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From HFMA: Hospitals Advance Quality and Access Amidst Rising Charity Care and Costs

Michelle Pointe, for HealthLeaders Media, June 18, 2009

Leaders from Catholic Healthcare West, Intermountain Healthcare, and Harborview Medical Center told a rapt audience at HFMA's final conference keynote how they are making key quality changes and improving access to care while struggling with rising costs, climbing charity care numbers, and occupancies that are stretched to 100% at times.

While the crowds are usually halved by the last day of most conferences, the room was packed—more proof that with so many new financial challenges, healthcare leaders are looking to their peers for new information.

At San Francisco-based Catholic Healthcare West, Barbara Pelletreau, vice president of patient safety and clinical risk management, said the system, with more than 40 hospitals, has set aggressive metrics to improve quality. That includes implementing a sepsis prevention program in the last few years that has reduced mortality rates by 52%, saved more than 700 lives, and created $15 million in savings. "Quality, safety, and financial are coming together," she said.

Pelletreau said the system has drilled down to 60 key metrics on which hospitals focus. Another strategy has been to share a sentinel event report across all clinical areas that tells patient stories. "Every month, CMOs, chiefs of nursing, and patient safety officers go through the real stories and help facilities present the stories," she said. "This is the most effective strategy after doing the metrics approach."

Meanwhile, Lori Mitchell, CFO of Harborview Medical Center in Seattle, which is part of the University of Washington, said the system, which does $2.4 billion net revenue on an annual basis, had $150 million in charity care this year, up from $120 million last year. "We are focusing on areas that are the same—putting the patient first is what this is all about," said Mitchell.

She acknowledged there is work to be done in customer service. "While it shouldn't be that hard to be nice, we run 100% occupancy and when people are running that fast, our service indicators are not as good as they could be."

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