In many industries, time is money. In health care, time means so much more. It can determine a patient’s outcome. It can make providers effective, or overstretched.
Caring for a unique population, Yuma Regional Medical Center faced extra pressure to maximize its use of time. Can a process take fewer hours and still lead to better results?
Yuma Regional Medical Center
- Southwest Arizona
- Private not-for-profit
- 406 beds
- 2,400 employees
How do you serve a community that changes every season?
Yuma Regional Medical Center is the region’s primary health care provider, offering the only Level IV trauma center in a 180-mile radius.
They enjoy a one-of-a-kind challenge: Yuma is the sunniest city in the world. Every winter, snowbirds double its population. (Not to mention tourists.) Could YRMC find the balance of resources to serve their community year-round, and into the future?
Overtime was endemic. Expenses were rising faster than revenues. YRMC would need to transform its ways of working long-term, and focus on making the most of every minute of care.
Saving hours where time is of the essence
Integrating all the elements
Applying measurements to these areas led to improved services, and a more efficient support system. “Physicians gained confidence that adjustments to their workflow also would make a positive difference,” said Farren.
Tangible metrics empowered physicians to fine-tune their own ways of working. Monthly data comparing providers’ patients-per-hour and average lengths of stay provided context. Next, hourly data measuring patient “ins and outs” helped them benchmark themselves against target times.
With everyone involved, length of stay in peak season was reduced by nearly an hour. A further effort focused on sequencing the workflow of physicians and nurses netted two more hours. Average times for patients were cut from almost six hours, to under three. When minutes can make all the difference to a patient’s outcome, this was a proud achievement.
What’s more, a more efficient ED meant far fewer overtime hours for staff. It became a better place to work, and a better place to receive care.
47% reduction in overtime hours
44% drop in agency personnel costs
14% reduction in observation hours
From just-in-case to just-in-time
An efficient supply chain isn’t simply about sourcing. It’s also about how supplies actually make their way through the facility. This infrastructure can impact care in ways providers may not even realize.
In perioperative services and operating room surgical services, nurses and technicians were filling shelves and stocking case carts themselves, to be sure they had exactly what they needed. The unrecognized cost? Spending valuable time away from patients.
Vizient partnered with YRMC to revamp the system, with redesigned storing and stocking procedures, plus a new approach to filling preference carts and case carts. The reorganization also opened up space for cart staging closer to the operating room.
Now nurses and clinicians could trust that carts had what they needed, the moment they needed it. Minutes spent picking case carts were reduced 75%, and more time could be given to patients.
What’s more, switching to a “just-in-time” approach revolutionized the operating room. Once overstuffed, it now holds a third of the supplies it used to. Everyone can work more smoothly, and turn times have decreased.
The potential of group purchasing
Supply chain spend accounted for 16% of YRMC’s total annual expenses. Tapping into the buying power and insights of the Vizient GPO is beginning to change that.
“Changing group purchasing organizations is always a large process, but I couldn’t be happier with the results: high-level cost savings and dramatic increases on service levels,” said Richard Bergmann, administrative director, perioperative services and system supply chain.
The Vizient team has worked with YRMC to analyze all available contract opportunities, implement them at the appropriate tier for maximum savings, and activate them in the system so that purchase orders reflect the correct pricing. “Supply chain operations are now perceived as an asset to the organization,” said Terry Cox, director, supply chain services. “Regular reporting of our results is now reaching the C-suite.”
A brighter future
As it continues serving the sunniest corner of America, YMRC is enjoying positive trends. According to Farren, FY 2017 began $6 million behind budget – and ended $13 million ahead. The 6% operating margin was double the budgeted amount.
In the first year of these efforts with Vizient, YRMC completed 12 improvement projects with an estimated cost savings of $600,000. As the culture of continuous improvement has set in, the impact has multiplied. The organization has now completed over 400, with a cumulative impact of nearly $10 million – $7.6 million in just the last year. Supply chain operations have contributed an additional $3 million.
“Every month that goes by, the organization is achieving more improvements, so that now we are having a hard time keeping up with tracking them all,” Farren said. "Just within the past couple of years, we've positively impacted quality, services, operational efficiency and finances."
Improvements aren’t just about the numbers, however. With more efficiency in every area, the YRMC staff can devote more of their efforts to caring for their community. Whatever the season may bring.
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