1 Comanagement Collaboration Governance Model Benchmark Report Case Time Predictive Analytics Agenda Strategies for Net Cost Reduction 3 CoManagement Agreements 4 Overview of CoManagement Structure ID: 713685
Download Presentation The PPT/PDF document "Strategies for Cost Control & Collab..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Strategies for Cost Control & Collaboration
1Slide2
Co-management
Collaboration
Governance Model
Benchmark ReportCase TimePredictive Analytics
AgendaSlide3
Strategies for Net Cost Reduction
3Slide4
Co-Management Agreements
4Slide5
Overview of Co-Management Structure:
A Model of Clinical Co-Management
5Slide6
Hospital Quality Efficiency Program
6Slide7
Bundled Payment Requires Collaborative Governance
7
Strengthen the perioperative
governing body to align
incentives
for
all aspects of
Perioperative Services
Surgical
Services Leadership Committee
(
SSEC
)
Surgical Leadership
OR Nursing Leadership
Anesthesia
Leadership
Sr. Hospital
Leadership
Chaired by Medical Director(s) of Perioperative Services
Administration-sponsored Surgery Board of Directors
Controls access and operations of OR
Sponsors and directs
Perioperative team
activitySlide8
Steering Committee Responsibilities
8Slide9
Supply Costs Can Be Controlled
9Slide10
Questions to Ask
10Slide11
Physicians Scorecard
11Slide12
How to Address Outlying Behavior
12Slide13
OR Case Time is Very
Expensive
13Slide14
The Elephant in the OR: Case TimeSlide15
Case Time Date: Driving Organizational Change
15Slide16
Reduce Case Time
16Slide17
OR Case Time Variance By Procedure
17Slide18
Impact
18Slide19
Case Study – East Coast Community Hospital
19Slide20
Predictive Analytics in Perioperative Services
20Slide21
Why is Efficient Block Scheduling Important?
21
Establishes “draw down” and optimizes room utilization
2.5 FTE/Room
Approximately $300,000 Anesthesia cost
Reduces costs from having under-utilized rooms
Reduces the cost per occupied bed
F
igure 1.
Heatmapping the operating room aids
in visualizing peak operating hours and helps to minimize non-productive time.Slide22
Effective Block Design
The goal is to maximize access for the most productive surgeons
Block forecasting correlates physician practice patterns to precisely match demand for block
Predictive models also allocate appropriate time for urgent, emergent, and electively scheduled casesDrastically reduces overtime expense and improves throughputMinimizes need for additional resources after hoursHospitals use this schedule to forecast ICU admissions and efficiently manage bedsSlide23
Designing a Block Schedule by Forecasting Demand
23
Helps to load balance the OR
Reduces variance and improves predictability of the daily schedule
Improves surgeon access
Incorporates physician practice patterns into the model
Minimizes interference with clinic schedule
Reduces overtime cost
Provides “wiggle room”Slide24
Scheduling Accuracy is a Critical Component of an Efficient Block Schedule
Helps control labor costs
Reduces day-to-day variability in the schedule
Provides sufficient notice of gaps or complex casesSlide25
Scheduling Accuracy, cont.
Case Time
is non-Gaussian
Log-normally distributedSeveral effective approaches
How to best handle outliers?
Use the expectation value:
(with some guidelines)
Slide26
Case Study - What is the Daily Huddle?
H Healthcare
U United
D Daily (to make)D DecisionsL Leading toE Excellence
Recap of previous day
Total case review for next days out – PAT and scheduling
c
ompletion
Review of schedule
Total number of anesthesia providers to start the day
PAT problem review
Antibiotics review
Review pending action itemsSlide27
Unused Time = 4 hours
Unused Time = 3 hours
4
th
Case = 1.5 hours
Turnover = 1 hour
Turnover = 1 hour
2
nd
Case = 1.5 hours
Turnover = 1 hour
1
st
Case = 1.5 hours
3
rd
Case = 1.5 hours
Flip
Room
Avg. Duration
1.5
hours
Avg.
Turnover -
15
minutes
Calculating Utilization
With a negative turnover:
=
1.25 x 4 = 5/8
‘
unadjusted
’
for flip = 62%
Adding 30 min adjusted turnover between each
case:
= 1.5 x 4 + .5 x 3 = 7.5/8.0
Is the Adj. Util. = 94%
Room 1
Room 2
1.25
1.25
1.25
1.25
1.50
.5
1.50
.5
1.50
.5
1.50
Utilized
Utilized
27
Case Study - Solution for Room Flipping & Calculation for Adjusted UtilizationSlide28
Case Study - Impact
28Slide29
Case Study – Volume Snapshot 2015 & 2016Slide30
Case Study – OR Utilization Snapshot 2015 & 2016Slide31
Implementation ChecklistSlide32
Work Plan
32Slide33
Information Collection
33Slide34
Physician Scorecards
34Slide35
Clinical Redesign
35Slide36
Protocol / Clinical Pathway
36Slide37
Patient Education
37Slide38
Office Staff Education
38Slide39
Risk Reduction Tools
39Slide40
Cost
40Slide41
Implementation Checklist
41Slide42
Institution Support Is Key
42Slide43
Surgical Directions
541 N. Fairbanks Court
Suite 2740
Chicago, IL 60611
T 312.870.5600 F 312.870.5601
www.SurgicalDirections.com