Improving the value stream of cochlear implant service models.

Background: Increases in the demand and range of cochlear implant services due to expanded criteria over the past 30 years have not correlated with increases in funding. Quality standards for CI service delivery must be maintained. This paper outlines the mapping of value stream of the CI model of service and the financial implications for ensuring standard of care is maintained whilst maximising economic efficiencies. Method: A total of 56 intervals of service delivery over a 10 year period was mapped across the journey of adult CI recipients. A review of the profit and loss of service delivery over this 10 year period based on a range of parameters cost of service, recipient and clinician numbers and appointment types. Results: Results indicated that cochlear implant services were not profitable until 5 years post cochlear implantation. All service delivery prior to that point was running at a significant loss. Costs did not even out until approximately 9 years following cochlear implantation. Five areas emerged that showed cost inefficiencies. Conclusion: Cost inefficiencies of a cochlear implant service delivery model were identified using the value stream mapping approach. This enabled steps to be taken toward implementing a more sustainable model of CI service delivery whilst maintaining good quality of care. [ABSTRACT FROM AUTHOR]