Summary of Proposals in “Future Directions for Surgical Services in British Columbia”
Overarching Principle: Significantly improve timely access to appropriate surgical treatments and procedures.
The Provincial Surgery Executive Committee (PSEC) has been give the mandate and the authority to drive a common vision and a comprehensive
policy framework that gives priority to improving the quality of surgical services and embed the philosophy of patient centred care into strategic
and operational processes. PSEC will lead the consultation on this paper and by June 2015 develop an initial 2 year action plan on the final set of
policy directions.
When
What
Implement a patient and family centred approach to
care.
- Requirement for fully informed consent based
on comprehensive, plain language material
along with fulsome discussion between patient
(and family as appropriate), family physician,
and the surgical specialist.
- Information should cover benefits, risks,
limitations, pre-op preparation, post-op
recovery, and expected timelines.
- Develop standardized care pathways and
evidence-based timelines (including all the
steps in the process) for specific surgical
patient groupings linked to high volume routine
surgical procedures, and complex high resource
surgical procedures. The pathways will address
patients living in a variety of geographic
settings.
- Increase plain language information available
on hospital and surgeon performance quality
indicators.
- There should be an easily accessible
mechanism for patients to provide feedback
during their care journey.
Why
Patients/families need more understandable
and accessible information about their
condition, options, the surgical journey and
process, their status in the journey, as well as
the steps to optimal recovery. Patients
should also be given the opportunity to make
suggestions for improving surgical services.
Who
-
-
2015-16
Introduce provincial, standardized patient
satisfaction surveys and follow-up calls from
nursing/allied health staff to patients after
surgery.
Patient advisors/representatives should be
invited to join senior level Surgery Committees
and Surgery Quality Councils in each health
authority.
Implement practice guidelines for consulting with
patients on treatment options.
How treatment options are discussed by
physicians amongst themselves and with the
patient is an important element of providing
appropriate and acceptable care.
Encourage, support and implement alternative practice
models. This could include:
- Surgeons working in partnership with a
multidisciplinary team of nursing and allied
health professionals.
- Use of third-party facilities to offer day
procedures.
Increase access to surgical care and improve
quality by providing patients with an
integrated care pathway.
HAs in
collaboration with
surgeons,
anesthesiologists,
nursing and allied
health
professionals
Optimize existing surgical infrastructure:
- continue to move appropriate surgical
procedures from the operating room to
procedure rooms, from inpatient care to day
care/short stay care, and to private surgical
centres using public funds.
- Introduce pooled referrals, central intake for
referrals, and first available surgeon models in
health authorities.
Increase timely access to surgery, eliminate
backlogs, and mitigate over-capacity
pressures from Emergency Departments and
medical inpatient units.
HAs
Optimize wait list management:
Increase timely access to surgery and
- determine goals for wait time performance that eliminate backlogs.
-
-
-
Full
deployment by
April 2016
will be achieved within 5 years.
introduce a standardized approach to
management of surgical patient waitlists by
2016.
adopt standardized wait list definitions and
processes across all health authorities and
surgeons’ offices (using more patient accessible
terms such as ‘waiting for tests’, ‘waiting to see
surgeon’).
complete diagnosis prioritization code review in
2015 and audit procedure codes in 2016. Use
prioritization code information to determine
the most appropriate locations for
consolidation of specialized services.
Develop and implement a comprehensive performance
measurement, reporting, and accountability framework
for surgical services.
- define the optimal state of quality performance
for surgical services.
- establish public reporting, monitoring, and
impact/outcome assessment mechanisms
- Introduce NSQIP (National Surgical Quality
Improvement Program) to all hospitals in BC
and provide provincial level reports to the
Provincial Surgery Executive Committee.
Improve quality monitoring and reporting.
Further leverage the use of Health Shared Services BC
for procurement of surgical supplies.
Optimize costs of surgical supplies.
MoH, PSEC