Achieving Mayo s s Value Equation: The Role of Systems and Procedures

Transcription

1 Achieving Mayo s s Value Equation: The Role of Systems and Procedures AIMC Health Care Workshop April 28, 2010 Sharon Gabrielson, BS, MA Section Head, Systems and Procedures Mayo Clinic, Rochester, MN

2 Group Exercise What do your customers value?

3 Group Exercise How do you know what your customers value?

4 The Mayo Clinic Value Equation Value = Quality (Outcomes, Safety, Service) Cost Value increases when quality is improved and when cost is decreased

5 Overview Mayo Organization/Systems and Procedures Overview Systems and Procedures as a Value Add to Mayo Clinic Recruitment, On boarding, Retention Quantifying the Value Add

6 Mayo Clinic February 2010 Physicians and scientists 3,649 Allied health staff 48,913 Residents and fellows 2,271 Total personnel 54,833 Mayo Clinic in Rochester Mayo Clinic in Arizona Mayo Clinic in Florida

7 VISION EXECUTION PRIORITIES Primary Value: The needs of the patient come first Mission: Mayo Clinic will provide the best care to every patient every day through integrated clinical practice, education, and research Vision: Mayo Clinic will be the premier patient-centered academic medical organization Individualized Medicine Satisfy Our Patients Achieve the highest levels of patient service and satisfaction Demonstrate Mayo Clinic as the choice destination medical center Mayo Clinic Strategic Plan Quality Integration Science of Health Care Delivery Achieve Mission-Advancing Financial Performance Achieve operating margin target Achieve sufficient and stable sources of funding for Research and Education Improve and Demonstrate Quality, Safety, Service, and Value Achieve the highest levels of quality care and safety Develop high-value care models targeted to specific patient populations Attract, Develop, and Retain the Best People Improve staff satisfaction, training, retention, Strengthen leadership development and recognition Establish a culture of innovation and discovery Increase diversity of all staff

8 Systems and Procedures Internal business consulting group at Mayo Objective resource with a focus on applying a systems approach to the design, development, and implementation of solutions Strong business knowledge, systems engineering, analytical, process improvement and execution skills

9 S&P Staff Education/Background Industrial Engineering Business Administration Operations Research/Systems Engineering Healthcare Administration Public Health MD, PhD, Nursing, Operations, Finance, etc.

10 Systems and Procedures Adding Value to Mayo Clinic Case Study-What Customers Value 2008 Internal and External customer surveys Common themes surrounding our services, on boarding, skill sets, tools and methodologies, competition from other internal groups How do we leverage these value drivers to increase the value of our service to our customers and enhance Mayo s s business

11 Redesign Around Value Standardize the way we work Define our business lines and services Develop an S&P consulting model Invest in orientation, training, & continuous education Create a portfolio of tools, processes methodologies, best practices Leverage what we do best End to end solutions Objective Trusted partner

12 Business Line and Services Business Strategy and Planning Business assessment Business case analysis Facilities planning New product/services

13 Business Line and Services Business Process Engineering Re engineering Process improvement Workflows Optimization through simulation modeling/analytics

14 Business Line and Services Business Transformation Current to future state Resource management Change management Organization transformation Solution implementation/execution

15 Consulting Model Systems & Procedures Establish Establish Partnership Partnership The consulting model is comprised of 9 core elements: 3 Integrated process groups which support, enhance, and enable the 6 sequential stages. Each element and IPG consists of key principles, tools/techniques, and critical steps Close Close Engagement Engagement Implement Implement Create lasting value for Mayo Clinic, our patients & our staff Recommend Recommend Discover, Discover, Diagnose Diagnose & Gather Gather Data Data Analyze Analyze Information Information 2010 Mayo Foundation for Medical Education and Research (MFMER)

16 EPD Delivery Framework IPG: Managing Change Consulting Model Day 1 Managing Projects in S&P Change Management IPG: Communicating Consulting Model Day 1 Crucial Conversation HR class Negotiation Skills & Techniques Integrated Process Groups IPG: Knowledge Sharing Establish Partnership Discover, Diagnose & Gather Data Analyze Information Recommend Establish Close Partnership Discover, Engagement Create Diagnose & value Gather Implement Analyze Data Recommend Information Establish Partnership Close Discover, Engagement Create Diagnose & value Implement Gather Analyze Data Recommend Information Establish Partnership Close Discover, Engagement Create Diagnose & value Gather Implement Analyze Recommend Information Establish Partnership Close Discover, Engagement Create Diagnose & Implement value Gather Analyze Data Recommend Information Consulting Model Day 1 Consulting Model Day 2 Consulting Model Day 2 Consulting Model Day 2 Consulting Model Day 2 More coming in EPD Phase 2 Facilitation Techniques Systems Thinking Committee Navigation Observational Research Problem Solving Tools Facilitation Techniques Decision Support & Data Analysis Benchmarking Benchmarking Implement Establish Partnership Close Discover, Engagement Create Diagnose & value Gather Implement Analyze Data Recommend Information Consulting Model Day 2 Managing Projects in S&P Balanced Scorecard Close Engagement Establish Partnership Close Discover, Engagement Create Diagnose & value Gather Implement Analyze Data Recommend Information Consulting Model Day 2 Customer Feedback

17 Recruitment, On boarding, Retention

18 Recruitment Rigorous process Telephone screening In person interview Submission of written work Presentation Behavioral interview Case study

19 On boarding Competency Assessment to analyze competency gaps (incorporate AIMC assessment tool) Training curriculum aligned with the 6 stage project consulting model and its 3 core integrated process groups

20 Education and Professional Development (EPD) Program The goal of this program is to: Obtain greater consistency in project approach and consultant skill levels Introduce the tools, processes, and methodologies to analysts for use in the front line work Provide continuous learning environment -retention factor

21 S&P Ed & PD Program Business Intelligence & Analytics Forecasting & Modeling Techniques Advanced Team Skills Relational Database Use Advanced Portfolio Management November 11, 2009 Industrial Engineering Techniques Knowledge Sharing Software & Tool Selection/Approval/ Implementation S&P Consulting Model Managing Projects Balanced Scorecard In S&P Facilitation Techniques Decision Systems Mayo Committee DS/DA Support Thinking Benchmarking System Navigation Methods Library Resources Healthcare Finance & Services Observational Meeting Prototyping Research Facilitation Customer Feedback Change Interpersonal The MGPs Management Skills Intro to Business Clinical Problem-Solving Writing Human Factors HR Systems Tools NEO Engineering Publishing Emerging Technologies Team Skills Computer Basics Administrative Orientation Unit Heads Workflow Communication Presentation Optimization Skills Skills Value Creation & Value Engineering Organizing, Delivering & Presenting Information IT Systems Non-EMR Mentors IT at Mayo S&P 1-Day NEO Computer Basics Negotiation Healthcare Business Environment Patient Experience At Mayo Clinic Business Strategy & Development Strategic Thinking & Business Planning Staffing Model Designs & Uses Advanced Research Methods Mathematical Modeling Of Systems Organization Transformation Methods SE/OR Methods

22 Quantifying Value Add Metrics Key performance indicators Aligned with the Mayo Clinic Strategic Plan

23 VISION EXECUTION PRIORITIES Primary Value: The needs of the patient come first Mission: Mayo Clinic will provide the best care to every patient every day through integrated clinical practice, education, and research Vision: Mayo Clinic will be the premier patient-centered academic medical organization Individualized Medicine Satisfy Our Patients Achieve the highest levels of patient service and satisfaction Demonstrate Mayo Clinic as the choice destination medical center Mayo Clinic Strategic Plan Quality Integration Science of Health Care Delivery Achieve Mission-Advancing Financial Performance Achieve operating margin target Achieve sufficient and stable sources of funding for Research and Education Improve and Demonstrate Quality, Safety, Service, and Value Achieve the highest levels of quality care and safety Develop high-value care models targeted to specific patient populations Improve staff satisfaction, training, retention, and recognition Increase diversity of all staff Attract, Develop, and Retain the Best People Strengthen leadership development Establish a culture of innovation and discovery 23

24 1/1/09-12/31/09 Mayo Clinic Rochester Systems & Procedures Primary Value: The needs of the patient come first. Mission: Systems and Procedures will partner with our Mayo Clinic colleagues to achieve the best patient experience through objective, innovative, and integrative business consulting. Vision: Systems & Procedures will be Mayo Clinic s premier business consulting team. Quality & Safety Integration Individualized Medicine Science of Healthcare Delivery Customer Service 1.1 Overall Customer Satisfaction 1.2 Project Requests (clinical, research, education, administration) Financial Performance 2.1 Projects with Expense Reduction, Efficiency, Revenue Growth 2.2 Estimated Project Duration Improve and Demonstrate Quality, Safety, Service, and Value 3.1 Alignment with MC or MCR Strategic Priorities 3.2 Strategic Partnerships 3.3 Committee Assignments Institutional Departmental 3.4 Support for Mayo Transformation Initiatives 3.5 S&P Quantitative Metrics 3.6 S&P Qualitative Advantage 4.1 Staff Satisfaction Key Drivers for Overall Satisfaction and Discretionary Effort Attract, Develop, and Retain the Best People 4.2 Education and Professional Development Staff Development & Training Scholarly Activity 4.3 Staff Demographics Turnover Rate Diversity Rate 4.4 Leadership Development/ Succession Planning Staff Prepared Internal Hires

25 2.1 Projects with Expense Reduction, Efficiency, and Revenue Growth The cumulative number of active projects that should yield significant expense reduction, efficiency, or revenue growth benefits. Project Requests Year end 2009 Expense Reduction 100 Efficiency 235 Revenue Growth 69

26 3.4 Support for Mayo Transformation Initiatives Project 1. Hospital Census Management 2. Manage Patient Mix/Access 3. New Models for Internal Consults 4. Surgical Redesign & Coding Improvement 5. Critical Care Delivery System of the Future 6. Manage to Reimbursement 7. Staff to Workload for Outpatient Practice 8. Transcription Services Redesign 9. Center for Innovation (CFI) 10. Employee and Community Health IMP Projects 11. International Destination Medical Center 12. Lab PACE 13. Blood Management 14. MS-DRG/Documentation Status S&P Support YES YES YES YES YES YES YES YES YES YES YES YES YES YES Potential Impact $4,000,000 TBD $5,385,000 TBD TBD $12,200,000 $9,100,000 $1,400,000 $4,996,000 TBD $4,160,000 NA $5,000,000 $5,000,000 On target to meet plan Moderate risk of not meeting plan

27 3.5 S&P Quantitative Metrics S&P Estimated Hourly Consulting Expense* $80-$90 (Includes salary and benefits for all analysts, S&P leadership, and support staff and appropriate overhead expenses) % S&P Consultant Time Dedicated to Projects 90% Examples of Additional S&P Projects with Quantitative Impact *External Consultant Hourly Charge, $200-$500/hr (References on external consultant hourly charges)

28 Examples of Projects with Quantitative Impact Project Description Quantitative Annual Impact ACTION: Cancer Center Clinical Trials Integration Surgical AM Admissions Mayo Rochester & MHS ICD-9 9 to ICD-10 Neurology Appointment Duration EMR Auto Dismiss of Clinical Episodes Waste Expense Reduction PPI enabled through Patient Portal Gonda 3 Process Improvement project Transportation Expense Management Cardiac Cath Lab Consolidation Project Barcode Medication Charting 50% reduction in cycle time Improved on time arrivals from 66% to 96% Significant revenue loss avoidance Optimize patient itinerary length - overall reduction of 1,200 hours/month Overall 2 FTE reduction/day, $24,000 (cost savings for printing) $180, $200,000 (cost savings) $500,000 (cost savings) $500,000 (revenue enhancement) $600,000 (cost savings) $680,000 (cost savings) *$79,800,000 (potential cost avoidance) *One study found that each preventable Adverse Drug Event that took place in a hospital added about $8,750 (in 2006 dollars) to the cost of the hospital stay. (IOM Preventing Medication Errors; July 2006)

29 3.6 S&P Qualitative Advantage End to End Consulting Providing Services from project initiation through final execution/implementation Knowledge Retention Knowledge from completed projects is retained at Mayo and subsequently leveraged Improved Consulting Cycle Times Internal consulting staff are positioned to expedite turnaround on project deliverables Relationship Credibility Long-term relationships lead to improved client understanding, buy in and commitment Objective/integrative institutional perspective Strategic, operational and healthcare business experience allows staff to provide broad institutional perspectives Commitment to the Mayo Vision An internal consulting group understands the value and is committed to the institutional Mission ion and Vision Networking with External Expertise An institutional resource with the knowledge and expertise to effectively benchmark with external organizations.

30 4.2 Education and Professional Development Activity Year end 2009 % of core training modules completed by staff 54% % of advanced training modules completed by staff available 2010 # of S&P staff who attended conferences 17 # of abstracts/presentations/poster presentations 27 # of manuscripts submitted/articles published 7 # of adjunct faculty at external academic institutions 3 # of staff who have Mayo Quality Fellow certification 9 S&P sponsored the Mayo Clinic Conference on Systems Engineering and Operations Research in Healthcare

31 Questions?