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Doing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

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Page 1: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Doing More with Less:

How One Health System Improved Patient Experience

with an Efficient, Cost-Effective Operating Model

Page 2: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Discussion Guide

Introductions

North Shore-LIJ Health System:

At a Glance

Establishment of Need

Unique Challenges

Lessons Learned & Outcomes: Doing More with Less

Questions & Answers

2

Page 3: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

About Our Speakers

Roe Long, RN, BSN, MBA: Vice President, Ambulatory Services at North

Shore-LIJ Health System

Leads Transformation and Operations for the Physician and Ambulatory Network

Services

25+ years of management experience in healthcare operations for hospitals and

medical groups

3

Rebecca Flink, RN, BSN, MHA: Senior Operations Planner, Hammes

Company

Led the design, development and implementation of operations of 150+ capital

projects for 20 years with a regional health system

Helped clinicians recognize specific need and identify operational model of care

and flow

Dave Connolly: Vice President & Architect, Hammes Company

Development and management of major healthcare project assignments nationally

Led the visioning session and development of prototype models for NS-LIJ

engagement

Page 4: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

North Shore-LIJ Health System:

Establishing Needs

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Page 5: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

North Shore-LIJ Health System: At A Glance

5

– 16 award-winning hospitals (5

tertiary, 7 community, 3

specialty, 1 affiliate)

– 400 ambulatory physician

practices

– Long Island, Manhattan,

Queens and Staten Island –

service area with a population

of 7 million

Nation’s third largest non-profit, secular healthcare system

Nation’s sixth largest physician group practice – North Shore-LIJ

Medical Group

North Shore-LIJ Health System – Great Neck,

New York

Page 6: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

A Comprehensive Strategy

6

Key planning elements:

Ambulatory Network Planning

Strategic Facility Planning

Key implementation elements:

Buy-in

Operationalize

Facility development

Page 7: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Establishment of Need

7

Develop the Ambulatory Network Plan

– Then apply tools / toolkit to implement

Deploy consistent, cost-effective approach

to ambulatory service deployments

Consolidate practices to build a consistent

operational model

Standardized practices:

– Benchmarks

– Kit of parts

– Prototyping

Build consensus internally with champions

Page 8: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Our Approach:

Visioning, Prototyping & Standardization

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Page 9: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Preliminary Visioning Session

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What Message Do We Send To Our Patients?

What Message Do We Send To

Our Staff?

What Message Do We Send To Our Physicians?

What Are Our ‘Big Ideas’?

Highest Quality Care

Actualize and EmpowerOur Staff

We Support Our Physicians

Value Our Patients

Page 10: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Guiding Principles

10

Form Follows Function Follow

Flow (Follows Funds)

Efficient Use of:Spaces

ProcessesSystems

Create Flexible Planning Tool Replicated As

Needed

“90/Rule”90% of What a

Care-Giver Needs is Within

5 Seconds of Where They

Need It

Page 11: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Patient Flow

11

GREETER / CONCIERGE

Welcome

Patient Information

Packet

MonitorWaiting

List of Daily Patients

Oversee (future)

Electronic Kiosk

Provide for Patient

Comforts / Questions

PATIENT / FAMILY LOUNGE

Appropriate Seating

Positive Distractions

Private Cell Booths

PATIENT SERVICE CENTER

“IN”

Insurance Verification

Collect Co-Pay

Insurance Consultation

EMR Updates• Demographics• Insurance

AdditionalCo-Pay

NextAppointment

Referrals

INTAKE

Weight / Height

Meds Check

Allergies

Vitals

PATIENT SERVICE CENTER“OUT”

EXAM

Consult Exam

Enter

Exit

ClinicalSummary

EKGAdditional Test

Referral

Prescription

Clinical Summary

Page 12: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Staffing Model

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Off-SiteServices

4-6 Providers

Centralize Appointment SchedulingBilling Services (Future)

Surgery Scheduling (Future)

12.5 FTE’s(Does Not Include

Site Manager)

23.0 FTE’s(Does Not Include

Site Manager)

Provider Pod 2

Biller 1 FTEWithout EMR – Input ChargesWith EMR – Charges Go Direct

Medical Record 1 FTEWithout EMR - Pull / Org. Charts

for Patient DayWith EMR – Scan Paperwork

MA 1 FTEMD / PA

Provider 12-3 Exams

Biller 1 FTEWithout EMR – Input ChargesWith EMR – Charges Go Direct

Medical Record 1 FTEWithout EMR - Pull / Org. Charts

for Patient DayWith EMR – Scan Paperwork

Practice Manager# of Sites

Based on Size

MA 1 FTEMD / PA

Provider 22-3 Exams

MA 1 FTEMD / PA

Provider 32-3 Exams

MA 1 FTEMS / PA

Provider 42-3 Exams

MA 1 FTEMD / PA

Provider 52-3 Exams

MA 1 FTEMD / PA

Provider 62-3 Exams

4-6 Providers

MA 1 FTEMD / PA

Provider 12-3 Exams

MA 1 FTEMD / PA

Provider 22-3 Exams

MA 1 FTEMD / PA

Provider 32-3 Exams

MA 1 FTEMD / PA

Provider 42-3 Exams

MA 1 FTEMD / PA

Provider 52-3 Exams

MA 1 FTEMD / PA

Provider 62-3 Exams

ClinicalStaff Coordinator

1 FTE (RN)

Provider Pod Receptionist /

Greeter

Pod 1 1.5 FTEPod 2 .5

Additional FTE

Check Out Receptionist 2 FTESchedule Next Appointment

Referral ScheduleAnswer Phone Calls for Pod

Cross Function With MA

Check Out Receptionist 2 FTESchedule Next Appointment

Referral ScheduleAnswer Phone Calls for Pod

Cross Function With MA

Provider Pod 1

Page 13: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Unique Challenges

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Page 14: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Unique Challenges

Urban setting

– Building new sites not feasible

– Inventory of ambulatory locations not

always designed for healthcare setting

Differences in markets

– Manhattan vs. Suffolk

– How do you differentiate yourself?

Managing expectations

– Differences across practices - tied to

geography, senior leadership and providers

– Physicians expecting perfection - versus following

the process of the Visioning Session

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Page 15: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Lessons Learned & Outcomes

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Page 16: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Lessons Learned & Outcomes

Buy-in and team consensus critical

– Visioning Session for new practices to

lead staff and physicians to design their

own future

– They will recognize challenges and need for

change – we will supply the toolkit

Lower-cost provider

– Value-based reimbursement future

– Must drive down expense yet remain productive and

efficient with a best practice patient experience

Prototype model

– Different for every health system – where you are and who you are

– Derived from culture, level of physician integration, market characteristics

and unique operational considerations

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Page 17: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Questions & Answers

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Page 18: Doing More with Less - Hammes CompanyDoing More with Less: How One Health System Improved Patient Experience with an Efficient, Cost-Effective Operating Model

Please direct all inquires to:

[email protected]