OR Optimization: Right-Sizing to the Future

Transcription

1 OR Optimization: Right-Sizing to the Future

2 BETTY JO ROCCHIO, RN, BSN, CRNA, MS VICE PRESIDENT PERIOPERATIVE PERFORMANCE ACCELERATION MATTHEW MENTEL, CMRP,MHA, MBA EXECUTIVE DIRECTOR INTEGRATED PERFORMANCE SOLUTIONS

3 Mercy Demographics ,000 FY Facilities OR Rooms Periop Procedures July - June $2,093,276,868 Perioperative Revenue $351,487,571 Perioperative Spend $1,741,789,297 Periop Contributing Margin

4 Five Dimensions of Excellence

5 Triple Aim for Perioperative Retained Surgical items Wrong Site Surgery Surgical Site Infections Minimize distractions Satisfaction with waiting times Raising OP Surgery Satisfaction Scores Financial Supplies Labor Overhead/Resources

6 Fiscal Year Comparison Perioperative Operations FY15 FY14 Periop Locations OR Suites OR Cases 135, ,474 Inpatient 36,822 35,935 Outpatient 99,011 89,539 Surgeons 2,602 2,580 Integrated 1,705 1,650 Non-Integrated Co-Workers 1,768 1,769 RN 1,033 1,030 Technical Ancillary Clinical Clerical Support Revenue $2,093,276,868 $2,207,931,239 Supplies $253,724,844 $257,820,021 Labor $97,762,727 $100,303,743

7 Supply Chain Challenges Rev/Case Supply/Case Labor/Case FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20 Impact to Supply/Case and Labor/Case FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20

8 Why is this so important right now? Perioperative Services Reimbursement shifts Long-term viability High revenue but also high cost to deliver care Impact on margin contribution are significant What got us here will not get us to the Triple Aim!

9 Value For Surgery Revenue Center TODAY Cost Center TOMORROW Appropriate surgical solutions: Matching clinical need, which includes costs and efficiencies New world: Penalties based on Medicare spending and Value Based Purchasing Business bottom line: Managing cost of supplies, labor, and overhead

10 Mercy Expense Breakout (Top 14) 12.0% 10.0% 9.8% $1.2 BILLION spend in top 5 categories Representing 34.6% of Expense 8.0% 6.0% 4.0% 3.9% 2.0% 1.8% 0.0%

11 Steps to Success Assess Current State: Business & clinical environment Identify Challenges/Barriers: Financial & operational Clearly Outline Opportunity: Identify & quantify projected benefits Establish Future State: Standardization & Lean Processing Alignment: Organizational mission and culture Communicate & Engage: People Process Technology Define Success: Performance metrics

12 OR Optimization Goals Improve OR inventory management Eliminate patient safety risk surrounding product expiration Improve execution on product recalls & expiry Improve workflow in the OR Leverage the benefits of Unique Device Identifier (UDI) Appropriately document product information Improve cost per case accuracy

13 Supply Chain Challenges Reimbursement Healthcare cost Patient safety Patient satisfaction Charge Capture Inventory Management Inventory availability Multiple product locations Inventory value & valuation Preference card accuracy Recognizing consumption on demand Process and Workflow Management of expired product Management of product recalls Product Documentation Product tied to Patient tied to Outcome

14 Supply Chain Opportunities Reimbursement Improved charge capture Improved patient outcomes Comparative effectiveness/outcome based analytics Inventory Management Inventory as an asset-valuation Inventory expense reduction Preference cards accuracy/ maintenance/optimization Inventory visibility and standardization Process and Workflow Redesigned, clinically-driven workflows UDI and risk visibility Instrument and equipment tracking Tissue tracking and regulatory compliance

15 Five Dimensions of Excellence Clinical Excellence Inventory Visibility Preference Card Management Workflow Regulatory/Risk Management Cultural Excellence Transformative to our OR and Materials Cultures Community Excellence More accurate EMR information More Accurate Patient Billing Data and Cost Stewardship Excellence Improved Visibility to Expenses Efficiency in Labor Utilization and Productivity

16 CLINICALLY LED OPERATIONALLY DRIVEN People Process Technology Metrics Variation Opportunities for Solutions Metrics to drive results defined/measured/tracked/reported Variation Reduction Automation of Process Work Clinical Solution Automation Optimization at local and system levels Organized clinical solutions for procedural workflows (People Work) Optimizatio n

17 CLINICALLY LED People Process Technology Patient-centered to improve care and flow through the OR with awareness of financial impacts to the delivery of consistent or improved outcomes Right patient, right procedure, right supplies, right time.every time. Process Redefinition

18 CLINICALLY LED OPERATIONALLY DRIVEN Defining Success Through Resource Management Realizing unrecognized inventory assets Improving inventory utilization Optimizing charge capture Improving Preference card accuracy $2.4M $4.7M $13M $459K Automation of replenishment Reduction in cycle counts Improving clinical user satisfaction Ability to optimally manage $4.8K $167K Survey owned vs. consigned inventory

19 QUESTIONS? Thank you