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GE Healthcare Camden Group Insights Blog

Facing Bundled Payments

Posted by Matthew Smith on Apr 20, 2017 11:05:07 AM

By Dominic Foscato, Vice President, GE Healthcare Camden Group

Change in reimbursement isn’t waiting for tomorrow. It’s happening right now. Rather than paying for each procedure and office visit, government and private health plans are moving toward a payment model based on the health of an organization’s patient population. During this transition, an organization’s success depends on its ability to manage a variety of payment models.

Health care organizations must successfully administer these payment models — which continue to evolve and grow more complex —while optimizing quality, outcomes and patient satisfaction. In short, they must manage “fusion reimbursement” or risk significant cuts in revenue.

Clinical Integration, Clinically Integrated Networks

Reprinted with permission from the February 2016 issue of Trustee magazine, vol. 69, no. 2. © Copyright 2016 by Health Forum Inc. Permission granted for digital use only

Topics: Bundled Payments, Value-Based Payments, Alternative Payment Models, Dominic Foscato

New White Paper Download: Top 10 Characteristics of High-Performing Healthcare Organizations

Posted by Matthew Smith on Apr 18, 2017 11:30:49 AM

By Darryl Greene, MS, Vice President, and Robert Green, MBA, FACHE, CHFP, Senior Vice President, GE Healthcare Camden Group

high-performing healthcare organizations

Prompted by the Affordable Care Act and numerous other environmental factors, many healthcare organizations, physicians, employers, and newcomers to the industry have been simultaneously focusing on multiple objectives to decrease an unsustainable cost of care growth while improving the quality of care and access for millions of patients. A question for healthcare organizations to consider is how to remain relevant to patients and financially viable in an industry that has been in and will likely continue to be in a constantly developing landscape?

We have observed consistent and common characteristics or attributes among the leaders and many of the employees who work in the highest performing organizations. Our new White Paper discusses 10 characteristics to consider as you journey through this sometimes uncertain and sometimes turbulent, but always challenging and many times rewarding industry we call healthcare. 


GreenB1.pngMr. Green is a senior vice president and the practice lead for the financial operations and transaction advisory practice at GE Healthcare Camden Group. He has more than 26 years of healthcare experience with 13 years of healthcare consulting experience and 13 years of provider-based financial, operational, and strategic experience among health systems, hospitals, medical groups, management services organizations (“MSOs”), and physician hospital organizations (“PHOs”). Mr. Green has significant expertise in building high-performing teams and leading and executing transformational change. He may be reached at robert.t.green@ge.com. 


d.Greene-1.jpgMr. Greene is a vice president for the strategy and leadership practice at GE Healthcare Camden Group. He has more than 18 years of strategy to execution consulting experience, including 11 years in healthcare. He has significant expertise in strategic planning, business management systems implementation, talent management, performance improvement, leadership, and leading and executing transformational and culture change. He may be reached at darryl.greene@ge.com. 

 

Topics: Top 10, White Paper, Robert Green, Health System Integration, Staff Planning, Darryl Greene

Which Do You Prefer…Tax Preparation or a Visit to the Doctor?

Posted by Matthew Smith on Apr 17, 2017 11:12:52 AM

By Robert Zisman, Vice President, and Mark Krivopal, MD, MBA, Vice President GE Healthcare Camden Group

Spring is here, and Tax Day is almost upon us. Hopefully you’ve filed your taxes. You’re not one of those procrastinators, right?

It’s hard to miss the noise related to potential changes in healthcare and tax policy. Given all the talk on these two topics, comparisons of these two “facts of life” cannot be avoided.

Our united view: As divided as our country may be at times on these two issues, it’s easy to miss where we are united. Most people don’t enjoy doing their taxes, nor do they enjoy going to the doctor. Understand the necessity? Absolutely. Enjoy it? Likely not.

So, let’s explore our common lack of enjoyment for these two industries and dream a bit as to how these experiences could catch up to those we truly enjoy (or at least look forward to).

Access: For most people, booking an appointment with a tax pro or completing your taxes online isn’t that bad. However, finding time on your doctor’s calendar or researching the right provider for a specific ailment tends to be a bit more challenging. Once you’re in—especially if you’re the first appointment of the day—congratulations, you’re golden! If you receive any other appointment slot, be prepared to wait. Sometimes after waiting weeks and months for the appointment in the first place, you realize that you need a different specialist to help you with a problem.  

Ability to figure it out on your own: Fortunately, the ability to do your taxes online has been simplified by companies like TurboTax and their proclamation, “You answer simple questions about your life. We do all the math.” The good news here is that taxes are fairly formulaic, so this approach can work. They also have online experts available for questions. On the healthcare side, when someone has a health issue, where do they turn? You guessed it – Google. Not the best idea when there are websites out there such as WebMD where you can utilize a symptom checker and online doctors to answer questions you may have. While the possibility exists in both industries to figure it out on your own, many still prefer meeting with your tax pro or doctor, eye-to-eye.

Ability to meet eye-to-eye… from your couch! When it comes to doing your taxes online, the market hasn’t dictated the need for video chat. While taxes are complicated - and no two returns are the same - they don’t have feeling or emotions (although many can admit to having wept silently and experienced a sense of loss after pushing the “file your return” button). On the other hand, the human connection in healthcare is still extremely important and virtual doctor visits are beginning to take off. Health insurance coverage is finally catching up to market demand, and several experts predict the number of virtual visits to double over the next several years. However, few physician practices have adopted virtual visits into their care delivery system and workflows. Yet some pioneers have figured this out and offer a glimmer of hope for the future of virtual medicine. For example, Kaiser Permanente performs more virtual visits than in-person office visits. Other progressive healthcare systems are dipping their toes in the world of telemedicine with a focus on improving convenience and reducing costs.

Value for the dollar and payment: Whenever paying for a service, it’s expected that you receive value in return for the money you spend. With taxes, we start with a formulaic approach set by the government. Then, each person has their own, unique opportunity to impact that approach. Fees are usually stated up front, but somehow they always seem to change (rarely decreasing) by the end of the tax meeting. However, if you receive a refund, those fees usually aren’t too hard to swallow (i.e. H&R Block – Get your billion back!). When visiting the doctor, it feels eerily similar—except you often don’t know how much your visit, tests, and procedure will cost until you receive several bills post-visit. Unfortunately, paying your medical bills is far more complicated and seems never-ending. And you don’t get money back…unless you mistakenly pay the same bill twice. Greater transparency from the healthcare system’s side—as well as simplified processes and enhanced consumer engagement—must be developed to improve the overall experience.

You receive the best possible outcomes based on data and science: The tax code itself is extremely complex (74,000 pages) and no two returns are the same. H&R Block recently took a step in the right direction by partnering with IBM’s Watson. They’ve taken H&R Block’s 60 years of experience and 600 million data points to figure out how to deliver each customer the best outcome--in most cases, a refund. In healthcare, it seems we still have an opportunity to catch up. When seeing a doctor in person, the digital data capture of that appointment has not kept up with advancements in other industries. You often check off your symptoms, review your medical history (sometimes electronically, more likely in a manila folder) and arrive at a solution that we “believe” will address the symptoms outline. The ability to use data, artificial intelligence, and predictive analytics is becoming more prevalent in healthcare and will soon transform how you interact with your doctor, how hospitals are managed, and more. There are some great highlights recently mentioned on this topic by The Economist.

Looking to a better future: It seems both industries and experiences are making advancements to move up the likeability chain. Yes, potential policy reform still lingers above both industries, but ultimately improving the experience will rely more on innovation led by the public and private sectors. We welcome your thoughts in the comments section below on which experience you like the most and what these industries can do to move up your likeability list.

P.S. Just one more day left to file. Don’t miss the deadline!


Robert_Zisman.pngMr. Zisman leads the GE Healthcare Camden Group’s US operations team, responsible for recruiting, staffing, marketing, business development, operations and knowledge management. He also leads efforts related to 3rdparty strategic partnerships and collaboration with GE Healthcare Partners consulting businesses around the world in areas such as Canada, Latin America, Europe and the Middle East. His previous roles included leading large and complex engagements focusing on improving key performance metrics such as growth, margin, quality, patient satisfaction, and sustainable results. He may be reached at robert.zisman@ge.com.

krivopal_M-963748-edited.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. His experience spans not-for-profit and privately held organizations of various sizes as well as start-up environment in the healthcare information technology space. He may be reached at mark.krivopal@ge.com

Topics: Patient Access, Patient Activation, Robert Zisman, Mark Krivopal, Integrated Care Delivery

What Can Clinically Integrated Networks Offer Physicians?

Posted by Matthew Smith on Apr 13, 2017 9:00:00 AM

By Mark Krivopal, MD, MBA, Vice President, GE Healthcare Camden Group

Much has been written about clinical, post-acute care facilities and physicians, has led health system executives to invest substantial financial and human capital to set up infrastructure and operating processes that improve value in health care.

These organizations intend to be prepared for current and future challenges such as increased regional competition, government regulations and payment reform. If the value proposition of these organizations is articulated and delivered in a genuine patient and physician-centric way, significant rewards can be gained not only by the health system itself but also by its individual physicians.

To continue reading this article and the 10 considerations for physicians when deciding whether to join a CIN, please click the button below.

NOTE: This article is password protected on the American Association for Physician Leadership website, but may be accessed by logging in with the following credentials:

Login: gehccamden@ge.com
Password: gehccamden
 
Clinical Integration, Clinically Integrated Networks

krivopal_M.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. His experience spans not-for-profit and privately held organizations of various sizes as well as start-up environment in the healthcare information technology space. He may be reached at mark.krivopal@ge.com

 

 

Topics: Clinical Integration, Clinically Integrated Networks, Physician Leaders, Mark Krivopal

What Clinically Integrated Networks Offer Physicians

Posted by Matthew Smith on Apr 12, 2017 3:05:58 PM

By Mark Krivopal, MD, MBA, Vice President, GE Healthcare Camden Group

Much has been written about clinical, post-acute care facilities and physicians, has led health system executives to invest substantial financial and human capital to set up infrastructure and operating processes that improve value in health care.

These organizations intend to be prepared for current and future challenges such as increased regional competition, government regulations and payment reform. If the value proposition of these organizations is articulated and delivered in a genuine patient and physician-centric way, significant rewards can be gained not only by the health system itself but also by its individual physicians.

To continue reading this article and the 10 considerations for physicians when deciding whether to join a CIN, please click the button below.

NOTE: This article is password protected on the American Association for Physician Leadership website, but may be accessed by logging in with the following credentials:

Login: gehccamden@ge.com
Password: gehccamden
 
Clinical Integration, Clinically Integrated Networks

krivopal_M.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. His experience spans not-for-profit and privately held organizations of various sizes as well as start-up environment in the healthcare information technology space. He may be reached at mark.krivopal@ge.com

 

 

Topics: Clinical Integration, Clinically Integrated Networks, Physician Leaders, Mark Krivopal

Measuring the Importance of the Human Side of Change

Posted by Matthew Smith on Apr 10, 2017 1:59:30 PM

By Elina Spule, MBA, Senior Consultant, GE Healthcare Camden Group

Have you ever been part of a change that was very successful? Have you ever experienced a change that was not very successful? What were some of the key elements that distinguished each of them?

Research conducted by GE across hundreds of change initiatives concluded that “100% of all changes evaluated as ‘Successful’ had a good technical solution or approach. Over 98% of all changes evaluated as ‘Unsuccessful’ also had a good technical solution or approach.1

So what is the differentiating factor?

I posed this question to 23 individuals during the Change Acceleration Process (“CAP”) training that I led at one of the premiere healthcare systems in the nation, and these were some of the answers regarding successful change initiatives:

  • There was a strong leader
  • The change was sustained
  • People supported it
  • Staff understood why we needed to do it
  • There was a strong communication
  • The team was knowledgeable
  • The team was aligned
  • The new process was better than the old one
  • People were excited
  • It had a start and an end date
  • People were recognized for their hard work

I then shared with the class that one of the key concepts in this class is the formula Q X A3 = E1 that translates into the following:

Quality of Solution     x     Alignment       =      Effective Results

Acceptance

Accountability

This means that in order to have effective results, it is not enough to simply have a great solution (e.g., a new process, a better system, a new technology, a new strategy etc.) but one has to gain the human buy-in for this new solution.

For example, as a part of a project to reduce denials for a certain type of lab tests, a client developed a payer grid (a solution) that would help administrators determine upfront which tests are covered by which payers and which are not.

Let’s assume that on an arbitrary scale of 1-10 where 10 is the best, the quality of the grid is at 8 (it is regularly updated, it contains a comprehensive list of payers, it is user friendly, etc.).  But if we don’t have the buy-in from the clinic administrators to use it, the change formula would be as follows—indicating there will be no results.

8 x 0 = 0

Look what happens when we spend just little more time explaining why we need to adopt this new grid, what we hope to achieve with it, and how to use it. The results already are much better!

8 x 33 = 216

Now imagine what would happen if we spent little more time planning who should be on the team, how to involve our stakeholders, and how to communicate it better. Our results could be more like:

8 x 83 = 5632

That’s already 26 times the difference!

While we were reviewing the formula, one of my colleagues helped me organize the ideas that the class brainstormed and provided across the change formula Q X A3 = E1 as to the differentiating factor between successful and unsuccessful changes. What do you notice about it?

qae.pngDuring our outcomes based process improvement projects, we encourage our teams to take it one step even further – can you look for ways to measure all three sides of the equation? As the old saying goes: “If you can't measure it, you can't manage it.” I have listed below some of the ideas related to measuring the denials project:

qae2.png

Although this particular initiative is still ongoing, our historic experience shows that it is possible to achieve process improvements of greater than 50 percent improvement. However, it is critical to focus on and measure both sides of the equation: the quality of the technical solution as well as the human side of change.

Think about the current change that you are implementing or your organization as a whole: What would a typical Q X A3 = E equation look for you? What do you measure on your process improvement process? How have you measure the alignment, acceptance, and accountability?

1 Slide 14 in “Change Acceleration Process” (CAP) training developed by GE Crotonville

Change Acceleration Program (CAP)


Spule.jpgMs. Spule is a senior consultant with GE Healthcare Camden Group specializing in the areas of outcomes based process improvement and clinical transformation. Ms. Spule has also experience in capacity strategy, governance, analytics, and leadership development. She is a GE Master Change Agent certified to teach and coach process improvement and change management. She may be reached at elina.spule@ge.com. 

 

 

 

Topics: CAP, Change Leadership, Change Acceleration Program, Elina Spule

Top 10 Characteristics of High-Performing Healthcare Organizations

Posted by Matthew Smith on Apr 4, 2017 3:34:17 PM

By Darryl Greene, MS, Vice President, and Robert Green, MBA, FACHE, CHFP, Senior Vice President, GE Healthcare Camden Group

The following is an abbreviated version of ourwhite paper with the same title. For the full white paper, which offers additional insights on each characteristic or attribute, please click on the button at the bottom of this page.

Prompted by the Affordable Care Act (ACA) and numerous other environmental factors, many healthcare organizations, physicians, employers, and newcomers to the industry have been simultaneously focusing on multiple objectives to decrease an unsustainable cost of care growth while improving the quality of care and access for millions of patients. A question for healthcare organizations to consider is how to remain relevant to patients and financially viable in an industry that has been in and will likely continue to be in a constantly developing landscape?

We have observed consistent and common characteristics or attributes among the leaders and many of the employees who work in the highest performing organizations. Here are 10 of these characteristics to consider as you journey through this sometimes uncertain and sometimes turbulent, but always challenging and many times rewarding industry we call healthcare. Some of the characteristics below are basic, but well worth mentioning again because of their foundational importance.

1. Continuously Learning, Well-informed, and Insightful. These organizations understand the current environment with an eye toward the future change trajectory. It is only by keeping a constant pulse on the numerous environmental factors that have multi-faceted impacts such as political (government), economic (market segment), social (population), and technology (information, devices, web) that high-performing organizations can begin to make meaning of the trends and organizational changes required. In turn, they can set their course and pursue imperatives that best position them to be successful in this dynamic environment of healthcare.

2. “Change-Forward” with Bold, Inspiring Vision. High-performing organizations are not satisfied with incremental change, but desirous of “breakthrough, transformative change.” They are not just “change ready,” but embrace change management as a competitive advantage. The type of change underway in healthcare is clearly significant, and the pathway to the transition from fee-for-service to value-based care is not a clear one. It is being discovered through pilots, trial and course correction, and some failed attempts.

3. Agile and Adaptable.  High-performing organizations continue to pursue strategy and find value through staying agile and adaptable. Because the world is accelerating the time frame, the strategy needs to be more flexible and “opportunistic” and is rarely beyond one to three years with an emphasis of planning the specific goals of the most immediate year. Prioritizing the change underway for the organization according to strategic pillars and related value proposition is important to manage the diverse portfolio of imperatives. These pillars translate into multiple project efforts that are more synergistic with similar goals (and measures to impact). For example, improving OR throughput, while addressing readmission issues, and while creating new care models of evidence-based care, are not an unusual portfolio of programs with different timelines and needs of an organization.

4. Actionable Information-Oriented. These organizations understand how to translate data into data analytics, into information, into transparent, actionable-information and ultimately, into “predictive analytics.” Many organizations are challenged by the following: overall analytics framework that does not outline and prioritize information or reporting needs; overlapping reporting efforts across various analytics silos; limited transparency and understanding of reporting capabilities and queues of each silo; and limited or no understanding of alignment of analytics efforts against strategic and operational goals. Unfortunately, much of this disarray and uncertainty stymies action or creates “analysis paralysis.” Many high-performing organizations have analytic strategies to ensure they are leveraging data and actionable information to gain a strategic market position and incorporate that into their value-based payer strategies. When successful in addressing the challenge of “actionable information,” these high-performing organizations can, for instance: Improve access to care across the network; create information architecture in support of population health initiatives; continually improve provider network’s performance while decreasing spend; evaluate clinical programs and initiatives and understand the effect of the interventions and return on investment; and reduce out-migration of patients and better understand referral patterns across the network.

5. Financially Disciplined. High-performing organizations have financial discipline as a priority. This is to meet the vision and mission of the organization while achieving a financial balance between the capital needs and financial capabilities. This translates to clarity on the level of strategic investment the organization can make relative to an overall operating profit and loss portfolio and credit rating objective. A well-integrated, strategic, financial, and capital planning process is paramount to achieving the balance. Defining the financial goals forecasted out 5 years and annually, along with clear objectives designed to meet the expected well-defined capital needs is a key goal.

6. Respectful and Optimized Staffing. One of the greatest “wastes” in healthcare is not deploying staff at their “highest and best” use. With labor typically comprising more than 50 percent of any hospital or health systems expenses – salaries, wages, and benefits are typically a common “target” for cost savings. Unfortunately, an “across the board” cut or an even more focused reduction in force, tends to never get to the “root cause” of underlying disjointed, ambiguous, and sometimes even broken processes, and certainly the savings are never sustained.

High-performing organizations engage their staff from the “ground up” or by the “diagonal slice” in helping to resolve the long-standing challenges of more efficient and effective care. These organizations will assess the entire “human capital value chain,” ensuring best practices in strategy and talent management (workforce planning, employee engagement, learning and development), workforce management (scheduling, staffing and assignment, span of control, productivity, coaching and mentoring) and human capital operating model (reporting and analysis, improve and control, training, benchmarking).

7. Accountable and Execution-Focused. Many organizations, if not most, struggle with implementation and effective execution. The reasons are numerous: inability to effectively prioritize; multitude of initiatives dilutes effectiveness; “analysis paralysis”; “no one is accountable”; and overwhelmed staff already busy doing their “day jobs.” Effective transitions from direction setting and strategic planning by the leadership of the organization to execution by the middle management and frontline levels of the organization are done best by high-performing organizations. High-performing organizations have found a nuance to increase accountability – creating venues to ensure bi-directional input between owner and sponsor for the imperative, project, or task – at the organization level and the local level at which the individual contributes. And what to do when the accountability goes beyond the four walls of the hospital? At a time when leadership extends to new groups and partners, some of which are not inside the four walls of the hospital this bi-directional exchange and development of local plans to deliver are critical to best create ownership.

8. Patient-Centric and Operationally Proficient. These organizations are focused on standardizing care processes, embracing clinical protocols, and effecting seamless, patient access. Efficient and effective operations discipline in the way care is delivered and supported, as well as, broad and deep ongoing improvement efforts, are key attributes of high-performing organizations. Maximized operational efficiency with top-decile clinical quality is the priority, with emphasis on areas that impact patient access, patient flow through the system, and effective discharge to the right post-acute care entity (“right care, right place, right time”). As well, standards set relative to evidence based care and effective standard care plans for treatment types are important to providing reliable care with reproducible patient experience and quality outcomes. Process improvement work is a key enabler to achieving these goals through practices, tools, and methods addressing waste elimination, improving inefficient operations, redesigning care processes, and standardizing work delivery. Additionally, many high-performing organizations are utilizing real-time decision-making driven by predictive analytics, enabling ability to accommodate capacity demand, complex transfers, ED boarding, and PACU holds while driving seamless patient access and maximizing resource utilization.

9. Creative Collaborators. A key attribute is partnerships and joint ventures with other providers, payers, employers, clinical technology companies, and other key stakeholders, all intended to create and increase value for patients and communities. Many organizations are challenged in determining the right value-based payment arrangement programs and investments to set up over a multi-year window (3-5 years) to realize the organization’s strategic vision and achieve financial strength. For high-performing organizations, it starts with addressing the basics of creating reliable quality care highlighted in patient centric and operational proficiency. Along with this, high-performing healthcare organizations expand this focus to connect and align the fragmented system of care delivery to improve patient experience, cost, access, and quality outcomes vertically and horizontally across the care continuum. This effort is incentivized by CMS’ continued transition to value-based payment reimbursement. New partnerships are expected, aligning physicians, payers, employers, providers, and consumers helping healthcare payments transition more quickly from pure fee-for-service to alternative payment models. Identifying the clinical programs, care models, and care interventions coupled with aligning and coordinating the physicians in the care continuum around common goals of value-based care, is a priority. Population health models and clinical and financial integration vehicles will continue regardless of administrative or legislative action as employers, providers, and patients are expecting and even demanding greater value.

10. Realizing the Value of System Integration.  Many healthcare organizations, in pursuit of economies of scale and scope, have acquired a collection of overlapping units that have failed to achieve the intended goal of system integration and transformation. High-performing organizations create value through economies of scale and scope with system integration and optimizing synergies. They enact a unifying vision, strategy, processes, technology, and especially culture to achieve improved performance expected as an integrated system. With a deep understanding of financial operations and clinical care as well as the related decision-making structures and processes, high-performing organizations tend to work a customized problem-back approach to system integration, understanding the “precious few” areas to focus on that will be prioritized and sequenced in a way that creates the most value for the organization.


This top 10 is an abbreviated version of our white paper with the same title. For the full white paper, please click the button, below.

high-performing healthcare organizations


GreenB1.pngMr. Green is a senior vice president and the practice lead for the financial operations and transaction advisory practice at GE Healthcare Camden Group. He has more than 26 years of healthcare experience with 13 years of healthcare consulting experience and 13 years of provider-based financial, operational, and strategic experience among health systems, hospitals, medical groups, management services organizations (“MSOs”), and physician hospital organizations (“PHOs”). Mr. Green has significant expertise in building high-performing teams and leading and executing transformational change. He may be reached at robert.t.green@ge.com. 


d.Greene-1.jpgMr. Greene is a vice president for the strategy and leadership practice at GE Healthcare Camden Group. He has more than 18 years of strategy to execution consulting experience, including 11 years in healthcare. He has significant expertise in strategic planning, business management systems implementation, talent management, performance improvement, leadership, and leading and executing transformational and culture change. He may be reached at darryl.greene@ge.com. 

 

Topics: Top 10, Robert Green, Health System Integration, Staff Planning, Darryl Greene

Navigate the March Madness of Hospital Operations

Posted by Matthew Smith on Mar 22, 2017 11:07:51 AM

By Stephen Verdi, MS, Manager, GE Healthcare Camden Group

As a lifelong sports fan, a former athlete, and a Duke alum, there’s no month on the calendar that commands my attention quite like March. With March comes brackets, Cinderellas, buzzer-beaters, nail-biters, and the best 67 basketball games of the year. It’s time for the NCAA men’s Division I basketball tournament – affectionately and appropriately known as “March Madness.”

More than 350 teams have played through their 30-game regular season schedule for the opportunity to compete in the tournament. Now, for the 68 teams who made the cut, the real season starts. The National Championship is in sight, but now the stakes are higher, the room for error is gone, and the pressure is on.

In the world of hospital operations, it feels like we have entered our own version of March Madness. Years of process improvement and creative solutions to complex access challenges have served us well, allowing us to provide care to our patients as bed capacity has dwindled. We’ve competed well in a tough environment over the course of time. Despite our sweat and tears, the capacity challenges haven’t let up, and an evolution of policy, demographics, and models of care have put pressure on costs, created volatility, and continued to fill our beds. This has created a new environment that demands a different operating point to be successful. We’ve made it through our own sort of "regular season," but the tournament has started, and the games have gotten tougher.

At GE Healthcare, we work with health systems to develop Hospital Command Centers that shift us to a new operating point. We stay true to our belief that a strong foundation of mindful strategy and efficient process still punches your ticket into the tournament, while also recognizing that the decision support, situational awareness, and visibility offered by a Hospital Command Center are now necessary to excel in healthcare’s March Madness.

Fundamentals – Your Ticket to Play

To get the chance to compete for the NCAA National Championship, a team must first be one of the 68 teams selected to play in the annual tournament. The teams selected are those that assemble the best bodies of work over the course of the regular season (or those who get an automatic bid by winning their conference championship, but let’s keep it simple). Success in the regular season comes to those who generally get the fundamentals right-–take smart shots, limit turnovers, box out, hit free-throws, play hard-nosed defense, and so on. Strong execution of the basics helps a team win games, and teams who win games get the chance to play for the Championship. During the regular season, individual games matter less than the sum of a team’s performance. No single turnover will wreck the season. No single loss will exclude a team from contention for the NCAA tournament.

Like a team fighting to make the tournament, when we think about a hospital striving for world class operational performance, we first imagine a hospital that is nailing the basics – staffing nurses and ancillaries to match demand, aligning discharges to bed requests, reducing waste from the bed assignment process, designing efficient OR block schedules, right-sizing their bed mix, and so on. This is the work that many of us have been doing for a long time now, fending off the high costs of inefficiency. Process improvement has allowed us to operate at inpatient utilization rates near 80 or 85 percent. We still may not always feel comfortable at these occupancy levels, but we can care for our patients and deliver good outcomes. We may have declined the occasional outside transfer or left the occasional bed open while patients lined up in the Emergency Department, but we have performed well overall. By building smart capacity strategies and activating them through process improvement, we have made it through the regular season portion of our journey to top performance.

Stepping Up Your Game

After Selection Sunday, when the 68 tournament teams are announced, the whole game changes. There is a new level of pressure on teams who are now just one loss away from falling short of their goal. Whereas individual mistakes may not matter in the regular season, they can spell the end for a team during March Madness. Without a doubt the fundamentals these teams relied on all year will be critical during the tournament, but they now need to reach a new level of performance. They need to play flawless basketball through six (or seven) games while under intense pressure.

Today, under the many stresses of healthcare, our hospitals and health systems need to find ways to reach that next level of performance. We need to continue to pull the levers of capacity strategy and performance improvement, while also finding new ways to perform under more and more pressure. We are getting used to managing at 80 or 85 percent occupancy, but the time has come where we need to be capable and comfortable operating at 90 percent or 95 percent without sacrificing outcomes. Now is the time we look to Hospital Command Centers to raise our operating point. By bringing people, data, and information together, we make decisions faster and act faster. A Wall of Analytics with custom-built analytic tiles provides us with the situational awareness we need to see around corners. The ability of those tiles to make accurate predictions about the future allow us to prevent problems before they arise. With more information, more insights, more speed, and more operational horsepower, we hit a new level of performance. We no longer have to decline that transfer, or board that patient in the Emergency Department, or cancel that surgical case.

The Lasting Impact of Success

Winning the NCAA National Championship delivers much more than a banner in the rafters. The team that takes the trophy achieves a new stature on the national stage, forever to be recognized as a national champion. This recognition helps them recruit talented players who want to be part of a winning team. Better recruits lead to better teams, and better teams get prime-time games on television that attract viewers and sponsorships--further filling the recruiting funnel. On April 3rd, one of the 68 teams will win that last game of the tournament and be crowned National Champion. And while the celebration that night will be a good one, the real impact of the win will be felt for years to come.

A large East Coast academic medical center partnered with GE Healthcare to set out on their Hospital Command Center journey, seeking to bring their people and information together to help them better manage the operations of the hospital. In the summer of 2016, they opened a 2,550 square-foot Hospital Command Center in the center of their main hospital. While the opening ceremony was a great day for the staff and patients, the Command Center has continued to produce results well beyond the ribbon cutting:

  • Patient transfers from other hospitals: There has been a 60 percent improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country.
  • Ambulance pickup: A critical care team is now dispatched 63 minutes sooner to pick up patients from outside hospitals.
  • Emergency Department: A patient is assigned a bed 30 percent faster after a decision is made to admit him or her from the Emergency Department. Patients are also transferred 26 percent faster after they are assigned a bed.
  • Operating room: Transfer delays from the operating room after a procedure have been reduced by 70 percent.
  • Patient discharges: Twenty-one percent more patients are now discharged before noon, compared to last year.

For the next few weeks I’ll be tuned in to see how each of the 68 teams perform under the bright lights of the NCAA tournament. Each of them has done their job to deliver a strong regular season performance, now they will be shifting into a different gear to succeed in the tournament. By relying on their basics and playing mistake-free basketball, they’ll give themselves a good chance. At the same time, our hospitals will be striving for a path to their own version of success under the bright lights of high occupancy. By supplementing a culture of process improvement with the horsepower of a Hospital Command Center, they’ll get there.


Verdi.jpgMr. Verdi is a manager with GE Healthcare Camden Group specializing in the areas of patient throughput, capacity management, hospital simulation, data analysis, and change management. He also has experience in operating room scheduling, governance, care management, and length-of-stay reduction. Mr. Verdi brings over 10 years of GE experience in engineering, project management and healthcare consulting. He may be reached at stephen.verdi@ge.com. 

Topics: Hospital Operations, Hospital Command Center, Capacity Management, Stephen Verdi

Command Centers: Shining the Light Between the Seams

Posted by Matthew Smith on Mar 16, 2017 1:09:49 PM

Don't miss Command Centers: Shining the Light Between the Seams--co-presented by GE Healthcare Camden Group and The Johns Hopkins Hospital at Becker's Hospital Review 8th Annual MeetingApril 17-20, 2017 in Chicago.

Session Overview:

Physicians want the best outcomes for their patients, but have minimal control at the juncture where treatment delays and many problems develop--at the seams between caregivers, facilities and hospital units in a patient’s journey. That’s about to change. The emergence of command centers in hospital settings delivers real-time and predictive decision-support tools, enabling optimal decisions at the moment they are required. These technological resources permit multiple systems in an enterprise to work in harmony with each other by applying data science to redesign system dynamics across a delivery network.

The Johns Hopkins Hospital, for example, employs GE’s Command Center to reduce patient wait time in the emergency department, accept more highly complex patients, and reduce waits following surgery. The facility has experienced a 70 percent reduction in OR holds and a 24 percent increase in pre-9:00 a.m. discharge orders.

Command Centers shine a light into the seams in care, maximizing efficiency, enhancing utilization, reducing risk and improving outcomes. While there’s a lot of talk about delivering seamless care, these resources offer the missing link providers need to explore this territory and retrieve vital information at the moment it is most essential.

Presented by:

Bree Theobald, Vice President, GE Healthcare Camden Group

James Scheulen, PA, MBA, Chief Administrative Officer, Emergency Medicine and Capacity Management, The Johns Hopkins Hospital

Date:

Wednesday, April 19

3:05-3:45 PM

Location:

Hyatt Regency Chicago
151 E. Wacker Drive
Chicago, Illinois 60601

Register for Becker's Hospital Review 8th Annual Meeting:

Command Center, Capacity Command Center

Topics: Care Management, Command Center, Bree Theobald, Capacity Command Center, Capacity Management

Beyond Risk Sharing: Forming Relationships Based on Outcomes

Posted by Matthew Smith on Mar 7, 2017 1:03:26 PM

By Helen Stewart, Managing Principal, GE Healthcare Partners

Health care organizations face incredibly complex problems, including regulatory pressures, dropping revenue from public and private payers, and consumer demands for greater convenience, transparency and connectivity. These stressors are heightened by the current political uncertainty around health care reforms.

In these rapidly changing times, traditional fixed-price, transactional relationships between health care providers and vendors are of little value. When providers buy a discrete product or service, they do so with the intent of integrating it into their strategy, assigning it a specific role in achieving their goals. But if the market shifts, if regulations change, if their strategy runs into roadblocks, they are left with what they bought.

As a result, many organizations have turned to risk-sharing or risk-balanced relationships in which both sides — health care providers and vendors — take on specific accountabilities. In risk sharing, there are always two sides: the underlying assumption is that “you will be responsible for a, b and c” and “I will be responsible for x, y and z.”

In an environment as interdependent and complex as health care, someone is always left holding the bag if the original strategic assumptions do not prove out in the long run. Even with so-called risk sharing, most or all of the risk of achieving the goal falls on provider organizations. If they can’t effectively connect what they purchased — products, services or consulting — to the action they are trying to drive, they are often left to figure it out on their own.

To read this article in its entirety, please click the button below to be immediately directed to the full article posted on Hospitals & Health Networks.

Hospitals and Health Networks, Risk, Hospitals

Topics: Risk, Helen Stewart

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