St. Joseph’s General Hospital is taking a new approach in an effort to reduce its high occupancy rates.
According to St. Joseph’s vice-president of finance, capital and support services Eric Macdonald, a strategy to lower occupancy rates — called the patient flow and access plan — will be presented to the board of directors along with the final budget this year.
The strategy is a companion piece to the budget because high occupancy rates mean more financial strain on the hospital’s budget.
“It takes a broad brush approach,” said Macdonald. “We’re going to be looking at avoiding admissions unnecessarily — if people are coming into hospital because something’s collapsed in the community on them, trying to make sure that we try and prevent that from happening.
“And we’re looking at, certainly, the ALCs (alternate level of care patients, who don’t need acute care) and some of the atypical lengths of stay, and trying to see what strategies we could apply there to get better follow-up care potentially, and primary care and better community support options.”
St. Joseph’s plans to work with community organizations and the Vancouver Island Health Authority to implement the strategies and strengthen other community care options to take some of the pressure off the hospital’s acute-care beds.
Macdonald noted occupancy rates fluctuate throughout the year; it was running above capacity during April and earlier this month, but the occupancy rate was coming down last week, for example.
A significant number of hospital patients lay in acute-care beds while they wait for a publicly funded bed to open up at one of the long-term-care facilities, or while they wait for home care arrangements to be made. The yearly average of acute care beds being used by ALC patients is about 30 per cent.
Macdonald noted “it’s becoming a necessity” for the hospital to develop strategies to keep acute-care beds open for those who need them.
“The main objective here is to make sure we preserve access to acute care for those that need it, and so part of that involves making sure that we don’t utilize that capacity for those that don’t have an acute care need per say, but are here for another reason — either because their support system in the community, for whatever reason, is not allowing them to return back to the life they had before they came to us,” he said.
“It is a spectrum (of reasons these people end up staying in hospital), but at the end of the day, we want to make sure that we manage our capacity so that it’s available as best we can for those that need acute care.”
The hospital expects to cut $2 million in spending out of its $80-million operating budget this year, though the final amount won’t be known until St. Joseph’s receives its funding letter from VIHA — which is expected later this month or early June. Within 30 days of receipt of the letter, a final budget will be presented to the board of directors.
“All the departments are involved (in finding the savings) so it’s not sort of singling out a particular service and saying this has to get cut or anything like that,” he added. “It’s doing things in each of the departments just a little bit more efficiently, and it does add up fairly quickly when you’ve got an $80-million budget.”
According to Macdonald, finding savings of this sort is not unusual at budget time; he said the hospital was looking for approximately $1.8 million in savings at this time last year.
New technology is another big reason for strain on the hospital budget. For example, Macdonald noted the hospital’s green light laser used during surgery means patients rarely experience post-operative bleeding and don’t need to stay in hospital overnight. But, he also pointed out each laser fibre costs $800.
“That’s where the technology side is a challenge,” he said. “It’ll bring something wonderful in that’s the right thing to do ethically, it’s the right thing to do for the patient, and in the grand scheme it saves capacity, but at the end of the day, that improvement means that we’ve got to save some money somewhere else to pay for it.”
St. Joseph’s is looking at things like group purchasing to try to drive the price of supplies down.