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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 [email protected]. 

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

Webinar OnDemand: New Approaches to Capacity Optimization and Command Centers

Posted by Matthew Smith on Mar 2, 2017 11:17:31 AM

This webinar, hosted by the Association of Academic Health Centers and presented by GE Healthcare Camden Group, University of Michigan Health System, and The Johns Hopkins Hospital, focuses on innovative, forward-thinking approaches that two leading Academic Health Centers have undertaken. Specifically, the goals for these organizations include the improvement of patient flow and the optimization of capacity to achieve measurable outcomes, including designing and implementing a first-of-its-kind Command Center.

Using both systems as case studies, the speakers share their experiences, challenges, and successes with achieving capacity transformation without expansion, as they enable the transformation needed to thrive as an AHC of the future.

Speakers

Bree Theobald, Vice President, GE Healthcare Camden Group

Jennifer Naylor, Senior Consulting Manager, GE Healthcare Camden Group

Mary Martin, MPA, Associate Hospital Director – Surgical Services, University of Michigan Health System

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

To view the webinar, please click on the button below and complete the short form. The webinar will launch in a new window. 

Capacity Optimization, Command Centers

Topics: Webinar, Capacity Command Center, Capacity Management

GE Healthcare Included in Fast Company's "Top 10 Innovative Companies in Health"

Posted by Matthew Smith on Feb 13, 2017 1:42:10 PM

GE Healthcare is featured as one of Fast Company's Top 10 Innovative Companies in Health of 2017. As part of the magazine's World's Most Innovative Companies ranking, the Fast Company reporting team reviewed thousands of enterprises searching for those that tap both "heartstrings and purse strings" and use the engine of commerce to make a difference in the world.

From Fast Company:

GE Healthcare works with partners ranging from the University of California San Francisco to Johns Hopkins to develop both hardware and software technologies that solve some of the most pressing problems in health care. Some are drawn from health systems; for example, UCSF needed a partner to develop machine learning algorithms for medical imaging, and Johns Hopkins needed a NASA-style command center to better manage patient flow in and around the hospital. Early results from Johns Hopkins have been promising: The hospital has reported a 60% improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country; its ambulances are able to get dispatched 63 minutes sooner to patients at outside hospitals; and its emergency department is assigning patients to beds 30% faster.


To learn more about The Johns Hopkins Capacity Command Center, watch this short video and click on the links to Modern Healthcare and Health Facilities Management, below.

 

To speak to the GE Healthcare team about Capacity Command Centers, please click the button below:

Capacity Command Centers

 

Topics: Hospitals, Hospital Operations, Command Center, Capacity Command Center, Capacity Management, Hospital Occupancy

Digital Twins Revolutionize Strategic Planning in Healthcare

Posted by Matthew Smith on Aug 29, 2016 1:04:36 PM

By Jeff Terry, MBA, FACHE, Managing Partner, GE Healthcare Partners

What’s a Digital Twin?

A digital twin virtualizes a hospital (or other) system to create a safe environment in which to test the impact of potential change on system performance. In other words, to play “what if?” with system dynamics. This is important because healthcare delivery is massively complex. Common sense, spreadsheets, and statistics just don’t have the horsepower to inform strategic decisions. 

Are Digital Twins New?

Not exactly. Digital twins use discrete-event-simulation techniques which have been around for 30 years and applied successfully in healthcare to model departments like radiology. But modeling a hospital above about 400 beds has proven too difficult for all but the most experienced modelers using the best tools. 

What is New?

What’s new is using digital twins to design efficient new hospitals and to redesign system dynamics in existing large hospitals. "System dynamics" includes bed mix, staffing, model of care, floorplan, bed algorithm, etc. This is becoming more common with better toolkits and more experienced practitioners at companies like GE and EY. For example: GE analytics consultants using our healthcare-specific simulation platform have modeled >1,000 bed academic medical centers 75% faster than teams of PhDs using traditional methods.  

How are Digital Twins Revolutionizing Strategic Planning?

Digial twins enable massively collaborative, data-driven, and scenario-based decision making. Without a digital twin, leaders rely on tribal knowledge and basic analysis to plan new facilities and next year’s budget for existing facilities. This is normal but it leaves much to be desired. With a digital twin, leaders virtually test changes to bed mix, bed algorithm, task assignment, floorplan, equipment, ALOS, model of care, staffing etc.

The traditional answer is to do our best and see what happens.

  • For example: neuro has recruited two new surgeons, medicine is closing a unit, we’re opening a transitional care unit, the State is buying our rehab unit to convert it to psych beds, and we expect to reduce ALOS for knees by .75 days and for general medicine by 0.2 days. What will that do to ED Boarding? What is our maximum volume with different scenarios of growth by cohort? Can we accommodate the neuro volume? What’s the best day to add these cases to the OR schedule?
  • With the Digital Twin, we learn that we can accommodate the volume but only if the ALOS work succeeds. We add the cases Wednesday and shift two orthopods from Thursday to Tuesday. Alternatively, we could upgrade the transitional care unit to an ICU (but that’s expensive). These answers lead to new questions… which are tested in the digital twin.

Digital Twins Revolutionize Planning in Four Ways:

Digital twins close the gap from “requirements” to system dynamics. Today this is a leap of faith. The simulation model closes that gap when we design new facilities, when we redesign existing patient flow, and when we convert service-line volume plans to annual budgets.

  1. Digital twins target process improvement efforts by putting each process improvement project into larger context. This enables us to charter projects with specific goals tied to both local and system performance. 

  2. Digital twins facilitate massively collaborative strategic planning. Health systems are full of super smart leaders with ideas. Those ideas need to be heard and tested. The digital twin gives us the tool do so. In many cases the result is to demonstrate that some ideas are bad. That’s a great result because it allows that leader to move forward and embrace the eventual strategy the Digital Twin helps to clarify.

  3. Digital twins can also power ongoing short-term forecasts. For example, when we build a digital twin in our Hospital of the Future Analytics Platform to redesign a medical center's system dynamics, we use the same simulation model to power predictive decision support apps outside-the- EMR.

In the end, digital twins help leaders design and execute models of care which are good for patients, families and caregivers. Revolutionary.

 
 Digital Twins, Capacity Management, Hospital Operations
 

Jeff_Terry.jpgMr. Terry is a Managing Principal of Healthcare Partners, the consulting arm of GE Healthcare that works with healthcare systems to define and achieve transformational outcomes related to quality, access, culture and cost. Partners' capabilities include management consulting, mobilizing change, technology integration and advanced analytics. He has a diverse background in consulting, sales, product development, Lean Six Sigma, business strategy, and services. Areas of focus have included clinical asset management, patient safety, patient flow, hospital operations, radiology and advanced analytics. He may be reached at [email protected].

 

Topics: Hospital Operations, Command Center, Jeff Terry, Hospital Command Center, Capacity Command Center, Capacity Management, Digital Twins, Hospital Occupancy

Demystifying Length of Stay Projects

Posted by Matthew Smith on Aug 16, 2016 11:39:35 AM

By Dominic Foscato, Senior Vice President, and Bree Theobald, Vice President, GE Healthcare Camden Group

When educating healthcare executives to lead high-occupancy organizations, one of the fundamental outcomes-based measures to monitor is Length of Stay (“LOS”). Usually, the organization has tried many approaches to solving capacity problems but many have failed due to some of the following reasons:

  • Competing priorities
  • Misaligned incentives for key stakeholders (physicians and hospitals)
  • Perception of negative impact to revenue for percentage of charges and per diem payers
  • Poor communication within and between departments
  • Not aligning care models around the consumer experience
  • Lack of data to drive transparency and accountability

When healthcare leaders approach us with a LOS problem, we ask them the following questions before advising on how to proceed:

  • How do you define LOS? Current/in-house, discharged average LOS severity adjusted (comparing observed to expected benchmark)
  • Is it isolated to a specific hospital, department (Emergency Department (ED), Post Anesthesia Care Unit (PACU), etc.), nursing unit, service, disposition, time of year, day of week?
  • How much of a LOS problem is felt by a mid-afternoon census alert? Could it be a throughput/flow issue instead

We then want to understand the internal dynamics, such as:

  • How would other leaders and disciplines respond to the three questions above? Does your organization have a single, consistent point-of-view?
  • How frequently are LOS measurements and key process measures reported? Are department/hospital/system clinical leaders reviewing these metrics and continuously improving?
  • Are incentives aligned for the key stakeholders (especially those that are not in your organization)? How can you influence those groups to help you achieve your goals?

Once we’ve obtained a high-level understanding of the challenge(s), the next step is to understand stakeholder involvement, alignment, and expertise.

Case Study

Here’s a common scenario where health systems engage GE Healthcare Camden Group, coupled with our approach to improving operations:

Background

  • 450 bed, Level I Trauma Center in medium-sized city
  • State Medicaid expansion and physician recruitment have increased demand for IP beds
  • Hospital is working through many solutions: co-locating patients, redesigning hospital beds, planning for IP and ED expansions, managing internal projects on discharge timing, readmissions, and bundled payments

Challenge

The Performance Improvement department has recently assessed LOS and reported to its Senior Leadership Team that the organization has a LOS problem.

Our Solution:

  • Perform a ‘Flash Discovery’ by conducting key stakeholder meetings and data analyses
  • Create/Modify a Steering Committee charged with engagement oversight, communication, resource allocation, and executing decisions
  • Conduct a 3-5 month ‘Capacity Strategy’ engagement to model operations and unique patient pathways around 3-4 key strategic questions
Follow-on initiatives include:
  • Create highly efficient/effective, daily multidisciplinary rounds to discuss each patient’s plan for the stay/day, progress towards transition/discharge with all key members of the care team
  • Re-allocate beds to services based on historic demand, budgeted volume or other initiative to mirror the patient placement matrix
  • Redesigning Case Management to ensure appropriate staffing, staff utilization, resource utilization, workflow and expectations align with efficiently delivering healthcare
  • Target specific patient populations for administrative or clinical LOS opportunity (e.g., pneumonia, heart failure, hips/knee replacement)
  • Reduce elective variation in the Operating Room and create a more predictable outflow with ‘priority discharges’ to better align demand and availability of beds

Value

los.png

  • Each healthcare market is unique, but in this example, the hospital was losing patients to competitors due to capacity issues. By creating organizational alignment, studying LOS and process metrics and selecting a few initiatives to impact LOS, the client reduced severity-adjusted LOS and created capacity to treat new patients.
  • By treating more patients, referring physicians and network facilities were more engaged as the hospital was now more ‘accessible’ and information more widely trusted/understood.

There is great power in taking more of a transformative approach with this as a major initiative well supported by leadership, data driven, and executed in a way that involves a number of change management tools to help drive and sustain change.

 Capacity Management, Length of Stay


Foscato.jpgMr. Foscato serves as a senior vice president with GE HealthcareCamden Group responsible for the overall design andimplementation of solutions, thought leadership and solutiondevelopment. Mr. Foscato has deep domain expertise in improvingclinical operations, implementing enabling technologies, optimizingrevenue cycle and patient access functions for healthcare providersto deliver more effective patient care and financial performance. He also assists clients withactivating strategy leveraging GE’s world renowned management and leadership systems. He may be reached at [email protected]. 

 

Bree_Theobald.pngMs. Theobald has been leading healthcare organizations through transformation efforts for 8 years with GE Healthcare Camden Group, focusing on utilizing simulation modeling and advanced analytical tools to optimize capacity, whether that be inpatient, procedural, or clinic capacity. This has allowed organizations to improve access for patients, streamline operations and improve financial performance, while also creating a culture of continuous improvement. Currently, in her role as a vice president, she has spent the last five years navigating and aligning academic medical centers to deliver measurable improvements. She may be reached at [email protected]. 

Topics: Dominic Foscato, Bree Theobald, Capacity Management, Occupancy, Length of Stay

Top 10 Opportunities for Improved Acute Care Access and Capacity Management

Posted by Matthew Smith on Apr 22, 2016 11:19:31 AM

The time is now for health systems and hospitals to engage physicians, create actionable data, and plan for operational and financial changes in order to continue to drive better acute care access. Even with population health strategies that are successfully shifting care settings and expectations for target patient populations, there is a continued increase nationally in inpatient demand at large tertiary and quaternary facilities that are designed and required to continue to serve high acuity, time-sensitive conditions.

These facilities report a mid-week operating capacity often exceeding 90 percent occupancy. The hospital is not going away any time soon. To thrive in today’s environment, health systems must align operations with this new reality, and be judicious in expansion plans, as well as managing access to the costly but vital services that are provided.

Top performing health systems do not just look at improving acute care operations as a tactical, cost out effort – operational excellence is being executed as an organizational capability that drives competitive advantage in a market where patients are increasingly becoming consumers, physicians and staff expect a better workplace, and payers aggressively work to bend the cost curve. Here are ten opportunities for improving acute care access and better overall capacity management.

1. Embrace systems thinking. Companies like Amazon, Walmart, Uber, and many others have figured out how systems thinking across their delivery of goods and services can be a competitive advantage; leading healthcare organizations are starting to do the same. The days of finding big opportunity in localized optimization are limited; much of the low-hanging fruit is gone. Healthcare executives must shift their focus to the whole – the whole hospital, the whole health system, and the whole continuum of care – for big wins. This has been a slow process because of the existing fragmented delivery system and incentive structure. Cost pressures and payment reform are forcing “systems thinking” with the acute care setting in a way that we have not seen before, bringing a much wider group to the table in strategic planning and operational reviews to have real discussion around how to improve operations and patient experience.

 
2. Expand as a final resort. Organizations continue to be in a “wait and see” mode in regards to expansion efforts. They have spent a tremendous amount on expansion in the past decade and have heavily invested in healthcare information technology. The last thing most CFOs want to consider is another tower or other construction effort. This is forcing a new level of justification for expansion and deep discussion around how to maximize resources and eliminate duplication of services, including making very tough choices around moving services and appropriate care settings.
 
3. Greater focus on patient experience. After a while it can be easy for those in the operational world to grow numb to – or at least tolerant of – cancelled surgeries, declined transfers, long ED wait times, PACU holds, stretchers in hallways, and a host of other “last resorts” that have recently become permissible mitigations. It is not so easy for the patients. In a recent study commissioned by GE Healthcare Camden Group and Prophet, the gap between the perceptions of patients and health system leaders about the state of patient experience is widening. Despite the rising expectations of healthcare consumers, health systems struggle to move the needle given the myriad of challenges they face. There is not a healthcare professional in the world who does not think there is room for improvement, but it is a task that is too large for a single individual and needs to be approached in a transformative and collaborative way. It also needs to be integrated with efforts to enhance efficiency. The goals are the same:  improve access and streamline the patient care process. We are seeing many organizations take an executive commissioned fresh look at what the world could look like with “Patient Itineraries” and a world class type of experience standard that one would expect in other industries around billing, wait times, transparency to plans of care, and a long list of others. This can be incredibly powerful in creating a shared need and future vision for patient and family centered care.
 
4. Staff smarter. Patients do not get sick Monday through Friday on a defined schedule, yet this is the way many hospitals are run. There is also intense pressure to manage expense budgets by controlling costs in areas such as nursing or support services, but when not done thoughtfully, these efforts can have an impact on patient access in a way that compromises the overall financials in a much greater way. This is a very difficult nut to crack, but one where real progress is being made with approaches such as acuity-based staffing, realignment of staffing models, and smarter use of services based on data models that link demand to the consumption of services.
 
5. Increase flexibility. As beds become more constrained, hospitals are seeking creative ways to increase flexibility which often takes the form of adding flex capacity to absorb fluctuations in demand or increasing the versatility of the existing beds. This includes increasing tele coverage, sharing of beds between departments in times of peak census, rethinking incentives to promote better collaboration around patient care vs. optimizing for an area or department, redesigning processes to say “yes or no” faster, and more. The key for organizations is to promote collaboration and innovation around positive change – this takes data to build a case and strong leadership to overcome a long history of siloed operations.
 
6. Adopt hub and spoke models. Large integrated delivery networks are being much more judicious in aligning their operational strategies around where care is delivered. Increasingly, organizations are seeking to increase the complexity of care at their largest facilities where the most complex and costly services are provided, and use other satellite hospitals in a health system as virtual step downs. This requires a huge degree of coordination to rationalize and relocate services, redefine access patterns, and communicate the change to patients and staff. When done in a thoughtful way, this can be an incredibly effective approach to improving operations, patient experience, and the overall cost structure.
 
7. Target underlying issues. There is no shortage of process improvement effort underway in the acute setting related to access, patient flow, patient experience, and overall capacity management. This is often done in a fragmented way, putting out the fires that burn the hottest instead of taking a comprehensive look to deeply understand the issues and the impact those issues (process/capacity/cultural) are having on our operations. Firefighting can easily result in a “squeezing of the balloon,” where tremendous resources are invested in one area only to shift the issue to another. To truly make a dent in today’s capacity challenges, organizations need to take big swings, building holistic solutions to chronic issues such as long LOS, misalignment of discharges to admissions, inconsistent or misdirected patient placement practices, variation driven by surgical schedules to reduce variation, and more. Though never easy to address, these are the sorts of underlying issues at the root of capacity challenges, and the results of solving them tend to warrant the investment it takes to do so.
 
8. Find partners. A comprehensive look at acute care access and capacity management sheds light on those tough patient populations where we must work smarter and not harder. Organizations are exploring aggressively how they can prevent admissions and shorten stays through the use of retail clinics, partnerships with other hospitals, and improved relationships with post-acute providers that leverage data and establish service level commitments.
 
9. Use smarter operational analytics. Certainly institutions may tout their new EMR or a new bed management system as the solution to all of their problems – but in reality, this is not the case. The sophistication required to understand information in real-time from multiple systems and make critical decisions exists only in small pockets. Innovative organizations are investing in real-time analytics that can help solve their most complex problems in the moment. A problem back approach to analytics is critical. More proactive tools are also being developed that allow organizations to predict operations 24 to 48 hours in advance with amazing precision.
 
10. Consider command centers. In one of the most complex industries in the world, teams are asked to work in silos, often communicating via pagers, fax, and telephone to navigate and resolve complex daily issues. Healthcare may be one of the last industries to actively use pagers in daily work. There is a growing trend to co-locate staff, supported by real-time information from dozens of systems that generate insights and drive action, and well-defined procedures to run hospitals like a busy airport or mission critical space shuttle launch.
 
This is an incredibly exciting time for hospital operators to rethink the Hospital of the Future. It often seems like an overwhelming task because of the complexities of daily operations, the heroics that occur, and the time required to drive change. With a well-informed plan on activities that can truly move the needle, strong leadership, and effective change practices, a better state is just around the corner.

Geoff_Martin.png

Mr. Martin is an Executive Vice President with GE Healthcare Camden and leader of the Care Design and Delivery Practice. Mr. Martin specializes in the areas of hospital operations, process improvement, and the use of advanced analytics to develop innovative solutions. He also has extensive experience in strategy development, care design, population health development, value management, and large scale technology implementations. Mr. Martin has worked with leading academic medical centers and large integrated delivery networks across the country to improve clinical, financial, and operational performance. He may be reached at [email protected].

Topics: Acute Care Hospitals, Acute Care Efficiency, Geoffrey Martin, Command Center, Capacity, Capacity Management

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