Premier advantages help IDN achieve $5M cardiovascular savings
Heartland Health, an integrated health delivery system, includes a medical center, physician practices, foundation and a health plan. Heartland seeks to improve the health of area individuals and communities and to provide the right care, at the right time, in the right place, at the right cost with outcomes second to none. Through commitment to this mission, Heartland Health has become the healthcare leader in a 21-county area of northwest Missouri, northeast Kansas and southeast Nebraska. www.heartland-health.com
Challenge:
Clinical quality and financial performance are inseparable. Efficiency without quality is unthinkable. Quality without efficiency is unsustainable. In 2007, Heartland Health in St. Joseph, MO, a 2009 Malcolm Baldrige National Quality Award winner, set out on a three-year journey to ensure that its cardiovascular service line – the medical center’s largest – was in the top decile for quality and top quartile for cost. "We must be better stewards of our resources,” said Lynette Wheeler, cardiac, vascular and pulmonary service leader. “It's one thing to provide quality care. It's another to provide quality care that's cost-effective and cost-efficient so patients can afford it.”
Solution:
Heartland engaged Premier Consulting Solutions™ (PCS), other Premier healthcare alliance units and Premier’s unique products, tools and databases in a transformation project to save $4.6 million while improving care and eliminating waste and inefficiencies.
The first goal was to get physicians engaged. "You must align incentives with physicians," Wheeler said, so she concentrated first on getting the hospital processes mapped and initial standardization work begun.
Patient care labor utilization was benchmarked with top performers from across the country with Premier's OperationsAdvisor® labor benchmarking and productivity solution.
Other improvement opportunities were identified using QualityAdvisor™ for clinical efficiency and quality performance benchmarking; CardiacFocus™ for cardiovascular supply chain benchmarking; and SpendAdvisor® MySpend™ for spend management decision support.
In year two, the focus was on cardiologists, first on clinic and cath lab scheduling. “We won their attention with wait times. In the first month of implementing simple scheduling changes, half our physicians reduced patient wait times by 50 percent. Since one goal was to improve patient satisfaction, this was a definite winner.”
The focus now is on heart surgeons. “We’re at the hard part,” she said, “Standardization of supplies and process. But healthcare reform has been a booster shot. The doctors are getting it. They finally understand that their practice affects our costs.” With Heartland’s three heart surgeons, there is a $200 difference between the major packs and a $100 difference in the minor packs they use. The committee outlined other differences in product use for similar procedures.
“‘We’re that different?’ they asked,” Wheeler said. “They’ve been here six years and this is the first time the difference has been questioned.”
Wheeler and her team expect to work closely with their supply chain counterparts on an ongoing basis because supply costs – especially physician preference items – change dramatically and quickly. “It’s a continuing process,” she said. “Our final outcome must be triggers on identified supplies. We need red flags that pop up to remind us about supply costs. There are too many players to leave it to chance; it’s got to be an automated system.”
Results
By employing Premier’s unique capabilities, Heartland achieved significant savings in its cardiovascular service line. The combination of clinical, financial and operational data, national benchmarks and industry-leading supply chain contracts resulted in sustainable improvements. By working with Premier’s consulting experts and pacesetting collaboratives, the service line is set to celebrate the elimination of as much as $5 million during the past three years as care improved.
PCS Principal for Client Engagement and Delivery Larry Burnett cites several reasons for success:
- Patient quality is first and foremost. “No decision is made without considering how it will affect patient quality. If anything, after three years the quality of care is better.”
- Committed leadership. “They’ve been very tenacious and focused. A lot of organizations start quickly and fade. They’ve kept their eye on the target and continued to move forward.”
- Nothing is sacred. “Every process, product and practice has been on the table.”
- Physicians are involved. “I don’t mean they have monthly meetings. I mean they bring their physicians to the table regularly. It’s been very challenging, but they’ve taken been remarkably successful with their tactics and dedication.”
- Premier products and tools provide the data.
Wheeler pointed to Burnett’s leadership; Premier’s products, tools and resources, especially the national benchmarks; consultants’ expertise; and support from Region Director Pat Bell, especially with supply chain matters.
Participating in three Premier collaboratives also helped: the groundbreaking Premier-CMS Hospital Quality Incentive Demonstration pay-for-performance project; the QUEST®: High Performing Hospitals collaborative and the eighth annual Collaborative Breakthrough Series.
"Working with Premier on this journey has been a great experience for
us,” Wheeler concluded. “We know we’re going to make our goal. There’s no think
about it. We must be competitive. Ours is a very mobile society. If we aren’t
competitive, our patients can easily go to another provider that is."
Lynette Wheeler
Cardiac, Vascular and Pulmonary Service Leader
Heartland Health
St Joseph, MO
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