Engagement Snapshots - HOSPITAL

• For a major Harvard teaching hospital

• Reviewed operations of a large, hospital-based primary care practice. Because of uncoordinated scheduling, double the number of patients were scheduled on the busiest weekday as on the least busy, but with the same support staff schedule. One result: schedules were redone to match staffing to work volume without adding FTEs.
• Improved encounter form information (clinic to billing). Results: the rate of missing information, and therefore rework, dropped from nearly 10% to under 1% in two months.
• Developed orientation and training material for a Patient Accounting Department in a large teaching hospital, resulting in reduction in communication 'silos', managers involved in orientation, and written competency checklists.

• For a major pediatric hospital:

• Improved specialty practice operations, with engagement goals of enhanced customer service, improved efficiency, and a 30% increased patient volume. Results after two years: specialty volume up 37%.
• Successfully combined a primary care ambulatory teaching practice with their non-teaching practice. Elements of the solution included negotiation of physician and room scheduling, staff roles, and process flow improvements.

• Led numerous hospital process improvement teams:

• Improved the Revenue Cycle, facilitating a team that reduced Days in A/R from 67 to 54 in six months. Interventions included implementing patient pre-registration, reviewing the charge master, capturing pharmacy charges appropriately, actively managing the DNB (Discharged-not-billed) list, improving MD documentation, and cleaning up the MPI (Master Patient Index).
• Reduced Medicare ALOS sufficient to close an inpatient floor. Utilization/Care Management interventions included more pro-active LOS expectations; establishing swing beds; generating more frequent, formal communication between hospital and SNF; and instituting nurse availability for discharges on weekends, clarifying 'observation' status and improving medical records documentation.

• Part of a consultant team that developed the operational plan to combine three hospitals, maintaining services at each location. Benchmarked and developed plans to consolidate shareable or referable services such as Laboratory, Radiology, Cancer Treatment, Cardiothoracic, Rehab, SNF and PT. Wrote plans to standardize Utilization Management and reduce ALOS. The plan was formulated in 3 months, approved by the Boards, and executed. Results 15 months post merger: The combined hospitals reported a $4.4M profit, vs. a $6M loss for the 3 facilities prior to merger. The CEOs appeared on the cover of a Modern Healthcare issue dealing with successful mergers in 2004.

• Served on a three-person interim management team for a large, campus-wide Facilities Management Department. Restructured and organized extensively over a period of 24 months, filled approximately 30 staff vacancies, defined roles of and hired six of the top administrators, tightened processes, created policies and procedures and effected controls.