To respond to staffing challenges and reimbursement changes, and to meet patients’ needs, worked to integrate three pillars of innovation: Technology+Process+People. By applying intelligent process design, they were able to remove inefficiencies in patient flow – adding access and more value to each patient visit, as well as increase staff engagement and satisfaction. This was accomplished by creating a space for staff ideas to take hold in the care process, through an efficient process improvement model – stimulating different conversations of how care is delivered and creating a shift in clinic culture.
With real-time data, we can test new models of care delivery and empirically validate how changes impact our capacity, profitability, and patient satisfaction.”
-Dr. Darin Leetun, Orthopedic Surgeon – Altru Advanced Orthopedics
Challenged to not just “randomly change” or add more to the care environment, Altru Health System took a new approach to operational improvement. Altru understood that today’s healthcare pressures of reduced reimbursements and staff shortages meant they needed to pull and understand data showing how care resources were being used and where inefficiencies in the patient visit were occurring.
Altru Advanced Orthopedics had precisely defined goals in their expansion project:
To be successful, Altru knew that their efforts needed to be supported by:
To deliver on their goals, Altru partnered with Eide Bailly to provide Business Process Optimization (BPO) consulting, Intelligent InSites to utilize their patient flow software solution, and Sonitor Technologies for their real-time location (RTLS) hardware.
According to Jill Wilson, Administrative Director at Altru Health System, who championed the initiative, “technology and data alone will not yield sustainable results. You need to commit to investing in process improvement.” Therefore, from the very beginning, she challenged her team to think differently, to use data to find root causes of process delays, and to break the status quo.
The solution has offered Altru new data to understand where pinch points are in processes that were not discoverable before. With the guidance of Eide Bailly’s consultants, they began to look at new metrics and learn why they are important and leveraged improvement tools to change processes, while having the opportunity to see in real time the impact of implemented changes.
New measures being used by Altru include:
When it comes to driving patient access, resource efficiency, and patient and staff satisfaction, there are a few aspects of utilization:
With a goal of continuously optimizing patient flow, Altru staff meets daily to discuss the day’s data – specifically patient cycle time and value added versus non-value added time for the patient and provider. Using Business Intelligence tools and visualization, the team can see levels of variation and establish context for outliers. By mobilizing the data and driving process improvement throughout the clinic, they can manage change more efficiently and effectively.
Our conversations began to switch from being reactive to being proactive. We became ignitors for change.”
– Rhonda Enger, Advanced Orthopedics Manager – Altru Health System
One year after applying intelligent process design, Altru Health System has standardized their processes and decreased variation. Through cycle time reporting, they have implemented a number of processes to improve the flow of patients throughout the clinic. Variation in vital sign compliance has improved and order entry has been streamlined. Patients are spending less time in the clinic, yet more time with providers. Care teams continue to huddle about their cycle times at pivotal points in the day, adjusting resources accordingly.
We migrated from a place where our teams were overwhelmed, wondering how they were going to meet patient demand; and where physicians were always running behind. We are now to a place where our doctors and their teams are holding one another accountable to stay on schedule and to finish today’s work today.”
– Jill Wilson, Administrative Director – Altru Health System
Altru Health System is a community-owned, integrated system with an acute care hospital, a specialty hospital, more than a dozen regional clinics, and a large home care network. Altru employs 200 physicians and 4,000 staff.
Applied Processes and Technologies:
 Source: American College of Physicians http://annals.org/article.aspx?articleid=254670450%
 Source: Physicians for a National Health Program http://www.pnhp.org/news/2016/september/physicians-spend-two-hours-on-ehrs-and-desk-work-for-every-hour-of-direct-patien
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