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HEALTHCARE: Academic Medical Center & Health System
Total Investment
Organization
Results
Total time of
engagement
was 4 months.
This health system is centered upon one large, academic hospital in a large metropolitan city on the
east coast in a “capitated-type” environment. Among other services, they have a large physician
network and hospice organization. Other areas of improvement partnered together to improve were
hospice pain control, falls reduction, CAUTI reduction, ED LWOBS reduction and PU reduction.
ED Time in Dept
(minutes)
Each data point is the
weekly average. Volume
was relatively flat during
the shown time period.
BEFORE
AFTERVSM Workshop x 1 10,000$
Improvement Workshop x 4 62,000$
Daily Management Workshops x 2 31,000$
103,000$
[Academic Medical Center]
[xxxxxxxxxxxxx]
FEB 2015
Case Example: Healthcare – Hospital of the Future3P (People-Preparation-Process)
BEFORE Kaizen AFTER Kaizen• Typically 3-6 month process
for new design/build with multiple revisions and change requests
• Limited understanding of 3P process and Lean
• Basic layout proposed with limited involvement with front line staff
• 140,000 sq ft baseline design served as a benchmark
• Trained 60 cross functional staff in concepts and application of 3P
• Rationalized lines of service and needs versus benchmark design for HOF
• Reduced Patient Travel by 63% versus benchmark
• Reduced Nurse Travel by 61% versus benchmark
• Full cardboard mockup of complete Nursing Unit with live simulation
• Final Site Layout proposed with:
• 3D design
• Drawings to scale of each room and overall layout
“Hospital of the Future” concepts to be used across Health Network
Case Example – IP Discharge Process
Average Cycle Time = 102 min Average Cycle Time = 65 min
(> 40% Reduction in Discharge Cycle Time)
HEALTHCARE: Length of Stay ReductionStand-Alone Community Hospital
Annual
LOS Reduction Direct $ Impact 600,000$
Additional Cost Savings 233,000$
Additional Hospital Gross Revenue Capture 87,000$
Additional Cash Flow 420,000$
Additional Provider Office Gross Revenue Gain 340,000$
VSM Workshop x 1 10,000$
Improvement Workshop x 6 93,000$
Results
Total Investment
*higher case mix indicates
more complex care delivered
to sicker patients
Hospital
Total time of engagement was 10 months.
The client was
experiencing growth yet
was not reaping any
additional margin benefit.
The goal was to absorb
the growth without any
addition of fixed expense
within a year’s time. Net
income was increased
from <4.5% to > 5.5% in
< 1 year.
FEB 2015
Case Example: Managing for Daily Improvement (MDI) – Family Practice
A Faculty Family Practice was struggling with key population management quality metrics
BEFORE MDI AFTER MDI • The Physicians were unaware of best practices available to them for recording and reporting. • The Physicians had little confidence even small problems in the Practice were being addressed. • The Staff was not aware how daily activities resulted in bottom 10% performance level in the system.
• All Physicians could give an account of current standing in each of the daily metrics. • 74 Practice related problems were identified and addressed. • Performance on the three key metrics were top 5% in the system.
2/8/2011
Practice moved from perennial bottom 10% performance to top
10% in 3 months!!!
During the same period, ED Readmits were reduced from >2,200 to < 450
WHILE performance to quality “bundles” were either stable or improved.
75% + reduction in monthly readmissions over 9
month period across the system (in-patient)
481
108
9 months
HEALTHCARE: Readmissions Reduction3 Hospital System
Total Investment
OrganizationResults
This multi-hospital, non-profit organization
has 3 wholly-owned acute care locations and
two community hospital partnerships. They
have a complementary medical services
group. Net Revenue is roughly $500M with
3% operating margin and an A+ bond rating.
~ 70% of inpatient encounters are Medicare
& Medicaid and ~ 20% are commercial and
managed care. On the out-patient side, they
are ~ 55% and ~ 30%, respectively. The
organizational level result shown here is one
of ~10 done in partnership.
VSM Workshop x 1 10,000$
Improvement Workshop x 3 46,500$
Strategy Deployment Workshop 28,500$
Daily Management Workshops x 2 31,000$
116,000$
Total time of engagement was 8 months.
