Weekends at Olive View presented by The Weekend Warriors June 2013.
-
Upload
grant-dixon -
Category
Documents
-
view
215 -
download
0
Transcript of Weekends at Olive View presented by The Weekend Warriors June 2013.
![Page 1: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/1.jpg)
Weekends at Olive View presented by
The Weekend Warriors
June 2013
![Page 2: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/2.jpg)
CastO Gezman AbdullahiO Saba Al-HashimiO Ashvin KamathO Sewon OumO Steven ReineckeO Geoffrey TsoO Adviser: Dr. Soma Wali
![Page 3: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/3.jpg)
Case
45 yo F with ESRD, DM, HTN, HLD presenting with anasarca and hyperkalemia. Admitted for initiation of dialysis… on a Friday afternoon…
![Page 4: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/4.jpg)
ChallengesO Getting non-emergent IR procedures over
the weekend does not happen at OVMC.
O Patients often stay in hospital unnecessarily for 2-3 days awaiting procedures.
O As result, patients may undergo extra invasive procedures (ie temporary dialsysis access while awaiting permacath)
![Page 5: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/5.jpg)
PurposeO Identify key services not available
over the weekend that result in unnecessary hospital stays.
O Identify challenges in implementing these services that are lacking over the weekend.
![Page 6: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/6.jpg)
Study Design
O Cross-sectional study
O Survey of housestaff on inpatient medicine for 3 weeks in January 2013
O Data collection from existing databases from Utilization Review, “Dr Balingit service”, and related departments
![Page 7: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/7.jpg)
Survey1. Over the past weekend, what is the total
number of patients that stayed in-house without medical need? What is the total number of days?
2. Over the past weekend, what is the total number of patients that stayed in-house without medical need due to home health issues? What is the total number of days?
3. Over the past weekend, what is the total number of patients that stayed in-house without medical need due to interventional radiology? What is the total number of days?
![Page 8: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/8.jpg)
Survey4. Over the past weekend, what is the total number of
patients that stayed in-house without medical need due to PICC line placement? What is the total number of days?
5. Over the past weekend, what is the total number of patients that stayed in-house without medical need due to PT/OT? What is the total number of days?
6. Over the past weekend, what is the total number of patients that stayed in-house without medical need due to cardiac stress test? What is the total number of days?
7. Other reasons?
![Page 9: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/9.jpg)
ResultsServices Number of patients Number of total days stayed
Home health 6 11
IR 15 35
PICC line placement 8 27
PT/OT 5 5
Placement Issues 4 32
Stress test 12 32
Cardiac MRI 1 2
LHC 2 4
Pacemaker placement 1 4
TTE 3 9
TEE 1 2
AFB sputum results 2 2
![Page 10: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/10.jpg)
Costs to Olive ViewO Cost of hospital stay: $2200/day
O Accounting for fixed costs such as salaries and variable costs such as medications, costs of ancillaries to operate a bed at Olive View.
O OV gets approximately $1,500/day in reimbursement for Medi-Cal recipients.
![Page 11: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/11.jpg)
Costs to Olive ViewO Cost of running one IR room (salaries and other
costs as of 2009)
O Radiology tech salary: $4,116.55 to $5,399.09 per month.
O RN II salary: $5,614.00 to $8,178.53 per month
O Interventional radiologist salary: O Dr. Au: $268,568 base, $45,190 overtime,
$41,339 additional compensation, total $355,097.
O Dr. Lee: $263,926 base, $15,817 overtime, $70,809 additional compensation, total $350,551.
![Page 12: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/12.jpg)
Cost AnalysisO For an unnecessary stay of 3 days, the
cost to Olive View is as much as $6600 per patient.
O According to survey, 15 pts stayed awaiting IR procedures over span of 3 weekends
O Thus considering an avg of 5 pts/weekend, will cost $33,000 for hospitalization
![Page 13: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/13.jpg)
Cost AnalysisO Cost of running IR lab for one weekend
(two days):O Radiology tech: $359.92O RN: $545.24O IR attending: $1945.74O The cost of running the IR lab turns out to
be ONLY $2850.90!!!
![Page 14: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/14.jpg)
O Over the 3 weekends surveyed, 15 patients stayed a total of 35 unnecessary days, costing $77,000
O Operating IR suite for 3 weekends, would cost $8552.70
O The hospital would have saved $68447.30!!!!!!
O If the data can be extrapolated, annual saving for 52 weekends would potentially be 1.1 million dollars!!!!
![Page 15: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/15.jpg)
GoalsO Presentation of findings to QI, IR department
O Challenges faced by IR department
O Establishment of IR services over the weekend
O Future goal: Establishment of other ancillary services over weekend such as: PICC line placement, Social work, Stress tests, MRI, etc.
![Page 16: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/16.jpg)
Thank you!
OPreguntas???
![Page 17: Weekends at Olive View presented by The Weekend Warriors June 2013.](https://reader035.fdocuments.net/reader035/viewer/2022062806/56649e4c5503460f94b424de/html5/thumbnails/17.jpg)
Welcome to the Olive View Family Interns!!