Supply, Patient Tracking Pays Off Big for Healthcare System

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Supply, Patient Tracking Pays Off Big for Healthcare System Philip Betbeze, for HealthLeaders Media, February 8, 2013

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he Virtua executive team’s biggest challenge, as CEO Rich Miller sees it, is transitioning from a reliance on acute hospital-based care into providing or arranging care outside the hospital’s walls. From that perspective, the New Jersey-based non-profit healthcare system’s CEO is probably not much different from hundreds of other health system CEOs across the country, many of whom are making big—and risky—changes in the ways their hospital or health systems do business. It’s clear that in order to continue to exist, as an array of incentives and disincentives work together to force institutions to look at healthcare more holistically, senior leaders must not only provide a vision for what the future may look like, but they also must evoke a change in culture from their employees. Further, and most importantly, they must articulate a vision for how that transformation can be achieved. As I’ve pointed out previously in this space, the challenges are relatively easy to identify. The key difficulty in any transformation is not in identifying processes that are less beneficial for patients (and soon less beneficial to the bottom line), but in finding

out what changes deliver the biggest improvement in patient satisfaction, elimination of waste, and ultimately, improvement in outcomes. “Getting people in all settings to think differently about the connectivity between each setting is what will make the model work over the next 10 to 15 years,” Miller says of the fourhospital, 885-staffed-bed system in Marlton, NJ. “It’s kind of like turning a battleship.” If that’s the case, the turn is already well under way. The system is banking on the fact that it will be able to organize transitions effectively and efficiently, and with 46% of its business now in the outpatient sector, that ability is crucial to long-term survival. To continue to the ship-turning analogy, sometimes technology can act as a rudder, Miller says. In Virtua’s case, a move toward a patientand-equipment tracking system helped supply proof that changes in processes can pay big dividends, not only for the system itself, but for patients and employees. In Virtua’s case, says Alfred Campanella, Virtua’s executive vice president of strategic business growth and analytics, the system is on the third leg of a technological journey that is enabling that culture change not only among senior leadership but all the

way to the most elementary levels of patient care. Having invested years ago in its EMR and data warehousing capabilities, Virtua leaders believed they had two of the three legs of their competitive stool built. The third, however, wasn’t possible without the first two, and was perhaps the most important: real-time location systems that track things that are moving, whether assets or people. Perhaps it’s obvious that in an industry that has to focus on effective transitions in care settings this kind of technology will be essential, but it’s a foreign concept for healthcare. In 2010, Virtua was in the process of building a replacement hospital for its Voorhees campus, its largest. Miller says the leadership team identified that it was an opportunity to redesign care such that it functioned using the most up-to-date technology, methods and strategies for efficient patient care and access to treatment. Part of that planning involved implementing an asset and patient management tool from GE, called AgileTrac, to track bed and patient flow, as well as mobile assets used by patients, and often “hoarded” by caregivers who wanted to assure they would have equipment when needed. Of course, this all created a vicious

circle of equipment hoarding and bed delays that belied the goal of achieving efficiency. “We were building this millionsquare-foot replacement facility where the biggest challenge is knowing where equipment and people are,” says Barry Graf, Virtua’s vice president of integrated operations. Graf says the importance of both right-sizing inventory and making sure it’s always readily available for patient care held promise of big returns on investment. Not to mention the savings of time and effort among the clinical staff who were spending inordinate amounts of time on the phone and on foot searching for equipment or trying to get rooms cleaned and turned over for the next patient. Backlogs in the ER were the most visible sign of the problems, but so was hallway clutter. Equipment used in patient care was often “parked’ in hallways between use. To minimize the disruption associated with the move to the new hospital, executive leadership rolled out the new technology, which uses RFID

tags to track equipment, patients, and employees, at the existing hospital prior to the move. “We wanted to work through and optimize workflow so when we moved, they would be developed already,” says Graf. Now, any caregiver can go to any computer and identify where a piece of equipment is, which eliminated hoarding, and allowed Virtua to rightsize its inventory. The new, 1 millionsquare-foot Voorhees hospital is three times the physical size of the building it replaced. “Employees realized they don’t have to walk so far to get things done,” says Graf. “When you have that highlevel caregiver, such as a nurse, you want them focused on the patient and not looking for equipment and so do they. This is maximizing time to spend with the patient which improves outcomes.” Three of the four hospitals at Virtua now use the system, and by the end of the year, all will be using the RTLS, or real-time location system.

The new system has resulted in an estimated $1.2 million in savings. Average ER-to-inpatient bed wait times have decreased from 16.2 hours to two, and the average wait time for “ASAP” equipment delivery is down from 202 minutes to 12. For “routine” equipment, it’s down from 184 minutes to 14. By the time the fourth hospital has been rolled out, Virtua will be making use of 9,000 patient tags and 11,500 of them for asset tracking. But those figures don’t even begin to address the downstream improvements in patient care that can’t immediately be categorized in a statement of ROI. There’s a lot of talk about “disruptive” technologies in healthcare these days, says CEO Miller. “This has been disruptive in a good way. It’s the best we’ve rolled out,” he says. “When we give tours and we show visitors and patients these features, their eyes light up. We’re sharing information at a much different level.” Philip Betbeze is senior leadership editor with HealthLeaders Media.

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