Dr. Andrabi began by quoting Lewis Carroll, saying “if you don’t know where you’re going, any path will take you there.” In order for a hospital to increase its quality and efficiency, it needs to know where it wants to go and how to carve a path to get there. One way a hospital can prepare for what is ahead is to use an “efficiency-to-effectiveness formula,” said Dr. Andrabi. The formula includes four main components.
1. Effective thoroughput to maximize capacity. This component involves focusing on the workflow of physicians and nurses as well as the flow of health information. When all of these aspects are maximized to their full capacity, there should be a better operational flow through the hospital. “Efficient information flow is the first step toward treating patients with the correct information at the right time to make the right decisions,” says Dr. Andrabi.
2. Improve resource management. This component involves identifying how hospitals can overhaul physician and clinician processes to systematically change operations. This approach helps hospitals identify tasks that are unsuccessful or inefficiently utilized. Then, those tasks can be replaced.
3. Quality and safety. According to Dr. Andrabi, quality and safety are critical for a hospital’s “journey to zero.” To reach zero mistakes and 100th percentile in safety and quality, a hospital needs to understand that the first decision should involve what is right for the patient, rather than what is right for the health system.
4. Exceed customer expectations. Patient experience is a major component of quality and efficiency. If quality and efficiency are reached, the patient will most likely be satisfied. In order to achieve optimal patient satisfaction, the hospital’s physicians and staff need to be satisfied as well. In addition, the hospital should strive to coordinate its system to provide the best healthcare services, said Dr. Andrabi.
Following Dr. Andradi, Ben Sawyer, executive vice president of CareLogistics, discussed four mechanics that help drive success in quality and efficiency improvements:
1. Create a culture of efficiency
2. Adopt a new care coordination model
3. Implement enterprise logistics software
4. Establish outcomes-based, real-time performance management
Ben Sawyer and Dr. Andradi turned to Mercy St. Vincent’s Medical Center as an example of potential outcomes from the efficiency to effectiveness model using the above mechanics.
Mercy St. Vincent’s Medical Center case study
Mercy St. Vincent’s is a teaching hospital with more than 190 residents, 300 medical students and eight critical care units. From 2008 to 2010, the hospital achieved improved efficiency and quality by following the above four components with CareLogistics’ mechanics. The following are some key statistics demonstrating the improvement in efficiency and quality:
• Reduction in falls and DVTs by 38 percent;
• Achievement of 97th percentile in patient satisfaction;
• Forty-nine percent reduction in infection rates;
• Core measure performance increased by 37 percent.
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