Next Level Care: the Advanced Ambulatory Surgery Center

Transcription

1 Next Level Care: the Advanced Ambulatory Surgery Center

2 Roadmap

3 Roadmap YNHH by the Numbers YNHH Facility Strategy Center for Musculoskeletal Care What is an Advanced Ambulatory Surgery Center? Where are we now? Discussion

4 YNHH by the Numbers Facts and Figures

5 Yale New Haven Health System CRITICAL INDICATORS YNHDN* BDN* GDN* NLDN*/WHDN* NEMG** SYSTEM TOTAL Total Licensed Beds 1, NA 2,535 Inpatient Discharges 80,503 18,454 12,439 17,000 NA 128,396 Outpatient Encounters 1,085, , , ,868 NA 1,931,020 Total Revenue $2.4 B $445 M $343 M $408 M $164 M $3.76 B Medical Staff 4, ,447 Employees 11,436 2,512 1,754 2,512 1,091 19,305 Westerly, RI New London Yale-New Haven Bridgeport Greenwich * DN = Delivery Network ** NEMG = Northeast Medical Group

6 YNHH Facility Strategy

7 Two Campuses 0.5 Miles Apart Shuttle bus service Staff parking between campuses

8 Yale New Haven Hospital (2011) York Street 1,030 bed teaching hospital 925 patients average daily census 57,702 total discharges 8,308 staff 2,500,000 SF

9 Hospital of Saint Raphael (2011) 533 licensed beds Catholic community (teaching) hospital 250 patients average daily census 22,801 total discharges 3,128 staff 1,000,000 SF

10 Clinical Services Alignment York Street Campus Both Campuses Saint Raphael Campus Children s Hospital High Risk OB Major Trauma Transplant Cardiac Surgery Behavioral Health Emergency Services General Medicine General Surgery Heart & Vascular Neurosciences Oncology Urology Women s Services Musculoskeletal Low-Risk, High Amenities OB Specialty Geriatrics Care Niche Programs Bariatric Hernia Center Digestive Diseases Cardio-Renal Stroke Unit

11 Center for Musculoskeletal Care

12 Center for Musculoskeletal Care (CMC) Planning Short Term Consolidate, Recruit and Commit Aggregate and renovate CMC nursing units Create two new dedicated musculoskeletal ORs Hire CMC chair and create new offices Develop satellite CMC clinics Build new CMC Advanced Ambulatory Surgery Center Long Term New major CMC facilities Develop new outpatient CMC hub Plan new building for inpatient MSK services Create new SRC campus identity

13 Consolidate Bed /Nursing Unit Renovations Aggregate & Renovate SLA 3 Bed Unit Renovation Verdi 4 North and 4 East Musculoskeletal (Ortho)

14 Consolidate

15 Recruit & Develop Program New musculoskeletal ORs Newest, state of the art YNHH ORs CMC service anchor Make appealing to MDs, staff Program recruitment

16 Recruit & Develop Program

17 Recruit & Develop Program $24M (will support future OR renovations) New 50,000 CFM AHUs Added new 50,000 CFM Air Handling Units

18 Recruit & Develop Program CMC Administration Consolidate leadership Innovation space

19 Recruit & Develop Program CMC Outpatient Satellites Long Ridge Medical Center Yale Physician Building Long Ridge Medical Center

20 Commit to Program Center for Musculoskeletal Care McGivney Surgical Center 6 ORs 23 Prep/Recovery spaces 1 Special Procedure Room / Flex Induction Room Physical Therapy Education space ~28,000 DGSF former Cancer Center

21 What is an Advanced Ambulatory Surgery Center (AASC)?

22 Shifting Complex Inpatient Surgery to Outpatient 70% of inpatient MSK volume can transition to outpatient Knee and total hip replacement; minimally invasive spine Retain & grow volume, mitigate outflow Advances in technique, shorter acting anesthesia, improved pain control Focus: Business Model Safety Efficiency Education Convenience

23 Business Model Discourage volume from shifting to competition Outpatient vs. Inpatient facility fees Outpatient vs. Inpatient staffing costs Quantities Skill sets Insurance billing

24 Safety Connection to hospital Availability of face-to-face clinical consults Larger, better equipped ORs to support advanced procedures Clean Core Mock-ups and simulations Reduced chance of HAIs

25 Efficiency Service Lead Support Same-handed ORs Clean Core / SPD location Multi-Use spaces Identical room layouts

26 Education Non-Rehab facility focus Pre-procedure Patient, family exercise review In-bed education - expectations, DME training Post-procedure Virtual Exercise Rehabilitation Assistant (VERA) DME equipping

27 Convenience Access to pharmacy Access to full cafeteria Reduced patient time commitment Streamlining physician workload

28 Where Are We Now?

29 AASC Construction

30 CMC Outpatient Hub 64 Exam / Consult Rooms 4 Treatment Rooms Radiology Complementary Medicine PT/OT Motion Capture/ Performance Lab

31 Master Plan and Inpatient CMC East West Invest in eastern side of SRC; newer and operationally feasible Demolish western side over time; older and / or limited use McGivney prepped for vertical expansion (4-6 new floors) Achieve parity with York Street Campus

32 Master Plan and Inpatient CMC East West New campus identity, entry CMC (+other) beds CMC clinics New surgical platform

33 Master Plan and Inpatient CMC

34 Discussion