An eye for efficiency
Continuing its pace-setting initiatives to enhance patients’ access to timely care while increasing workplace efficiency, the Jewish General Hospital (JGH) has identified potential improvements that could increase the capacity for cataract surgery by as much as 50 per cent. The analysis, using an approach developed at the Harvard Business School, was piloted by the JGH Transformational Change program, an ongoing hospital-wide initiative to improve efficiency and cut costs all in an effort to enhance patients’ access to timely care.   
The investigation determined that in routine cataract surgery, considerable variation exists in surgical techniques and in the way that resources are used by different surgeons. By identifying and standardizing seemingly minor changes in procedure, the JGH can save time and expense, ensuring that the procedure is performed more cost-effectively, all the while shortening waiting lists to the benefit of patients.   
“This method of analyzing what we do could be a real game changer in how we allocate resources and in getting a better understanding of the implications of what we do,” says Dr. Lawrence Rosenberg, Director of Transformational Change and Chief of Surgical Services.
This prompted the Transformational Change program to adopt Harvard’s Time-Driven Activity-Based Costing, which evaluates the availability of resources — such as equipment, space, and personnel – against operating costs to determine whether the resources can be used more cost-effectively. The method starts from a patient-focused perspective and seeks to optimize value for the patient.
Experts from the JGH and McGill University’s Desautels Faculty of Management collaborated in this exercise, which is aimed at standardizing work activities to improve the quality of care and make the best use of staff and equipment. The experience of the Transformational Change program will also be applied to other surgical areas, so that efficiency and cost-effectiveness will improved at the same time the patient experience is optimized..
“I applaud the decision to conduct this analysis,” says Dr. Michael Kapusta, JGH Chief of Ophthalmology. “Cataract surgery was already considered to be time-efficient, so the results of this evaluation will help to further improve spending, efficiency, and time management.”
“The Transformational Change program has proved its value once again by helping us find new ways of providing faster and more efficient treatment to patients who need cataract surgery,” says Dr. Hartley Stern, JGH Executive Director. “While improving the patient experience remains the top priority, Transformational Change has the added benefits of enabling us to reduce our costs, while identifying ways of streamlining and upgrading certain aspects of the Quebec healthcare system as a whole.”


August 5, 2013