January 2012 Viewpoints – Patient Care Transitions

Momentum For Our Mission

Our Mission is to drive operational excellence in healthcare organizations through leading-edge process management innovations that streamline enterprise workflow, improve financial return, and enhance the patient experience.

Since our introductory newsletter in October 2011 we have grown from a handful of readers to over 400 seasoned healthcare and related industry professionals. Most of you are also part of our Linked-In community and we appreciate that additional connection. For those of you with whom we are not yet “linked-in”, please join us at LinkedIn.

We have also been busy speaking with industry leaders, hospital administrators, practice managers, physicians and consultants about critical “pain points” in healthcare operations. What became very clear is that patient handoffs or “transitions in care” are a common challenge with few proven solutions in sight. Process inefficiencies, which in some cases are a matter of life and death and in all cases are a matter of waste leading to higher costs and lower revenues, are present even in hospitals and practices with advanced EHR, PM and legacy IT systems. This is not a shortcoming of the systems, but rather a “gap” in the availability of information “bridges” that better connects people and improves the orchestration of the work that these people need to get done.

For this reason, this newsletter will feature one of the initiatives we are working on to address the challenge of transitions in care. As before, we welcome your feedback and the opportunity to discuss these and other process or workflow issues your organization may have.

OHI Feature: Patient Care Transitions

One of the many challenges facing provider organizations is how patients are transitioned from one physician’s care to another in terms of the exchange or “handoff” of critical information. Optimium Health believes that optimizing information exchange from one caregiver to another through process automation will secure three key benefits: 1) improve patient safety, 2) enhance patient and provider satisfaction, and, 3) increase provider financial performance.

An October 2010 Joint Commission study across ten hospitals of national prominence indicated that 37% of patient handoffs were defective and did not allow the receiver to safely care for the patient. Additionally, 21% of the senders were dissatisfied with the quality of the handoff. Further, the commission study stated that handoff failures account for 80% of all adverse events.

While EHR systems provide significant data capture and storage, most do not offer a means to improve caregiver workflow processes that are manually intensive and, therefore, are ripe for errors, omissions, and duplications. Optimium Health can use an EHR system as a foundation technology and then overlay the OPTIMI$ER process engine to create tailored dashboards, checklists, alerts, and information bridges that will facilitate caregiver handoffs.

This kind of data “push” and “pull” interoperability will enhance the value of an EHR system, as well as other systems like lab, scheduling, etc. that currently operate as information “silos” versus a vertically integrated information exchange. The net result is significantly improved:

  • Accuracy by reducing errors, omissions, and duplications;
  • Timeliness by the use of proactive dashboards and alerts;
  • Safety by improving the accuracy of the handoffs
  • Satisfaction of the patients and caregivers by creating the safer and more efficient environment

Specifically, OPTIMI$ER can positively impact perioperative care orchestration and information exchange. Why is this area of interest to us? Operating rooms account for approximately 42% of a hospital’s revenue. And yet, a poor on-time start rate for the first case of the day is recognized as the principal cause of inefficiency in the operating room. The average OR starts on time 27 percent of the time which is clearly a disastrous performance. And, according to the Health Financial Management Association (HFMA) “…improving throughput by just one additional procedure per day per OR suite can generate anywhere from $4M to $7M in additional revenue for the average-sized organization”. OPTIMI$ER has been designed to address the specific workflow issues that cause such an outstandingly bad performance across the majority of the 34,000 operating rooms.

Leveraging Today’s Healthcare IT

Today’s healthcare providers face constant pressure to improve the quality, safety, and efficiency of care while reducing costs and increasing revenue. Many incentives encourage providers to improve performance (such as financial incentives to demonstrate meaningful use of electronic health records [EHR] technology)—and increasingly, the healthcare community is being asked to do more with less. These pressures extend to all aspects of the organization, from clinical operations to revenue cycle and administrative processes.

Investments in process optimization, throughput, and workflow efficiency technologies offer a way for providers to meet operational goals against the backdrop of an ever-more daunting strategic agenda.

Article Reference: John Glaser/Ray Hess “Leveraging Healthcare IT to Improve Operational Performance

OHI Feature: What’s Ahead?

Upcoming examples for how handoffs in the perioperative setting can be improved through workflow automation: scheduling, surgical checklists, supply audit trail.

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