NORTH VANCOUVER, B.C. – Lions Gate Hospital (LGH), a recognized trauma centre with 276 beds, is one of only five neurosurgery centres in British Columbia and the fourth busiest hospital in Vancouver. LGH is part of Vancouver Coastal Health Authority (VCHA).
VCHA has shown itself to be an innovator with the successful implementation of the McKesson Capacity Planner in six Vancouver hospitals – indeed, VCHA was the first organization in North America to take advantage of the solution. Since the Vancouver-area implementations, McKesson Capacity Planner has been installed in many other health facilities in Canada and United States. Many of them have visited our site to learn about the system.
McKesson Capacity Planner is a predictive analytics solution that helps organizations accurately forecast patient demand, enabling proactive resource alignment. Its predictive accuracy rate of scheduled and unscheduled demand is 95 percent one month out and 98 percent three days out.
The system combines capacity planning, resource planning and real-time information management that guides operational decision-making on three different planning levels:
• Budget and operational planning – forecasting one year in advance;
• Short-term planning – projecting a week in advance; and
• Real-time management.
All levels guide both occupancy management and staff resource planning. The tool uses selected algorithms that account for monthly, weekly and daily variations, anticipating patient admissions and discharges and creating patient demand forecasts.
The algorithms are configured to provide a long-term plan based on the last two to three years of historical data and a short term projection that gives extra weight to the last six weeks of activities, thereby guiding discharges and helping to adjust staffing on the fly.
How have we done since the implementation of the system?
Upon implementing the solution at Lions Gate Hospital, we have been able to create accurate staff schedules by matching staffing to predictive demand using the McKesson Capacity Planner.
We started to proactively plan and manage capacity, which helped streamline patient flow, reduce length of stay in the inpatient units, decrease ED wait times, optimize surgical slates and their impact on overall hospital occupancy, while managing and complying with surgical wait-time targets.
Before McKesson Capacity Planner and after: At LGH, we used to invest a considerable amount of time in preparing the layout of work prior to the utilization of the system. Now, key initiatives at LGH are part of the Strategic Capacity Management Plan, focusing on the most efficient use of resources and providing the best quality patient care.
Managers and directors meet twice daily in regular meetings and discuss projections of capacity and staffing for the next two-to-five days, and are able to make data-based decisions.
We have also established routine bi-weekly meetings for planning long-term strategy; led by capacity planning managers, the meetings provide a venue for developing action plans to deal with forecasted demand. By predicting occupancy levels accurately, the hospital is able to adjust its longer-term capacity plan months in advance. It can also create a more precise near-term staffing plan a few weeks in advance and modify its discharge plan.
Through accurate forecasting, the solution enables us to absorb increased demand using currently booked resources or by increasing the staffing to levels aligned with the forecasted occupancy. This has led to a reduction of overtime in our surge units by 50 percent.
Before, our direct patient-care staffing level had not always been aligned to current or future occupancy levels; now, we’re planning with confidence, utilizing accurate short and longer-term forecasts to match resourcing.
Prior to using the McKesson Capacity Planner, we could not easily plan our discharge activity; now we are accurately projecting discharges and matching over/under performance to daily and weekly targets.
Before, we often worked separately from one another; now McKesson Capacity Planner enhances interaction among managers and our nursing units by providing us with visibility and allowing us to make decisions on cross-unit resourcing.
Not only does it maximize the alignment of staff with occupancy across the hospital, but it also alleviates staffing shortages or over-booking, resulting in decreased overtime.
Strategic planning: Periodically we have a meeting of the Director of Acute Services, the Director of Finance and the Capacity Planning Manager to discuss the forecast, operational plan and the strategic budget. The McKesson Capacity Planner enables us to provide a clear road map for both financial and operational stakeholders. Any variations in the plan are monitored and broadcast in real-time so action can be proactively implemented.
The strategic operational plan incorporates a staffing resources model that allows us to plan the number of full-time employees required to support our rosters.
Results and successes: Thanks to our team of operational managers, directors and dedicated corporate support during the implementation phase and afterwards, we reduced our surgery overtime shifts by over 50 percent.
We also achieved annual savings of about $450,000 in fiscal year 13/14 at LGH on overtime costs. (VCHA has implemented strategies to reduce overtime, and Planner was one of several tools utilized.)
Together with other management initiatives, McKesson Capacity Planner contributed to a decrease in average length of stay on medical and surgical units by an average of 16 percent. Planner was a key factor that contributed to a revenue increase in fiscal year12/13 of over $1 million from a provincial procedure funding model that is no longer in place, effective April 1, 2014. Significantly, surgical waitlist targets for patients waiting over 52 weeks have been met.
Ron Dunn, Vice-President, Information Solutions, McKesson Canada, commented: “We are pleased with the results achieved at Lions Gate Hospital. Capacity Planner is designed for end-to-end proactive planning and the significant improvements achieved at LGH clearly demonstrate the benefits in key areas of cost efficiency, human resource management, length of stay and revenues.”
Michal Majercin is Optimization Manager, LGH Capacity & Resource Planning Leader, OR Booking.