HEALTHCARE: Academic Medical Center & Health System

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1 HEALTHCARE: Academic Medical Center & Health System BEFORE Results ED Time in Dept (minutes) Each data point is the weekly average. Volume was relatively flat during the shown time period. [Academic Medical Center] Total Investment VSM Workshop x 1 $ 10,000 Improvement Workshop x 4 $ 62,000 Daily Management Workshops x 2 $ 31,000 $ 103,000 Organization AFTER Total time of engagement was 4 months. [xxxxxxxxxxxxx] FEB 2015 This health system is centered upon one large, academic hospital in a large metropolitan city on the east coast in a capitated-type environment. Among other services, they have a large physician network and hospice organization. Other areas of improvement partnered together to improve were hospice pain control, falls reduction, CAUTI reduction, ED LWOBS reduction and PU reduction.

2 Case Example: Healthcare Hospital of the Future 3P (People-Preparation-Process) BEFORE Kaizen Typically 3-6 month process for new design/build with multiple revisions and change requests Limited understanding of 3P process and Lean Basic layout proposed with limited involvement with front line staff 140,000 sq ft baseline design served as a benchmark AFTER Kaizen Trained 60 cross functional staff in concepts and application of 3P Rationalized lines of service and needs versus benchmark design for HOF Reduced Patient Travel by 63% versus benchmark Reduced Nurse Travel by 61% versus benchmark Full cardboard mockup of complete Nursing Unit with live simulation Final Site Layout proposed with: 3D design Drawings to scale of each room and overall layout Hospital of the Future concepts to be used across Health Network

3 Case Example IP Discharge Process Average Cycle Time = 102 min Average Cycle Time = 65 min (> 40% Reduction in Discharge Cycle Time)

4 HEALTHCARE: Length of Stay Reduction Stand-Alone Community Hospital Results Hospital Annual LOS Reduction Direct $ Impact $ 600,000 Additional Cost Savings $ 233,000 Additional Hospital Gross Revenue Capture $ 87,000 Additional Cash Flow $ 420,000 Additional Provider Office Gross Revenue Gain $ 340,000 *higher case mix indicates more complex care delivered to sicker patients Total Investment VSM Workshop x 1 $ 10,000 Improvement Workshop x 6 $ 93,000 Total time of engagement was 10 months. The client was experiencing growth yet was not reaping any additional margin benefit. The goal was to absorb the growth without any addition of fixed expense within a year s time. Net income was increased from <4.5% to > 5.5% in < 1 year. FEB 2015

5 Case Example: Managing for Daily Improvement (MDI) Family Practice A Faculty Family Practice was struggling with key population management quality metrics BEFORE MDI The Physicians were unaware of best practices available to them for recording and reporting. The Physicians had little confidence even small problems in the Practice were being addressed. The Staff was not aware how daily activities resulted in bottom 10% performance level in the system. AFTER MDI All Physicians could give an account of current standing in each of the daily metrics. 74 Practice related problems were identified and addressed. Performance on the three key metrics were top 5% in the system. Practice moved from perennial bottom 10% performance to top 10% in 3 months!!! 2/8/2011

6 HEALTHCARE: Readmissions Reduction 3 Hospital System Results Organization 9 months This multi-hospital, non-profit organization has 3 wholly-owned acute care locations and two community hospital partnerships. They have a complementary medical services group. Net Revenue is roughly $500M with 3% operating margin and an A+ bond rating. ~ 70% of inpatient encounters are Medicare & Medicaid and ~ 20% are commercial and managed care. On the out-patient side, they are ~ 55% and ~ 30%, respectively. The organizational level result shown here is one of ~10 done in partnership. 75% + reduction in monthly readmissions over 9 month period across the system (in-patient) During the same period, ED Readmits were reduced from >2,200 to < 450 WHILE performance to quality bundles were either stable or improved. Total Investment VSM Workshop x 1 $ 10,000 Improvement Workshop x 3 $ 46,500 Strategy Deployment Workshop $ 28,500 Daily Management Workshops x 2 $ 31,000 $ 116,000 Total time of engagement was 8 months.