Optimizing Flow: Driving Patient & Provider Benefits

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What’s happening today?

Only 25% of every dollar goes to patient care

Reducing costs is an imperative

Hospitals are feeling recessionary impacts

Consumer expectations are changing

Revenue pressures are increasing

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Concept of Flow

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Lean Tools: Applied to Improve Quality while

Reducing Time and Cost

Recurring Theme throughout History

Flow: Eliminate “Unevenness” through

the System

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Lean in Healthcare

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View Value from Patient Perspective

Understand Process & Clear Obstacles

Guiding Principles to Drive Flow

• Staff & patient moving continuously• No patient waiting, no idle staff• Pull materials, supplies, medications when needed• Synchronize assets, patient schedules and staff• Ensure information integrity at first capture

“Pull” from Preceding Events

Build in Flexibility & Responsiveness

Strive for Perfection

Patient Focused

Provider Focused

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Applying Flow

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•Patient access•Admission to seeing Doctor / pre-op prep•Therapy delivery•Checkout / discharge to follow-up

•Capacity management and patient throughput•Charge capture, documentation, coding•Health information management•Checkout to billing and reimbursement / collections

•Lab•Pharmacy•Materials Management / Purchasing• Nutrition services

Patient Pathways

Administrative Processes

Service Operations

Link patients with service delivery across internal bou ndaries

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Recovery

Endoscopy Patient Journey

ExitORHallwayPre-OpPrepWaiting Room

Admit

Case Study

TT TT TT TT TT TT TT

“One Patient Flow”

Issues• Administrative batch processing

• Duplication of tasks• Poor asset productivity

• Sub-optimal space utilization

Situation• Wait times of 2 - 3 hours• Low patient satisfaction

• 14 patients per day throughput

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Low Procedure Room Utilization

Reduced throughput and high patient wait times

Softer bedding increased utilization 50%

Procedure Room Utilization

CE174%

CE226%

Older patients not transferred to large room due to hard bed

Small Room

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Asset and Space Improvements

Large beds consume recovery room space and are difficu lt to maneuver

Oversized Beds TrolleysTrolleys

Implemented trolleys in procedure and recovery rooms

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Recovery Room Improvements

Transforming waiting room into daycare patient preparati on room gives five patients privacy and keeps them out of va luable bed space

C C

C

CC

Improved Admissions

Eliminated patient batching

Improved Space

20%20%

Patient Throughput

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Long Lead Time for Appointment

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Case Study20 - 40 day scheduling wait for Cardiac Scan

Increased capacity

Upgraded equipment

20%20% 30%30%

Patient Throughput

Processing Time

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Long Delay for Discharge

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Case StudyTypical 2 - 6 hour wait for patient discharge

Established 24-hour notice “pending” discharge

Streamlined lab/radiology workflow

50%50%

Discharge Time

Improved Patient requirement data collection

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High Wait Times in Outpatient Clinic

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Case Study

15%15% 50%50%

Revenue

Waiting Time

Low patient satisfaction: 2.5 hour appointments

Registration bottleneck

Eliminated redundant activities

“Externalized” select tasks

Streamlined data collection

Check-up Room bottleneck

Rebalanced staff routines / workflow

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Impacts:

Reduced Capacity

Decreased Return on Capital

Issues:

� Fewer procedures performed

Poor Productivity

Increased Risk-Management Issues

Example � Patient wait times are prevalent� Bottom line impact is compelling

� Equipment not optimally utilized

� Additional personnel required

� Frustrated patients

A recent study demonstrated that 10% reduction in length of stay in a 800 bed hospital

� Frees up 80 beds/year

� Allowing 4000 additional procedures

� Increases operating profit by $30M

Inefficiencies Impact Profitability

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Impact of Flow

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Wait Time

Patient Stay

Quality

Patient Satisfaction

Costs can be reduced while improving patient outcomes...

Capacity

Productivity

Material Costs

Revenue

...While implementing the priorities of the provider

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Healthcare Improvement Operating System (HIOS℠)

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FinancialPatients &

PayersInternal

Operations

Patient-centered, purpose-driven performance managemen t system

• Quality Control and Safety• Capital Productivity• Service Department Effectiveness

Process Excellence

• Appointment and Internal Wait Times• Effective Outcomes• Lab and Pharmacy Responsiveness

Patient Experience

• Staff Productivity• Scheduling and Internal Coordination• Patient Flow and Throughput

Operational Efficiency

Deploys the Healthcare Executive Agenda with key performance metrics

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Improved Outcomes

Patient-Centered

From Accession... ...Through Delivery of Care...

...To Effective Outcome......To Bottom Line Results!

Ron MelcherExecutive Vice Presidentr.melcher@argoconsulting.com404.307.4681

www.argoconsulting.com

Significantly enhance patient satisfaction and outcomes

We focus on your defined business priorities. Our engagements are designed to quantifiably improve your operating and financialperformance, while significantly enhancing patient satisfaction and outcomes. Our goal is to provide no less than a 5:1 ROI.