SIP Team 5 Strategic Planning Meeting

SIP Team 5 Strategic Planning Meeting Minutes May 3, 2005

AGENDA MINUTES Date Tuesday, May 3, 2005 Called to 4:30pm Order Location BB389 Adjourned 6:30pm Called By Edward Walker, MD Recorder Kimberly Knight Present: M. Alotis, R. Battie, A. Bowdle, P. Buckley, J. Canfield, T. Martin, J. Perkins, H. Shawcroft, P. Simmons, E. Walker Agenda 1. Existing Commitments – Ed Walker 2. Standards, Benchmarks, and Best Practices – Judy Canfield Announcements  The April 5 minutes were approved as submitted. Existing Commitments – Ed Walker Dr. Walker presented UWMC’s existing commitments.  UWMC’s existing commitments over the last 4 – 5 years have promoted the expansion of the service lines.  The service lines take a patient centered approach to care. The idea is to benchmark a patient’s journey, including profitability and against external competition.  CORM creates toolboxes that are designed to make service lines as functional as possible.  UWMC has had a 10 percent increase in growth from 1998 – 2003.  UWMC’s most profitable services are inpatient. Each year the number of surgeries performed increase.  Due to UWMC’s training demands as an institution we are allowed fewer degrees of freedom when compared to community hospitals.  When looking at the service lines and essential services, they fall into 4 categories:  Unprofitable and Large  Profitable and Large  Unprofitable and Small  Profitable and Small  It is positive that we do not have any unprofitable and large services. The services trend seems to be shifting towards more profitable services over time, for example, the neurosurgery service.  The services were adjusted by patient load per day.  The essential services are difficult to monitor because the service is sometimes embedded in the DRG. The goal is to expand the out patient essential services.  Our largest and most profitable service line is oncology.  Implementing issues that UWMC is currently facing:  Transplant/ Cardiac Surgery: supporting two cases at one time and accommodating urgent cases in the operating room.  Orthopedics: With the increase in various implants and procedures, how do you create a standardized service while recruiting new medical staff members. D:\Docs\2018-04-16\00f8b6db8b0d6fbb74c13d1c30e28e01.doc 1 SIP Team 5 Strategic Planning Meeting Minutes May 3, 2005

 Block time: how do we fill it, what is the best way to match cases with resources.  With the decline in the operating margin over the past few months, it is important to think about ways of reinventing the way UWMC conducts business, when it comes to cost reduction. Areas of focus include case mix, redefining structure, and creating lean processes. Standards, Benchmarks, and Best Practices – Judy Canfield Operation Standards and Benchmarks UHC:  University Healthsystem Consortium is the institution UWMC uses most frequently for benchmarking comparisons. UWMC became a member of UHC in 2003, there are now approximately 35 academic medical centers who have membership.  For the SIP project there is a wealth of information. UWMC is using UHC data to search for intensive care unit, inpatient care, turnover, staffing, and patient flow benchmarks and information to list a few.  In addition UHC offers executive summaries, reports, and papers that all members have access to. As a member you are able to email like institutions questions and problem solve.  UWMC has made significant improvements since joining UHC and is now able to monitor national trends. OR Benchmarks:  There are specific OR benchmarking programs that are conducted through a consulting company. These generally cost between 25,000 - 30,000 dollars for a consult. A drawback of conducting a consult is that it is not representative across the board, hence potentially less useful. Surgical Outcomes:  Surgical Outcomes provides an operation where you send them your data and they match you against comparative institutions that also have membership to this program. BD Health Care Consulting:  BD Health Care offers recommendations for improvement based on benchmarks that they have gathered from previous clients. This offers variable results since it depends on how relevant their clients are when comparing to UWMC. ECG Management Consults:  ECG Management requires a one time membership fee. This consult can provide you information on operational measurements and performance outcomes. Sun Clinical Data Institute:  Sun Clinical Data Institute provides specialty services information. The purpose of this organization is to offer a one time benchmark for a consultation fee. PeriOptimum:  PeriOptimum’s objective is to focus on what area’s your institution wants to study across these various elements: patient flow across services, software, or capacity management. AORN:  AORN is a professional organization for nursing. It offers a plethora of documents, dashboards, and articles. UWMC has several individuals who have membership. UWMC uses this service to look for standards of best practice. One is able to enter data and get immediate feedback. OR Manager: D:\Docs\2018-04-16\00f8b6db8b0d6fbb74c13d1c30e28e01.doc 2 SIP Team 5 Strategic Planning Meeting Minutes May 3, 2005

 This program is aimed at management. It offers benchmark information related to all surgical services. The Advisory Board Company:  The Advisory Board offers solid information; however; some of the information is duplicative to what UHC provides. Regulatory Standards JCAHO:  The Joint Commission on Accreditation of Healthcare Organizations is used as a quality check, to find where UWMC sits compared to national hospitals. Leapfrog Group for Patient Safety:  Leapfrog is working on creating higher standards for hospitals. It is a quality measuring tool that employers are using, for example, Boeing, when offering their employees medical insurance programs. The focus is reducing cost and improving efficiency. Centers for Medicare and Medicaid Services:  CMS reporting is necessary in order to receive full reimbursement. UWMC currently reports core measures, the structure for documenting these measures has room for improvement. American College of Surgeons National Surgical Quality Improvement:  NSQIP data provides a statistical analysis of expected over actual data. The American College of Surgeons plans to encompass all surgical specialties in the future. Institute for Healthcare Improvement:  IHI is a quality improvement program that is striving to save 100,000 lives this year. UW Medicine has committed to participating in this campaign. Quality Websites  It would be advantageous for UWMC to have a quality website. Websites worth looking at include:  Cleveland Clinic: This website provides you with staffing information, state measures, and comparative data. Annual reports are also posted.  John Hopkins: Each department or specialty has a quality corner that one can access for information.  Stanford University  Colorado Hospital Quality Website  UWMC endorses the use of UHC as the leader for benchmarking.  Pay for performance is on the forefront. Quality reporting will become even more imperative as additional mandates become required. ACTION ITEM: The OR Management Committee needs to set up a system for routinely gathering best practice, peer review, and appropriate comparative reports. A system needs to be created where this information can be shared on an ongoing basis. ACTION ITEM: Dr. Buckley will contact Lisa Brandenburg regarding what is the appropriate inpatient/outpatient mix, what direction does UWMC want to head? Looking Ahead  The next meeting will be held June 7 from 4:30-6:30pm in BB389.

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