Becker's Hospital Review

16 Financial Management and clinicians have worked diligently to identify septicemia patients early, par- ticularly those who walk through the emergency department. "Septicemia is very scary, the mortality rate gets to be very high and it's also very expensive," Ms. Hunter says. "Certain measures [like septicemia] have better outcomes when they are standardized. We find we have fewer readmis- sions in those cases, which is clearly better for us financially but also better for the patient and care quality, as well." Small actions that make a big difference Mr. Goodnow says Benefis has been successful today in its pursuit of Medi- care breakeven because the entire organization has bought into the idea. He shared 10 imperatives other hospitals and health systems should follow if they want to find similar results. • Build commitment among all senior management, led by the CEO, as well as the board of directors. • Entrench the cost reduction mindset throughout the management and supervisory ranks, and consider including cost reduction incentives within compensation. • Show the strategic important of cost reduction consistently and often. • Emphasize why cost reduction is important for all employees through clear communication. • Measure results, report the results often and celebrate actual successes. • Include physicians, employed and independent, as cost reduction partners. • Be prepared to look beyond the low-hanging fruit. • Know that there are always ways to reduce costs, and leave no rock un- turned. • Evaluate external partners, like GPOs, to see if they are helping or hurt- ing your cost reduction process. • Be persistent, and don't get discouraged. "Leaving no rock unturned" is one of the system's most intriguing strategies. Benefis employees scrutinize literally every expense to find savings. For ex- ample, in 2013, a renegotiated contract for food and environmental services saved more than $184,000; taking control of sprinkler head maintenance net- ted $18,000; Benefis even saved $3,000 by notifying employees of their annual pay increase via online methods instead of using snail mail. Although surviving on Medicare rates is still more of a mental exercise than a reality at this point, the mindset may benefit hospitals in the long run. But it's worth reiterating, according to some, that strategic changes of this magni- tude don't happen overnight. "I hope no one has that Wall Street analyst outlook, where you're looking at next quarter's earnings," Flagler's Mr. Barrett says. "These efforts take time to accrue benefits. The community provider doesn't have to go the way of the dodo bird." n Barclay Berdan. COO of Tex- as Health Resources (Arling- ton): I've always believed in investing in people and their futures. Over the last several years, Texas Health has invest- ed more than $10 million per year in leadership develop- ment, employee education and growth and training. We are constantly striving for improvement and excellence. We demonstrate this to our employees through ongoing, two-way communication, as well as through programs and offerings that show them their personal growth is valued and sup- ported. It is also essential to nurture relationships and keep open lines of communication with all of our stakeholders. Therefore, I've always made it a priority to be visible with all of the departments I work with — this includes rounding — and I have made it a point to try to get to know as many of our 22,000 employees as possible. Various awards, honors and recognition from ex- ternal groups and organizations, along with em- ployee satisfaction surveys and market research, continue to tell us we are doing the right things related to investing in people. Lynn Britton. President and CEO of Mercy (Chesterfield, Mo.): You could argue Mercy's best investment was the fin- est electronic health record we could implement, and set- ting an aggressive timeline for training and utilization. Or you could make the case for the investment we're making right now, building the nation's first virtual care center. But I believe the most important investment we made was the clinical integration of our physicians. Without them being on the Mercy team, our other efforts wouldn't make much of a difference. Ben Carter. Executive Vice President and CFO of CHE Trinity Health (Livonia, Mich.): CHE Trinity Health's investments in changing busi- ness as we know it are signifi- cant and already showing re- turns. We are investing in the development of clinically inte- grated networks to position as for population health management. We're investing in new-and-improved capabilities to support this, like data analytics and actuarial expertise, where we've increased our bud- get by more than 65 percent. We've also had a 300 percent increase in staffing dollars related to payer and product innovation. These are related invest- ments and good ones, too. They are already result- ing in innovative arrangements with payer partners that, paced with changes we are making in our clinical practices, are helping us take care of several high priorities. They are helping us bridge the gap between the present and the future while making changes that will really result in more access to better care and lower costs for people and communities. Doug Cropper. President and CEO of Genesis Health System (Davenport, Iowa): Perhaps our best investment at Genesis Health System has come from setting the goal several years ago to be a leader in patient safety. Saving lives and reducing readmissions is worth the investment, regardless of the actual cost. Our first step was to seek independent, outside analysis of our patient safety. The cost to imple- ment recommended changes and train staff to hardwire a culture of safety into the health system was more than $1 million, but the results have been measurable. Our staff has reduced falls to 1.51 per 1,000 patient days compared to the na- tional standard of 3.06; our inpatient mortality is .92 (observed/expected) compared to the national standard of 1.0; our hospital-acquired pressure ulcers per 1,000 patient days has fallen to 0.08 compared to the national standard of 2.51, and our safety events have fallen by 60 percent. Our safety improvements have measurable return on investment but more importantly, our safety improvements have had a positive impact for our patients. Robert H. Groves Jr., MD. Vice President for Health Management at Banner Health (Phoenix): Banner Telehealth in the intensive care unit is advanced tech- nology that enhances the care and safety of ICU pa- tients by teaming our on-site medical staff with intensive-care specialists who follow patients' care from a remote monitor- ing center 24 hours a day, seven days a week. When a potential problem is identified, the re- mote care team can be immediately available via video and audio links to recommend and deliver appropriate interventions so that the potential adverse outcome is avoided. This solution serves as a high-tech, centralized patient safety net, and provides another set of watchful eyes to provide proactive care by con- stantly checking early warning indicators for any "My Best Investment": 9 Hospital Executives Reflect (continued from cover)

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