Center Streamlines Cost, Revenue and Patient Satisfaction!
Volume 7 Issue 4 April 2008
— Part II By Bill HazenCase Study: New Processes,New Software Help ASC Reach Elusive GoalsCenter streamlines cost, revenue and patient satisfaction through use of technologyL ike most ambulatory surgery centers (ASCs), the Surgery Center at Pelham in Greer, S.C., is constantly reminded of the need to accomplish challenging goals that are oftenthought to be contradictory: reducing operating costs, improving patientsatisfaction, and increasing net revenue per case. broken down by stage of the visit. We track a patient’s time in the facility very closely, because the longer a patient’s visit lasts, the less likely the patient will be satisfied. And, of course, the average length of patient visits tracks closely with costs. Our goal is to safely limit the overall length of patient stay to the least amount of time possible, which The road to meeting those goals is a modules working in unison to promote has translated into significant cost savingssteep one, especially in a surgical practice cost savings and streamlined management for the center.that, like most, comprises busy staff with functions. Included in the suite of The software was highly customized fortheir own responsibilities to fill — from the applications are a schedule manager, clinical our 19 nurses to better meet the center’ssurgeons and nurses to procurement and manager, an electronic health records, specific needs. Although it is not a full-administrative staff. The overall question financial manager, supply chain manager, blown electronic medical record, nursingfacing the facility was how could everyone report manager, an integration manager, staff can still perform certain clinical stepsbe aligned to pull in the same direction, and patient satisfaction and benchmarking. and documentation functions such as casetoward the same set of goals, when, as the As one of the first centers to deploy management procedures. For instance, allsaying goes, the one hand rarely knew what Vision software, the Surgery Center at discrepancies and variances are tracked,the other was doing? Pelham was aware that a common pitfall so when cancellations occur, the reasons For the Surgery Center at Pelham, the of any software rollout is the failure to use are noted in the system. This informationsolution consisted of two parts. First was the system to its fullest potential. We were is used to complete the ASC Associationthe commitment from physicians and staff determined to utilize all of the system’s quarterly report.to thoroughly reengineer the processes functionalities to achieve the goals we had Since reshaping our processes andwe had become accustomed to. Second identified. This was an important decision, adopting the new software, the centerwas the judicious application of software because it enabled us to fully mesh our goals has enjoyed very strong results. Patientthat addresses a full range of practice- with the system’s capabilities. satisfaction stands at 99.85 percent. Inmanagement functions. And it goes without Today, our practice-management software July 2007, case cost dropped to a recordsaying that the entire staff was to remain handles virtually all management functions, low of $159 — including medical supplies,constantly mindful of the fact that high including real-time, live monitoring of implants and drugs. Average case cost nowquality patient care and patient satisfaction charges during procedures in the operating stands at a modest $214, and inventory hasare always our overriding goals. room. When a case is over, an administrator been kept below $205,000 for our 450 cases can meet the surgeon at the door and per month.Successful Process Transformation immediately present the full cost of the case. Another important element of the center’s The foundation of our successful Cost tracking is truly comprehensive, down improvements to practice management isprocess transformation has come from the to $0.04 thermometer covers. the implementation of a quarterly incentiveuse of Vision software from Birmingham, Vision also features a tracking system program. We use Vision to track the bonusAla.-based SourceMedical. Vision is a that allows staff to monitor the exact amount criteria, and we have been very pleased atfully integrated solution that includes eight of time a patient spends in the center, the level of detail the system allows us to
“The foundation of our successful process transformationhas come from the use of Vision software from amounts of paperwork for the end of a shift. As this example demonstrates, a majorBirmingham, Ala.-based SourceMedical.” priority of our process upgrade was to be more mindful of the time constraints that everyone faces: our physicians, our staff, and of course, our patients.monitor. For staff to collect the full bonus, Even the physicians are closely monitored The results to date have more than livedthe following five criteria must be met: when it comes to case costs. For example, up to the expectations of physicians and each physician is assigned a confidential staff, and although every staff member has1. Inventory must be below $205,000 number that represents his or her costs per had to alter his or her work habits to meet2. Net revenue per case must be $1,500 or higher procedure. So when evaluating the cost of our efficiency goals, the results have made3. Patient satisfaction must be 98 percent or higher an ACL reconstruction, each physician can those efforts worthwhile. Indeed, physicians4. Physician satisfaction must be above 98 see where he or she falls in the cost arena. and administrators at other ASCs might percent Highlighting those numbers prompts the well find our example to be useful as they5. Full-time equivalents (FTEs) must be 13 or physicians to share with each other the best look for ways to navigate a changing, often fewer per case strategies for performing the procedure challenging, healthcare environment. o with the least expense. In many cases, our Other tactics, used in conjunction with the physicians gravitate to using the same supplysoftware, have enabled the center to achieve sources as a result of sharing this information, Bill Hazen, RN, is the practicean overall reduction in operating costs. For which leads to better prices through their administrator for theexample, we obtain supplies on consignment group purchasing power. Surgery Center at Pelham.when possible, use single-source vendors, and And last, but certainly not least, Vision He can be reached atuse custom packs for various cases. These and software allows staff to handle their firstname.lastname@example.org initiatives have contributed to streamlining administrative duties throughout the coursethe center’s operations and reducing costs. of the day, rather than postponing significant SrcMed-TSCrprt08-2H4C.indd 1 4/23/08 8:37:47 AM