hospital admissions is 20 per cent higher in Western than the rates in St. John�s or Eastern NL.
• There may be unnecessary hospital admissions in both regions. In Grenfell, the rate is 112 per cent above the provincial average, while Western�s rate is 20 per cent above average.
• There are opportunities to improve staff productivity in various areas by redesigning work processes, improved use of technology and alternate service delivery approaches. Areas include nursing, housekeeping, food service. This results in potential savings of $5.5 million for Western and $800,000 for Grenfell.
• Sick leave usage in Western is higher than other regions in the province. While the report notes an aggressive program to reduce absenteeism has been introduced, there is still potential to produce additional savings of $1.4 million.
• There is a need to consolidate services to improve the quality and safety of patient care. Suggested service realignments include consolidation of clinics in both regions, reduced scope of surgery in St. Anthony, Stephenville and Port aux Basques and reduced scope of obstetrics in St. Anthony and Stephenville.

2005 02 24 12:30 p.m.