1. © 2016 Vizient, Inc. All rights reserved.
ODB Most Improved
Mining the Operational Data Base
June 2016
This periodic newsletter showcases organizations that have significantly reduced expenses and/or
improved operations in key areas over the past year, according to analysis of the Operational Data Base
(ODB) data. If you have questions about this issue or would like assistance in maximizing the value of the
ODB program, contact Jack Gottlieb at (312)775-4191 or Sheri Downey at (412)494-4908.
Oregon Health & Science University (OHSU) improved capacity utilization in two
1
of its community
Oncology/Hematology ambulatory clinics between January and December 2015, compared with the
previous 12 months as measured by a 26.8% collective increase in visits per exam space per hour of
operation from 0.21 to 0.26. During the same period, the Vizient AMC/Major Teaching compare group
median increased by 3.4%.
Use of ODB/ActionOI Data
• OHSU uses the ODB/ActionOI data to identify opportunities for financial/operational improvement and
for more efficient utilization of organizational resources. Leaders routinely use ODB metrics to review
departmental productivity compared to benchmarks, to evaluate requests for additional resources,
and to support cost saving initiatives. Integral to the successful application of ODB findings are the
relationships and networking opportunities to share best practices among Vizient peers.
Reduced Capacity and Increased Volume
• Recognizing that its clinic space was being underutilized, OHSU incrementally reduced its number of
patient examination spaces in the 2 clinics by 17.9%, from 56 to 46 spaces.
• Concurrent with the capacity reduction initiative, the following initiatives contributed to a collective
17.5% increase in patient visits:
o An improved pre-authorization process enabled physicians to more easily refer patients for
infusion therapy visits. At least one financial counselor was dedicated to address the
increasing number of prior authorization requirements before to treatments and scans.
Volume and work required of the financial counselor team was carefully monitored and flexed
appropriately amongst clinic sites to mitigate the risk of seeing a patient without a prior
authorization.
1
The two OHSU Oncology/Hematology clinic department instances identified include 33022-Beaverton and 33023-Northwest.

2. © 2016 Vizient, Inc. All rights reserved.
o The appointment reminder call process was improved by reviewing the classifications of
patients who were receiving reminder calls and ensuring that the call was appropriate (i.e.,
initial visit patients, hospital follow up patients, three month follow up patients, et al).
 The pre-authorization and appointment reminder related improvements also
contributed to a 23.5% reduction in missed appointments as a percent of patient
appointments scheduled from 20.6% to 15.8%.
o Due to contracts secured by OHSU leadership and the managed care team, volume grew by
expanding the number of health plans accepted at the clinics.
o A new patient infusion appointment scheduling template was implemented, highlighting
wasted time in the infusion area. Staff were charged to schedule patients in an effort to
minimize waste. The increase in the number of visits per space per day increased from four
to six without increasing hours of operation.
Improved Patient Throughput
• A revised RN staffing decision model was created and employed to assign each
chemotherapy/infusion area nurse to three infusion chairs throughout the day. Previous to
implementing the model, there was an artificial ceiling to the number of patients the nurses would see
per day (e.g., two treatments
2
and one procedure
2
in the morning and in the afternoon for a total of six
patients per day).
• Two administrative nursing positions were dedicated to improve and manage the clinic triage
3
function at both of the clinics, allowing the chemotherapy/infusion area nurses to focus entirely on
direct patient care.
o Previous to this decision, the chemotherapy/infusion area nurses were juggling triage
3
calls
throughout the day as they continued to care for patients in the infusion area.
• The additional physical space created by the previously mentioned elimination of 10 patient
examination spaces was reconfigured to facilitate improved patient flow. In one of the clinics, the
distance patients were required to travel to get through the care experience was reduced by 21%
4
.
• A medical assistant was dedicated to ensure smooth throughput of patients and family members
navigating through the clinic.
Improved Staff Productivity and Reduced Expense
• The increased volume and improved efficiencies enabled the two clinics to improve productivity and
reduce expense per workload unit as evidenced by a collective 46.7% reduction in hours worked per
APC relative weight from 1.35 to 0.72 and 31.1% reduction in total expense AWI adjusted per APC
relative weight from $93.01 to $64.04. Added internal controls over procurement also helped to
decrease total operating expenses at the two clinics.
For more information about OHSU’s performance, please contact Dianne Price or Monica Cfarku at (971)
262-9600, Abraham Gage at (971) 262-9000, or Glen Lawrence at (503) 494-2641. If you have an ODB
case study to share, contact Jack Gottlieb at (312) 775-4191 or Sheri Downey at (412) 494-4908.
2
For purposes of this document, ‘treatments’ are defined by OHSU’s Community Oncology/Hematology group as “anything given
intravenously” and ‘procedures’ are defined as “any central line maintenance procedure or lab draw.”
3
For purposes of this document, “triage function” refers to anything that could be considered assessing or managing patient
symptoms, sending or corroborating appropriate lab results, care coordination amongst other providers, etc.
4
The clinic layout at 33022-Beaverton initially required patients to travel approximately 700 feet from entering the building to exiting
the building; however, after the redesign, that requirement was reduced to approximately 550 feet.