COORS Leadership Capital proudly announces Charles Hall as Superintendent and Chief Executive Officer at Island Hospital. Located in Anacortes, WA, Island Hospital is an award-winning 43-bed rural, not for profit, district hospital supported by over 190 physicians and healthcare providers. With over 24 years of operational healthcare experience, Charles will now direct the mission, vision, culture and values of Island promoting excellence, accountability and focus on superb patient care while forging strong ties to the community. Prior to accepting his new position, Charles served as the interim Chief Executive Officer at Alliance Health Durant & Madill in Oklahoma. Congratulations and Best Wishes on your new position from Coors! For more information, check out the link below!
The shift towards alternative payment models has illuminated the necessity for healthcare leaders to re-evaluate the strategic importance of clinical service lines. Across the industry, executives are asking similar questions: how should we align service lines to support shifts in site-of-care and advancement of goals, what is the optimal structure and how do we cultivate dyads leadership models to support cross functional collaboration, and how do we prioritize service offerings to ensure quality and financial solvency.
While there are many points of discussion and opinions, the following abbreviated case studies highlight both the value and complexities of service line rationalization and alignment to support strategic prioritization.
Service Line Rationalization
A service line portfolio review is a valuable endeavor to support leaders in making informed decision regarding the elimination of services that are, redundant, low volume, lack local demand or have a negative net margin, while ensuring the medical needs of a community are met.
ACS Verified Level-II Trauma Center, Hold or Fold?
A 475-bed community hospital located in the mid-West had been operating a well-established ACS verified Level-II Trauma Center for more than two decades. The leadership team debated the financial feasibility and relevance of continuing as a Level-II Trauma Center with regard to the high cost associated with specialty call pay, staffing requirements to support the program, and degree of market saturation within the catchment area. In consultation with the leadership team, we conducted a comprehensive review and modeled three scenarios: (1) continue as a Level II Trauma Center, (2) downgrade to a Level III Trauma Center, or (3) close the Trauma Program, and evaluated the impact of each decision on the community at large.
Highlights and final recommendation from the Trauma Service Line assessment were as follows:
- The data showed a steady, positive trend in patient volume, year over year.
- While the program yielded a net positive contribution margin, it was slim. However, opportunities were identified to optimize the financial performance by improving the billing workflow and revising specialty call coverage.
- The program had excellent patient care statistics based on positive TQIP results and a recently implemented fracture protocol resulted in a decrease hospital length of stay from 4.5 days to 4 days.
- A market review of the competitive landscape would most certainly have yielded an organic shift of patients to the nearest higher level of care, should the decision be made to downgrade the program to a Level-III Trauma Center.
- Despite perceived market saturation, analysis of the catchment area supported the value and community need to continue trauma.
Based on the finding of the Trauma Service Line rationalization assessment, the unequivocal recommendation was to maintain their ACS-verified Level-II Trauma center designation.
Aligning Service Lines to Advance Strategic Goals
Historically, healthcare leaders have focused on revenue generating service lines, such as Orthopedics and Cardiology, to financially sustain their organizations in the fee for service environment. As the industry is rapidly evolving towards cost transformation, many organizations are viewing the emergence of service lines, such as Geriatrics and Primary Care, as a necessary model for advancing goals of strategic importance.
Geriatric Consult Program in the Emergency Department
A large healthcare system located in the Northeast, strived to decrease unnecessary hospital admission/re-admission rates, among other initiatives. They instituted a Geriatric Consult program in three emergency departments serving a dense geriatric population. The program was led by a board certified Geriatrician and designed with the following characteristics and results.
- A screening process was instituted for high risk patients.
- The EDs were staffed with Geriatric APRNs, with backup from Geriatrician.
- Geriatric consults are billable, maintaining budget neutrality.
- Realized a decreased ED recidivism by 3-7%.
- >60% of patients evaluated had no need for hospitalization.
- 85% of patients had changes with medication reconciliation.
Marcia Messer MBA, MHA
Healthcare Executive Consultant
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There have been many initiatives over the last several decades to improve an organization’s efficiency and effectiveness. Few have achieved actual results and even fewer have been tested in the most difficult situations. The United States Navy has lived and proven the results of HRO for the better part of 30 years.
One of the most potent weapons available to doctors and patients when fighting disease is time. When it comes to conditions like cancer, stroke, or diabetic retinopathy, the earlier they are diagnosed, the better the chances for successful treatment. New diagnostic tools incorporating artificial intelligence are currently being developed that may help doctors in different specialties make more accurate diagnoses more quickly
Whether you’re a private practice or a large hospital, risk mitigation should be an integral part of the of the organizational process. While many organizations have emergency plans to handle obvious risks, it’s important to think about risk very broadly: risks can be anything that causes you to lose revenue (both current and potential).
As the political landscape and patient expectations continue to change, committing to processes that concentrate on superior care and risk mitigation is critical. Maintaining Highly Reliable Organization (HRO) status is not only a goal for healthcare organizations, it’s required for sustaining competitiveness.
Organizations that are renowned for upholding this gold standard almost always have commonalities in how they approach their processes. Here are some traits we find in the most successful HROs:
As the expectations of quality healthcare change, progressive leaders are now looking beyond the traditionally myopic patient-care standards to provide a holistic approach to patient outcomes. This approach considers not only the patient’s state of well being, but also the care provider. Emotional intelligence (EQ) is the ability to use one’s own emotions to positively manage high-stress situations and overcome challenges. For medical professionals, this can translate into the ability to better communicate and empathize with their patients and coworkers, as well as harness their internal stress and approach problems with a clear, open mind.
Leveraging innovative technology has become more of a requirement for healthcare organizations to remain competitive with patient expectations. As healthcare IT continues to rapidly advance, identifying a solution that adds value and drives profit can be a daunting task, not to mention the hassle of transitioning internal processes.
As we head into the new year, let’s take a look at a few trends that we expect to shape the way we approach, and manage patient care.
When it comes to the healthcare industry, one thing is certain: things will never stop changing. From the introduction of new technology to improving best practice standards, our industry is constantly evolving. It’s up to our leaders to manage these changes in the right way, and at the right pace.
Here are a few tips to help leaders navigate their teams and organizations through any transition
Stress impacts everything–from our bodies to our minds–and it can even cause changes in behavior.
Physically, it can cause headaches, stomach problems, and difficulty sleeping. Mentally, it can affect our mood, making us feel anxious, restless, and overwhelmed. It can even play a role in our behavior, causing emotional outbursts, withdrawal, and changes in eating habits.
What else can stress do? It can cause us to make mistakes, like venting to the stranger at the deli, over-analyzing minor details, procrastinating important responsibilities, and making hasty decisions.