Tag Archives: best practices

12 Things Healthcare Must Achieve Flash Video Series – Operate as a System, But Act Small

Julius Heil, President and CEO, IntalereBy Julius Heil, President and CEO, Intalere

More than sharing a name and a logo, health systems should truly strive to collaborate and get organized. Integration must be more aggressive and forward thinking, aimed at consistency in care, standardization and centralization of data, purchasing and financial systems, and most importantly culture.

As a simple, yet effective example, Intalere member Miravida Living (formerly Lutheran Homes of Oshkosh) is a system providing a full continuum of housing and healthcare services for elders and others in need. As it continued to evolve and grow, the organization was challenged with combining the purchasing efforts of its multiple locations. Each facility within the Miravida group was managing their purchasing separately. This led to multiple inventories and an inefficient use of manpower, and did not take into consideration optimizing volume purchasing to bring down pricing.

In undertaking their streamlining initiative, there were many objectives to investigate and implement. Among the most pressing:

  • Consolidate purchasing efforts.
  • Build and maintain a central inventory.
  • Create a method of tracking product usage and location.
  • Ensure the correct inventory usage is applied to the proper department.
  • Standardize product choice and consolidate purchasing to take advantage of opportunities for volume discounts from suppliers.
  • Decrease labor hours as it relates to purchasing.
  • Reduce hard-copy output connected with the manual purchasing system.

Working with Intalere and a supplier partner, Miravida was able to use a single procure-to-pay system across their entire campus. Since the launch of the program, Miravida Living realized an initial reduction of 1,300 hours related to the purchasing process, an annual savings of $30,000 in labor spend. They saw a 51 percent increase in contract utilization, resulting in an increase in rebates and an approximate reduction of $517,000 in price paid for goods.

The need to “Act Small” may seem a bit at odds with the above achievement to “Operate as a System,” but it actually is a significant building block on the way to integrating standardization and best practices. It speaks to agility, daily meetings and huddles, and basic operational rigor in services offered including surgery, pharmacy and emergency.

The idea is that small businesses must be much better at what they do on a daily basis because their margin of error is generally extremely thin and their mere survival depends on it. They have to pay attention to every detail, have a very close grasp on their financials, strive for consistency of service and focus on common incentives. Along with this, they must be able to adapt quickly to changing market forces, competition and any other fluctuations.

Larger organizations must understand, essentially, that the details matter, and that they may seem innocuous and challenging at first glance. However, adhering to them and demanding the same from the entirety of the organization can pay off significantly in better bottom line results.

Check out the latest video, Operate as a System, But Act Small, in our Flash Series and stay tuned in the coming weeks for more posts and videos about 12 Things Healthcare Must Achieve.

You can also download the executive briefing at Intalere.com.

Intalere Member Best Practice Spotlight – Copper Ridge Surgery Center – Patient Experience Initiative

Issue

In 2016, when CMS announced new ways to measure patient experience, Copper Ridge Surgery Center’s goal was to prepare for the new requirements by taking a close look at each aspect of the patient experience and assess the facility’s readiness to meet those requirements by utilizing people, processes and tools.

Solution

Copper Ridge Surgery Center leadership enlisted staff to help them gain an understanding and awareness of the patient experience. Fictional personas were created: patients with specific conditions, limitations and expectations. Phases of the patient experience were defined and then the clerical and clinical interactions encountered before, during and after their procedure were described. A system map was created that depicts interactions from the patient’s view: the message shared, by which staff member, in what medium and at what moment in time. Having visualized the experience in a system map, Copper Ridge created the Infinity Loop, a graphical representation of all aspects of the patient experience. Finally, new language and tools were designed and tested with staff and patients.

Outcome

The new patient experience (PX) initiative was launched at an all-staff celebration, creating a starting point to improved internal conversations around PX, leading to increased staff engagement and understanding of their roles. New groups were formed, designed to address PX and unlock change from within the organization culture: PX Leadership, PX Champions (for ongoing initiatives), Process Improvement, Training & Orientation. A greater patient experience will ensure continued Medicare reimbursements, which is the primary measure of success. For staff, this will translate into profit sharing and compensation.

About Copper Ridge Surgery Center

Copper Ridge Surgery Center (formerly known as Northwest Michigan Surgery Center) is a 14-year-old free-standing ambulatory surgery center (ASC). The surgery center is a joint venture owned by an ASC physicians group and local hospital Munson Medical Center. Copper Ridge Surgery Center employs 108 FTEs and is one of the busiest ASCs in the U.S., doing more than 21,000 procedures per year.

Check out the project video and view the Copper Ridge Surgery Center page in the 2018 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – Boston Children’s Hospital – Healthcare-centric Contract Management Comes of Age

Issue

Despite holding the top spot on U.S. News & World Report’s Best Children’s Hospitals for 2017-2018 and earning a spot in the ECRI Institute’s 2017 Healthcare Supply Chain Achievement Awards, Boston Children’s Hospital’s supply chain department recognized that it must find more innovative ways to better manage its multitude of complex, high-dollar contracts.

Solution

After diligently researching off-the-shelf contracting solutions, a multi-disciplinary project team was formed to co-develop a leading-edge healthcare-centric contract workflow solution that would significantly improve cross-departmental usability as well as streamline the overall contract management process. The supply chain department concurrently set out to eliminate off-contract spend to help control the cost of supplies, including improved utilization of its Intalere GPO contracts. This module manages users and approval workflows, communicates pending expirations, accounts for distributor markups, and highlights rebate opportunities amongst other features. It is also fully integrated with all inbound and outbound EDI transactions for improved spend visibility.

Outcome

Boston Children’s reduced its off-contract spend by 39% in 2017, which exceeded aggressive expectations. They also realized a 30% process time savings per request. Staff efficiency gains and improved usability have reversed the trend of self-contracting and self-managing of contracts. Making doing the right thing the easy thing has led to dramatically improved compliance, data accuracy, synchronization and measurement. Planned future capabilities will also support Boston Children’s plan to implement just-in-time inventory systems to further increase efficiency and decrease waste by ordering products only when needed.

About Boston Children’s Hospital

Holding the top spot on U.S. News & World Report’s Best Children’s Hospitals for 2017-2018, Boston Children’s Hospital is a 404-bed comprehensive center for pediatric healthcare. As one of the largest pediatric medical centers in the U.S., Boston Children’s offers a complete range of healthcare services for children.

Check out the project video and view the Boston Children’s page in the 2018 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – Virginia Mason Medical Center – Virginia Mason Memorial Supply Chain Integration

ISSUE

With Supply Chain expenses for medical supplies, devices and implants hovering around 10% of an organization’s total net revenue, this is an area where economies of scale, negotiating power and collaboration come together to make healthcare more sustainable and cost effective. The Virginia Mason Health System is committed to taking advantage of these opportunities through a team-centered approach which results in better financial results and improved, focused patient care.

SOLUTION

A team consisting of Virginia Mason Supply Chain leadership, Intalere and Health Resource Services (HRS) representatives instituted weekly meetings that focused on sharing best practices, analyzing standardization opportunities, identifying technology solutions and developing joint project plans. Intalere Savings Roadmaps identified savings opportunities available by simply taking advantage of existing Intalere and HRS regional agreements without any conversion, known as Quick Wins, or by aggregating volume and tier optimization. These Quick Wins accounted for approximately $532,723 in aggregated savings in 2016 and was accomplished without having to convert any suppliers.

OUTCOME

Virginia Mason Health System was able to prioritize and implement more than 60 contracts and tier adjustments. Total savings for phase one of the project topped $1.2 million for the health system. In later phases, the health system will work with Intalere and HRS in the areas of physician preference items, purchased services and other non-labor spend.

ABOUT VIRGINIA MASON MEMORIAL

Established in 1920, Virginia Mason Health System is a non-profit organization offering a system of integrated health services. A multispecialty group practice of more than 460 employed physicians, it offers both primary and specialty care as well as an acute care hospital, licensed for 336 beds.

Check out the project video and view the Virginia Mason page in the 2017 Intalere Best Practices Compendium. Read the full success story.

Intalere Member Best Practice Spotlight – Early Detection of Breast Cancer Saves Lives – Making 3D Mammography Happen at Crossing Rivers Health

ISSUE

3D Tomosynthesis Mammography, the most advanced mammography technology available, was not currently offered in the northeast Iowa or southwest Wisconsin region served by Crossing Rivers Health.

SOLUTION

Crossing Rivers Health strongly believes residents of rural communities deserve access to the best quality healthcare and technology available, without having to travel long distances.

The Crossing Rivers Health Medical Imaging department utilized collaborative partnerships with several organizations to reduce the overhead costs to purchase a 3D Mammography unit. Improved quality through leading-edge technology provides increased cancer detection rate, specifically for invasive breast cancers. With 3D Mammography, breast cancers can be detected at the earliest stages when they are most easily cured.

OUTCOME

Since the inception of this advanced technology in April 2016, the Medical Imaging department maintained a 100% rating of “Excellent” for the first 9 months, as measured by outpatient satisfaction surveys. Smaller, Stage 1 cancers have been detected at an estimated 25% higher rate as compared to 2D.

For the first time, patients who did have a positive cancer diagnosis had the option to discuss their results directly with a radiologist, who also helped to develop a plan of care that was personalized for that patient. No additional cost was incurred by any patient to obtain a 3D versus a 2D mammogram. Furthermore, catching the cancer early provides a significant reduction in cost to the patient, as the course of treatment would be less extensive.

ABOUT CROSSING RIVERS HEALTH

Established in 1957, Crossing Rivers Health offers the people of southwest Wisconsin and northeast Iowa access to more than 100 healthcare services. We’re proud to deliver high quality, personalized healthcare and education to people in every stage of life, collaboratively with other regional healthcare providers.

Check out the project video and view the Crossing Rivers Health page in the 2017 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – Parkview Health – Product and Equipment Trials Project Analyst

ISSUE

In a growing IDN, migrating to the Institutes Model of organizational structure, more specialty and subspecialty physicians are being recruited into Parkview’s healthcare system. Parkview clinicians make significant efforts to ensure evidence-based best practice products and equipment meet patient needs and provide for optimal patient outcomes. These initiatives have led to a significant upturn in product and equipment trials.

SOLUTION

The need for a point person for trials of products and equipment was evident. This solution was identified using Six Sigma value stream mapping and DMAIC (Define, Measure, Analyze, Improve and Control) to refine and operationalize a strategic plan to address and sustain a consistent single source-of-truth to orchestrate the cradle-to-grave trial process and potential conversion. The review, revision and streamlining of the trial process ensured a consistent trial process, documentation and conclusion via a trial analyst project manager.

OUTCOME

With the implementation of a trial analyst project manager, Parkview Health can report positive trends in customer and vendor satisfaction (one point of contact), cost management (elimination of back-door trials) and closing the loop on coordination of trial decisions and conversions. An additional benefit allowed Parkview Health to collaboratively support demand planning needs. The biggest plus was aligning supply chain strategic planning with organizational performance improvement and growth goals.

ABOUT PARKVIEW HEALTH

Parkview Health is a not-for-profit, community-based health system serving the northeast Indiana and northwest Ohio population of more than 820,000. With more than 10,000 employees, it’s the region’s largest employer. Its mission is to improve patient health and inspire patients to take steps to improve their well-being. Parkview Health has been serving its communities since its early beginnings as Fort Wayne City Hospital in 1878.

Check out the project video and view the Parkview Health page in the 2017 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – NYC Health+Hospitals/Sea View – Enhanced Interdisciplinary Palliative Care Services

ISSUE

To provide optimum compassionate and dignified care for residents with an acute or chronic serious illness, NYC Health+Hospitals/Sea View needed to enhance their palliative care services.

SOLUTION

Sea View implemented a Palliative Care Program that fosters an interdisciplinary approach that supports both residents and families alike, where attention to physical, psychological, social and spiritual needs are addressed. This process enables Sea View to align care with resident wishes. At each encounter with the resident or resident surrogate, the principles of palliative care and the benefits of palliative care are discussed. By utilization of education, interactive principles and care paths, unwarranted hospitalizations have decreased. An all-inclusive palliative care policy and procedure was developed in which advance directives, pain management, depression, acute care transfers, as well as quality of life, are linked. A revision of the pain management program, including non-pharmacological interventions was established.

OUTCOME

Over a 14-month period, the facility doubled the number of actively engaged Sea View residents receiving palliative care services. In addition, 98% of residents have advance directives in place. The number of acute care transfers trigger a 7.8%, far below the National Benchmark of 12.9%. Quality of life has been proportionately enhanced, with no residents receiving palliative care services exhibiting pain or depressive symptoms.

ABOUT NYC HEALTH+HOSPITALS/SEA VIEW

Sea View is a 304-bed long-term care facility governed by NYC Health+Hospitals. Sea View is located in Staten Island, N.Y., on a 60-acre campus. Specialty services include dementia and traumatic brain injury. Sea View is the proud recipient of the CMS 5 Star Rating. It ranks nationally in the top 5% of all long-term care facilities.

Check out the project video and view the NYC Health+Hospitals/Sea View page in the 2017 Intalere Best Practices Compendium.

 

Intalere Member Best Practice Spotlight – Lompoc Valley Medical Center – Robot on Call – Telemedicine Saving Lives

ISSUE

Because the Lompoc Valley does not have a neurologist available around the clock, patients displaying signs of a stroke are often transferred out of town to larger hospitals with more advanced treatment capabilities, delaying potential life-saving care and forcing a patient’s support network to travel to be near the patient.

SOLUTION

After several months of detailed planning and training, Lompoc Valley Medical Center (LVMC) was able to collaborate with Santa Barbara Cottage Hospital to provide 24/7 access for consultations with neurology specialists via a 5-foot-tall computerized mobile robot. LVMC is now an “Acute Stroke Ready Hospital,” a designation bestowed by Santa Barbara County’s Emergency Medical Services. With the new designation, when a potential stroke patient arrives at the Emergency Department (ED), the attending physician and medical staff order lab tests and a CT scan to determine the best course of treatment. Once a Code Stroke is initiated, the robot disengages from an electrical docking station near the ED and glides to the treatment room to allow an interface between the patient and the neurologist.

OUTCOME

LVMC was able to meet its goal of < 60 minutes for door-to-needle time for TPA. Not only has this new system allowed for more timely administration of thrombolytics, but in most cases, patients are able to remain at the hospital and in their own community for recovery.

ABOUT LOMPOC VALLEY MEDICAL CENTER

Lompoc Valley Medical Center was the first operating healthcare district hospital established in California and was created in 1946 by the Santa Barbara County Board of Supervisors. The District now includes a state-of-the-art, 60-bed general acute care hospital and a 110-bed skilled nursing facility.

Check out the project video and view the Lompoc Valley Medical Center page in the 2017 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – Brookmeade Culinary Arts Exploration

ISSUE

The Community at Brookmeade perpetually strives to ensure its residents’ quality of life. It offers many programs that foster self-expression and the restoration, maintenance and progression of residents’ abilities. Through social interaction and fostering latent communication skills, the diagnoses of Dementia and chronic illness are effectively and skillfully addressed with the implementation of its many burgeoning and flourishing programs nurturing social enhancement.

SOLUTION

Under the guidance of Chef Eric Stritt and the direction and foresight of Karen Zobel, CEO/Administrator, Brookmeade launched The Culinary Arts Initiative through its International Culinary Hour and Soup for the Soul programs. These programs are centered on creative expression, food history, investigation of cooking methodologies and social interaction. The sensory experiences derived elicit responses that prompt memory, engaging discussion and the benefit of total sensory stimulation.

OUTCOME

Residents were empowered to choose their own level of participation and means of self-expression through this culinary experience, resulting in increased psycho-social behaviors and a measurable increase in their quality of life. This program has promoted hydration, and chosen dishes and soups are perfect vehicles to augment the residents’ diets and promote hydration and nutrition.

ABOUT THE COMMUNITY AT BROOKMEADE

The Brookmeade Community, located on 75 country acres just outside the Village of Rhinebeck, is a senior living retirement community serving the Hudson Valley and surrounding areas. Arbor Ridge offers independent living, The Terraces offer assisted living, and The Baptist Home provides long-term care, sub-acute rehabilitation, palliative care and outpatient rehabilitation services.

Check out the project video and view the Community at Brookmeade page in the 2017 Intalere Best Practices Compendium.

Intalere Member Best Practice Spotlight – Coastal Carolinas Health Alliance – NEST Program

ISSUE

Southeastern North Carolina has some of the highest rates of infant mortality, averaging an 8.5 rate compared to the state’s rate of 7.1 (2014). The state itself ranks 42nd in mortality rate nationally.

SOLUTION

Through a collaborative effort between Coastal Carolinas Health Alliance (CCHA), its member hospitals and Coastal Carolina Neonatology, the NEST Program was developed to train delivery room providers and transport teams to improve communication, teamwork, medical knowledge and clinical skills for treating critically-ill and/or high-risk newborns.

The NEST Program utilizes patient simulators and a multidisciplinary training team to recreate high-risk neonatal scenarios in situ participating hospital’s nursery. Scenarios include meconium aspiration, respiratory distress syndrome, maternal placental abruption and an extremely premature infant. These scenarios were selected because they are not frequent enough for clinicians to practice often, but may result in fatal outcomes if not properly managed. After conducting the simulation scenario, a debriefing is held with trainees, which reinforces clinical skills and standards of care. It also provides the opportunity to review appropriate medical protocols and identify latent safety threats, which was not intended but was very valuable to participating hospitals.

OUTCOME

A total of 243 providers were trained and found a demonstrated improvement in the participants’ confidence, particularly in the care of the extremely low birth weight infant.

ABOUT COASTAL CAROLINAS HEALTH ALLIANCE

Coastal Carolinas Health Alliance (CCHA) is a not-for-profit organization providing value to its members by facilitating improvement of quality and delivery of healthcare and achieving operational efficiencies through collaborative efforts. Coastal Carolina Neonatology offers pediatric specialty care in southeastern North Carolina, working collaboratively with community hospitals, pediatricians and family practitioners to serve children throughout the region.

Check out the project video and view the Coastal Carolinas Health Alliance page in the 2017 Intalere Best Practices Compendium.