Client

Bermuda Hospitals Board

Duration

12 Months

Scope  

Bermuda Hospitals Board is the island’s sole acute healthcare provider, delivering healthcare services to c.60,000 residents. Bermuda has significant population health challenges including high rates of obesity, high, increasing rate of diabetes amongst the population and under-funded primary care and social care services. Faced with changes to the hospital’s funding model, a $30m forecast deficit position and no ability to run a deficit without borrowing from the capital markets. As a result, the hospital needed to set up a rapid transformation and efficiency programme to:

1.  Realise tangible, recurrent cost savings at pace

2.  Optimise productivity of clinical services

3.  Engage and empower frontline teams to deliver transformation and improvement programmes

4.  Reduce the length of hospital stays

5.  Develop the hospital’s Clinical Services Plan

A Diagnostic Imaging workstream was established as part of the efficiency programme, focused on improving department efficiency and reducing costs by:

-  Increasing radiology activity and income at no additional cost by reviewing clinic templates at modality level, ensuring they align to UK benchmarks

-  Reducing diagnostic imaging pay budgets by aligning diagnostic imagining AHP staffing levels to UK national best practice benchmarks

-  Reviewing Radiologist in-session productivity, scoping opportunities to improve in-house reporting volumes by analysing in-session reporting standards against UK Royal College guidance and benchmarks

-  Developing an outline proposal to repatriate offshore reporting activity by sustainably growing the department and improving its productivity

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Impact

-  Improved diagnostic imaging productivity in under 3 months, driving improvements by aligning clinic templates of all modalities to UK benchmarks and embedding daily PDSA cycles within the department

-  Reduced AHP establishments by $500k in Radiology (c.10% of department headcount and expenditure)

-  Identified opportunities to reduce the outsourcing of radiology reporting by reviewing reporting standards at clinician level against UK Royal College guidance, demonstrating a need to better utilise medical staff time within the department

-  Delivered a $1.1m reduction in Dialysis nurse staffing costs by aligning nursing rotas to patient demand

-  Scoped, identified and delivered over $30m of recurrent cost savings across the hospital, outperforming in-year and full-year savings targets

-  Delivered the hospitals entire savings programme target ahead of schedule by month 10