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Eight new projects going forward in BC

VANCOUVER – Fraser Health and Vancouver Coastal Health are collaborating on a series of pilot programs as part of a two-year, $75-million Lower Mainland Innovation and Integration Fund. The province announced in October that eight projects, with a total budget of about $20 million, are now set to go forward.

“We believe significant opportunities exist to improve the speed and quality of care our patients receive across the Lower Mainland,” said Ida Goodreau, president and CEO of Vancouver Coastal Health. “In some cases we are expecting a 50 percent or better improvement in access and wait times. That is a significant step ahead in how we use our resources to provide services and demonstrates just what can be achieved by working together.”

Among the initiatives approved to proceed across Vancouver Coastal Health and Fraser Health are:

• MRI capacity: Through a centralized scheduling and booking system, and more efficient use of MRI image time, Vancouver Coastal Health and Fraser Health aim to perform as many as 18,000 new MRI exams across the Lower Mainland at a lower cost.

• The Providence Health Care distal extremity surgical project: By implementing a centralized referral service, the project is targeting a major reduction in wait lists of 60 to 70 percent for people seeking a referral for foot, ankle, hand, and wrist (distal) surgery.

• Spinal surgery expansion: Wait times for spinal surgery are projected to be cut as much as 50 percent by coordinating spinal surgery resources across the Lower Mainland for the first time.

• The Lower Mainland colonoscopy initiative: Introducing the innovative “swing room” concept at several hospitals as well as new scheduling practices and staffing configurations, Vancouver Coastal Health and Fraser Health hope to perform several thousand more colonoscopies for patients - leading to shorter wait times and wait lists.

The two health authorities, who serve over 60 percent of BC’s population, as well as providing many specialized services to the entire province, solicited creative and entrepreneurial proposals from physicians, staff and others in April 2008. That call for proposals resulted in over 500 submissions containing a wealth of ideas on improvements, changes, and increases in the provision of healthcare services. From these, the LMIIF steering committee approved eight projects to proceed with a total budget commitment of around $20 million.

“The commitment and creativity of our health professionals are resulting in tangible benefits for patients from across the Lower Mainland, and perhaps ultimately for people from across the province,” said Dr. Nigel Murray, president and CEO of Fraser Health. “By working collaboratively, our health authorities are improving services for patients today and also developing new, more sustainable ways to provide care to our rapidly-growing communities.”

While Vancouver Coastal Health and Fraser Health already cooperate in many ways on a daily basis, the two health authorities see the Lower Mainland Innovation and Integration Fund as another platform from which to launch new ideas and find further efficiencies.

The Lower Mainland Innovation and Integration Fund (LMIIF) is a key health initiative of the 2008 throne speech. It provides Fraser Health and Vancouver Coastal Health with $75 million to move beyond block funding toward a new province-wide patient-centred funding model. The new model ties funding to performance and increased service levels in specific areas such as surgical wait backlogs. Integration, standardization and consolidation are common features.

Eight projects have been officially approved to proceed by the LMIIF steering committee so far. They are:

Magnetic resonance imaging (MRI) capacity
Project budget: $5.3 million
Target: Around 18,000 new MRI scans. Activity increases as high as 95 percent (based on location capacity)
How: More efficient use of staffing and resources; centralized scheduling for patient appointments
Locations: Surrey Memorial, Royal Columbian, Vancouver General, UBC, Lions Gate and St. Paul’s hospitals

• The Providence Health Care distal extremity (foot, ankle, hand and wrist) surgical project
Project budget: $5.6 million
Target: Over 500 new procedures by April 2010; referral wait lists reduced by up to 70 percent
How: A coordinated and centralized intake and surgical process for distal patients, combined with an operating room “swing room” approach
Locations: St. Paul’s Hospital. Centralization will free up operating room time for other surgeries at Vancouver Coastal Health and Fraser Health hospitals.

• Spinal surgery expansion
Project budget: $1.3 million
Target: Reduce wait times by half; increase surgeries by 50 percent by March 2010
How: Linking spinal surgeons in the Lower Mainland to coordinate access and resources.
Locations: Lions Gate Hospital

• Cataract surgeries
Project budget: $552,000
Target: As many as 4,200 new procedures
How: Implement “swing room” concepts and other efficiencies
Locations: Lions Gate and Mt. St. Joseph’s hospitals

• The Lower Mainland colonoscopy initiative
Project budget: $3.8 million
Target: Up to 4,000 new cases; wait times reduced by one-third to one-half
How: Using best practices to make better use of staff time and resources, and support new endoscopes
Locations: Lions Gate, St. Paul’s, Vancouver General, Richmond, Ridge Meadows, Royal Columbian, UBC, Delta, Surrey Memorial and Abbotsford Regional hospitals.

• Sleep disorders
Project budget: $661,000
Target: Provide home testing for 1,200 obstructive sleep apnea (OSA) patients; reduce wait times by up to 50 percent
How: Consolidate existing therapies and introduce an integrated treatment plan
Locations: UBC, Richmond, Royal Columbian and Surrey Memorial hospitals.

• Gall bladder disease care initiative
Project budget: $726,000
Target: Up to 130 new day care cases
How: Reallocate operating room time to support specialized biliary stone surgery
Locations: UBC and Vancouver General hospitals.

• Additional operating room capacity at Richmond Hospital
Project budget: $2 million
Target: Over 100 elective and 600 day surgeries annually by 2010
How: More efficient use of existing operating room time; convert overnight stay procedures to day care short stay cases through patient booking best practice
Locations: Richmond Hospital.