Utilization management: reduced costs--improved service.

This is the first of a two-part series in which the authors discuss utilization management initiatives at Lions Gate Hospital in North Vancouver, British Columbia. These initiatives included data collected from the Hospital Medical Records Institute that led to a change in care patterns in the Psychiatry Department, adapting an external same-day surgery program that reduced bed-days, and an analysis of Emergency Room admissions that led to 55 per cent reduction in the number of these patients waiting for beds. In addition, a quick response program saved 2,000 bed-days, and a hospital-community discharge planning committee identified opportunities for further evaluation.