#hasummit14 session #23: $74m in healthcare operational improvements: how texas children’s...
TRANSCRIPT
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Session #23:$74M in Healthcare Operational
Improvements: How Texas Children’s Hospital Is Delivering on its Vision
Mark Mullarkey,
Senior Vice President
Pre-Session Poll Question
On a scale of 1-5, how effectively is your organization using healthcare analytics to drive operational improvements?1) Not at all effective2) Somewhat effective3) Moderately effective4) Very effective5) Extremely effective6) Unsure or not applicable
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Texas Children's Hospital, located in Houston, Texas, is a not-for-profit organization whose mission is to create a healthier future for children and women throughout our global community by leading in patient care, education, and research. We are proud to be consistently ranked among the top children’s hospitals in the nation.
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Our Improvement Opportunity
• In 2006 Texas Children’s Hospital (TCH) launched a health system wide initiative named “Vision 2010” that included $1.5B investment in expansion and IT.
• Upon completion in early 2012, TCH identified the need to improve financial performance of the health system by over $50M: Federal and state funding reductions driving most of this gap.
Higher margins crucial for replenishing capital and expanding TCH facilities.
Competitive threats driving expected gap closer to $75M.
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Our Improvement Opportunity
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Delivering on the Vision (DOTV)
• “Delivering on the Vision” (DOTV) became the operational
improvement effort following TCH’s rapid facility expansion.
• To achieve DOTV, TCH would need to improve the quality of patient
care, increase revenues, and reduce costs.
• TCH strategy for DOTV encompassed several efforts.
• Goal: To close an anticipated >$70 million gap.
• The common denominator in these efforts was a need for sustained,
transparent, easily visualized data, and measurement.
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Our Approach and Results
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Use of Analytics to Hardwire for Success
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Labor Expenses
Non-Labor Expenses
Physician Services
(Provider productivity, Practice management)
Clinical Operations/LOS
Clinical Documentation Improvement
EDW Platform
Focus on improving performance in every key
operational area
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Poll Question #2
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What is your organization currently leveraging analytics for? (Select all that apply.)
a) Provider productivity and practice management
b) Financials (statement of operations, revenue cycle management, labor productivity, etc.)
c) Patient satisfaction
d) Clinical quality improvement (reduction in sepsis mortality, lower CHF readmissions, etc.)
e) Operational efficiencies (LOS, throughput, etc.)
f) Other
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Improved Schedule Template Utilization
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Improving Operational Efficiencies
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Surgical Sections – Y/Y Change in wRVU per cFTE
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The Pediatric Surgery Sections reflect a marked improvement in provider productivity by comparison to both the prior year and the 50th percentile benchmark
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Medical Sections – Y/Y Change in wRVU per cFTE
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The Medical Sections reflect a marked improvement in provider productivity by comparison to both the prior year and the 50th percentile benchmark
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Labor Expenses – Results
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Length of Stay – Results
• aaa
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• LOS up 7.5%• CMI up >11%• Severity adjusted LOS down 20%
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Success with Clinical Documentation Improvement Drives SOI and CMI Up
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DOTV Results
FY13 the hospital had an operating margin of $70.2M on a budget of $42.5M; a $79.9M improvement from prior year.
FY14 the hospital finished the year at $77M.
FY15 the hospital is projected to approach near $90M in operating margin.
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Future Plans
Continue to broaden the use of healthcare analytics in support of a growing number of improvement efforts designed to achieve higher-quality care, reduced costs, and a better patient experience.
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Lessons Learned
Clear Focus Specific Goals Prioritization of
initiatives
Targeted improvement strategies
Time sensitive
Consistent Approach
Data driven - hardwired
Process improvement strategies (PDSA)
Best practices
Governance structure
Cultural Alignment
Patient-focused access
Questioning attitude
Fiscal stewardship
We can do more and better
Right People Physician
Engagement Admin & MD
Alignment
Internally Driven
External experts
Improved Patient Experience & Financial
Performance
The key ingredients driving our success…
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Analytic Insights
AQuestions &
Answers
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Choose one thing…
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Write down one thing will you do differently after hearing this presentation
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Thank You
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Session Feedback Survey
1. On a scale of 1-5, how satisfied were you overall with this session?
1) Not at all satisfied
2) Somewhat satisfied
3) Moderately satisfied
4) Very satisfied
5) Extremely satisfied
2. What feedback or suggestions do you have?
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Upcoming Sessions
Breakout Sessions – Wave 4 (1:15 PM – 2:00 PM)
26) Panel – How Community Hospitals Thrive with AnalyticsJohn Wadsworth, Vice President, Technical Operations, Health Catalyst
27) Quality Improvement in Healthcare: An ACO Palliative Care CaseDr. Robert Sawicki, MD, Senior Vice President, Supportive Care, OSF HealthcareRoopa Foulger, Executive Director, Data Delivery, OSF HealthcareLinda Fehr, RN, Division Director, Supportive Care, OSF Healthcare
28) Clinical Standards Work To Improve Evidence-Based Care Delivery: A How-To WorkshopCharles Macias, MD, MPH, Chief Clinical Systems Integration Officer, Texas Children’s HospitalTerri Brown, MSN, RN, CPN, Assistant Director, Clinical Outcomes & Data Support; Research Specialist, Center for Research and EBP, Texas Children’s Hospital
29) Five Months to Improvement: How Stanford Built an Improvement Program the Gets ResultsSpencer H. Kubo, MD, Associate Professor of Radiology (Pediatric Radiology), Stanford University Medical Center
30) Breaking Down Silos: Resolving Academic, Medical, and Research Interests Once and for AllSamuel L. Volchenboum, MS, MD, PhD, Assistant Professor of Pediatrics, Director, Informatics Program, The University of Chicago Medicine)
Location
Imperial Ballroom B
Imperial Ballroom A
Grand Salon
Murano
Venezia