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Using Healthcare Benchmarks as a Single Source of TruthBy Jane Vosloh, RN Assistant Administrator of Surgical Services Emory University Hospitals  Access to Data For a large academic medical center such as Emory University Hospitals, managing resources and controlling costs is essential to providing first-rate healthcare. To achieve success in a highly competitive environment, administrators, physicians and other stakeholders need easy access to reliable, actionable data. For us, this "single source of truth" for our surgical departments came through healthcare benchmarks. For years, we faced the challenge of accurately predicting needs and efficiently allocating anesthesia resources across two major hospitals and six outpatient clinics. We allocated services based on forecasted needs derived from historic usage. The allocation of these services directly determined how many ORs were available during particular times of day within each facility. Divergent Systems The challenge was that surgery and anesthesia operated on different information systems — we had two sets of data on OR usage that often didn't match. With no easy means to correlate the data – except by an arduous, manual process – the hospital often exceeded its budget for anesthesia services. The path to reconciling these conflicting sets of data came when we joined the OR Benchmarks® Collaborative (ORBC). After installing ORBC at our facilities, we were able to download data from our surgical and anesthesia information systems into one tool. The healthcare benchmarking tool enabled us to match actual productivity against services purchased. Our trending analysis provided actionable insights that scientifically validated a need to shift more "planned" resources to the hours past 3:00 pm in order to achieve our goal of 75% resource utilization and still cover all volume demands. Instead of taking weeks to obtain data compiled manually on OR usage, stakeholders can use the tool to drill down to physician and case levels, and monitor utilization against set targets on a monthly basis. This process has also eliminated inefficiency and the debate over which system contains the most accurate source of truth for data. Data Driving Change Accurate and trusted data is essential to driving change — especially for surgeons, who tend to be analytical by nature and driven by data. To that end, we present benchmarking data from ORBC at our monthly OR committee meeting to discuss changes that may be needed. For example, we used the tool to provide a graphical depiction of how anesthesia utilization was lower during "prime time" and unreasonably high during after-hours. Shifting resources to after 3 p.m. generated a 4% increase in primetime utilization and a 6% decrease in after-hours utilization over a year's time. Alignment of the resources increased scheduling accessibility, enabling us to run more rooms for a longer period. In addition, it positively affected surgeon satisfaction and the bottom line because we were able to equalize the supply and demand of resources. When Emory opened its new Orthopaedics and Spine Hospital, we used volume history and resource intensity data captured in ORBC to evaluate our resource needs and set targets for the new facility. The result was an impressive 90% for on-time case starts. Efficiency and Satisfaction We've achieved impressive results across our surgical departments. On-time first case starts have risen from an average of 30% to better than 60%. At our outpatient clinics, first-case starts have risen from 73% for on-time starts to 84%. Better use of resources is also vital to maintaining staff satisfaction. Without a system driven by accurate information, OR personnel can find themselves without enough cases to occupy their time. There are few greater sources of frustration for trained professionals than to arrive at the OR and not have enough work to fill their time. Finally, the ORBC tool enables us to incorporate Current Procedural Terminology (CPT) codes into our data to more accurately evaluate OR use. In the past, more complicated procedures requiring longer case times might be recorded as a similar – but less time-consuming – procedure with a similar name. With better data, not only do we more accurately code procedures, we can also bill more accurately and receive appropriate reimbursement. Fostering High Performance "The truth" is fostering change within the OR, helping us improve turnover time, case accuracy and first-case starts. It also helps us develop high-performing teams by ensuring that we have the right resources in each location at the right time. The path to greater efficiency and better patient care is well under way at Emory. While we have achieved much, there is still much more that we can accomplish as we use this "source of truth" to drive change. Jane Vosloh is Assistant Administrator of Surgical Services at Emory University Hospitals.   |
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