Ga Gavi vin n Mer eredith edith Ge Gene neral ral Man anager ager - Aus ustr tralasia alasia Novari Health gmeredith@novarihealth.com Mobile: 0413 315 228 The 2 Things You Must Do T o Reduce Surgical Wait Times and Improve Operating Theatre Efficiency: The Ontario Experience HIC. 12 August 2019
Ga Gavi vin n Mer eredith edith Ge Gene neral ral Man anager ager - Aus ustr tralasia alasia Novari Health gmeredith@novarihealth.com Mobile: 0413 315 228 Conquering Geography and Wait Times with Speed and Efficiency: The Ontario Experience HIC. 12 August 2019
A Word About Novari Health • Founded in 2003, 75+ Clients / Hospitals • Canada, Australia & the United States • We focus exclusively on Ac Access cess to to Car Care e software solutions – nothing else *Wait List Management *eBooking *Central Intake *Virtual Care (eVisits) *eReferral *eConsults • Novari is a and partner
A Word About Novari Health • Founded in 2003, 75+ Clients / Hospitals • Canada, Australia & the United States • We focus exclusively on Ac Access cess to to Car Care e software solutions – nothing else *Wait List Management *eBooking *Central Intake *Virtual Care (eVisits) *eReferral *eConsults • Novari is a and partner
www.novarihealth.com.au
Where are we?
North West Local Health Integration Network. (LIN) • Largest of Ontario’s 14 health networks • It is about double the size of Victoria. • 5 sub regions – integrated district networks • Smallest population of all the networks 231,000 • 21.5% are Indigenous • Travel distances for patients are long (300km) and potentially dangerous (-30oC)
What was the Problem? Orthopaedic Wait times were some of the longest in the country! • Chaotic referral patterns (multiple Primary Care referrals to multiple sites) • Queuing not based on referral date or formalized triage system • Inequitable access to care across the region • Lack of standardised referral process/referral form • Inappropriate imaging and investigations • Efficiency disparity across Operating Theatres at the different sites
Magic Happened
What are the Solutions? Develop a new Model of Care • ‘Hub and Spoke model’ • Central point of access for processing of patients • Triage patients for appointments and assessments • Surgical teams to see the patients at the satellite facilities • Better manage the existing operating theatre resources
What are the Solutions? Partner with Novari Health to support the Develop a new Model of Care MOC • ‘Hub and Spoke model’ • Novari eRequest • Central point of access for • Novari ATC/eRFA processing of patients • Triage patients for appointments and assessments • Surgical teams to see the patients at the satellite facilities • Better manage the existing operating theatre resources
How this was achieved and supported? Practice Change Novari support
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form
Cu Current ent St Stat ate: e: Point to Point Faxed Referrals
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form • Central intake for Hip, Knee, Spine & • All referrals directed to a single point of Shoulder access
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form • Central intake for Hip, Knee, Spine & • All referrals directed to a single point of Shoulder access • Advanced Practice Physiotherapist reviews • Triage • Physical functional
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form • Central intake for Hip, Knee, Spine & • All referrals directed to a single point of Shoulder access • Advanced Practice Physiotherapist reviews • Electronic Management of the referral • Triage • Electronic Management of the surgical • Physical functional waiting list • Pooled lists – patients can be viewed by all sites
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form • Central intake for Hip, Knee, Spine & • All referrals directed to a single point of Shoulder access • Advanced Practice Physiotherapist reviews • Electronic Management of the referral • Triage • Electronic Management of the surgical • Physical functional waiting list • Pooled lists – patients can be viewed by all • Theatre Scheduling sites • Booked for Surgery
How this was achieved and supported? Practice Change Novari support • GP uses specific referral form • Digitised fax form • Central intake for Hip, Knee, Spine & • All referrals directed to a single point of Shoulder access • Advanced Practice Physiotherapist reviews • Electronic Management of the referral • Triage • Electronic Management of the waiting list • Physical functional • Theatre Scheduling • Pooled lists – patients can be viewed by all • Provided data for the districts sites • Provided reporting capability to Health • Booked for Surgery Authorities
MSK Hip & Knee Centralized Intake, Assessment & Management Model
MSK Hip & Knee Centralized Intake, Assessment & Management Model
MSK Hip & Knee Centralized Intake, Assessment & Management Model
MSK Hip & Knee Centralized Intake, Assessment & Management Model
MSK Hip & Knee Centralized Intake, Assessment & Management Model
Additional Benefits • Centralized Intake that is scalability to expand to medical or surgical pathways • Multiple Orthopaedic Pathways: Hip/Knee, Spine, Shoulder, Foot & Ankle • Real time referral status to communicate to Primary Care/GPs • Surgeon Wait List dashboards • Transparent wait lists across all 4 surgical sites – in real time • Standardized Care Paths/Best Practice • Automated Complex reporting to CCO-WTIS • Established ‘Short Notice’ lists • Discharge planning starts on day 1 of assessment
Results • One program • multi-site with • rotating sub-specialty service to all sites with • APP model of care : • Achieve sufficient volumes; • Critical mass at each surgical site; • Wait time has gone from 9 months to between 4 and 12 weeks • Wait time for surgery has gone from 12-24 months to less than 6 months
Caroline Fanti BHSc(PT) BHSc(HK) MHM Director Regional Orthopedic Program Thunder Bay Regional Health Sciences Center Email: fantic@tbh.net Gavin Meredith David A. Puskas MD MSC FRCSC Australasian General Manager Novari Health Section Chair Orthopedic Surgery Northern Ontario School of Medicine gmeredith@novarihealth.com Mobile:0413 315 228 www .novarihealth.com.au Together We Can Improve Access to Care.
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