IRVING, TX – VHA, Inc., is putting its nationwide comparative database to work to help hospitals cut millions of dollars in wasted expenses from their high-cost cardiology, orthopedics and spine service line procedures through a new "Door-to-Discharge" program.
The program will make use of VHA's Physician PreferenceLYNX national comparative database, which provides performance metrics on patient procedures, clinical conditions, physician practice, operational measurements, readmission and mortality, among other factors.
Irving, Texas-based VHA, a national healthcare network of more than 1,400 hospitals and 28,000 non-acute care providers, will add clinical integration tools to its usual focus on supply costs.
By looking at each patient's case as a single episode of care and applying Lean Management and Six Sigma methodologies, officials say the Door-to-Discharge program can cut material use costs by as much as 30 percent, streamline patient flow by up to 40 percent and reduce supply chain acquisition costs by as much as 25 percent.
"Current financial pressures and future demands accompanying healthcare reform efforts will force hospitals to implement rapid and effective cost-reduction strategies that engage and align clinicians, physicians, administrators and staff," said Patricia Tyson, vice president of performance services for VHA. "By focusing on each step of the patient care process we can monitor the expense and revenue opportunities buried within each step and help hospitals improve their financial position by preserving money that would otherwise have fallen through the clinical cracks. At the same time, we're tackling issues like room turnover time, registration delays and infections, all of which impact patients directly."
In launching the Door-to-Discharge program, VHA officials noted that several member hospitals have already used the service. Among them are the Memorial Hermann Healthcare System in Houston, Community Hospital of the Monterey Peninsula in Monterey, Calif., and the Crozer-Keystone Health System in Springfield, Pa.
"Healthcare providers have to think differently about healthcare delivery due to impending decreased reimbursements and pay-for-performance measures," said Dan Humphrey, Memorial Hermann's systems executive for the supply chain. "Memorial Hermann executives identified a $195 million target as the amount required to earn a profit margin at Medicare payment rates, an analysis that hospital executives nationwide are currently performing. With that kind of required cost reduction, hospitals will need to begin with quick wins, focusing improvement efforts in the most expensive care delivery areas and those areas that have a high percentage of Medicare patients, such as cardiology."
"The healthcare industry is moving toward a bundled payment model, at least for some portion of our reimbursement income, so it's vital that we learn to shrink our process times and all the costs associated with delivering care, not just the costs for the products we use," added Steven Packer, president and chief executive officer of the Community Hospital of the Monterey Peninsula. "We look forward to using VHA's Door-to-Discharge program to identify opportunities for change in our delivery system for some of the highest-cost procedures so that both the organization and the patients benefit."
VHA officials said Door-to-Discharge will target several areas in the process, including supply acquisition costs and use, ancillary service use, patient throughput, operational productivity, clinical quality, documentation and coding and physician engagement. The program is designed to apply clinical metrics to these areas to minimize physician and nurse practice variations, improve the use of existing capacity, reduce waste and drive down service line costs.
