Patient discharge management optimization - going from data to dollars

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Inpatient and ancillary services

Ali Birjandi
Corproate VP of Operational Performance Improvement
ProMedica Health System

Lisa M. Bragg
VP Care Coordination
ProMedica Health System

How often do we look back at a project and reflect on whether we did it right? ProMedica Health System (PHS) managed to identify the optimal alignment between quality, customer service, and performance to improve the discharge management function. Data driven strategies became the re-ngineering platform for attainable and sustainable results.

ProMedica Health System is a 10 hospital system with 190 employed physicians and an insurance arm located in Ohio and Michigan. Preliminary information indicated opportunities for improvement in the discharge management process. A significant amount of quality, operational, and financial data was compiled from various surveys, systems, and staff. After an intense analysis of the data using Six Sigma, lean, and some common sense, a bold strategy precipitated from 18 key findings. An optimal design was developed based on this strategy.

The changes derived from the new design were broken down into the management of people, process, and technology. Targets were developed based on these changes and ultimately quantified to produce an ROI. The ROI included 1600 avoidable days, 30 minute reduction in ALOD, 10 percent reduction in denials, one FTE reduction in back office processing, eight FTE reduction in care coordination, increased post acute care referrals to capacity through superior quality and service, increased DME and retail at the point of care. Because the automation requirements were based on the optimized process, developing an RFP for a technology solution was simple. Implementation took about four months and the results have exceeded all expectations and targets. With a 97 percent ROI, this is one of the best projects initiated at PHS.