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Solucient, part of Thomson Healthcare

The Medical Center of Central Georgia (MCCG)recognized the value of benchmarking as a meansto achieve national levels of excellence, but it hadexperienced inconsistent results with early attemptsto drive change and improve across the organization.MCCG wanted to implement a robust operational andclinical benchmarking program. Its objectives were tobuild on the organization’s previous successes and tolay a solid foundation to measure future performanceso that executives and management could ensurethat they were meeting their targets.With the goal of re-attaining 100 Top Hospitals®status within one year, MCCG engaged Solucient®Professional Services to revitalize its ACTION O-ITMprogram. MCCG had been named a Solucient 100Top Hospitals National award winner in 1993, anda 100 Top Hospitals Cardiovascular winner in 1999and 2001.

BUSINESS CHALLENGE

The Medical Center of Central Georgia (MCCG) recognized the value of benchmarking as a means to achieve national levels of excellence, but it had experienced inconsistent results with early attempts to drive change and improve across the organization.

MCCG wanted to implement a robust operational and clinical benchmarking program. Its objectives were to build on the organization’s previous successes and to lay a solid foundation to measure future performance so that executives and management could ensure that they were meeting their targets.

With the goal of re-attaining 100 Top Hospitals® status within one year, MCCG engaged Solucient® Professional Services to revitalize its ACTION O-ITM program. MCCG had been named a Solucient 100 Top Hospitals National award winner in 1993, and a 100 Top Hospitals Cardiovascular winner in 1999 and 2001.

To help meet its goals, MCCG selected Solucient to conduct an Operational Performance in Action (OP-ACTIONTM) engagement. OP-ACTION is part of Solucient’s suite of Operational Improvement Services, designed to help hospitals improve effi ciencies and reduce costs. In an OP-ACTION engagement, the Professional Services team works side by side with selected department managers for 12 to 14 weeks to translate benchmark fi ndings into improvement projects and action plans.

At MCCG, the Solucient team worked with managers to review and assess their current state, identify areas of opportunity and develop an action plan based on data from ACTION O-I and other Solucient tools and programs.

“Several factors aligned to drive us to use Solucient’s OP-ACTION service,” says Robert Lummus, director, management engineering at MCCG: “The desire to win the 100 Top Hospitals award, the need to closely manage our costs where reimbursement is shrinking, the success of peer hospitals in using OP-ACTION, and our leadership’s requirement that we hold ourselves accountable for performance by monitoring certain signifi cant metrics.”

Approach

The Professional Services team started by conducting a customized 100 Top Hospitals analysis. They benchmarked MCCG against national peer group hospitals and then compared it to 100 Top Hospital winners on several performance measures to see how it stacked up against top-performing hospitals.

Next, Professional Services audited MCCG’s ACTION O-I process, paying careful attention to methods for submitting and validating data. Valid data must be entered to extract genuine insights from ACTION O-I. Professional Services walked through the data entry process with MCCG’s primary ACTION O-I users and ensured that the data was both valid and correctly entered.

Finally, Solucient’s Professional Services consultants implemented an OP-ACTION engagement where they worked side by side with department managers to identify specifi c opportunities for improvement based on all their benchmarking work. This process lasted fi ve months and resulted in the identifi cation of two departments presenting signifi cant opportunities for improvement in labor and medical supply costs. They identifi ed opportunities to reduce and standardize medical supply kits, negotiate new supply contracts and implement new charge capture processes.

The Professional Services team also created and cultivated internal performance improvement supporters to lead future projects. By aligning departments and performance improvement efforts, MCCG is well positioned to achieve its goal of becoming a 100 Top Hospital again—and more. According to Joe Lavelle, senior vice president, ancillary, “MCCG’s focus on the nine metrics associated with the 100 Top Hospitals program will also serve as a framework for prioritizing decisions to guide the organization.”

CHALLENGE #1: IMPROVING PHARMACY OPERATIONS

Result: $3.9 million in annual net revenue

Solucient Professional Services identifi ed several clear opportunities for reducing costs related to labor and medical supply in the pharmacy. MCCG’s labor costs in this department were in the 75th percentile compared to its peer hospitals, and its medical supply costs were in the 90th percentile. The department set a goal of bringing its labor and medical supply costs down to the 50th percentile or lower.

Professional Services and the pharmacy improvement team identifi ed several factors that could help them achieve this goal. For example, they determined that the department was not consistently charging for or documenting saline fl ush administration, letting millions of potential revenue dollars go uncaptured. They also realized that they were using syringes that needed to be individually fi lled with saline before use, instead of using pre-fi lled syringes. Although the initial cost of pre-fi lled syringes is higher, they are safer, faster and more nurse-friendly.

The pharmacy department decided to implement the use of pre-fi lled saline syringes and began a new charge capture process. Its calculations showed that if implemented correctly, this one change could yield $5.7 million in gross revenue, or $3.9 million net revenue.

CHALLENGE #2: SAVING ON CARDIOLOGY MEDICAL SUPPLIES

Result: Potential savings of $1.7 million

MCCG’s Georgia Heart Center (GHC) is the largest heart program in the state outside of Atlanta, performing a high volume of procedures from cardiac catheterization to angioplasty to stent placement, and averaging more than 1,100 annual open-heart surgeries.

GHC’s medical supply costs were very high and needed to be brought down, but because cardiology labs traditionally use such a large amount of costly medical supplies, it was extremely diffi cult to monitor and manage the situation to assure best pricing.

Additionally, medical kits for the various procedures performed in the heart center were not standardized. Different physicians wanted different items stocked in kits used to perform the same procedures. This forced the heart center to stock multiple types of kits, driving costs up. Technicians who put together these kits also had to take extra time to determine who the kit was for and the physician’s preferences, increasing labor costs. Hospitals with similar cardiac volumes had lower medical supply costs, and GHC was well below benchmark levels for the category.

Based on these considerations, and the fact that GHC performs such a high volume of procedures requiring complex and expensive medical supplies, GHC decided to hire a full-time employee to monitor medical supplies and negotiate medical supply contracts. Professional Services determined that if this individual focused on just the handful of highestcost medical supplies, there was a potential cost savings of more than $1.7 million.

Through more aggressive contract negotiations, MCCG has already been able to reduce the unit cost of one of GHC’s most expensive cardiac supplies — drug-eluting stents — by 20 percent.

Based on the success experienced in the cardiology lab, MCCG is looking forward to applying the same methodology in the noninvasive cardiology and endovascular departments.

About Solucient and Thomson Healthcare

Solucient is a part of Thomson Healthcare, the leading provider of decision support solutions that help organizations across the healthcare industry improve clinical and business performance. Thomson Healthcare products and services help clinicians, hospitals, employers, health plans, government agencies, and pharmaceutical companies manage the cost and improve the quality of healthcare.

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