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• W2892690376 abstract "The delivery of cardiac surgery care in the context of the Canadian health care system is under constant pressure to improve performance despite increased resource constraints. Partnership with industry in this context remains rare in Canada. The New Brunswick Heart Center (NBHC) partnered with Medtronic Inc. and its Integrated Health Solutions (IHS) to help address an unmanageable growth in the cardiac surgery wait list in the province of NewBrunswick. The IHS implementation began in 2016 following a complete review of the Department of Cardiac Surgery, its components and its processes of care. As part of the process, team leaders were identified from each of the target areas including surgeons, anaesthesiologists, nurses (operating room (OR), intensive care unit (ICU) and post-operative ward), access coordinators and administrators. The methodology used was based on Kaizen principles aimed at continuous improvement exercise by participation of all team with the support and mentorship of IHS. Process improvement projects were identified and implemented by team leaders on a continuous basis. No additional hospital beds, OR theatres or physician resources were added during the period in question. A weekly dashboard was created to monitor and facilitate improvement efforts. After two years, the annual number of cardiac surgical interventions has increased from 788 in 2016 to 873 in 2017, representing a 10.8% increase in capacity. The median wait time for patients decreased from 118 to 70 days (41% reduction). The 90th percentile wait time decreased from 283 to 159 days (44% reduction). The overall increase in capacity could be explained in part by the significant increase (2 fold) in fast tracking from the ICU to the ward and of the percentage of patients bypassing the ICU altogether (13%). Despite these successes, challenges persist as the number of OR cancellations remain around 8% of all cases, mainly due to limited ICU resources. The NBHC / IHS partnership has resulted in excellent engagement by team members and has promoted team cohesiveness. Furthermore, it has allowed significant reorganization and realignment of efforts to limit wait times and maximize overall capacity. While these efforts cannot fully address gaps in resources, they can provide significant benefit to the organization in the Canadian health care system." @default.
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• W2892690376 date "2018-10-01" @default.
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• W2892690376 title "IMPACT OF A COMPREHENSIVE INTEGRATED HEALTH SOLUTION PARTNERSHIP ON CARDIAC SURGERY VOLUME" @default.
• W2892690376 doi "https://doi.org/10.1016/j.cjca.2018.07.404" @default.
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