The Truven Health Blog

The latest healthcare topics from a trusted, proven, and unbiased source.

 

Three examples of how performance improvement opportunities were hiding in this health system’s data

By Truven Staff

Like most health systems, Indiana University Health System (IU Health) leaders knew they had large amounts of valuable data stored throughout the organization. The challenge for the largest health system in Indiana was how to use the often-segmented data to quickly identify opportunities for cost controls and financial decision making, especially at the regional level.

To meet this challenge, the system pulled together a results-driven group called the Profitability & Utilization Support Hub (PUSH), made up of experts in revenue cycle, supply chain, clinical operations, labor analytics and more. The team’s charter: Make data-driven recommendations that could eventually drive operational and financial improvements.

The PUSH group began to identify opportunities by leveraging a comprehensive comparative database. The robust and detailed benchmarks allowed the team to see where their organization stood compared to peers.

Here are just three examples of how the team incorporated performance benchmarking to fuel its recommendations:

#1 Reducing above-average telemetry usage

The group proactively found that telemetry usage at one of the system’s hospitals was 70 percent higher than the comparison group median. The PUSH team recommended a review of the hospital’s electronic medical record order set and staffing ratios, which led to changes. The hospital’s telemetry utilization was reduced to the comparison group median within three months.

#2 Increasing oncology patient volume

The health system had recently converted one of its hospitals into an outpatient facility offering emergency department (ED) and oncology services. Using comparison data, the team discovered an imbalance between oncology patient levels and staffing levels. Leadership acted quickly and launched a campaign to increase oncology patient and provider volumes to align with staffing levels.

#3 Boosting ED capacity

The chief financial officer of an IU Health hospital asked the PUSH group for guidance to figure out why ED visits were declining even though staff reported full capacity. The data showed the hospital was efficiently using its available space — treating 20 more ED patients per day than the comparison peer average — but it had six fewer treatment spaces. Based on that insight, the hospital received approval to expand to accommodate 25 more visits per day.

If you’d like more information on how the health system achieved these remarkable results, please reach out to us.

 


Measuring the potential impact of a new palliative care service line

By Truven Staff

When you discover your mortality rates for stroke, pneumonia and heart failure aren’t where they need to be, what do you do?

The quality team at Carson Tahoe Health, a health system based in northern Nevada and eastern California, recently faced that challenge — and knew they had to answer two key questions: why is this happening and what can we do about it?

After a concentrated chart review, the health system discovered that the majority of patients who died in their care were at the end stages of their diseases.

Recent studies had pointed to the implementation of palliative care as a way to improve patient care and lower mortality rates. So to test the theory in their own environment, Carson Tahoe Health decided to roll out an inpatient care protocol in which hospitalists refer patients with end-of-life issues to a palliative care physician.

Comparing outcomes to determine progress

Using a clinical performance monitoring and benchmarking solution, the quality team was able to analyze several metrics, focusing on heart failure and chronic obstructive pulmonary disease (COPD) diagnosis-related groups in end stages of the diseases.

They tracked two groups of patients: those who participated in the palliative care protocol and those who did not. That way, cost, utilization, readmission, length of stay and other comparisons could be made.

The health system gained some key insights on the value of palliative care:

To see if they could move the dial even further on care improvement, the health system built and analyzed population reports to review the potential return on investment for an outpatient palliative program.

Informing the next step

With the new data and reports in hand, the health system proposed an outpatient palliative care service line to its board of directors, and the board approved it. Now Carson Tahoe Health offers a palliative care/heart failure chronic disease management clinic that sees patients within five days of discharge.

Seeing progress

After implementing the palliative care initiatives, the health system’s 30-day inpatient mortality rates for acute myocardial infarction, heart failure, COPD, pneumonia, stroke and coronary artery bypass graph surgery began trending lower than the national average.

They plan to expand palliative care services to other chronic end-stage disease groupings in the future.

If you’d like more information on how the health system achieved these results, please reach out to us. You can also read the full case study here.


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