Performance Reporting

Report on Results

Core Business: Services Delivered by Ministry

While the vast majority of health services are delivered in partnership with health authorities, physicians and other care providers, the ministry does deliver some services directly to the public. For this core business, the ministry has one key objective — to provide clients with equitable and timely access to services delivered directly by the ministry.

Goal 1: High Quality Patient Care

Goal 3: A Sustainable, Affordable Health Care System

Objective 5: Provide clients with equitable and timely access to services directly delivered by the ministry.

This objective focuses on improving the services the ministry currently delivers directly to the public. Priorities include better integration of ambulance services with other health services, and timely delivery of Medical Service Plan (MSP) and PharmaCare registration services and Vital Statistics services. The ministry must develop new models for delivering these customer services efficiently and effectively, while making the health system affordable.

The BC Ambulance Service (BCAS) is a key part of the health care system, providing pre-hospital treatment and transportation. The ambulance service operates 190 ambulance stations across the province and employs approximately 1,250 full-time and 2,000 part-time paramedic and dispatch staff.

The ministry is committed to ensuring the ambulance service delivers responsive and efficient care, and that the service is flexible and financially sustainable to meet the needs of BC patients now and in the future. To meet this commitment, the ministry is examining options and strategies to better integrate ambulance services with health authorities, to strengthen coordination of pre-hospital emergency care, and to better manage inter-facility transfers.

This measure provides insight as to whether the ambulance service is performing its principal responsibility well — responding to sudden, acute care needs as quickly as possible. Many metropolitan Emergency Medical Services in Canada have adopted a response time goal of less than nine minutes, 90 per cent of the time. Although ideal to strive towards, meeting this goal in all communities can be difficult. Some areas are larger and less populated than others; therefore, it is unreasonable to expect ambulances in a large geographic region, such as Langley, to respond as quickly as ambulance services in a more densely populated region like Vancouver.

Results:

Target		Fiscal Year
		2001/02	2002/03	2003/04	2004/05
			5.0%	5.0%	5.0%
	Total number of urgent calls in metropolitan settings	19,899	21,542	22,798	N/A
	Per cent of Responses within 9 minutes	53.8%	58.0%	64.9%	N/A
	Change in per cent of responses within 9 minutes	—	7.8%	11.8%	N/A

Analysis: Ambulance response times are the sum of the time it takes to assess a call (dispatch time), notify a responding ambulance crew (selection and notification time), mobilize the ambulance (chute time), and get to the patient (drive time).

In 2003/04, data show improvements in ambulance response times. Most improvements resulted from faster dispatch times through BCAS' rollout of a Computer Assisted Dispatch system in the Vancouver metropolitan area. This system has reduced dispatch times by improving mapping and area knowledge, automatically identifying locations of regular callers, and electronically signaling an ambulance crew dispatch for an emergency before all information has been collected.

To improve drive time, BCAS is working to reduce the time ambulances wait at emergency rooms. Not all people using the ambulance service require immediate care; however, paramedics are responsible for a patient once picked up, and they can get tied up at emergency rooms waiting for patients to be admitted. This reduces the number of ambulances on the road and lowers response times for subsequent calls. This is a primary reason the ministry is developing strategies to better integrate and coordinate ambulance services with health authorities and hospital services.

The Medical Services Plan (MSP) provides coverage to beneficiaries for medically required services provided by physicians and some other health care practitioners. PharmaCare is the province's drug insurance program, which helps British Columbians by providing financial assistance toward eligible prescription drugs and medical supplies. The ministry operates the two programs, including registering BC residents who are eligible for coverage. The ministry has been working to improve registration services, and is currently negotiating an alternative service delivery arrangement with a private sector partner.

The Fair PharmaCare Plan started on May 1, 2003. The new plan focuses financial assistance on BC families who need it most. Fair PharmaCare combines the previous major PharmaCare plans — the universal plan and the seniors' plan — into one, with assistance based on families' ability to pay. To receive their maximum level of financial assistance, individuals or families must register with the Fair PharmaCare Plan. BC families with the lowest incomes will receive immediate financial assistance under the Fair PharmaCare Plan. Other BC families will pay their full prescription drug costs until they reach their deductible. Once their deductible is reached, PharmaCare will assist families in paying for their eligible drug costs for the remainder of the year.

Results:

Annual Target		Fiscal Year
		2003/04	2004/05
		65.0%	73.0%
	Eligible BC families	1,940,000	N/A
	Number of Eligible BC families registered for Fair PharmaCare	1,299,000	N/A
	Per cent of Eligible BC families registered for Fair PharmaCare	67.0%	N/A

Analysis: In its first year, Fair PharmaCare registered just under 1.3 million families — 67 per cent of all eligible families in the province. Approximately 94 per cent of senior families have registered. Over 300,000 families have lower deductibles under Fair PharmaCare.

Measuring the amount of time it takes for applications and premium assistance applications to be processed are key indicators of MSP/PharmaCare registration services. Enrolment applications are used for new or returning beneficiaries, while premium assistance applications are for beneficiaries whose income level makes them eligible for reduced premium payments.

Results:

Analysis: BC's Medical Services Plan has made significant improvements in reducing times for enrolment and premium assistance applications, exceeding the 2003/04 service plan targets by a wide margin. Overall, processing time for enrolment applications has been reduced from the 2002/03 baseline of 16 weeks to 4.4 weeks — a reduction of 72 per cent. Significant improvements have also been made in eliminating backlogged applications; the ratio of applications over 60 days dropped from 61 per cent in April 2003 to only one per cent in April 2004.

For premium assistance applications, overall processing time was reduced from the 2002/03 baseline of 12 weeks to 5.3 weeks — a reduction of 56 per cent. The backlog of premium assistance applications was similarly reduced from 64 per cent of the inventory being over 60 days old in April 2003 to only one per cent a year later.

Two major strategies contributed to the ministry exceeding its targets for improving registration services. The first has been the implementation of a new management process, which included implementing an electronic document technology to increase efficiency. The second has been a partnership with an external call centre to handle routine inquiries, such as address changes, making more staff resources available to process applications.

Results:

Analysis: The British Columbia Vital Statistics Agency exceeded its target for registering vital events. Data show an average of 36 days for completing 90 per cent of the registrations of birth, death, and marriage events and producing certificates.

The agency reduced registration completion times by 10 per cent from the previous year, mainly due to facsimile transmission of notices of births and registrations of deaths from hospitals and funeral homes, plus greater processing efficiencies of the award winning VISION system.

The agency will continue to explore strategies for further reduction of registration processing times. Reducing the time between the occurrence and report of vital events will enhance the validity of the data collected, thereby making it more valuable to health researchers and planners.

Results:

Analysis: The agency achieved an average percentage of 97.2 per cent for customer satisfaction for courtesy, helpfulness and promptness, exceeding the target of 96 per cent.

Since last year, the target has been reduced by one per cent due to a new security initiative that may have an effect on customer satisfaction. However, the Vital Statistics Agency has been able to maintain high satisfaction levels during the implementation period.

Results:

Analysis: Access to the Vital Statistics data warehouse (VISTA) enables in-depth analyses of mortality and natality health issues to support health surveillance, program planning and monitoring, resource allocation, and health research by individuals and organizations engaged in these activities. In 2003/04, BC's Vital Statistics Agency successfully provided secure, web access to its VISTA warehouse to primary users of vital event information products within the ministry. The agency will continue to expand the scope of external client organizations accessing the VISTA warehouse.