Location: Southeastern United States
Type: Not-for-profit, teaching hospital with five affiliated hospitals in the region, offering multidisciplinary care to a 12-county area
Annual revenue: $3.5 billion
*Because of client confidentiality, this case study does not identify the organization by name. The snapshot description is accurate, and the facts and figures reported as results are true to 3M findings; only the institution’s name has been altered for privacy reasons.
Hospital leadership at the organization knew it needed to improve operational performance by specifically shortening length-of-stay (LOS) in a clinically appropriate manner. Located in the urban center of a mid-sized city, the organization cares for a disproportionate share of publicly funded or uninsured patients compared to its competition in the market.
Between financial pressures, accreditation concerns and quality objectives, the organization needed to find a solution. Leadership identified the following challenges and objectives:
The organization’s leaders recognized they needed a deep and highly specific understanding of their organizational performance to tackle these challenges and meet their objectives. The organization expanded upon its 14-year relationship with 3M Health Information Systems (3M) and add the 3M performance improvement platform.
The 3M performance improvement platform combines decades of coding and risk-adjustment methodology and experience from 3M with the data-processing power of Verily, a subsidiary of Alphabet Inc. (formerly Google Life Sciences).
The 3M team looked at the organization across multiple performance measures and uncovered three specific 3M™ All Patient Refined Diagnosis Related Group (APR-DRG) codes that encompassed the largest opportunity for performance improvement: hip fractures, lower limb traumas and amputations. The orthopedic surgery service line presented an opportunity to improve average length of stay (ALOS) with a potential financial impact of $2.9 million in savings and enhanced internal revenue.
3M’s analytics and professional consulting services team was led by a physician, a seasoned engagement leader, four clinical transformation consultants (one physician, three nurses) and a project manager. The 3M team attacked the organization’s operational problems by considering coding, clinical documentation integrity (CDI), throughput/workflow opportunities, alignment with best practices and utilization of supplies and drugs.
The 3M team soon eliminated factors such as coding and CDI, quickly identified the true root causes and implemented sustainable performance improvement for long-term, impactful results. By aligning with the hospital’s existing 3M data monitoring software, the 3M team addressed these areas:
Once root causes and solutions had been identified and back-end issues resolved, the 3M team worked with the organization to improve patient handoff communications between service lines and care team members; begin discharge planning and insurance authorization early; and introduce social workers into the care process sooner.
Together, the 3M team and the organization selected the performance improvement projects from the opportunity list that would best combat the excessive LOS rates and improve throughput. These priorities emerged:
Just three months after the implementation and on-site 3M advisory services, the organization reduced ALOS overall by 0.77 days and on the orthopedic surgery service line alone by 0.75 days—a 15 percent reduction—during a period when the organization’s case mix index also increased by 0.27.
Three months post-implementation, the organization saw impressive results
To take on a project of this size and scope can be overwhelming, but the not-for-profit, teaching hospital and the 3M team were committed to deploying the data and using performance analytics methodologies to quickly identify the root causes. 3M PMx helps organizations achieve long-lasting, sustainable performance improvement across clinical, financial and quality measures.
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