Download

144 Section IV. EconomicsTABLE 13.1. Assessment of and change in the current systems.Who Goal(s) WhatClinic assessment 1. Focus on a review of each clinic’s operations. Access assessment2. Develop recommendations for efficiency, satisfaction, Clinical operationscapacity, etc.Comprehensive work flow3. Establish an implementation team and guide the start General operationsof the redesign effort.Readiness assessment4. Develop a system to continuously monitor each clinic’s Redesign consultingattainment of its established goals.Space assessmentSatisfactionBilling assessment 1. To better understand the financial process and to Billing processescollect the money billed in the shortest time.Charge capture processThe macro goal became to transform the Vanderbilt healthcare systems into a modelfor the future, including improved clinic redesign as well as creating the enabling technologytools to “transform our organization through people and systems” (TOPS).The TOPS initiative had five interlocking components that together constituted thetransformation goals:1. Delivering the right care and only the right care (clinical guidelines, evidence-basedmedicine, and a reduction in variation)2. Being able to deliver the right information when and where it is needed (the informationsystems and the informatics leadership in conjunction with the clinical andclinic operation leaders)3. Quality patient interaction (listening to patients, meeting their needs, involvingpatients)4. Supporting patient transactions (including parking, timely check-in, seeing thephysician promptly, no waits, no delays, etc.)5. Having a culture where employees understand and model the science of improvementin their daily work.Trusting financial improvements to process redesign through information technologywas a gutsy move for Posch. By betting success on a nonexistent technology productto be developed quickly and implemented efficiently—without ever disrupting workflow—Posch put his neck on the line.VUMC BackgroundVUMC is a university-based comprehensive healthcare organization comprised of professionalschools and wholly owned clinical facilities, including hospitals and grouppractices, as well as off-campus clinics. Its medical group practice participates in numerousjoint ventures and affiliations. The medical center board, which reports to the VanderbiltUniversity board of trustees, oversees the institution’s $1.2 billion budget.The Vanderbilt clinical enterprise has two primary components—hospitals and outpatientclinics. The hospital component is comprised of four divisions: the universityhospital with 650 beds; the children’s hospital with 170 beds; the rehabilitation hospitalwith 80 beds; and the psychiatric hospital with 88 beds. The outpatient clinics componentincludes more than 95 specialty practices that see more than 688,000 patients