COVID-19 is a catalyst for change
“The definition of insanity is doing the same thing over and over again, but expecting different results” – Albert Einstein
When the WHO declared the coronavirus outbreak as a global pandemic, it is as if we declared war against an ‘invisible’ enemy. As a result, every country in the world implemented some level of restrictions (Lockdown) on their citizens, emptying the streets, shops, etc. This disruption has created a situation and opportunity that may never come up again.
Historically major world events like World War II, have provided numerous advances that are still in use today eg communication networks and devices. Despite the chaotic situation and disruption, WWII saw a six year window for innovation, development and changes.
“Grand strategy is the art of looking beyond the present battle and calculating ahead. It requires that you focus on your ultimate goal and plot to reach it.” — Robert Greene, The 33 Strategies of War
Other countries already have their eyes on us and are watching our every move.
As we begin our focus on recovery, our window for updates and implementing changes begin to close as taps are slowly turned back on and more services come back online.
What new changes will we implement as a result of this Lockdown?
What challenges are we facing?
While the COVID-19 Pandemic is putting the brakes on some industries and making people re-think how they operate and they deliver their services moving forward. So many industries and sectors from Agriculture to Zoo’s are effected. It’s has been like taking bright torch and shining a light on others. We only need to look at the amazing things that people all over the world are experiencing with the environment. E.g the visibility of Mt Everest from Nepal, clear canals in Venice and even Orcas in Wellington Harbour.
What challenges are you facing in your industry right now?
Update and restart New Zealand’s Health System
Before COVID-19, New Zealand’s hospitals and health services were already stretched with growing waiting lists and costs. The Lockdown has slammed the brakes on our public health system and as a result the momentum that was already in the growing waiting lists is now compounding and building up even more pressure.
Can our current system cope with the pending added pressure?
The standard approach will be that productivity is accepted “as is” and “this is what it costs”. The risk of continuing our existing model for funding and employment that is used in isolation rather than in a combination of other options will be slow and costly. With current strict budget and funding measures the ability to utilise available funding in optimal ways is rejected.
What exceptions or relaxed measures do we need for optimal funding utilisation?
How will our Hospitals catch up?
Innovation is the way. We must act with a long term goal in mind from our current position and make the most of our opportunity with new ways of delivering health services. The result will be greater capacity and efficiency in the health system and we will find ourselves at the forefront of leading change while the rest of the World is still fighting COVID-19. Our size and the fact that we have not been as heavily affected by this pandemic means we have an advantage to be able to make decisions faster and implement them quickly.
Spend or invest?
As details of budgets that are being created for our recovery from COVID-19 Lockdown, the allocations need to be carefully considered. In the first instinct it’s easy to have a knee jerk response and spend to catch up. While this is necessary, in some instances allocating funds for investing into innovative processes and systems can have a far greater positive and compounding benefits over the long term.
The best of both worlds
COVID-19 has created a testing time for the various types of Health systems and processes around the world. This Pandemic is also highlighting the weaknesses and limitations in the way the health services are delivered. We can keep what’s working here. We can add our own new innovative ways and what’s working in other parts of the world to improve our public health system.
Will we take this opportunity to learn?
What is the way forward?
The New Zealand health system and hospitals have slowly made changes over the years and adapted to use new technologies, however many of the processes and the way the medical system operates are somewhat traditional. COVID-19 has highlighted the pressures we place on our medical system by putting everything in a one-stop shop and operating in a traditional standard 9-5, face to face way.
We now know that we will be told to exercise safe distancing, cleaning and sanitising habits and be more aware of the interactions as a way of preventing future spread of COVID-19. Along with this we have the opportunity to put in place new proven solutions and processes that can help our health system not only catch up, it will help it be more efficient in the long run.
While the Lockdown has had a huge economic effect on us, the cost of recovery may actually result in greater efficiency, to the point where the health cost of the Lockdown can be recovered within the first couple of years.
SEQURE Health leading the way
Over the past four years, SEQURE Health has successfully tested and proven new solutions with public hospitals that can now be quickly implemented and adapted to fit into our health system. These solutions improve our capacity to deliver health services more efficiently and maintain them long after this pandemic has passed.
It is now or never
Now is the time to act for New Zealand as the window for us is open as the nation moves into our recovery process. A good recovery is not about being able to bounce back, it’s about coming back stronger and in a way you can prevent another costly Lockdown.
We want to bounce forward and be stronger from this as new changes are implemented as part of the recovery process. The time is right before we all go back to some sort of “New Normal” and get busy being busy. As Albert Einstein said “The definition of insanity is doing the same thing over and over again, but expecting different results”.
What will we do differently?
The window and the changes that occurred as a result of World War II has led to our world being always on and connected 24/7. Over the past 21 days many of us have created new habits for virtual working, learning new ways to communicate and collaborate and this is just the beginning. Many industries are taking advantage of this and becoming more efficient in more ways than one.
SEQURE Health believes that the Health industry now has a blessing in disguise to be able to change for the better, will we take it?
Is medical insourcing the new black?
Health Central talks to two health professionals about how medical insourcing can help DHBs get out of the red and into the
black when it comes to grappling with long waiting lists and increasing patient demands.
Every few weeks, another headline alerts us to the fact that District Health Boards are struggling to get on top of their waiting lists as patient demand continues to grow.
In the last few months alone across various DHBs, we’ve had reports about rescheduled and delayed appointments due to an “enormous” increase in the number of people seeking cancer treatment; concerns about hospital capacity, patient flows and long waiting times for elective surgeries; and reports of patients waiting years for orthopaedic surgery.
Stories like these begin to paint a picture of an over-burdened healthcare system, struggling to keep up with demand.
And DHB health professionals are starting to feel the pressure. Take Lisa Rogerson, a specialist echocardiographer, based in Hamilton.
“Patients complain when they’ve been waiting a long time. Operations get put back because we can’t keep up with demand. And the situation is only going to get worse because of the population and the health problems in New Zealand.”
Clinical Nurse Specialist Jane Hawthorn agrees. Jane, who works in ophthamology, has worked across several DHBs and says the problems are widespread, with many patients having to wait longer than expected, particularly for follow-up appointments.
Many DHBs are working hard to ease the pressure, trialling different initiatives to clear waiting lists and meet their targets.
For example, the Southern DHB is trialling new initiatives to improve waiting times at its crammed emergency departments, including the introduction of a ‘Valuing Patients’ Time’ programme, ‘Fit2Sit’ sitting area, a nurse practitioner and an Older Persons’ Assessment and Liaison unit in Dunedin.
And at Counties Manukau DHB, a new MRI machine at Middlemore Hospital has helped to counter the growing demand for MRI procedures, although there were still challenges in recruiting specialist staff to operate the new machine.
Jane points to other solutions she’s witnessed.
“At the moment a lot of DHBs are using locums, which is not really that innovative and costs a lot of money,” she says.
Jane says some facilities are also training nurses to take on more responsibility. In Jane’s field, this can mean nurses doing laser treatments, intravitreal injections and seeing patients with glaucoma.
Surgeries and other aspects of care are sometimes outsourced. Jane gives the example of a scheme at Hawke’s Bay DHB in which glaucoma patients are sent to the optometrist for review, while they remain under DHB care.
“So there are things going on, but I think a lot of it is getting the time and the people who are skilled enough to do it,” she says.
This is why Jane thinks medical insourcing is the way to go. Insourcing can help public hospitals reduce waiting lists by bringing experienced specialists and teams to hold clinics after hours and on weekends.
“I’ve worked in Wellington and Manukau doing injection clinics and they’ve been really successful. In one weekend I did 103 injections. That’s a lot of people having their treatments who would have waited otherwise. A lot of these treatments are for things like macular degeneration and diabetes and are very time-dependent.”
Time is critical in healthcare.
“You make headway doing the course of injections and then if you don’t follow up you’re back to square one or worse in some cases,” says Jane.
Medical insourcing makes good sense on a number of levels. Jane says access to the facilities and equipment outside of the working week is a huge benefit.
“During the week you might get all these locums in, but the facilities you’re working in are still crammed. So while you might have enough staff, you don’t always have the facilities available to work efficiently. That adds to the stress.
“Often places only have one treatment room and that might be used for other things during the week. Even if they wanted to see more patients, and they’ve got the people there, often they can’t due to the limitation of the facilities themselves.”
Lisa Rogerson agrees.
“Equipment and facilities are all paid for and just sitting there – it seems silly not to run seven days a week now.”
Lisa works Thursday and Friday in Auckland, Saturday and Sunday in another institution and the rest of the week she “enjoys being a mum”. She says while weekend work isn’t for everyone, it works well for her.
Lisa says the patients also love the option of having their treatment on a weekend.
“A lot of patients have an elderly relative that they have to bring to the hospital, and they don’t want to take time off work to attend appointments. So from the patients I’ve dealt with and spoken to, they’re all very happy to come somewhere really quiet with no problems parking on a Sunday morning.”
Naturally there are costs involved with insourcing initiatives, a factor that might deter some DHBs.
However, Lisa is convinced the benefits outweigh the costs.
“Initiatives like working weekends does provide an extra 20 percent on top of what their staff can already provide,” she says.
SEQURE is at the forefront of providing medical insourcing and is keen to work with DHBs to help deliver solutions.
They operate a straightforward service. DHBs let SEQURE know what clinics, procedures and surgeries they need to happen, by when, and when their facilities are available.
SEQURE then finds the right medical staff who are available at the right time and gets the team to the hospital, where they deliver the treatment.
Feedback from hospital manager Patrick Ng, Executive Director, Southern DHB, describes the partnership with SEQURE as “hugely valuable”.
“They’ve assisted our quest to meet Ministry of Health targets, allowing more patients to be seen in a timely manner.”
Another hospital manager reports that the atmosphere at their hospital has lifted thanks to SEQURE’s help in getting through 3000 urgent follow-up patients.
Insourcing solutions like this might be to help get a hospital through a particularly busy period, or it might be a regular fixture to keep up with patient demand, or it might be just help with filling a gap.
Jane says she was part of a multi-disciplinary team flown to Dunedin to see “lots and lots of patients” while other people were getting trained up to continue the service.
Could medical insourcing be the answer to DHBs’ challenges when it comes to grappling with waiting lists and increasing patient demand? According to a number of health professionals, hospital managers and patients, it could be the way forward.