Northern Health finds huge savings in home and community care


The Challenge: Maintain high-quality care with fewer resources

Northern Health, one of British Columbia’s six healthcare authorities, delivers services to people spread over more than two-thirds of B.C’s land mass. Northern Health is home to the highest projected growth rates of seniors in B.C. and an Aboriginal community larger than anywhere else in the province. While the geographic range that the authority covers may be larger than most other providers in Canada, Northern Health faces a stumbling block known well to virtually all healthcare organizations in our country—demand for services exceeds available resources.

The Improvement Project: Extensive literature review reveals several options

Bonnie Urquhart, Northern Health’s regional director of financial planning and analysis, tackled her organization’s challenge head on with support and training available through the EXTRA program. With support from Cathy Ulrich, the organization sponsor for the initiative and CEO of Northern Health since 2007, Urquart conducted a comprehensive review of research literature that deals with business management. This review enabled her to identify several models that her organization could potentially employ.

The Result: Hard-nosed decisions that take ethics and fairness into account

Urquhart’s chosen approach combines program budgeting and marginal analysis with an ethics-based resource allocation process known as accountability for reasonableness. The process is founded on principles of procedural fairness and enables Urquhart’s organization to take into account factors that go beyond the purely economic. Under this approach, decisions to invest and disinvest are made based on the ranking of business cases against set criteria. To test it, Urquhart launched a pilot project that involved Northern Health’s home and community care budget. Twenty-six business cases for investment and three for disinvestment were ranked according to 20 criteria.

The Impact: Decision-making process is transparent and saves money

The immediate outcome of the pilot project was approval of all three disinvestment proposals, three investment proposals and two more for one-time funding. These decisions have enabled Northern Health to save money. Perhaps the most profound outcomes of the new decision-making process are its transparency and objectivity. To capitalize more fully on all benefits, the organization intends to expand this approach to cover its mental health and addiction programs.

Bonnie Urquhart image Bonnie Urquhart
Regional Director of Financial Planning and Analysis
Northern Health
Prince George, BC
Cathy Ulrich image Cathy Ulrich
Northern Health
Prince George, BC

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