Local hospitals in the Central Zone of Alberta Health Services may not see any immediate or specific actions taken as a result of AHS's recently released Health Plan and Business Plan, which will govern the organization's decisions for the next three years, officials said.
“We've got our teams looking at what opportunities there might be to ensure that we're strategically investing in the right services, as has been highlighted in the health plan,” said Kerry Bales, senior vice-president of Central Zone AHS.
There are no specific timelines as to when to expect these initiatives to be carried out on a first-hand, local level, said Bales, though changes will be occurring on an ongoing basis between now and 2016 in service of the AHS's three-year plans.
“As opportunities are identified or present themselves, we'll be working with our local staff, communities, and stakeholders to take advantage of the opportunities,” said Bales.
“Though at this point, there is no absolute plan or initiatives being carried out immediately.”
Bales said officials are always looking for opportunities to be as efficient with expenditures and resource allocation as possible.
“In Central Zone, we are looking at all programs and services to identify things we could be doing better and ensure we are using all of our resources effectively and efficiently,” he said.
This will result in some changes, he said – all with an eye to ensuring residents have access to the services they require in an appropriate and sustainable manner.
“We've already started with this transformation,” he said. “For example, our project to move ophthalmology surgeries from Red Deer to Innisfail and increase the number of day surgeries performed at the Olds Hospital and Care Centre is now complete.
“This has freed up operating room time at Red Deer Regional Hospital Centre for more urgent, emergent and elective surgeries.”
They are also spending dollars where they have the best value, while working to meet increases in demand and reducing unnecessary costs, he said.
“In Central Zone, this includes new supportive living spaces for seniors, and a new cancer centre in Red Deer,” he said.
Olds, for example, will be one of the areas to see a batch of new supportive living beds coming available by mid-2014, said Bales.
“There's been some work to expand and collaborate with the Olds College to create more space, and that will be coming on board later in the fall. It will focus on chronic disease management and public health,” he said.
The goal, he said, is to “live the spirit of the health plan” by strengthening the community and primary care service delivery, as opposed to placing emphasis on treatment through acute care.
The May 29 AHS news release discusses several strategies it will be carrying out in order to achieve its targeted $220 million in savings by the end of its 2013/2014 fiscal year.
These strategies include eliminating duplicate services, ensuring service delivery is efficient, “containing costs” associated with delivering health care, and seeking new revenue opportunities.
Though the release suggests this could mean reduction in beds not urgently needed, eliminating programs and services that don't drive priority area improvements, and “redeploying staff”, Bales said he does not have a concrete idea yet as to how these initiatives will be specifically carried out in Central Zone hospitals.
One example of service duplication is offering the same specialty service (surgical, for example). Bales said AHS would be looking to make sure it's not duplicating that effort within a short travel distance of a facility that offers the same service.
“We don't want to be paying for equipment and specialty staff training within a 20 minute distance from one another,” he said. “We're also looking at the actual duplication of service as it relates to individual patients – trying to reduce the amount of time we have to do assessments on a patient in. The number of times we have to ask them information on their background.
“Trying to find efficiencies within the system to actually reduce how much human resource time we need to spend gathering that type of information. As well, that's not the best experience for the patient either.
“We want to make sure we're as streamlined as possible with the way that we manage a patient's experience through the system. It will vary from community to community, but we have actually tasked folks with making sure that we create those efficiencies so that we can allocate dollars to fund some of those strategic directions that have been outlined in the health plan.”
These strategic directions include: bringing appropriate care to the community through primary care strategies and additions of continuing care beds; partnering for better health outcomes by engaging local Albertans in their own health; and achieving health system sustainability by reallocating $220 million in cost-savings.
Though he wouldn't say outright there would be cuts to nursing staff, Bales alluded to every aspect of the health-care system being under scrutinizing eye of efficiency due to the new health and business plans.
Though, as Bales said, decisions will be filtered “through the lens of patient safety and quality care.”
“I think it's realistic to believe that we're going to actually be looking to find efficiencies in all areas of our operation,” he said. “It doesn't just apply to front-line care,” he said. “We're looking at administrative reductions, how we can streamline business processes. We want to make sure the system – from front-line to top leadership – is as streamlined and effective as possible.
“The goal is to make sure we are spending the money we have as responsibly and appropriately as possible. But I think it's unrealistic to believe that we may not be looking to pursue opportunities in various communities around improving those efficiencies.”
“This really isn't just about a ‘care reduction,' it's about how we're going to transform how we deliver care, and make it more efficient. In the context of a local hospital, what we might be looking at is how staff are scheduled.”
Bales went on to explain that AHS would be looking at ensuring the appropriate number of staff is scheduled to match the demand, based on the number of beds being utilized in an area, so that there is neither over nor understaffing.
A local hospital might also be examined to ensure its staff members' skills aren't being underutilized, and adjusting them to a place where they can carry out the more complex tasks they're trained for, he said.
“We want to make sure that we have that staff mix correct,” he said.
It's not about service cuts, he said, but matching patients' needs with staff that can deliver care for those needs most efficiently and cost-effectively.
Though the release mentions the closing of beds “where they are not urgently needed,” he said there is no one specific type of bed (long-term, ICU, etc.) that will be closed.
“It's more in that broader context of right-sizing services. AHS cannot, and does not want to be in, the position where we're providing services that aren't being utilized. If there is poor utilization of any service in a community – and that could be a seniors' service, an acute-care service, or a community-based service – we'd be looking at ways to right-size that service,” he said.
“That will be dependent upon the community, its mix of services, and how they are currently being used.”
AHS is seeking to fund ‘priority services,' which he said are the services that have the most direct relationships to patient outcomes.
“(We want) to make sure that people are receiving care in the most appropriate environment, which means not treating people in a hospital when they could be provided care through a community-based program like home care,” he said.
“(Hospital care) may be disproportionately more costly based on what they actually require. Where we want to be getting to is making sure they're getting care where they actually require it, not forcing them into scenarios where we're needlessly providing more costly care for something that could have been done in a more efficient way.”
“The real focus is matching the resources and the services with the need, making sure we're providing the right care in the right place, ensuring it's delivered in a way that's appropriate, effective, and efficient as possible.”
