1 ADVANCE for Executive Insight

CoO CFO Perspective
Cash may be “king” but quality is “queen.” Every hospital administrator should
have quality and satisfaction in the 97th percentile, but the challenge is to achieve
this level of performance while maintaining a healthy bottom line.
pense as a percent of net patient revenue remained consistent with
the prior year’s performance.
Technology
STPH has embraced technology throughout the patient care delivery
model and the entire revenue cycle, resulting in improved
productivity and a stronger bottom line. Some highlights include
2010 redesign of the pre-registration process, implementation of
benefit verification and copay estimator software, elimination of
duplication through autofill functions (asking the patient the same
question multiple times) and automatic physician order forward/
verification.
These gains are continued with concurrent coding process on
the floor, single sign-on for physicians and staff, and an electronic
health record storage device enabling remote access for physician
— all serving to decrease Discharged Not Final Billed (DNFB) by
2.1 days in 2011.
Standardized Platform
Physician integration comes in many shapes and sizes, but at
STPH we believe that one size may not fit the requirements of all
the physicians (staff and contracted). Nonetheless, a standardized
system platform means physicians no longer have to access multiple
applications, resulting in greater physician satisfaction and
increased productive time.
A standardized platform also eliminates multiple interfaces and
the need for additional IT staffing support, since individual applications
require upgrades that cause unexpected “Bolt On” applications
to be upgraded as well. CPOE
The potential benefits of Computerized Physician Order Entry
(CPOE) include a reduction in medication errors, decreased time
frame for order completion, improved adherence to core measures,
patient-centered decision support systems at the point of
care, error checking to prevent duplicated orders and an overall
reduction in pharmacy cost.
The implementation of CPOE systems is not without pitfalls resulting
from changes in physician workflow and the need for careful
integration and implementation by all of the members of the
hospital system. A successful CPOE implementation necessitates
physician involvement in all phases of the design and implementation
process.
The STPH medical staff is designing and building a customized
CPOE system using the Siemens Soarian platform, which has the
added benefit that our physicians are already all familiar with it. We
have in place a physician order set design and development team
using “Zynx” order sets to create evidence-based admission order
content. Our physician order set content and validation team of
representatives from across the STPH medical staff creates standardized
orders sets that improve physician workflow efficiency
and prevent problems associated with handwritten orders.
Staffing for PATIENT Improvements
Hospital operations depend on technology to improve staff utilization,
resource consumption and improve patient satisfaction
to contribute to the success of the hospital’s bottom line. Acuitybased
staffing models have been around for a number of years,
but the subjectivity of the patient’s severity has always been in
question.
Today, staffing models are driven by multiple matrices that allow
staffing flexibility tied to patient acuity, patient risk factors and
staff skill mix. Knowing how to manage these matrices can reduce
hours per patient day (HPPD), improve staff satisfaction and make
for a comfortable, cost-effective patient stay. Cash may be “king”
but quality is “queen.” Every hospital administrator should have
quality and satisfaction in the 97th percentile, but the challenge is
to achieve this level of performance while maintaining a healthy
bottom line. At STPH we have been successful in maintaining that
critical balance between cost and outcomes.
Embracing Change
As STPH looks ahead in times of reimbursement uncertainty, an
increased appetite for capital dollars, and added government compliance
reporting criteria means executive jobs are not going to get
any easier. Doing more with less has always been the buzz phrase in
our industry, but we need to use technology in concert with human
capital to their fullest potential to continue our success long-term.
Our commitment to embrace changes and improvements
may make it harder for the grandmother who was born here to
recognize us as the same hospital, but those advances are the
reason her grandchildren will be proud to choose St. Tammany
Parish Hospital as their community health system into the next
generation.
26 ADVANCE for Executive Insight