Form Fits Function: How Innovative Healthcare Design and Programming Promote Wellness

hfma || FALL CONFERENCESeptember 17, 2018Chris Proctor, MPT

OBJECTIVES

UNDERSTAND BENEFIT OF PROGRAM DIRECTED DESIGN

DESCRIBE IDEAL STAKEHOLDER TEAM

DESCRIBE LESSONS LEARNED

EXPLAIN HOW A MAJOR PROJECT CAN ACHIEVE:• PHYSICIAN ALIGNMENT• STAFF ENGAGEMENT

UNDERSTAND HOW TO KEEP YOUR CFO HAPPY

BARTON HEALTHCARE SYSTEM

1963 – ACUTE CARE HOSPITAL OPENED

63 PATIENT BEDS

LEVEL III TRAUMA CENTER

1200 EMPLOYEES, PHYSICIANS, VOLUNTEERS

BARTON HEALTHCARE SYSTEM

ED VISITS – 20, 283

CHC VISITS – 20,124

OUTPATIENT REGISTRATIONS – 181,554

3500 SURGERIES PER YEAR

2000 ORTHOPEDIC SURGERIES

BARTON COMMUNITY

PRIMARY SERVICE AREA – 35,100

SECONDARY SERVICE AREA – 147,000

VISITING POPULATION – 150,000+

75% OF PATIENTS FROM PSA

20% OF PATIENTS ARE SECOND HOME OWNERS

ORTHOPEDIC SERVICE LINE

ORTHOPEDIC CLINIC VISITS – 24,400

SURGERIES – 2,380

REHABILITATION VISITS – 24,892

ACCOUNTS FOR 50-60% OF SYSTEM REVENUES

BARTON || FINANCIAL PICTURE

PRIVATE – 40%• PERCENTAGE OF CHARGES – STILL!

MEDICARE – 30%MEDICAID/MEDICAL – 30%

CASH - $250MDEBT - $30M OM – 9.5%

CFO DILEMMA

ESTIMATED PROJECT COSTS:• CENTER - $20M• GARAGE - $10M

WHY WOULD WE DO THIS???

BARTON || ORIGIN STORY

FOUNDERS• BILL AND OUIDA

VALUES• INDEPENDENCE• SUSTAINABILITY• “SUR-THRIVAL”

ORIGIN STORY || ORTHOPEDICS

ORTHOPEDICS IN TAHOE – 1964

CENTER || JOURNEY

2003 – ARCHITECTUAL DESIGN

2007 – PHYSICIAN PRACTICE MANAGEMENT

2010 – TAHOE CENTER FOR ORTHOPEDICS

2012 – ORTHOPEDIC CENTER

2014 – MALOFF DONATION

ROBERT MALOFF CENTER

26,000 SF FACILITY• ORTHOPEDIC CLINIC• REHABILITATION CLINIC• AQUATIC CENTER• PEFORMANCE TRAINING• INTEGRATIVE MEDICINE• WELLNESS

2,500 SF COMMUNITY ROOM• SUPPORT GROUPS• LECTURES• CLASSES

BARTON || “STRATEGERY”

2016 – PYRAMID

CENTER || BUSINESS CASE

NEW PROVIDERS• CLINICAL SPACE AND SUBSPECIALTY• RECRUITMENT AND RETAINMENT• ENGAGEMENT AND ALIGNMENT

PRIMARY V. SECONDARY SERVICE AREA

LOCAL R REGIONAL ? NATIONAL ?

GOAL: INCREMENTAL GROWTH

CENTER || PATIENT EXPERIENCE

COORDINATED CARE EXPERIENCE• RIGHT INTERVENTION• RIGHT TIME

• RIGHT PERSON RELATIONAL

SAME DAY SERVICE

RETAIL SERVICES • COMINGLING REVENUE CENTERS

REGIONAL REACH – MEDICAL TRAVEL?

CENTER || PROVIDER EXPERIENCE

LEAN WORKSHOP – OPERATIONAL EXCELLENCE

PROVIDER SUPPORT• EPIC OPTIMIZATION• LEADERSHIP - DYADS

SUPPORT STAFF SUPPORT • SHARED WORK AREAS• CROSS TRAINING

MULTISPECIALTY ORTHOPEDICS

INTEGRATED AND SPECIALTY REHABILITATION

BARTON PERFORMANCE BY ALTIS

WELLNESS

THE EVOLUTION TOWARDS WELLNESS

FORM FITS FUNCTION

UNDER BUDGET!• CENTER - $18M• GARAGE - $8 M

CORE REVENUE CENTERS• ORTHO – 37%• REHAB – 30%

NEW REVENUE CENTERS • WELLNESS – 393 DISTINCT VISITS• PERFORMANCE – 307 MEMBERS

PRELIMARY RESULTS – 3 MONTHS

STAKEHOLDER RECRUITMENT• BOD• PHYSICIANS• ADMINISTRATION

FRONTLINERS

IMPORTANCE OF PROJECT MANAGEMENT• MODIFIED

COMMUNICATE, COMMUNICATE, REPEAT

LESSONS LEARNED

BECOME YOU, ONLY BETTER

THANK YOU

QUESTIONS OR COMMENTS

APPENDICES

PILLARS OF HEALTH PERFORMANCE

TRAIN WELL ◊ EAT WELL ◊ RESTORE WELL

PILLARS OF HEALTH WELLNESS

NUTRITION

STRESS MANAGEMENT

FITNESS

SENSE OF PURPOSE

WELLNESS SERVICES

INTEGRATIVE MEDICINE

ACUPUNCTURE

BEHAVIORAL HEALTH

NUTRITION