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Session #23:$74M in Healthcare Operational

Improvements: How Texas Children’s Hospital Is Delivering on its Vision

Mark Mullarkey,

Senior Vice President

Pre-Session Poll Question

On a scale of 1-5, how effectively is your organization using healthcare analytics to drive operational improvements?1) Not at all effective2) Somewhat effective3) Moderately effective4) Very effective5) Extremely effective6) Unsure or not applicable

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Texas Children's Hospital, located in Houston, Texas, is a not-for-profit organization whose mission is to create a healthier future for children and women throughout our global community by leading in patient care, education, and research. We are proud to be consistently ranked among the top children’s hospitals in the nation.

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Our Improvement Opportunity

• In 2006 Texas Children’s Hospital (TCH) launched a health system wide initiative named “Vision 2010” that included $1.5B investment in expansion and IT.

• Upon completion in early 2012, TCH identified the need to improve financial performance of the health system by over $50M: Federal and state funding reductions driving most of this gap.

Higher margins crucial for replenishing capital and expanding TCH facilities.

Competitive threats driving expected gap closer to $75M.

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Our Improvement Opportunity

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Delivering on the Vision (DOTV)

• “Delivering on the Vision” (DOTV) became the operational

improvement effort following TCH’s rapid facility expansion.

• To achieve DOTV, TCH would need to improve the quality of patient

care, increase revenues, and reduce costs.

• TCH strategy for DOTV encompassed several efforts.

• Goal: To close an anticipated >$70 million gap.

• The common denominator in these efforts was a need for sustained,

transparent, easily visualized data, and measurement.

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Our Approach and Results

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Use of Analytics to Hardwire for Success

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Labor Expenses

Non-Labor Expenses

Physician Services

(Provider productivity, Practice management)

Clinical Operations/LOS

Clinical Documentation Improvement

EDW Platform

Focus on improving performance in every key

operational area

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Poll Question #2

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What is your organization currently leveraging analytics for? (Select all that apply.)

a) Provider productivity and practice management

b) Financials (statement of operations, revenue cycle management, labor productivity, etc.)

c) Patient satisfaction

d) Clinical quality improvement (reduction in sepsis mortality, lower CHF readmissions, etc.)

e) Operational efficiencies (LOS, throughput, etc.)

f) Other

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Improved Schedule Template Utilization

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Improving Operational Efficiencies

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Surgical Sections – Y/Y Change in wRVU per cFTE

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The Pediatric Surgery Sections reflect a marked improvement in provider productivity by comparison to both the prior year and the 50th percentile benchmark

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Medical Sections – Y/Y Change in wRVU per cFTE

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The Medical Sections reflect a marked improvement in provider productivity by comparison to both the prior year and the 50th percentile benchmark

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Labor Expenses – Results

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Length of Stay – Results

• aaa

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• LOS up 7.5%• CMI up >11%• Severity adjusted LOS down 20%

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Success with Clinical Documentation Improvement Drives SOI and CMI Up

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DOTV Results

FY13 the hospital had an operating margin of $70.2M on a budget of $42.5M; a $79.9M improvement from prior year.

FY14 the hospital finished the year at $77M.

FY15 the hospital is projected to approach near $90M in operating margin.

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Future Plans

Continue to broaden the use of healthcare analytics in support of a growing number of improvement efforts designed to achieve higher-quality care, reduced costs, and a better patient experience.

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Lessons Learned

Clear Focus Specific Goals Prioritization of

initiatives

Targeted improvement strategies

Time sensitive

Consistent Approach

Data driven - hardwired

Process improvement strategies (PDSA)

Best practices

Governance structure

Cultural Alignment

Patient-focused access

Questioning attitude

Fiscal stewardship

We can do more and better

Right People Physician

Engagement Admin & MD

Alignment

Internally Driven

External experts

Improved Patient Experience & Financial

Performance

The key ingredients driving our success…

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Analytic Insights

AQuestions &

Answers

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Choose one thing…

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Write down one thing will you do differently after hearing this presentation

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Thank You

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Session Feedback Survey

1. On a scale of 1-5, how satisfied were you overall with this session?

1) Not at all satisfied

2) Somewhat satisfied

3) Moderately satisfied

4) Very satisfied

5) Extremely satisfied

2. What feedback or suggestions do you have?

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Upcoming Sessions

Breakout Sessions – Wave 4 (1:15 PM – 2:00 PM)

26) Panel – How Community Hospitals Thrive with AnalyticsJohn Wadsworth, Vice President, Technical Operations, Health Catalyst

27) Quality Improvement in Healthcare: An ACO Palliative Care CaseDr. Robert Sawicki, MD, Senior Vice President, Supportive Care, OSF HealthcareRoopa Foulger, Executive Director, Data Delivery, OSF HealthcareLinda Fehr, RN, Division Director, Supportive Care, OSF Healthcare

28) Clinical Standards Work To Improve Evidence-Based Care Delivery: A How-To WorkshopCharles Macias, MD, MPH, Chief Clinical Systems Integration Officer, Texas Children’s HospitalTerri Brown, MSN, RN, CPN, Assistant Director, Clinical Outcomes & Data Support; Research Specialist, Center for Research and EBP, Texas Children’s Hospital

29) Five Months to Improvement: How Stanford Built an Improvement Program the Gets ResultsSpencer H. Kubo, MD, Associate Professor of Radiology (Pediatric Radiology), Stanford University Medical Center

30) Breaking Down Silos: Resolving Academic, Medical, and Research Interests Once and for AllSamuel L. Volchenboum, MS, MD, PhD, Assistant Professor of Pediatrics, Director, Informatics Program, The University of Chicago Medicine)

Location

Imperial Ballroom B

Imperial Ballroom A

Grand Salon

Murano

Venezia