The case for improved quality and cost savings

Saskatchewan’s healthcare system is exploring ways to address the challenges it is facing to meet the needs of a growing and diverse population. Healthcare providers are working together to achieve patient and resident satisfaction through quality services that are sustainable.

Business case development is a tool health system partners use to explore the development of new shared services. This process allows 3sHealth and its partners to establish a vision for the future, build on current practices and successes, and explore opportunities for new shared services that will improve quality and ensure the sustainability of the healthcare system.  

How is a business case developed?

3sHealth and its health system partners use a collaborative approach to create the case for each shared service opportunity. The steps to develop a business case are:

Identify and engage stakeholders: 3sHealth ensures that the patient is always placed at the centre and that key partners within the health system are consulted and engaged throughout the process. Each business case has Lead and Operations Committees composed of operators and senior leaders from across the health system that provide guidance, feedback and decision-making throughout the process. Partners in this process include clinicians, non-clinical healthcare providers, vendors, patients and family members, health region and cancer agency leaders in the areas of finance, labour relations, operations, and union members. Patient advisors are permanent members of the Lead and Operations Committees and bring valuable insight to business case development.

Establish a vision: Stakeholders gather for a visioning session at the start of the business case process. They review the current state of the service and create a vision for an improved future state.

Gather and analyze data: This determines an accurate picture of the current state. A number of methods are used including visits to facilities, interviews, gathering quantitative data with surveys or other tools, and visiting best practice sites.

Present data findings and determine gaps: Once the data has been gathered and analyzed it is presented to the Lead and Operations Committees. Other stakeholders may be included. The committees discuss the data and make sure it accurately reflects the current state.

Interim Report: An interim report is presented by the project team. Feedback from this report gives the project team direction to provide detailed analysis of the options and recommendations presented in the final report.

Final Report and Recommendation: A final report and recommendation is presented to decision-makers that include the 3sHealth Board of Directors, the Council of CEOs and the provincial government. The final report makes recommendations based on a robust analysis of the data, alignment with the provincial strategic priorities of better health, better care, better value, and better teams.

Implementation: Once the business case recommendations are approved by decision-makers, 3sHealth works together with its partners to develop a detailed implementation plan for delivery of the new shared service.

Business case work in progress

Enterprise Risk Management (ERM)
Enterprise risk management is the collection of activities undertaken by an organization to manage its key risks and opportunities, with the goal of ensuring that strategic objectives are met. It is a rigorous and on-going process that provides a lens to focus management decision making.The development of a provincial ERM process can help improve health system operational performance through better management and the mitigaton of risks. The ERM business case was presented to regional health authority and cancer agency decision-makers but no implementation plans are currently in place.

Environmental Services
Environmental services in a healthcare setting have a high impact on patient satisfaction. The business case for environmental services was developed with input from a large group of stakeholders including leaders in environmental services, environmental and support services workers, infection prevention and control specialists, representatives from unions, the Ministry of Health, and patients. The goal of provincial environmental services is to enhance patient safety through infection prevention and control, improve access to care through better patient flow, increase patient and public confidence through patient satisfaction in facility cleanliness, and to capture savings are through quality and efficiency. This would be accomplished through the creation of provincial standards and uniform training. The business case for environmental services transformation is being considered by decision-makers.

Medical Imaging and Medical Laboratory Services
Efforts to reduce medical service wait times, increase the quality of those services, and increase patient satisfaction, while also generating cost savings for the system are being examined through the development of business cases for medical imaging and medical laboratory services. Working with provincial healthcare leaders and the Ministry of Health, 3sHealth has used the business case development process to examine ways to enhance patient care and create long-term sustainability for the healthcare system. Most recently, project lead and operations committee members participated in collaborative design sessions in February and March, confirming opportunities for improvement to medical laboratory and medical imaging services in Saskatchewan. Together with stakeholders, the project team is now considering how service delivery might best be structured to meet the needs of patients and families. These business cases are being considered by decision-makers.

Supply Chain
A business case and program charter to transform supply chain management in Saskatchewan have been approved and implementation is expected to begin the summer of 2016, at the earliest. Working together representatives from health regions, the cancer agency, unions, and other stakeholder groups are preparing key areas for implementation. This work includes:

  • Creating a common item master file. This work will ensure that each healthcare service provider is using standard naming and numbering for all inventory and direct shipped items. This will provide improved visibility of product availability across the province as well as improved metrics on usage and vendor service levels;
  • Collecting baseline data to develop key performance indicators for supply chain management;
  • Refining and continuing to test provincial processes for reporting and communicating product issues;
  • Continuing to work with provincial procurement and contracting staff to move contracts from a regional to a provincial level; and
  • Working with human resource and union partners to develop a plan that will address the complex human resource impacts associated with provincial supply chain implementation.