Powerful Possibilities: Integrating Laboratory Systems in Catholic Healthcare

Transcription

1 Powerful Possibilities: Integrating Laboratory Systems in Catholic Healthcare Cheryl Vance CEO and President Alverno Provena Hospital Laboratories, Inc. Alverno Clinical Laboratories, LLC Alverno Provena Hospital Laboratories, Inc. 28 Hospitals Provena Health Resurrection Health Care Sisters of St. Francis Health Services, Inc. Join to form: Acute Care Services Alverno Clinical Laboratories, LLC State of the Art Esoteric Lab Hospital Non-STAT Testing Outreach: Couriers Client Services Sales LIS Billing 1

2 Model Hospital laboratories convert to Acute Care Services Labs providing on-site testing to meet patient and physician needs Customized for each location based on service requirements Site test menus determined by Pathology Council Models vary from site to site Non time dependent testing performed at Alverno Clinical Labs Standardization of equipment, policies, procedures, processes & vendors Organizational Statistics 14 million billable tests from APHL, Inc. and ACL, LLC 44 vehicles traveling 1 million miles per year Over 3,000 specimens brought to central laboratory each day All ministries CAP accredited Over 1,600 laboratorians Service area 150 mile radius from central laboratory Over 50 quality monitors tracked monthly 2

3 MISSION STATEMENT: Bringing Christ s Ministry to those we serve through timely, high-quality laboratory testing. Organizational Challenges Brand new organization as of September 1, 2005 Parent organizations needed to see savings sooner versus later No formal Quality Program as a system Very aggressive target for integration No budget established for LEAN and other quality initiatives No formal productivity targets Variability in meeting service goals related to TAT, morning rounds, etc. 3

4 Alverno Strategies Lead and manage laboratory services under a quality plan umbrella Professionally direct and execute the laboratory outreach program Standardize equipment, reagents, and consumables; use sole-sourcing whenever possible Pursue rigorous group purchasing negotiations Standardize work, level workloads, establish one-piece flow, and use just-in-time inventory coupled with continuous process improvement In-source reference tests at central lab Earn workplace and employer of choice reputation in the communities we serve Guiding Principles Support Faith Based Health Care Mission and Values. Driven by quality, growth and stewardship. Dedicated to work as a team to effect system integration. Culture of accountability and effective execution. Support health care systems, communities and physicians needs. Passionate about growth and retention of outreach business. 4

5 Geographic Layout Des Plaines/Evanston/Melrose Park/Oak Park/Chicago Chicago: West Addison, W. Talcott, N. Claremont, N. Lake Shore Drive, W. Division Streets Chicago Heights, IL Olympia Fields, IL Michigan City, IN Illinois -Aurora Elgin Joliet Hammond, IN Dyer, IN Crown Point, IN Illinois -Kankakee Urbana Danville Indiana: Crawfordsville Indianapolis Lafayette Mooresville/Beech Grove ACL/APHL Combined Projected Total Savings for 2006 through Budget Million Million Projected SSA Savings ACL/APHL ACL,LLC/APHL Actual (Excludes Market Actual Adjustment) 5

6 Total Cost Per RVU A B C 1.02 Budget $ Jan 06- Mar 06 Apr 06- Jun 06 Jul 06- Sep 06 Oct 06- Dec Quarter Jan 07- Mar 07 Apr 07- Jun 07 Jul 07- Sep 07 Oct 07- Dec 07 APHL, Inc. Average Expense Onsite Per RVU ACTUAL YTD 2007 BUDGET YTD 2007 ACTUAL YTD ELGIN AURORA JOLIET DANVILLE KANKAKEE URBANA ST MARGARETS Sites SAMC SACP ST JAMES ST CLARE SERH ST FRANCIS 6

7 Technical Productivity ST MARGARETS SAMC SACP ST JAMES ST CLARE SERH ST FRANCIS 0.30 A B C D E F G Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06 Sep-06 Oct-06 Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Apr-07 May-07 Jun-07 Jul-07 Aug-07 Sep-07 Oct-07 Nov-07 Dec-07 Gram Stain Monitor 2007 GRAM STAIN MONITOR % 99.0% Threshold 99% 98.0% 97.0% 96.0% 95.0% 94.0% 93.0% 92.0% 91.0% SMMN SMMS St. James St. A Mich City St. A Cr Point Olympia Fields Core Lab Provena Kankakee Provena Urbana Provena Danville Provena Joliet Provena Aurora Provena Elgin System Wide 90.0% 89.0% 88.0% Oct-07 Nov-07 Dec-07 4th Quarter 07 7

8 Urine Culture Turnaround Times % Acceptable 100% 95% 90% 85% 80% 75% 70% 65% 60% 55% 50% SMMN SAMC St. James CH St. James OF Core Lab Individual Site Sites SAH PUSMC PSJH PSJMC QTR1 QTR2 QTR3 QTR4 PMMC PCMC PSMH SMMS SERH St. Clare Total Emergency Department STAT TAT 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Year to date average Chemistry Cardiac CBC Coagulation 8

9 Early AM TAT Improvement 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Chemistry Hematology Coag Before Lean After Lean APHL Performance Comparison: Findings Emergency Dept: Troponin ED: Troponin Cumulative Test Completion Cumulative Test Completion Time (Collect to Verify) 100.0% 90.0% Percent of Total Verified 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Overall peer group average Minutes By Site PH: St. Mary PH: Samaritan PH: Covenant PH: Mercy PH: St Joseph (Elgin) PH: St Joseph (Joliet) SSFHS: St. Margaret (Hammond) SSFHS: St. Anthony (Michigan City) SSFHS: St. James (Chicago Hgts) SSFHS: St. James (Olympia Fields) SSFHS: St. Anthony (Crown Point) SSFHS: St. Margaret (Dyer) SSFHS: St Francis (Beech Grove) SSFHS: St Francis (Indianapolis) SSFHS: St Clare SSFHS: St Elizabeth SSFHS: Home Hospital Overall (APHL Labs) Overall (All Labs) 2007 Management Insight, LLC. Used with permission 9

10 APHL Performance Comparison: Findings ED: All Tests APHL compared to all laboratories All Laboratories Percentile Rank Name BT Vol Or-Cl Cl-Rc Rc-Pf Pf-Vr Rc-Vr Cl-Vr Or-Vr SSFHS: St. Margaret (Hammond) 371, SSFHS: St. Anthony (Michigan City) 189, SSFHS: St. James (Chicago Hgts) 329, SSFHS: St. James (Olympia Fields) 389, SSFHS: St. Anthony (Crown Point) 291, SSFHS: St. Margaret (Dyer) 172, SSFHS: St Francis (Beech Grove) 560, SSFHS: St Francis (Indianapolis) 604, SSFHS: St Francis (Mooresville) 118, SSFHS: St Clare 154, SSFHS: St Elizabeth 486, SSFHS: Home Hospital 365, PH: St. Mary 403, PH: Samaritan 337, PH: Covenant 368, PH: Mercy 353, PH: St Joseph (Elgin) 413, PH: St Joseph (Joliet) 1,002, Color Key (Percentile Rank) Upper Quartile (75-100) Middle 2 Quartiles (25-75) Lower Quartile (0-25) Insufficient Data 2007 Management Insight, LLC. Used with permission CAP Survey and Excel Performance 100 % Correct Challenges ACL Avg. CAP Wide Avg. 86 ABO/RH AP ABID Bacti XM Immuno Hemo Molecular Mycobact Myco Parasit Chem Syphilis TDM Toxi AB Detection Virology 10

11 Best Practice Political Arena Accountability Structure Connectivity through Interface Engine Dedicated Senior Leadership Team Communications Most Difficult Moving Quickly Simultaneous Projects Integration Cultural Transformation Implementation of Quality Initiatives Focus on Employees 11

12 Most Challenging Culture of Accountability and Effective Execution on Projects Managing New Growth Opportunities Lesson Learned Staff Acceptance of Changes 1. Having a bad day because 2 staff members called in sick blamed on LEAN 2. Hospital registration staff consolidation blamed on LEAN 3. LEAN didn t work for Toyota and it won t work for us! 12

13 Summary of Critical Issues and Goals QUALITY SERVICE STEWARD- SHIP PEOPLE GROWTH Develop and Implement System-Wide Quality Program Identify and implement best practice to achieve and maintain external patient satisfaction survey results to all ministries Identify and implement best practices to achieve and maintain outreach customer satisfaction scores in top quartile. Meet and exceed the seven-year financial benefits projected in the 2004 Integration Plan approved by Participant Boards. Develop and implement employee alignment program. Develop tangible reward structure for employees at all levels. Increase patron/participant hospitals in APHL. Update and Implement a market-based outreach program. Q & A 13

14 Thank you! Cheryl Vance CEO and President Alverno Clinical Laboratories, LLC Alverno Provena Hospital Laboratories, Inc. 14