an instance of innovation as applied to choplink projects
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An Instance of Innovation as applied to CHOPlink Projects. Presented By: Edna Volz Mary Rewinski Process Managers The Children’s Hospital of Philadelphia May 2007 - PowerPoint PPT PresentationTRANSCRIPT
An Instance of Innovation as applied to CHOPlink Projects
Presented By:
Edna Volz
Mary Rewinski
Process Managers
The Children’s Hospital of Philadelphia
May 2007
CHOP Process Innovation Center – Elizabeth Fogarty, Mary Fowler, Emily Goyne, Elaine Kazlauskas, Leonora Miller, Amy Nelson, Mary Rewinski, Amy Rubinstein, Eileen Serpiello, Young Shin, Anna Spraycar, Harold Strawbridge, Robert Sturmer,
Edna Volz, and open positions
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Agenda
• Overview of The Children’s Hospital of Philadelphia (CHOP)
• What is The Process Innovation Center (PI Center) at CHOP?
• An Instance of Innovation – What is CHOPlink?
• Features of Our Approach
• Results
• Lessons Learned
• Q & A
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The Children’s Hospital of Philadelphia (CHOP) Overview
• CHOP was founded in 1855
• CHOP has 512 inpatient beds with more than 1 million outpatient and inpatient visits annually, serving local, national and international patients
• In addition to the hospital, The Joseph Stokes Jr. Research Institute, one of the largest pediatric research facilities in the United States and the Children's Seashore House, a comprehensive pediatric rehabilitation center are located on the main campus
• The largest pediatric healthcare network in the United States, with nearly 50 sites located throughout Pennsylvania, New Jersey and Delaware
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Organization Mission Statement
The Children's Hospital of Philadelphia, the oldest hospital in the United States
dedicated exclusively to pediatrics, strives to be the world leader in the advancement of healthcare for children by integrating
excellent patient care, innovative research and quality professional education into all
of its programs.
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CHOP has been the birthplace of many Firsts…
Pediatric Hospital
Medical Training for Pediatric Medicine
Neonatal, Surgical and Pediatric ICU’s
Closed Incubators
Catheter Balloons for Cardiac Defects
Cause for Infectious Mononucleosis
Leader in Development of Family Centered Care
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What is the Process Innovation Center?
The PI Center provides effective process and project management to achieve continuous and measurable improvements through:
• Consulting• Tools• Methods • Coaching
Working with our internal customers we enable process innovation, project implementation, and assure skills and knowledge transfer to clinical and business operations throughout CHOP.
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What is the Process Innovation Center (PI Center) at CHOP?
We offer standard process and project methodology training and tools and consulting to three levels of CHOP projects
• Strategic projects with an enterprise-wide scope that require both process redesign/innovation and project implementation
• Tactical, short-term (30-90 day) projects that may require PI Center staffing along with consulting or training
• Short (30 day or less) projects where we provide just consultative support training
Our team consists of 18 Process and Project Managers that serve the entire organization.
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Influences for Change – Healthcare Industry
• External Forces
‐Government‐ Insurers‐Community
• Improve Patient/Family Experience
‐Consumer driven healthcare
One Child, One Record, One Outcome
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An Instance of Innovation – What is CHOPlink?
The vision of CHOPlink is to:
• promote a new patient/family centered environment by optimizing processes with state of the art technologies which deliver secure and ubiquitous access to complete, accurate and timely patient-related knowledge.
CHOPlink is designed to:
• support excellence in patient care, innovative research, quality professional education, child and family advocacy.
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Our Starting Point
• Processes Managed Locally
• Work Completed in Silos
• Previous strategy: Best of Breed approach
•No integrated solutions
• Disparate sources of data
•Multiple sign-ons•Multiple handoffs and possible points of failure•Process compromises•Proprietary/different data formats•No economies of scale
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CHOPlink Overview – What we planned to do..
• From “child/family need identified” to “child/family need satisfied”
• Integrated, end-to-end, enterprise view
• Future State Focused
• Aligned with Guiding Principles
• Led by Process Owners
• Tested with Family input
• Staged Implementation
• Linked to Technology Implementations
We will use process management to create a future state version of processes with these characteristics:
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Process Management Theory…
Process Management is….
Identify
Define
Implement
Improve
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Process Overview **
** Edited for External Distribution
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Examples of Change – Scheduling Process
What a Family Gets - One Call Does It All
I make one call and I can get all of my appointments even though we have some complicated combinations of services. They gave me various options for appointments at several times and locations. I can give my information to the hospital once during the call so I don’t have to repeat it every where I visit. I know my balance so I can be ready to pay when I get there. They told me what information was required for the appointment and were able to call my Primary Care Provider. They even gave me instructions on how to get there! I also got a reminder call a few days before the appointment.
Scheduling
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Examples of Change – Scheduling Process
Enabling the process changes via…
Shared Access Scheduling Combined Scheduling and Registration Complex Scheduling Referral (order) information Balance Information Collect & Verify Insurance via Electronic
Eligibility system Help Scripts Automatic appointment reminders
Scheduling
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What a Family Gets
OutpatientsI arrive at the front desk and we get registered faster than ever. The registration person scans in my insurance cards so I don’t have to show them over and over. I hear that our insurance company has already told the hospital that the visit is covered and all I have to pay is the co-pay. I can even pay that now so I don’t have to deal with a bill later.
InpatientsWe were whisked to the room in record time after we were greeted. The registration person came right to the room shortly after we got there. I was surprised that our Primary Care Provider stopped in to see us. CHOP notified her.
Examples of Change – Check In & Check Out
Check In
Check Out
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Examples of Change – Check In & Check Out
InpatientsCentralized Bed ManagementFaster Bedside RegistrationElectronic Insurance VerificationElectronic Signature InterQual Criteria Integrated Scanning ApplicationPrimary Care Provider Automated
Updating
Outpatients Quick Verification Document Scanning Electronic Insurance Verification Cash Collection Incomplete or Missing Registrations
Completed in 3 Working Days or Less
Enabling the Process Changes via…
Check In
Check Out
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Examples of Change – Clinical Visit Flow
Clinical Visit Flow
Examples of Change – Hospital Billing Process
What a Family Gets
I receive only a few bills; one for the hospital charges for all of my kids and one for all of the physicians charges for all my kids.
I spotted a questionable hospital charge so I called the 800 number. In one call, one person followed my problems through to resolution.
Billing
Examples of Change – Hospital Billing Process
Enabling the Process Changes via…
Automatic entry of charges into the billing system Review of charges based on pre-defined logic before
billing Ability to collect self-pay balances across the CHOP
Enterprise at the time of service Electronic claims and remittances with payer responses
filed back into the billing system Improved ability to determine that what was paid was
exactly what was supposed to be paid Improved capabilities to resolve any unapplied cash
across CHOP
Billing
Examples of Change – Physician Billing Process
What a Family Gets
I receive only a few bills; one for the hospital room and one for physicians. This makes it less confusing for me to sort out what I’m paying for.
I never get unexpected Bills from CHOP anymore. I get one clear bill for all physician charges for all of my kids.
I seldom get a billing error. That’s good! When I do find an error, I call a single phone number and get the error resolved.
Billing
A New Way to Look at the Physician Billing Process
Enabling the Process Changes via…
Automatic entry of charges into the billing system Review of charges based on pre-defined logic before
billing Ability to collect self-pay balances across the CHOP
Enterprise at the time of service Electronic claims and remittances with payer responses
filed back into the billing system Improved ability to determine that what was paid was
exactly what was supposed to be paid Improved capabilities to resolve any unapplied cash
across CHOP
Billing
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CHOPlink – What We’ve Accomplished
We created a future state version of processes with these characteristics:
• From “child/family need identified” to “child/family need satisfied”
• Integrated, end-to-end, enterprise view
• Future State Focused
• Aligned with Guiding Principles
• Led by Process Owners
• Tested with Family input
• Staged Implementation
• Linked to Technology Implementations
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• Executive support
• Guiding principles
• Ground plowing by trusted advisors
• Thinking blue sky
• Documented process mgmt approach
• Project mgmt discipline
• Focus on ideal patient experience and excellence in patient care
• PI team members new to CHOP
• “It’s an Epic implementation”
• “I’ve got a day job, too.”
• Enterprise level vs. department level process
• Language of process management new to CHOP
• Implementing process change an abstract notion
• Fear of change created resistance to blue sky thinking
• Clinician involvement
Advantages Challenges
All are lessons learned!
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Some PARC Process Management Facts
• Staffing‐ Process owners‐ Process managers‐ Approx 200 stakeholders across process teams (not full time)‐ Key participants include Business Architects, Application Coordinators, Project
Manager, Family
• Current State (Sept 05 – Oct 05)‐ Process Maps ‐ Barrier Lists
• Future State (Oct 05 – Feb 06 for definition; Mar 06 – Aug06 for implementation)‐ Strategic and Workflow questions and recommendations‐ Process Maps ‐ Critical Workflows‐ Role descriptions‐ Metric descriptions‐ Policies and Procedures‐ Integration grid‐ Implementation plan for major operational changes‐ Portfolio grid for prioritizing operational changes
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Summary
• CHOP Overview
• PI Center Overview
• Features of Our Approach
• Lessons Learned
• Q & A
‐ What is your reaction?