Lean methods reduce heart surgery wait times

SAINT JOHN, N.B. – Patients of the New Brunswick Heart Centre (NBHC) can expect reduced wait times and improved access to care as a result of an innovative project that the heart centre embarked on a little more than one year ago.

The goal of the project was to improve patient access to five clinical services at the NBHC, and successful completion of the initial project phase has resulted in reduced wait times for patients requiring heart surgery. The project is a five-year collaboration that was formed in May 2016 between Horizon Health Network (Horizon) and Medtronic Integrated Health Solutions (IHS).

“This progress shows how healthcare teams can work together to make a series of small changes that have a significant and positive impact on our patients,” said Dr. Jean-François Légaré (pictured), chief of Cardiac Surgery for the NBHC. “I’m very proud of the work our team is doing, and most importantly what it means for our patients.”

The initial phase of the project focused on cardiovascular surgery wait times, which had been identified as the most pressing need. This far reaching initiative involved teams from Horizon and Medtronic IHS as well as senior administrative and clinical leaders, physicians and staff from the NBHC and Horizon Health Network’s Saint John Regional Hospital, where the NBHC is located.

Using a Lean process improvement approach, and leveraging Medtronic’s deep clinical and operational expertise, within six months, the team has managed to:

• increase operating room (OR) capacity by 14 percent
• reduce average wait times by 44 percent from about 4 months to 2 months (i.e., from 118 to 66 days)
• reduce maximum wait times for 9 out of 10 patients by 31 percent from about 9 ½ months to 6 ½ months (i.e., from 283 to 195 days)
• reduce patient wait time during the discharge process by an average of half a day (reducing post-op average length of stay by 7.1 percent)

Together, these results have created capacity for additional cardiac surgeries and the number of patients waiting for cardiac surgery has been reduced. These positive trends are expected to progress as staff continues to implement these new strategies.

“Initially the process was intimidating,” said Michelle Brodersen, resource nurse with 5B North Cardiac Services at the New Brunswick Heart Centre. “But as I got more involved in the project, I got to see how one small change can make a huge impact – not just on our workload, but on patients’ lives.”

By increasing the NBHC’s capacity and improving processes, the project has enhanced the quality of care, provided insights that will be invaluable in controlling costs in the future, and has further promoted a culture of continuous improvement within the organization.

“We’re very encouraged by the results of this first phase of the project and what this approach to process improvement can do for the other healthcare services that have been identified,” said Geri Geldart, vice president, Clinical for Horizon Health Network. “Our staff and physicians have been very strong in supporting this project, and we’re excited about what can be achieved in these next phases.”

NBHC and Medtronic Canada are now turning their attention to the second phase of the project, which will focus mainly on increasing the efficiency of the NBHC’s cardiac catheterization laboratory, or cath lab, which uses diagnostic imaging equipment to investigate and diagnose abnormalities in the arteries and heart.

This new initiative will implement strategies to improve communication between healthcare providers and reduce the time a patient spends waiting in the system. The NBHC will be able to deliver the same level of care, to the same number of patients, while reducing overall cost.

Horizon’s industry partner, Medtronic Canada, is a subsidiary of Medtronic plc, one of the world’s largest medical technology, services and solutions companies with locations in North America, Europe, Asia, Africa, the Middle East, and Latin America.

The Horizon–Medtronic partnership is demonstrating that a collaborative approach between health organizations, health professionals and industry can lead to better care for patients while improving efficiencies and ensuring sustainability of healthcare services.

Learn more at www.medtronic.ca/NBHC.

About Horizon Health Network

Focused on patient and family-centred care, Horizon Health Network (www.HorizonNB.ca) operates 12 hospitals and more than 100 medical facilities, clinics and offices, and provides services ranging from acute care to community-based health services. With a collaborative, team approach to offering services in English and French, Horizon leads the way in delivering sustainable, safe and quality healthcare services to residents of New Brunswick, as well as northern Nova Scotia and Prince Edward Island. Horizon has an annual budget of approximately $1 billion and has more than 12,400 employees, 1,000 physicians and 5,700 volunteers, auxiliary and alumnae members, as well as 17 foundations and 18 auxiliary and alumnae organizations. Horizon ensures representation from urban and rural areas through a 15-member Board that consists of seven appointed and eight elected members of the public.

About the New Brunswick Heart Centre

The New Brunswick Heart Centre (NBHC) is located in Horizon Health Network’s Saint John Regional Hospital. The NBHC has been in operation since April 1991, and is the provincial referral centre for adult tertiary cardiac care in New Brunswick and surrounding areas. Services currently provided at the NBHC include general cardiology, interventional cardiology, electrophysiology and cardiovascular surgery. The New Brunswick Heart Centre works in partnership with the provincial health authorities to provide excellence in cardiac care along the entire patient care continuum.

About Medtronic

Medtronic Canada (www.medtronic.ca), headquartered in Brampton, Ontario is a subsidiary of Medtronic plc, which is one of the world’s largest medical technology, services and solutions companies – alleviating pain, restoring health and extending life for millions of people around the world. Medtronic employs more than 84,000 people worldwide, serving physicians, hospitals and patients in approximately 160 countries. The company is focused on collaborating with stakeholders around the world to take health care Further, Together.