Earlier this summer, I was asked at the last minute to fill in as moderator for a roundtable discussion about "hospital operations management." Frankly, I wasn't all that sure what the term meant. It seemed a little squishy, as though its definition could shift according to whomever happened to be using it at a given time. But the nearly three-hour discussion proved eye-opening, showing once again how fast hospital leaders are changing the way they run their organizations to keep up with the dramatic transformation health care is undergoing.
So what is hospital operations management? Turns out, it's both broad and specific. One participant defined it as "an emerging category," with hospitals "beginning to focus on managing the business differently from an operational standpoint. That includes such things as patient flow, capacity, throughput and utilization." Another said, "It's about creating value. And how you do it makes all the difference. Walmart and Kmart have essentially the same strategies, but their execution is entirely different." And another said it involves getting hospital operations and patient care staff to take a hard look at processes and "work together for the good of the patient."
Barry Graf, vice president of operations for Virtua Health, put it bluntly: "There is no way that health care, as it's designed today, can continue to function. We have to experiment. Not only does it have to be safer and faster, it has to feel different for the patient. Reimbursement is being tied to all those things."
The key to accomplishing all that? In one word: Data. Panelists agreed hospitals need to collect data about everything they do, preferably in real time. They need to analyze the data very closely. They need to share it broadly, across the organization. And they need to respond quickly and effectively to what the data are telling them.
"The availability of data has been a game changer in my career," said Paul Milton, executive vice president and chief operating officer of Ellis Medicine in Schenectady, N.Y. "We have more data to help us drive efficiencies, whether it's on the labor side, the equipment side or the supply side. That can help to reduce certain costs and lead to better resource utilization and help us turn beds faster."
Milton offered this example: "Say our average length of stay is 5.4 days. I know that a tenth of a day is worth four beds. If I can drive the length of stay down to 5.0 days, I've freed up 16 beds."
Another example: Reducing nurses' habit of hoarding supplies. Here's what Karen Bibbo, R.N., chief nursing officer at Aventura Hospital and Medical Center in South Florida, shared: "When we implemented our asset-tracking system, it took a long time to build trust with our nurses. But once we did, we saved hundreds of thousands of dollars in IV rentals. It was incredible. We found pumps in the back of patient rooms, in closets and in corners. Once we were able to get all of them in one place and dispatched as needed, we did not need as many … When we purchased new IV pumps, we were able to purchase 10 percent fewer than we normally would have."
Of course, old habits die hard, but data can help there, too. "The biggest challenges are changing practices, cultures and processes that have been in place for a long time," said Karen Myers, R.N., CNO at St. Luke's Episcopal Health in Houston. One area her organization is focusing on is moving patients out of the ICU as quickly as possible; so far they've managed to cut the transfer time to less than 60 minutes. That involves front-line staff, secretaries, transport staff and others. "We were able to do it because we had the metrics available to show them what was happening."
Good data can sway even the most set-in-their-ways staff.
Another key: Hospital executives and board members. "Leaders need to get out there and explain why change is necessary and how everyone will benefit, as well as make everyone confident their job is secure," Milton said. "By improving efficiency and cutting costs, we are protecting jobs."
The roundtable was convened by Hospitals & Health Networks and Health Forum, and was sponsored by GE Healthcare. A full transcript, with much more of the panelists' insights and advice, appears in the current issue of H&HN.
