In This Issue
Keith Lundquist, FACHE
Immediate Past President (also serving as Programs Chair)
Ken Peach, FACHE
Karl Hodges, FACHE
Daniel C. Honerbrink, FACHE
Robert (Bobby) McCullough
Timothy P. Menton, FACHE
Sandra L. Randolph, FACHE (also serving as Membership Chair)
Jan Moysey, Communications Chair
ACHE of Central Florida January Event (Category II)
The subject for the January event, “Maximizing the Efficiency of Your Existing Infrastructure" was a very timely event given the anticipated influx of patients and changes in reimbursement with the upcoming healthcare reform. The Category II session was well received, thanks to the sponsorship of Florida Hospital and GE Healthcare’s Performance Solutions business experts.
Presenting were Jeff Terry, Managing Partner – Clinical Excellence for GE’s Performance Solutions and Dr. Anthony Schuster, MBA, Medical Director for Perioperative Services at H Lee Moffitt Cancer Center and Research Clinic. Mike Wright, GE’s local Performance Solutions contact, moderated the event
Mr. Terry started off the evening beginning with background on GE’s Performance Solutions business and proceeding with a thought leadership presentation on how to maximize the efficiency of your existing structure, care delivery plan, staff, and clinical assets without adding additional capacity, staff, or capital.
Mr. Terry's presentation focused on first determining the right balance of amortizing your fixed costs against the cost of congestion. Once this balance is determined, patient flow must be looked at next in order to achieve the right utilization levels. The key components of flow are:
- Proper alignment of your admittance and discharge curves in order to open beds to pull patients through your system versus pushing them
- Once you have bed availability you can then open capacity by maximizing the utilization of your front doors; ED, OR, and direct admits
- Understanding the balance of fixing both your process and scheduling and their affect on flow
- Understanding an managing the interdependent departments that interact with the patient and affect flow
Mr. Terry proceeded into details of how to affect patient flow, more specifically:
- Flow improvement is all about improvements in scheduling, governance and process.
- Every hospital has a discharge curve that peaks at around 3 pm, your goal should not be to move that peak to earlier in the day, but rather to better align it with the admittance curve to drive bed availability and improved patient care.
- Improved discharge planning has direct correlation to ED ALOS and boarding. Historically improving the discharge process has driven an 18% improvement in ED ALOS and a 65% reduction in PACU boarding, without any additional work in these areas.
- Improving your asset management program to drive improved patient flow, patient safety, patient and staff satisfaction and reduced cost. The key is to drive asset utilization by assuring the assets are in the right place at the right time in the right condition and you know where they need to go next. Typical clinical asset utilization runs at less than 60%, so the majority of hospitals are running with significantly high inventory levels.
Dr. Anthony Schuster, MBA, Medical Director for Perioperative Services at H Lee Moffitt Cancer Center and Research Clinic, followed Jeff presenting results of their recent OR improvement project. Moffitt was looking to drive improvement in several areas: 1) number of cases they were doing in their 12 ORs to facilitate improved operating margins, 2) the ability to recruit new surgeons, and 3) to delay the building of additions OR suites in this tough economy. Their performance improvement results were significant and they were able to drive an increase in output by 106 cases per month, decrease in OT by over $500k annually, and improved operating margins by more than $8M annually all while driving improvements in staff satisfaction. Dr. Schuster admitted this was not an easy process and that without outside help they would not have been able to do it.
Dr Schuster presented a key statistic that a typical OR is more than 90% blocked and under 60% utilized and Moffitt specifically had only 13% of first cases starting on time, their schedule was 100% blocked, and their rooms were 58% utilized. The keys to fixing this were:
- Open up block time by using technology to defragment the block, apply governance to assure block utilization, and using a 3rd party to socialize and adjust the improved block in order to drive surgeon buy in.
- Improve first time starts through technology, teamwork, governance and a buy in by all staff as to the definition of on time starts.
- Improve room utilization through the above and process improvement for room turnover times.
- Smooth the schedule of elective surgeries.
Moffitt’s specific improvements included:
- Improved first case start times from 13% on time to more than 80%
- Improved average room turn time from 42 minutes to 30 minutes
- Opened the block time by reducing the block from 100% blocked to 90%, opening up time for emergent cases and surgeon recruitment
- Improved room utilization to in excess of 80%
The presentation was then concluded with a Q&A session.
If you would like further information or did not pick up your Category II credits please contact Mike Wright at Michael.email@example.com or 813.957.2148.
You are invited to attend the Category I (ACHE education) event in Orlando on March 30. Join your fellow members to network, enjoy food, earn credit and learn from fellow professionals.
Topic: Sustaining a Financially Vibrant Healthcare Organization
Date: March 30, 2010
Time: 6:00 P.M. Networking
6:30 P.M. Dinner
Location: Hilton Garden Inn,
6850 Westbrook Blvd.,
32821 (near Sea World, I-4, FL Turnpike, and the Beachline)
* Bob Snyder, COO, South Seminole Hospital
* Judy Killebrew, COO, Holmes Regional Medical Center
* Daniel Honerbrink, FACHE, CEO, Hampton aDel Healthcare Solutions
Moderator: Ken Peach, FACHE, Future Vision Group
Cost: $25 for students, $30 for members, $35 for nonmembers
*Those in attendance will receive 1.5 Category I credit hours.
To Register Contact: Ann Corniel (407-303-1410, firstname.lastname@example.org) or Ken Peach (407-451-7330, email@example.com)