slides 006 - needs based efforts for october nha
TRANSCRIPT
Community Needs Analysis Is Of Critical Importance
“Wishing and Hoping May Not Get us Where We Want to Go”
1
Thur., Oct. 22nd, 2015
Presentation Team and Introductions
• The Owner’s Perspective: Jeff Prochazka, Director of Strategic Planning, Methodist Health System
“Why Did We Do Our CHNA And What Are Our Needs?”
• The Architect’s Perspective: Patrick Leahy, Director of Planning, Research and Innovation for Holland Basham Architects (HBA)
“Do Architects Support CHNA’s and CON’s and FGI Efforts/”
• The Planner’s Perspective: Jim Easter, Principal, Easter Healthcare Consulting (Ehc)
“Isn’t Planning Changing to Asset Management and Dollars?”
• The IT/IS/Systems Perspective: Alan Dash, Principal, The Sextant Group
“How Will IT/Medical Communications Change our Vision for The Future?”2
Learning Objectives• O1: Some Historical Perspectives, Good or Bad, Here They Are
And Many Are Money Related.
• O2: Population Health Management Should Support Needs
Based Efforts, How Does that Work?
• 03: Who Benefits In This World of Needs Based Planning?
• 04: We Are Changing The Focus of Planning to Strategy and
Finance:• Why CHNA?
• Why CON?
• Why FMP?
• Who Wins?
• What Works Best? 3
Just A Little Background
4
We’ve Seen So Much
Planning + In America, Why Is That The Case?
Needs Wants and Wishes Competitive Dynamics Cost and Economic Development Process Change and Consumer
Awareness Technology
TheCONProgram
TheDeficit ReductionAct And COBRAPlus Medicare
ThePPS for MDsAndHIPAA
TheBalancedBudget ActPlus CMS Reforms
5
The Recent SupremeCourt Ruling
AndThe 2016
November Elections.
?
Sharing Ideas and Impressions(The Future Is Not Here Yet…Hard To Predict, Trends Are Easier To Manage)
• Regulatory Impact (ACA and Private Pay – ACO a little too fast…move toward Co-Management with MDs).
• Mergers, Acquisitions and Network Partnerships.
• Community Health Needs Assessment (CHNA).
• Certificate of Need (CON).
• Guidelines and Standards of Practice.
• Research and Regional Implications.
6
Summary of Todays Discussion
A Basic Trend Of Doing“More With Less”
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1. Different Types of Beds and More Ambulatory Care2. Improved Access, New Processes and Better Design3. Enhanced Efficiency and Cost Reductions
What Are The Consumer Benefits?
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1. Shorter Waiting Times.2. Convenient Access Through Better Pre-Arrival Work
Up and Preparation Efforts.3. Better Wayfinding Less Waste.4. Improved and Safer Access plus Handicap and HIPAA.5. Right Sizing and Right Treatments = Less Costs.6. Best Services Not Always Most Revenue (Emergency)
Summary of Today’s Discussion
Key Elements of a CHNA ProcessIntegrated Strategy and Master Plan(Market Share, Capital Budget, Space Needs, Master Plan, Process Change)
Partnership Effort On Strategy and Process
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Process Change and New Technology(We Are Learning Together)
Teamwork Is MandatoryHow The CAH/CHNA Links Providers With Overlapping Objectives Into the Service Area (Why Do We Need This Intensity of Effort?):
• FQHC and Primary Care Patnerships
• Acute Care Partner
• Fulfilling the Hospital’s Mission and Vision Via Partnership With Care Receivers And Other Providers (City, County, Federal, Public and Private)
• County Health Department
• Local Nursing Care Centers
• Mental Health Association
• Correctional System
• Pharmacy
• Local Practitioners
• Public School System
• Business Community
Our Responsibility.
Who Involved? Why?
Incentives?10
CHNA – An Overview
• New (2010) Requirements for most Tax Exempt
Hospitals (2,894 of total 4,999)
• Dual eligible (federal NFP) not required to provide
• While required, should be viewed as a useful tool to
determine vulnerable populations and health disparities in
the community
• Most hospitals haven’t utilized the information other than
to meet requirements
• Next wave of assessments to be conducted in 2016 (for
2015) 11
Key Elements of a CHNA Process
1. Data Assessment
- Service Area
Defined
- External and
Internal Sources
- Local Studies
- Community
Inventory
2. Community Input
- Public Health
- Underserved
Populations
- Chronic Disease
Populations
- Others
3. Implementation Strategy
- Summary of Data and
Community Input
- Prioritizing
- Implementation
Strategy for Each
- What is NOT included
and Why?
4. Reporting
- CHNA Summary
Report
- Implementation
Strategy Board
Approval
- Posted on Website
- 990 Reporting
5. Monitoring
- Measurements
- Annual Data
Updates
- Prepare for the
Next CHNA
What do we know? How do we package the
final material?
What are the priorities and
how do we implement?
What are we hearing?
What are we doing to track
results?IRS AuditOf Gaps!
Community Planning – CHNA
Partnership Effort On Finance, Needs and Strategy
Must ShareThe DataTo Work
Effectively!12
ACO Timeline
2007
Elliott Fisher of Dartmouth Medical School publishes “Creating Accountable Care Organizations: The Extended Hospital Medical Staff.” He is generally credited with coining the phrase “Accountable Care Organization.”
2011
• 3/31/11: CMS releases its proposed rules for the “Shared Savings Program,” inviting commentary before rules are finalized.
• 6/6/11 Comment period closes.
• Final rule will be released after all comments have been reviewed.
• CMS will accept applications for ACOs and will approve or reject by 12/31/11.
2014
All first year ACOs will have reached the shared risk stage, if they have continued with the Shared Savings Program.
Beyond2010
PPACA signed into
law
• Outlines a “Shared Savings Program.”
• CMS will determine how this program is to be implemented.
32 Around USA But 1/3 Dropped Out 13Supreme Court Ruling Has Impacted Many Service Delivery Programs.
Keys to Success
Successful Co-
Management Agreement
Transparency
The Necessary
Tools
A Clearly Defined Plan
Service Line Expert
Established Expectations
Physician Leadership
Active Participation
Future Physician RelationshipsEmployment + Co-Management
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Assessing “Common Good” In Society• Understanding the Basic Business Planning Principles That
Have Common Value Across The Board:• Access, Linkages and Referrals – Time Is Life Saving and Expensive
When Wasted. No • Nebraska Map of distances between hospitals.
• Longer Term Implications for access and connection.
• Partners with Federal Agencies
• Partnership With City/County Leadership
• Collaboration With Utility Providers (Water, Sewer, Electrical)
• Collaboration With Real Estate and Urban Planning
• Selecting key Consultants to Support CAH15
Nebraska Systems Are Working
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93 Counties90 Hospitals
64 CAHs6 FQHCs
2 Investor Owned 2 Medical Schools
Strategy + $ + Architecture
• Strategic Planning, Facility Master Planning and Detailed Functional Programming
• Staffing, Quality and Change Management (Hospitalists, Intensivists, Robots, Scribes, Technology, Extenders)
• Step-by-Step Process Following Basic Needs Analysis• Part of a Justifiable Business Plan• Road Map With Options And Detours• Vision
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Opportunity +
• Innovation and Creative Considerations:• Ambulatory Care Options For Small and Rural Communities• Shifting to Free Standing Emergency Centers, Ambulatory
Surgery Center and Primary / Visiting Specialist.• Creative HealthParks• Greenhouse Design for Senior Care• Memory Care and Assisted Living• Congregate Care Via The Full Continuum
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Key Questions• How Will Population Based Health and Integrated
Delivery Systems Impact Technology?
• Why Would “Needs Based Efforts” Apply In The Technology Arena?
• What Are The Asset Implications Of An Integrated Healthcare Delivery System?
• How Will Rural Health Services Change Over Time?
• Will IT Programs For the Future Show An ROI and What Are The Potential Savings?
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A Planning Perspective From Need, to Region, to Rural, to
The Front Door.
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Shift From Building Master Planning (MP) to Integrated System-wide Master Planning:
Consolidation Efforts (Impact of MD Employment and Extender Efforts)
Demolition (Combined With Preservation In Some Cases)Community Linkages and Continuity of Care (Needs Based and
Population Health)Real Estate (Re-Alignment of Assets Using Technology and Creative
A/E Design plus Energy is Expensive)Process Improvements (Modular Design, Waste Reduction, Efficiency
Metrics – HCA FacilitiGroup and Ascension Medexcel+ Trimedx Biomedical Support Program)
Technology (EMR, Digital, Remote Telemedicine and Robotics)
Why: More Effective Care With Better Access/Consolidate. GPS,
Onuma, Trelligence and Revit for A/E and IPD applications.
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Rural Health and Shifting Service Delivery DynamicsCAH Transition (25 + 10 Utilization Shifts). ADC = 8+/-CAH Move to Free Standing ED and Post Acute ModelHealthPark Applications With Modular and Flexible
Components (Re-Alignments and Re-Purposing for Efficiency Purposes)
Rural Health Linkages to Post Acute, Rehab, Nursing Home, Assisted Living, Memory Care, etc.
CAH Partnerships and FQHCs, Medical Home Models,TeleMedicine, Robotics, Centralized Clinical Support
Centers (Clinical and Asset Implications)Leveraging Regional Partnerships and Economic Development (City, County, State, Public Health,
Industry and Family)
Why: Rural Areas Are Changing, It Is Time To Change.
2
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Emergency Medicine (Industry-wide Trends)No Waiting Emergenuity ModelFree Standing EDs (Trend Driven) Free Standing ED + HealthPark Support ServicesRetail Medicine (Jury Still Out0Process Change and Training plus Performance Focused Clinical Pathways (SA, Children, Seniors, Cardiac)Enhancement of Efficiency + IncentivesRural and CAH Partnerships (Impact of FQHC Programs)
Why: Advanced, Less Expensive, Higher Quality Service Delivery Plus ED’s Need To Be BetterTeam Members. Stronger Data Interface.
3
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• Understanding The Dynamics and The Situation
• Changing Systems, Processes and Methods
• Community Linkages plus Demands
• Cost Reduction, Waste Reduction and Change
• Real Estate Re-Alignment and Savings (Energy, Rent, etc)
Integrated System-wide Master Plan(Full Continuum, Multiple Sites, 30,000 Foot Perspective)
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Integrated Systems and NetworksWith Implications For The Provider
IntegratedCollaboration
Clinical IntegrationWork Flow Mapping
(Process)
Master Planning Strategy
Architecture EngineeringConstruction
EPICCompliance
Follow Through
With Facility Linkages
TelemedicineePharmeImageeUrgent
Long Distance – Video Conference/Consult
Master Planning Process
Integrated System-Wide Planning
• Strategic Re-Alignment• Location and Needs• Highest and Best Use• Convenience• Efficiency
Clinics In The Right Location For TheRight Reason, the Right Cost, Right Sequence
and Appropriate Need.
NewTower
Specialists
ClusterServices
ClusterServices
ClusterServices
ClusterServices
ClusterServices
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Integrated System-wide Master Plan(Full Continuum, Multiple Sites, 30,000 Foot Perspective)
1. Situation, Mission, Vision, Goals and Objectives
2. Cultural Work Up + Data Collection
3. Asset Work Up, Inventory + Image + Updated Plans
4. System Work Up, Capacity + Conditions
5. User Perspectives, Daily Situation, Concerns
6. Consumer Perspectives, Patient and Family
7. Clinical Perspectives + Needs plus Physician Input
8. Size, Time, Money and Priorities + Phases of Change
9. Debt Capacity
10.Decisions + Action 27
Operations + Assets + People(Strategy, Buildings, Systems, Access, Process and Economics)
OldFragmentedObsoleteLow TechPoor EnvironmentNon – CompliantInefficientWrong LocationImageSafety
PartnershipsResource Re-Alignment
System UpgradesSmaller
Higher CapacityLess Maintenance Dollars
Shorter StaysFriendlier Staff
Safer + Modular + FlexibleSMARTER ARCHITECTURE
Program + Master Plan = Design
Excellence
The Architectural Program should be a key
aspect of the hospital campus master plan (MP).
The precursors to programming include: Owner and User Orientation to Process
Establish a Planning and Programming Leadership Committee
Completion of a Strategic Plan (Usually by Staff or Consultant)
Completion of a Campus Master Plan (MP) By Healthcare Consultant/Architect
Completion of Building Gross Program (All Departments Sized Using Various Methods)
Formal Approval of the MP and the First Phase Projects to be Programmed
Ideally, the Departments Are Programmed
Simultaneous With the MP
Process…Better Results! (Often a Fee Issue With Owners) 29
What is Programming in a Traditional Sense?
A PROGRAMMING MATRIX FOR HOSPITAL PLANNING
GOALS FACTS CONCEPTS NEEDS ISSUES
FUNCTIONMission Statistical Data Service Groups Space Requirements Unique and important
Maximum Number Area Parameters Departmental Groups Room By Room Performance standards
Individual Identity Manpower/Workloads People Groups Equipment that will ultimately
People Interaction/Privacy Utilization Trends Special Activities Systems/Services shape/drive function and
Hierarchy Of Values User Characteristics Priority Parking Building design.
Activity Security Community Security Outdoor Spaces
Progression Value of Loss Sequential Flow Building Efficiency
Relationships Segregation Time/Motion Studies Separated Flow Functional Alternatives The existing building is
Encounters Behavioral Patterns Linkages/Networks obsolete...should be
Efficiency Space Adequacy Separated Flow replaced.
Mixed Flow
Relationships Can't recruit physicians
FORMSite Elements Site Analysis Enhancement/QA Quality (Cost/SF) Major considerations that
Site Land Use Climate Conditions Climate Control Environment and Site will ultimately impact
Property Ownership Code Survey New Image/Character Influences On Cost building function and
Environment Neighbors Engineering Survey Safety design quality.
Individuality Soils Analysis Special Foundations
Quality Direction FAR/GAC Density
Access/Egress Surroundings Interdependence The building is in the wrong
Image Physiological/Psychol. Home Base Location
Quality Level Cost/SF Network
Efficiency Orientation/Access No land available nearby.
ECONOMYAmount Of Funds Cost Parameters Cost Controls Project Budget What is the general attitude?
Return on Investment Maximum Budget Allocation Of Resources Operational Costs related to the initial budget
Cost Effectiveness Time-Use Factors Multi-Functional Debt Capacity expectations and real project
Initial Budget Operational Cost Market Analysis Merchandising Life Cycle Costs cost and that relationship
Capital Costs Income/Reimbursement JV/Investment Energy Costs to project quality standards?
Operating Costs Maintenance Energy Source/Costs Energy Conservation Loan Capacity
Capital Expenses Economic Data Cost/Benefit Reserves
Life Cycle Life Cycle Reductions Competition
Equipment Activities/Climate Design Related Groups
Systems/Energy Historical Position Capital Cost Pass Through
Automation Credit Rating
TIME Preservation Significance Adaptability Escalation Implications Of Change, Growth
Master Plan Behind/Ahead Phased/Staged Phasing Plan on the overall long-range
Past Static/Dynamic Space Parameters Tailored/Loose Fit Workplan performance of service
Change Activities Convertibility
Present Growth Projections Expandability
Controls/Limits Linear Schedule Concurrent Schedules Leadership is key
Future Occupancy Date Progress Interchangeability
Revenue Streams Limiting Factors Fast Track Conservative leadership today.
What Is The Statement Of The Problem....Opportunity?
To create a more
efficient hospital
Zoning requires a 50’ set back with
a 5 story max. height
The budget is $50 M total project cost.
Funding?
Use a CM and prepare early
release packages will help us open
quicker
What does LEED gain our
community, building users
and staff?
Doesn’t it Cost more to achieve the LEED status?
We’ve converted
to CAH, now we
must down-size
We prefer the
PlanetreeConcept
Is
GreenhouseDesignMore
Expensive?
30
Integrated ProjectDelivery (IPD)
Is On The Horizon
For The Future.
Beginning Our
Capital Campaign
$
31
Other Site Plan
Studies For
Campus Plan…
Location
Access
Growth
Image
Value
ROI
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Simply Stated “Rural Health Will Be About Doing More
With Less And More Creatively”What Does This Mean Architecturally and More Importantly,How Do We Plan for The Changes?
What Will the Buildings Look Like and How Are They StructuredTo Be Cost Effective, Efficient and Less Wasteful?
Who Are The Primary Stakeholders and What Must They Do to Survive?
Are There Trade Off’s?(Yes, There Are A Few)
Partner Or Co-Manage Or New ManagementAdd + Expand Services
(Geriatric Psych, Memory Care,LTC, Senior Care, Post Acute Rehab Care)
Consider Linkages RegionallyProcess Improvement
Expert Coaching and DirectionExtenders, NPA’s, IT Leadership
Master Plan AssetsStrategic Shift In Direction
The Rural Health Situation(CAH, Step Down, Post Acute, ED, Free Standing ED orPossibly Innovative HealthPark Model; Less Costly and No Waste)
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B Model – M odest Reductions
M ASTER ZON IN G (M Z)
Conceptua l Design Our MP studies have illustrated the OPTIMUM HEALTHPARK but not a “precise application” on behalf
of the TRHMG smaller versions that may be more applicable to suburban and rural areas. In order to
prepare the prototype models, one must make some “gross assumptions” . In this case, we will TEST OUR
concepts with staff early in 2013 (scheduled for February briefings at this time).
Prototype M odels Plus Smaller Components
The development of these models is actually a reasonable way to begin a “prescriptive and iterative
process” which provides both CASE STUDIES and illustrative models that may be creatively adapted to the
TRHMG/ TRHMC regional services. Changes will occur as the MP process evolves due to the system-wide
adjustments in staffing, IT system enhancements and process improvements. These models will combine all
the existing services and “ test” as mentioned previously, new linkages that may not be readily apparent at
the onset. Briefly, each model; the A Model -- Full Scope, B Model -- Modest Reductions and C -- smaller
model all move toward the preferred groupings identified at the start of the MP process. (see representation
at left).
Each illustration decreases in size from 82,547 GSF to 49,586 GSF and finally, 33,988 GSF. The Excel
back up programs have been designed to permit a “careful and methodical selection” of rooms and
services that ultimately build the “preferred prototype” project. Smaller versions of these models can drill
down to the very basic services for example, the following:
A 9 E/ T Physician Clinica l Practice (No Diagnostic Support) New Construction:
o 10,070 BGSF (1,119 per MD)
o $2.0 to $3.0 M Total Project Cost Including All New Equipment
A Free Standing 6-Room Urgent Care Center Only:
o 5,710 BGSF for 6 Rooms plus Support
1. $1 - $1.5 M Total Project Cost Including All New Equipment
C Model – smaller model
Scope
A Model – Full Scope
A Model – Full Scope
Scope
A Model – Full Scope
Models Developed By Function and
ProportionalTo Need, Scope and
Situation.
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Imaging
ASCSurgery
Pre/Post Recovery
Lab
Women’sService
FSED or Urgent
Care
Pharm
PhysicalRehab/Fitne
ssCompMed
InfantCare
Co
nco
urs
e o
r M
all
MO
BC
afet
eria
CommunityEducation
Eng
SleepCenter
“A Clinically drivenAnd ACO FriendlyCenter”
“Outpatient = Instant Referral”
Spa
ALot of
Parking +ADA
spaces
ConvenienceOptimumVision + GrowthDirectionImpressionsHealthPlace FitnessAlready An IssueRegional ImpactClinical Pathways:
-Seniors-Women-Infants-SA/Pain/Addicition-Education -Prevention
Spiritual
WellnessCtr
CommunityOutreach
ALot of
Parking +ADA spaces
An IDS Friendly HealthPark With ED Hub
Retail:
PharmacyDME
CosmeticApparelPodiatricWellness
Other
An Important Rural Opportunity!Less Expensive + More Appropriate.It’s About The Outpatient Package.
37
The ED Is The WindowTo The Community
(Demand, Exchanges, Convenience, Portal of Entry, Poor PC Support)
LastingImpressions!
38
Key Drivers Of Change
• No Wait ED (Never The Patient)
• Bedside Triage/Registration
• Immediate Care In Rapid Assessment Unit (RAU)
• Tests/Treatment/Disposition Within An Hour
• Internal Disposition Area For Vertical Patients
• Functional Roles For Clinical Staff
• Performance Metrics Driven Model
Emergency Department Process Change.
40
High Capacity Unit
Fewer Filters - Patients Go Directly To ED Bed Immediate Nursing Assessment
Immediate Physician Assessment
Bedside Registration
Registration
Triage
Waiting Room
Main EDFewer ED FiltersNo WaitingNo LWOBS
Decreased Time Provider
Greeter
Rau
IDA
Holding Patients
Improved Process Changes
Decision Made On Need For “Stretcher Time”
Patients That Do Not Need Stretcher To IDA
Patients Requiring Complete Work-ups To Main ER
Super Track Process Map – Split Flow State
43
Traditional Capacity / Demand Analysis
Recommendation:29 Beds Currently40 Regular Beds Recommended
44
RME Model – Results Waiting
Recommendation:29 Beds Currently32 Beds-9 Chairs Recommended(Less Space Required Based on Function)
Re-design staff work spaces to support activities
Concentration
Consultation
Collaboration
Standardization & Innovation
• Standardized modules support efficient throughput• Modules support patient care pods / zones
images: Herman Miller Healthcare
Adaptive Environments & Innovation
• Design total work environment based on activities, needs & technology
Standing/TouchdownSeated SpacesVirtual Collaboration SpacePACS StationCopy / Fax StationSpecialty Carts
Adaptive Environments & Innovation
• Configuration supports efficiencies & reduces steps
• Lower support core enhances visibility
• Adaptive environments support process change & reconfiguration
• Medications, digital images & supplies easily accessed
• Partial height panels support ‘on-stage / off-stage’ activities
Business Performance Enhancements
LEAVE WITHOUT BEING SEEN (LWOBS)REGAINED PATIENT VOLUME
ADMISSIONS INCREASED ED ADMISSIONS &
REDUCTION IN DIVERSIONS
ANCILLARY TESTING INCREASED OP DIAGNOSTICS
OBSERVATION STAYS/RE-ADMISSIONSAVOID PENALTIES/2 MIDNIGHT RULE
.26% $1.87 M GAIN
157
PAT.PER DAY $2.63 M GAIN
MORE TESTING REVENUE
REVENUE
OPERATIONAL IMPROVEMENTS
TRADITIONAL
MODEL
HIGH
PERFORMANCE
MODEL
2.6%
149
PAT.PER DAY
LESS TESTING REVENUE
REVENUE
Case Study
Economic Impact
FACILITY PERFORMANCE ENHANCEMENTS
CAPITAL IMPROVEMENTS LESS OVERALL AREA REQUIRED
MEDICAL EQUIPMENT SAVING FEWER ROOMS BEING EQUIPPED
FURNISHINGS/EQUIP. SAVINGS PERMANENT BUILT VS. ADAPTABLE
FURNISHINGS DEPRECIATION LONG TERM VS. SHORT TERM
FACILITY IMPROVEMENTS
$8 MIL
MORE REQUIRED
MORE REQUIRED
30 YEAR
$6 MIL
LESS REQUIRED
LESS REQUIRED
7 YEAR
TRADITIONAL
MODEL
HIGH
PERFORMANCE
MODEL
CASE STUDY
Economic Impact
OPERATIONAL PERFORMANCE ENHANCEMENTS
OVERAL SATISFACTION
DOOR TO DOC TIMES
WAITING ROOM USAGE
CAPACITY DIVERSIONS DECREASED
40th PERCENTILE
60 MIN
ON AVERAGE
90% OF TIME IS FULL
700 HRS/YR
90th PERCENTILE
< 20 MIN
ON AVERAGE
90% OF TIME IS EMPTY
200 HRS/YR
( 0 HRS IN YEAR #2 )
FUNCTIONAL IMPROVEMENTS
TRADITIONAL
MODEL
HIGH
PERFORMANCE
MODEL
CASE STUDY
Economic Impact
STAFFING PERFORMANCE ENHANCEMENTS
NURSE PRODUCTIVITY EXTENDERS/MIDLEVELS/RECRUITMENT
STAFF SATISFACTION RETENTION & RECRUITMENT
ROLES AND RESPONSIBILITIESREALIGNMENT IMPROVEMENTS
PRODUCTIVITYSCRIBES /RESIDENTS/INTERNS
THRU-PUT BARRIERS
FRUSTRATION
RATIO NURSING
MULTIPLE RESPONSIBILITY
LEAN PROCESS
SATISFACTION
PRIDE
FUNCTIONAL NURSING
LEVERAGED RESPONSIBILITY
STAFFING IMPROVEMENTS
TRADITIONAL
MODEL
HIGH
PERFORMANCE
MODEL
CASE STUDY
Economic Impact
Economic Impact
LEAN OVERALL PERFORMANCE
STAFFING BURDEN
BUILDING AREA26,800 ED+
23,400 ED ONLY
24,000 ED+
20,600 ED ONLY
10% REDUCTION IN ED +
12% REDUCTION IN ED ONLY
16% INCREASE IN CAPACITY
EMERGENCY
DEPARTMENTINCLUDING: DIAGNOSTICS, OBSERVATION &BEHAVIORAL
HEALTH
TRADITIONAL
MODEL
HIGH
PERFORMANCE
MODEL
LARGER DEPT.
= MORE STAFF
SMALLER DEPT.
= LESS STAFF/
LESS STEPS
CASE STUDY
PERFORMANCE MODELKEY BENEFITS
OPERATIONAL• THROUGHPUT/EFFICIENCY/FLEXIBILITY• VOLUME/GROWTH• COMPETTION/MARKET SHARE
FINANCIAL• ROI/REDUCED OPERATING COSTS/VALUE BASED• MARKET SHARE• REIMBURSEMENT
CAPITAL INVESTMENT
• MEASURED INVESTMENT• VALUE BASED VS VOLUME BASED• REDUCED CAPITAL EXPENSE/OUTCOME DIRECTED
DELIVERY
• EFFICIENT/FRIENDLY/SAFE/SECURE• RESPONSIVE• PATIENT RESULTS ORIENTED
The Patient 1st.
Thank YouQuestions, Thoughts and Suggestions
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