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Think You're Operating at Capacity? Think Again

Philip Betbeze, for HealthLeaders Media, July 8, 2011

Efficiency is often in the eye of the beholder. I was just talking to one of my colleagues the other day about working hard versus working smart, and I was making the case to him that I feel like I work as smart as I possibly can. Without that sense of efficiency and juggling as many projects as I can at once, none of them would ever get done. But that doesn't mean I'm necessarily right. If someone who knows what they're doing got into the science of how I work, I'd be willing to be they could find at least a few ways I could improve my work capacity.

Margaret Van Bree had a similar thought nearly two years ago as she took the reins as CEO of St. Luke's Episcopal Hospital, the flagship of the health system of the same name in Houston.  

"We benchmark our performance against other hospitals, and we have a higher case mix index than many in the country," says Van Bree, who holds a doctorate in public health from Tulane. "But still, our length-of-stay was longer than it should be."

Not only that, but Van Bree is a firm believer that efficiency and quality in healthcare are directly related. Walking the halls, she says, the hospital seemed to be operating at capacity, only it wasn't.

"People were operating at this feverish pace," she says. "It wasn't like we were running at 95% occupancy and it had to feel like a fire drill. Yet people still had to use heroic efforts every day to keep up."

Decision-makers at St. Luke's were interested long term in building a replacement facility, but first, they wanted to make sure their current facilities were being used as efficiently as possible.

"We are contemplating a replacement facility and we don't want to build more beds to accommodate our inefficiency if there's a better way," she says. "If we could be more efficient, could we shutter units and operate on a smaller chassis?"

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