Closing the gap in provincial contracting

June 24, 2016

A common discovery in improvement projects is that processes are flawed because we’ve become embedded in the historic way of doings things and we lose sight of the waste and defects that exist.

This was certainly the case when a team of health care professionals gathered with 3sHealth to focus on reducing defects in clinical engagement and reducing lead time in provincial contracting processes.

“The team has created a standard, replicable process that means stakeholders who participate on a provincial contract process know exactly what they’re signing up for before the process even begins,” said Jennifer Fetch, a co-lead of the improvement team.

Establishment of an Interdisciplinary Contract Oversight Committee (ICOC) with leadership from across the province is being recommended and will go to the Shared Services Oversight Committee for consideration.The improvement team anticipates this committee would help to ensure potential province-wide clinical contracts are prioritized based on solid data gained from environmental scans and market analysis. 3sHealth currently manages more than over 1900 contracts for health care goods and services on behalf of the entire health system, ensuring better quality products are available for use by all providers and to all our patients. Between 2010 and 2015, provincial contracting was able to find $97 million in savings by standardizing the quality and service agreements.

Today, each provincial contract can take as long as 570 days from start to finish. The improvement team has proposed a standard process which would reduce that time to a 174-day process that incorporates time for meaningful trials of products, equipment and supplies where appropriate.

The process also spells out clearly how physicians and clinicians can and should be engaged. In a typical process, a clinician would commit to an average of five meetings as part of a project team. That team would have a maximum of 14 members; currently, some committees can grow to an unmanageable 52 people.

Dr. David Campbell, Unified Head of Anesthesiology and an end user of contracted goods in Saskatoon Health Region, was a participant in the improvement project.

“One of the defects we looked at was that decisions on provincial contracts are being made by non-clinicians in the current state,” he said. “That means decisions are made by individuals who may be uninformed regarding the actual use of a product. The future state will ensure a much better informed process with clinician engagement throughout the process.”

Dr. Campbell said the highlight of the week was the team’s receptive approach.

“Thank you for listening,” he said at a team wrap up session. “I felt like I was heard and it was nice to know that somebody felt it was important enough that the clinician perspective needed to be heard.”

Dr. Werner Oberholzer, Director of Physician Leadership with the Saskatchewan Medical Association, called the experience “total enlightenment” to a very complex process.

“I had no idea what needed to happen before I could touch a cotton ball in the ER,” he said.

Robbie Peters, VP of Finance and Chief Financial Officer with the Regina Qu’Appelle Health Region, said the biggest difference ahead for this process is the ICOC.

“It will be really helpful,” he said. “This group will have decision-making authority in terms of what contracts we should look at provincially.”

The decision-making process will be streamlined and simplified, said Jim Crawford, director of the provincial linen service.

“Once implemented, this process empowers the right people to make the right decisions.”

The recommendations of the group will be tested in the coming weeks and months.

Ensuring a higher level of physician and clinician engagement will help the 3sHealth team support the health care system in ensuring the highest quality products, services, and equipment are available to care for patients and families.

 




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