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April 2, 2010

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Compirion Healthcare Sponsors Webinar Series

July 2, 2009

ELM GROVE, WISCONSIN…Compirion Healthcare Solutions, a whole-hospital process improvement firm is sponsoring a series of free webinars to help educate hospital executives, managers and clinicians in strategies for optimizing processes and procedures. Topics include patient satisfaction, nurse rounding, time-of-day discharge, core measures and bed control. The full list of webinars can be found at http://www.compirion.com/webinars along with times, dates and registration information.

Compirion’s presenters are drawn from its pool of consultants, which includes registered nurses, former C-level executives, physicians, business mangers and clinicians. The webinars are running through September and average about 45 minutes each with a question-and-answer session at the end.

According to Compirion Management, “We are presenting this series of free webinars because we truly believe that efficiency in the hospital, especially the ED, not only saves time and money, it saves lives. The faster you can get a patient to treatment, the better the outcomes you can expect. It is the premise on which Compirion was founded.”

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site, using a team approach and offer a money back guarantee that all goals are met. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management, patient throughput and staff retention. Their experience includes emergency room, surgical services, laboratory, radiology, materials management, inpatient, outpatient and nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.

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Anderson ED Team Receives Pinnacle Award for Excellence in Customer Service

June 23, 2009

MARYVILLE, ILLINOIS…Anderson Hospital administration and their ED process improvement consulting group, Compirion Healthcare Solutions congratulate the ED Patient Throughput Team at Anderson Hospital upon its receipt of the coveted Pinnacle Award. The ED Patient Throughput Team, responsible for reducing wait times and improving patient satisfaction, was chosen from a group of three finalists to receive the award for their excellence in customer service.  The other finalists were the Laboratory Department and Information Systems. The annual award was created to honor a department or workgroup.

According to hospital president, Keith Page, “Selecting the Pinnacle Award winner was very challenging as all three finalists have distinguished themselves in their efforts to improve our customer service. All three departments had equally impressive stats.”

The changes in the department were the result of a massive patient throughput improvement project initiated last year that involved every department in the hospital working together toward a common goal. The project greatly improved patient satisfaction in many areas of the hospital. The patient satisfaction baseline prior to the project was in the 4th percentile PRC (Professional Research Consultants) ranking. After a hospital initiated improvement project, in January of 2008 it was still low, in the 33.1 percentile. In February, hospital administration enlisted Compirion Healthcare Solutions out of Elm Grove, Wisconsin to assist with the project. Compirion began an intensive 6-month period of coaching, piloting, and implementing in collaboration with the ED staff, physicians and management.  At the end of Compirion’s 6-month engagement, PRC rankings had climbed to the 73rd percentile when compared to other hospitals. Since then, the concepts and processes that were put in place while under Compirion’s tutelage have enabled Anderson Hospital’s ED patient satisfaction scores to continue to improve and to reach the 96th percentile PRC ranking.

“We are pleased that the Emergency Department was chosen to receive this distinguished award. We know how hard they all worked and continue to work toward providing the best patient care possible,” said Compirion Healthcare Administration.

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention.  Their experience includes emergency room, surgical services, outpatient and inpatient throughput, and nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.

For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/anderson.

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Compirion Helps Baxter Regional Medical Center Achieve Patient Satisfaction Rankings in the Top 5th Percentile Nationally

May 7, 2009

MOUNTAIN HOME, ARKANSAS… Baxter Regional Medical Center has recently reached the top fifth percentile ranking for patient satisfaction, in the National Database after a 6-month long improvement project in the Emergency Department. They have also reached number one in Arkansas, number one in Region Seven, and number one in Missouri. Compirion Healthcare Solutions, a hospital process improvement firm from Elm Grove, Wisconsin helped them get there.

Baxter Regional Medical Center prides itself on providing big city, state-of-the-art healthcare with a hometown touch. However, before the improvement project, its patient satisfaction ranking of  59%, evidenced that it was struggling.

The most obvious problem seemed to be the long wait times. While the clinical performance was high, it was determined by hospital administration that the long wait times were just a symptom of other problems throughout the Emergency Department unrelated to quality of care. After several attempts to correct the situation, the ED staff was losing hope. Hospital leadership determined that outside help was needed. Compirion Healthcare Solutions based in Elm Grove, Wisconsin, was engaged to manage the improvement process.

According to hospital CEO, Ron Peterson, “Compirion was awarded the contract because they looked different from every other consulting group I had seen. They worked on site and they implemented the changes.  They presented a total package for a lump sum (of money), with goals that were agreed upon beforehand…and they had the same goals we did.”

Compirion sent a team to work on site, side by side with hospital staff. The first few weeks were spent in observation of the processes and procedures in the department.  Compirion provided mentoring, leadership, coaching, and problem-solving facilitation while encouraging teamwork. They identified problems and helped set up pilot initiatives for testing solutions.

Dr. Pat Black, Emergency Department Medical Director commented, “Compirion made a significant contribution to the improvement project by showing us the value of observation and helping us set up a process to deal with problems. They did a fabulous job. They never dropped the ball or minced words. They showed us how to define the problems and the benefits of solving them instead of repeating the same problems over and over.’

“One of the things Compirion’s observation process revealed was the slow response from the teams on ‘the floors’ when they were needed in the Emergency Department. Our solution was to set up an ancillary team from lab and x-ray. We made it part of their responsibility to respond to needs in the Emergency Department in under 45 minutes.’

“Another problem  revealed through observation was that the Emergency Department physicians were complaining that nurses currently in triage were not up to the job. They were Fast Tracking the wrong people.  As a result, jobs were reassigned putting the best nurses in triage, and Fast Track was eliminated. Next, we worked to redefine the Charge Nurse role making it more supervisory. In addition, Charge Nurses now coordinate with triage to get patients into beds.”

Dr. Black added, “Charge Nurses want to be care nurses and disappear into rooms with patients. Without constant monitoring, we have a tendency to backslide. Our teams have to be in place at all times. Even so, we could use a little booster shot once a year.”

Baxter’s Michele Pierski commented, “As Director of the Cath Lab/ARU, I knew there was a problem with chest pain patient wait times and I had been trying to fix that for quite a while. Compirion supplied the ‘oomph’ that helped move things forward. When Compirion arrived, the first thing they did was get everyone in the Emergency Department on-board. The absence of a baseline for Core Measures was the first problem we uncovered relevant to wait times. They helped us determine one so we had something to measure against.  Our Core Measures baseline for the first quarter was found to be 50%.”

Previously, the process for the initial handling of chest pain patients had been to call a physician from cardiology to the Emergency Department to perform an EKG. This burned up critical minutes.  Now, a quick EKG is performed by an Emergency Department technician who has a printer near by. The print is handed to the ED physician to read immediately.”

Dr. Black added, “We have implemented a “Code Stemi” where everyone is notified via overhead page. The team literally swarms on the patient. Chest pain patients are now prepped by the Emergency staff and it is the ED physician who determines whether a person goes to the Cath Lab or not.”

Additionally, during peak times, a person from the Cath Lab is in the Emergency Department to expedite cardio patients.  After implementing these changes, Door-to-EKG time compliance to the Core Measure rose to 78%.

“Our ambulances now have the ability to perform twelve-lead EKGs. These EKGs are sent directly from the ambulance to the ED. In this way we can have EKG results before the patient reaches the hospital, saving those critical minutes,” said Pierski.

Other Core Measures initiatives for cardio patients were:

• Aspirin on arrival added to the standard order sheet

• Standardized procedures for Code Stemi

• Development of Code Stemi packets containing all paperwork, Med Kits, and

orders/protocol sheets

• Realtime data sheets that flag issues immediately

• Creation of a patient preparation board to educate ED staff on proper patient prep for cath procedures

• EMS or ED physician initiation of Code Stemi call-in

• Second IV started by EMS when feasible

Key Core Measures results over the term of the improvement project included:

• ASA at arrival from 86% to 98%

• Primary PCTA within 90 minutes from 56% to 91%

• Blood culture prior to antibiotic for pneumonia patients from 90% to 100%

• Antibiotic within 4 hours from 89% to 94%

Pierski added, “Their observation process proved to be a fabulous tool that I now use all the time. I used the tools Compirion supplied to move the whole house forward.”

The results of the improvement project were:

• Core Measures consistently above the 90th percentile

• Door-to-admission time reduced from 4.41 hours to 2.3 hours

• Door-to-discharge time for treated patients from 3.41 hours to 2.08 hours

• Percentage of those who left without being seen (LWBS) from 6.8% down to 2%

• Patient billable volume up 15%

At the conclusion of Compirion’s engagement, Press Ganey patient satisfaction rankings were in the 85th percentile.  Ten months after the end of the project, scores continue to climb and are consistently in the 95th percentile ranking, making Baxter Regional Medical Center number one in Arkansas, number one in Region Seven, and number one in Missouri. They are rated in the top 5% of the national database of 1053 hospitals.

According to CEO Peterson, “It is nice to know they were here. They were committed until the goals were achieved. They are very goal focused. Now there is more teamwork (at the hospital).”

Dr. Black concluded, “Our ED Physicians have reported that the improvement in patient satisfaction has made their jobs better. What the Compirion process taught us was respect for the patient and our coworkers. That is what it boils down to.”

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention.  Their experience includes emergency room, surgical services, outpatient and inpatient nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.

For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/baxter

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Compirion and Jefferson Memorial Hospital Use Accountability to Improve Patient Throughput, Patient Satisfaction in Emergency Room

October 7, 2008

ST. LOUIS, MISSOURI… Jefferson Memorial Hospital is a non-profit community hospital, located within an hour of St. Louis. It is the sole community provider of healthcare services for Jefferson County and other surrounding communities. With the intent of improving patient access, ed throughput and patient satisfaction, the hospital board backed by the community, invested millions of dollars into redesigning its Emergency Room. In June of 2006, the new emergency room opened. The ER had been designed without a waiting area, – a feature that leadership assumed would lower patient length of stay and eliminate wait times. It boasted 24 private, patient rooms built around a central clinical nursing core. Patient transportation, visitation, and other activities occurred via a perimeter hallway.

By December of 2006, hospital leadership learned that patient throughput times had not improved – ed throughput times had actually increased to 4.61 hours, productivity was at 4.5 hours per patient, and patient satisfaction scores were low at the 2nd percentile. Staff morale was declining. Compounding the situation, the hospital had been advertising “no waiting” for the Emergency Room. In January of 2007, hospital administration brought Jerome Ladous on board as Vice President of Operations to “fix” the Emergency Department.

By May of 2007, Ladous decided to enlist outside help to facilitate change of this size. Compirion Healthcare Solutions, a hospital consulting firm out of Milwaukee was engaged for 6 months to help the hospital staff develop tools and processes in order to effect permanent change. Goals included: improve patient throughput time from over 4 hours down to 3 hours, improve productivity, raise Press Ganey patient satisfaction scores to the 75th percentile and improve core measures scores. The Compirion team built tools to aid in the daily, real-time management of patients and resources. At the beginning of the improvement, LOS was at 4 hours, 12 minutes. At the end of the 6-month process, LOS was at 3 hours and billable patient volume had risen 6%. Productivity went from 3.5 worked hours per patient to 2.9 for a 17% improvement.

At the same time, specific goals were set for treatment of cardio and pneumonia patients: aspirin on arrival for 100% of patients with chest pain, door to PCI within 90 minutes (according to Medicare reimbursement guidelines), and door to EKG within 10 minutes. For pneumonia patients, 100% were to receive a blood culture prior to antibiotic, and an antibiotic within 4 hours of diagnosis. At the end of the engagement, aspirin on arrival, primary PCI within 90 minutes, blood culture prior to antibiotic, and antibiotic within 4 hours of diagnoses were all at the desired 100%.

Prior to the improvement, Jefferson Memorial Hospital did not have a patient satisfaction procedure in place. The team’s first step was identifying baseline percentile Press-Ganey rankings, which turned out to be lower than the 20th percentile, and setting goals for increasing scores. At the end of 6-months, Press-Ganey scores were in the 74th percentile.

Unexplained waits in the lobby averaging 23 minutes were looked at next. Initial door-to-treatment time was 59 minutes, and door-to-EKG time was at 35 minutes. Decreasing door-to-treatment time became a primary objective. A Quick Registration process was established. Nine additional standardized triage protocols were instituted based on ESI guidelines. A water cooler and a clock were placed in the lobby for patients, their families and friends. Door to treatment time decreased to 37.5 minutes and door to EKG dropped to 15 minutes.

According to V. P. Operations, Ladous, “What I liked about Compirion was that they used the resources of the hospital, specifically the front line managers, to come up with customized answers to fit Jefferson’s needs. Once-a-week we held and still hold Core Team meetings of accountability with the hospital CEO.”

E.D. Director, Shelley Layton added, “From my perspective, the accountability was the biggest piece Compirion brought to the table and was worth every penny!”

As part of their Sustainable Results Program, the Compirion team returns twice during the year, at no charge to the hospital, to review and make any adjustments.

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion focuses increasing client hospitals’ billable volume, staff retention and recruitment, core measures and patient satisfaction. Their experience includes Emergency Services, Case Management, Surgical Services, Laboratory, Diagnostic Imaging and Inpatient Nursing Care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line. For more information on Compirion’s sustainable healthcare solutions call 1-866-661-4677, or visit http://www.compirion.com/jefferson.cfm

The following images may be downloaded for print:

http://www.compirion.com/images/hi-res_jefferson.jpg 

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Compirion and Meriter Hospital Achieve an Extraordinary Improvement in Emergency Services Department Patient Satisfaction

March 13, 2008
MADISON, WISCONSIN . . . Meriter Hospital is a 448-bed non-profit community hospital that provides comprehensive health services for residents of a seventeen county area in south-central Wisconsin. It is a major teaching affiliate of the University of Wisconsin and the fifth largest hospital in the state. As Madison’s Emergency Services market leader in a very competitive healthcare market, Meriter Hospital has always valued a high-functioning Emergency Services Department. Late in 2006, it became apparent to Meriter’s Administrative and Emergency Services leadership that a significant improvement initiative was overdue if Meriter wanted to retain its Emergency Services market leadership position and meet patient care expectations;
  1. Patient wait times and through-put times continued to climb above acceptable levels creating a risk of patients leaving without being seen and ambulance services diverting patients to other facilities
  2. Patient satisfaction levels had fallen significantly below the 75th percentile using a national survey tool comparing Meriter to over 700 other hospitals nationally; Overall hospital inpatient activity continued to climb, making timely inpatient admissions from the ES very difficult
  3. Employee satisfaction and morale were falling and turnover increasing as the stress of a busy ES and employee overtime took its toll
  4. A key competitor, UW Hospitals and Clinics, the only Level 1 Trauma facility in the region, was planning the grand opening of their new state-of-the-art Emergency Services Department in June 2007.
Recognizing the need to enlist outside help to facilitate the kind of change necessary to address multiple operational and performance issues, Meriter’s leadership engaged Compirion Healthcare Solutions, a Milwaukee-based consulting firm. According to Vice President of Programs, Tim Sio, who championed the project, “Compirion was chosen for their unique behavioral approach to process improvement and high performance. Their approach was in line with leadership’s belief that to make long lasting change, you had to start with the behaviors of all of the team members involved in the care continuum and achieve alignment around purpose. We also agreed that this was a Meriter-driven project with Compirion playing an important and key support role. Meriter had to take ownership of the effort if we wanted long term and sustainable success.”
A multi-disciplinary team of Meriter management, staff, and physicians representing clinical and support departments across the hospital was convened to work on the project. With support from the Compirion consulting team, three key measures of success were identified for the effort;
  1. Sustain the Emergency Services market leadership position
  2. Improve patient satisfaction rankings to the Top 10 percentile
  3. Decrease patient throughput times to Top 10 percentile performance
In addition, Compirion assisted in the establishment of several key work teams and provided specific measurement tools and training for team members to immerse themselves in the Emergency Services Department processes. According to Sio, “Compirion trained the team members to do fundamental observational work of the key processes that made up the ES care continuum. The outcome of that work was enlightening for everyone involved.” The work team progress and key performance measures were summarized weekly, reviewed by the project steering committee and course corrections and resources allocated to the work teams as needed. This approach was crucial in sustaining the project momentum and team communication.

The Compirion consultants “lived” in the department. Making themselves available on all shifts, they took a very measured approach to reveal issues and observe hospital staff and their behaviors. According to Compirion project manager, Lisa Adams, “We tried to actively engage everyone on the staff and inject a positive approach. We coached the managers on how to coach peer interaction because sometimes people forget to be civil to each other -– especially when they are stressed. We made sure to incorporate the ideas of the staff members and soon we began to see a staff-driven change.

The work teams were set-up to address specific operational gaps; Patient Satisfaction Team, Registration/Triage Team, Throughput Team. One team in particular, the NOW (Staff) Team played a critical role in the improvement efforts. Chaired by staff nurse Mary Ryan and assisted by Compirion President Spence Tepper, this team focused on standardization of care protocols, respective physician and nurse roles, the use of acuity tools and understanding of the implications of patient census on staffing on an hour-by-hour basis throughout the three shifts. An important outcome of this team’s work was an optimum alignment of staffing resources with patient census by adjusting both staff schedules and department FTEs.

Along with the staffing realignment came a revamping of the Charge Nurse role. Responsible for the real time management of the patient flow in the ES, the Charge Nurses worked with management to redesign their role that included gaining access to computer based tools and resources that allowed them to monitor throughput time of patients in the waiting room and those in the ES. These improvements along with the other staffing and process improvements allowed the department to treat an increasing daily patient load, (from an average of 108 to 124 per day) in less time and with higher patient satisfaction scores. Another side benefit was an improvement in payer mix.

Sherry Casali, Emergency Services Department Director, lead the Registration/Triage Team. At both the front-end registration and back-end discharge processes, there were too many steps to go through before getting a patient into a bed or out the door. According to Casali, “The Meriter Team assisted by Compirion consultants redesigned the front-end flow by developing strategies for moving the critical patients out of the ES and into beds as inpatients. Registration was handled at the back end.” They also shortened the process by eliminating unnecessary steps and standardizing the triage, discharge and assessment processes.

Casali describes Compirion as “Very organized and methodical. They were working on-site alongside staff, listening and guiding people, which contributed a big part to the success. What they really created was an opportunity for a cultural change in the department.”

After a little more than six months of the Compirion – Meriter engagement, patient satisfaction soared over 24% to a Top 10 percentile ranking, the market leadership position was sustained, employee turnover declined and billable volume was up by 9%. In December of 2007, the Meriter Emergency Services Department received recognition as a “Star Recipient” (a Meriter internal recognition program) for their dramatic improvement in Patient Satisfaction.

To insure lasting results and continued improvement, the Steering Committee continues to meet weekly. Patient throughput has improved significantly and will continue to get most of the team’s attention in early 2008. As part of their Sustainable Results Program, the Compirion team returns to the hospital twice during the year at no charge to check on the team’s progress and provide insight and feedback.

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion focuses on making No. 1 Hospitals by increasing client hospital’s billable volume, staff retention and recruitment, core measures and patient satisfaction. They work onsite using a team approach and offer a money back guarantee that all goals are completed.

The professionals at Compirion Healthcare Solutions have been conducting sustainable performance improvement successfully for over two decades. Their experience includes Emergency Services, Case Management, Surgical Services, Laboratory, Diagnostic Imaging and Inpatient Nursing Care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.
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Compirion and Grandview Win Award for Improvements in Emergency Services

March 12, 2008
 
DAYTON, OHIO…Grandview Medical Center, Dayton, Ohio and their consulting firm, Compirion Healthcare Solutions have received the Kettering Medical Center award of excellence for “Improvement in Emergency Services.” Grandview is a member of the Kettering Medical Center Network, a faith-based Adventist Network in Allopathic and Osteopathic traditions. Grandview ED and Compirion received the award for achieving improvement in four key areas: overall patient satisfaction ranking – into the top 20th percentile, patient likely to recommend ranking- up 15%, total LOS – down 25%, and billable volume – up 10%. The improvements were accomplished within six months.
 
During the first quarter of 2006, before the improvement, patient satisfaction ranking in the emergency department at Grandview Medical Center had fallen into the Press Ganey 8th percentile. Reimbursements were being challenged from Anthem Blue Shield and Medicare causing losses in revenue. By end of third quarter, the situation showed no significant improvement and flu season was approaching. Complicating matters, the ED was about to loose a key physician to frustration. The new hospital director felt the hospital didn’t have its processes in place and recognized the need to rebuild the department from the ground up refocusing on the patient.
 
Hospital administration set project objectives with specific measurable goals that would result in better outcomes for the patient. Goals included achieving core measures performance in the top 10th percentile; reducing turnaround time to less than three hours; reducing patient-to-physician time to within 30 minutes; and increasing Press Ganey patient satisfaction rankings to the top 25th percentile. A financial goal was also set – grow $8,000.00 per week in new revenue, net expenses. Hitting all targets within six months was the final challenge.
 
To facilitate the change, Grandview’s administration enlisted the help of Compirion Healthcare Solutions, a Milwaukee-based consulting firm. According to Brenda Kuhn, Chief Nursing Officer, Vice President for Patient Care, and Executive Sponsor, “Compirion was chosen for their unique behavioral approach, management philosophy and their willingness to put their entire fee on the line by providing a money-back guarantee. Compirion sent a team of two to work with the hospital ED staff. The Compirion team had a non-cookie-cutter, behavior-focused approach that was different. They embedded themselves in the ED environment and observed. They defined those changes that would have the greatest impact and built teams from the ED staff to carry them out. Every member of the department was actively engaged in the improvement process. A weekly dashboard was created to measure results.”
 
The Compirion team redesigned workflow throughout the department and made it patient-focused and patient-friendly. They developed and implemented a patient satisfaction program and revamped the Charge Nurse system, changing the way work was assigned to improve patient flow. The development of the Charge Nurse role was a pivotal point in the project. It was soon realized how integral a part it played not only in bridging the communication gap between the ED and AOC, but as an important part of the bigger picture of patient throughput and flow within the ED, the hospital, the community and neighboring hospitals.
According to Vicki McElfresh, Charge Nurse, ED Grandview, “The ‘Wow’ moment was the shift in viewpoint of the staff and physicians. They stopped seeing the Charge Nurse as someone they could complain to who took care of problems. Instead, they saw a person who knew the big picture, developed plans and understood how to prevent problems. With tools, role modeling and coaching, the Charge Nurse suddenly took on a new leadership role. Barriers were broken down as they began to think outside the proverbial box. This new proactive approach allowed the Charge Nurses to be true leaders, internal role models and to hold staff accountable to a standard of care for the patient. Soon the rest of the staff started to emulate the Charge Nurses in taking responsibility!”
 
Dr. Charles McIntosh, ED Medical Director commented, “We saw a cultural change in the ED. As the staff and physicians began understanding the importance of change process, they became more involved in the department. The changes the team developed made our work easier and the result was better patient care. Having the Emergency Department physicians involved with the change gave them a better understanding of throughput process. Eliminating old habits resulted in better flow of patients (door to physician) and meeting quality standards.”
 
At the front end, a squad communication and management program was put in place. Specific goals for treating pneumonia and cardio cases were set by the Grandview team. These included performing blood cultures before antibiotic and administering antibiotic within four hours for patients with community acquired pneumonia. For cardio patients, goals included EKG upon arrival and door to balloon time in 90 minutes or less. Other improvements included developing a stroke program, bedside registration and improved patient tracking. Finally, the Compirion team designed a system to assess saturation level in order to determine when to divert.
In order to reach the financial goal, the team implemented several key initiatives. The first was development of a system of expectations and accountabilities. Next was improvement in the quality of documentation by implementing new charge forms. They determined a “top twelve list” of ways to maximize revenue and insisted they be printed on all documentation. To measure and ensure compliance, they developed and implemented a charge/documentation audit tool. To improve reimbursements, they worked with Anthem Blue Shield, and Medicare to help define goals.
 
By week four, total LOS time was down 24%. At the project start date, Press Ganey results were in the 16th percentile. By month four, Press Ganey results were in the 78th percentile and climbing.
 
At the end of the project, total LOS had dropped from 4.03 hours to 2.9 hours. Press Ganey rankings were in the 100th percentile. Billable visit volume increased by seven patients per day for a growth of more than 10%. Number of patients likely to recommend the Grandview ED were up 15%.
 
“I really enjoyed working with them,” said Kuhn. “Their clinical lead was exceptional as was their data person. Compirion was quick to respond to issues that came up before they became problems.”
 
According to Kuhn, what impressed her most with the Compirion team was “They promised they would help us hit the target in six months and they did. Their unique behaviorally focused methodology changed the culture in the Emergency Department. The physician we almost lost says he now looks forward to coming to work every day.” 
 
The steering committee continues to meet weekly to go over the data report card. As part of a Sustainable Results Program, the Compirion team returns twice during the year to review and make any adjustments. 
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