VICTORIA - Fraser Health is moving ahead on 10 priority actions to improve patient care in the region, announced Health Minister Terry Lake today, as he released the health authority’s strategic and operational report and concluded the Fraser Health review.

“The plan put forward by the Fraser Health board addresses the issues facing the health authority, from quality concerns to achieving balance between acute care and primary and community care,” said Lake. “I would like to thank the board and the review committee for the tremendous amount of work and consideration they took in preparing this plan.”

The report identifies 10 priority action areas to ensure quality and sustainable service delivery in Fraser Health. They include improving the health authority’s capacity for care by reducing unnecessary use of hospitals; investing in more community care; improving the quality of care delivered in hospitals; building on recent primary care achievements; and delivering a balanced budget.

“We will continue to invest in our acute care system, but we need to ensure the right mix of services in the community, so patients can better manage their health, avoid hospitalization and move more safely and quickly through the hospital system,” said interim board chair Wynne Powell. “We will hold ourselves accountable to the actions identified in the plan and will be regularly reporting out to the ministry and the public on our progress.”

A ministry-led sub-committee also looked at how health-care services are delivered and coordinated in the three lower mainland health authorities. It found there are a number of opportunities to improve services such as cardiac care, stroke care, medical research and education, through better coordination across the Lower Mainland.

“We have a lot of work ahead of us but we have clear direction and clear goals,” said interim CEO David Ostrow. “I have seen first-hand the dedication of staff in Fraser Health and I am confident that we will be able to work together with the other Lower Mainland health authorities to provide the best possible patient-focused care, for the residents of the Fraser Valley and the entire Lower Mainland region.”

The review also found the current regional health boundaries in the Lower Mainland effectively serve their respective populations. However, it concluded there may be benefits to re-examining health authority boundaries. Over the next year, the ministry will review the boundaries to ensure they properly reflect the demographics and patient needs. Boundary changes would only be considered after full community engagement and consultation.

In late October 2013, Health Minister Terry Lake ordered a strategic and operational review of Fraser Health by a team of B.C. health leaders. The board of directors of Fraser Health supported the operational and strategic review, and was required to submit this new, three-year strategic and operational plan following the review.

Learn more:

Link to Fraser Health's Strategic and Operational Report: http://fraserhealth.ca/about_us/strategic_plan

Two backgrounders follow.

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

BACKGROUNDER

Priority actions for service delivery in Fraser Health

Fraser Health has identified 10 areas they will prioritize in the coming years. These will be the basis on which their service and budget plans will be developed, and will be tracked at individual sites and across the health authority.

1. Capacity for care across all sectors
   • Focus on reducing readmission rates, length of stay and the number of days a patient stays in a hospital bed while waiting for placement in residential care or another facility (alternative level of care days), to save money and reinvest savings in community and long-term care.
2. Quality and safety
   • Continue the progress of reducing hospital-acquired infection rates.
   • Study Hospital Standardized Mortality Rates to eliminate poor performance and emulate good performance.
   • Reduce the number of adverse events for patients.
3. Public health measures
   • Improve immunization rates for measles, mumps and rubella.
   • Increase the number of communities with a healthy living plan.
4. Accountability
   • Create a scorecard of key performance measures by region and site.
   • Update and publish the scorecard on the Fraser Health website.
5. Staff and physicians
   • Review and improve employee and physician engagement plans.
   • Ensure staff and patient safety, decrease overtime for nurses and other health-care workers.
   • Improve staff safety programs.
   • Engage physicians to work collaboratively across the system - between the emergency department, hospital wards and operating rooms.
6. Patient centeredness
   • Ensure the patient and their health care experience is the centre of all health care decisions. This includes recognizing and celebrating the diversity within Fraser Health.
7. Governance
   • Improve practices in board operations, including increasing board meetings and succession planning for senior leaders.
8. Operational organization and management
   • Careful analysis of portfolios, internal structure and site management within Fraser Health to optimize service delivery empowering frontline response to patient needs.
9. Lower Mainland collaboration
   • Ensure there are no barriers for collaboration with neighbouring health authorities. 
10. Budget accountability
    • Maintaining a balanced budget while ensuring the best possible care for Fraser Health residents. 

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

BACKGROUNDER

Summary points from the Fraser Health Strategic and Operational Plan

Fraser Health serves approximately 1.7 million people in the Lower Mainland, accounting for just over one third of the total provincial population. The population profile of Fraser Health includes a younger than average population, a diverse cultural community and a slightly healthier population with a life expectancy of 82.3 years, compared to the provincial average of 82.0.

Chronic disease

• The population of Fraser Health experiences a modestly higher prevalence rate for chronic conditions than B.C averages.
• In 2012/13, 475,000 Fraser Health residents experienced a low complex chronic condition, 136,000 experienced a medium complex condition, and 68,000 experienced a high complex chronic disease.
• It is projected that the prevalence of chronic disease could increase as much as 58% across the province in the next 25 years.
• The report suggests Fraser Health needs to build on and accelerate the implementation of strategies to prevent or delay chronic disease.

Mental health

• 17% of the regions adult population currently live with some form of mental illness.
• The number of adults living with some form of mental illness in Fraser Health is expected to increase by 11.5% by 2020 with an additional 160,000 to 200,000 people in need of withdrawal management or treatment services for substance use.
• An estimated 14% of children and youth in Fraser Health also experience mental health problems.

Access to primary care

• 77.9% of the population sees a primary care group and 66.3% see a particular family physician, near provincial averages.
• There are 10 Divisions of Family Practice in the region - the most comprehensive coverage by Divisions in the province.
• Partnerships between Divisions and Fraser Health have resulted in the Surrey Diabetics Collaborative, South Asian Health Centre, Global Family Care Clinic and the Chilliwack Primary Care and Senior Clinic. Approximately 8,000 patients receive care through these programs.

Home and community care

• Fraser Health has some of the lowest client rates in the province for home support, adult day services, home nursing care, and rehabilitation services for clients ages 75 and older.
• Fraser Health recognizes the need for an integrated approach to home and community care and connections to primary care programs in order to provide quality care outside of hospital settings.

Residential care

• Fraser Health accommodates more than 8,000 adults in residential care facilities in the region.
• Fraser Health’s residential care bed base has increased by 3.64% since March 2010; however, population growth has outpaced new residential care capacity.
• Fraser Health would require an additional 297 net new residential care beds to reach the provincial per capita average of 80 per 1,000 persons, 75+.

Acute care

• From 2008/09-2012/13 Fraser Health has had the highest acute care occupancy rates for all health authorities.

Emergency department visits

• The number of emergency department visits made by residents has increased to over 550,000 visits in 2012/13.
• Trends show emergency department use is increasing at rates much higher than population growth, 6.5% compared to 1.7%. The report suggests this is related to a group of frequent users who are more likely to be older, have co-morbid conditions, with lower socioeconomic status, and who lack a regular source of care.
• Emergency department triage assessments at Abbotsford Regional, Burnaby, Royal Columbian and Surrey Memorial hospitals show the majority of patients could receive their care in a primary or community care setting.

Surgical volumes

• Fraser Health’s increase in surgical volumes is in line with its population growth, with wait times remaining steady.

Patient safety

• At Burnaby Hospital Nursing-Sensitive Adverse Events (NSAE) rates, which are one indicator used to assess quality of hospital care, have been the worst in Canada for two consecutive years. Rates at Surrey Memorial, Burnaby and Ridge Meadows hospitals have been almost double the national average and with no demonstrated improvement over the past three years.
• This suggests further education of both medical and nursing staff needs to take place, as well as more effective use of daily safety huddles.

Actual vs. expected length of stay

• While Fraser Health has an average number of beds per population, in 2012/13 more than 35% of admissions exceeded the expected length of stay, which limited bed capacity.
• At Burnaby, Royal Columbian and Surrey Memorial hospitals, patients admitted under hospitalist physicians, or who have had hospitalists involved in their care, have had actual length of stays far longer than patients admitted under other members of the medical staff.

Nursing staff

• Fraser Health is the largest employer of nursing staff in B.C., and one of the top 10 in Canada.
• Fraser Health's nurse overtime has dropped significantly, from 3.93% of regular hours worked last year to 3.35% this year.

Finances

• Funding for Fraser Health is consistent with its population profile.
• 57% of Fraser Health’s funding is spent on acute care, while significantly less is spent on residential care, community care and mental health and substance use services at 18, 9% and 7% respectively.
• If the Vancouver Coastal Health services accessed by Fraser Health residents are taken into account, acute care spending consists of 60% of all of Fraser Health’s funding - the highest throughout the province.

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)