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Hospital's 'What If' Scenario Becomes Reality

 |  By HealthLeaders Media Staff  
   June 23, 2009

The patient access team at Skagit Valley Hospital has many goals as it works through this economic recession: Sustain morale, maintain trust, minimize criticism, and acknowledge success.

Michele Hill, CHAM, patient access manager at the Mount Vernon, WA, facility, knows it's not easy considering what the hospital faces:

  • Federal and state budget cuts
  • Change in payer mix
  • Increased charity care requests
  • RAC audits

"Our facility, like many others, is facing significant challenges during this time of economic downturn," Hill says.

To cope, leaders at Skagit Valley asked managers like Hill to provide a 5% and 10% reduction plan. Originally, it was a "what-if" scenario. Economic woes, however, made it a reality, and Hill and other managers were forced to trim 5%.

So she went to work in several key areas:

  • Reduced monthly staff meetings to quarterly and implemented a newsletter to keep staff up-to-date

  • Identified a less expensive, yet more user-friendly patient armband that has reduced the use of the expensive armband/label sheets; this resulted in a $10,000 annual savings

  • Eliminated printing duplication in ED that results in significant paper and toner expenses

  • Deployed staff to the shifts that have greater volumes, while saving on shift differentials and increasing productivity

  • Eliminated all travel for 2009

  • Centralized patient access services throughout the organization to provide a highly trained and efficient team that can be deployed to any area for support

"Other processes have been evaluated," Hill says, "and utilizing lean methods, we have found many ways to reduce waste that while not in the hundreds of thousands of dollar savings, are adding up to make a significant difference."

 

Then came the difficult part. Skagit Valley could only do so much internal restructuring and cost-cutting before it took a hard look at labor expenses.

It implemented a wage freeze. Each full-timer must give up 64 hours of work/pay between May 1 and December 31.

"Working with my teams, we have come up with creative ways to make this happen," Hill says. "We are on a no-lunch agreement, and during down times, staff take an hour for lunch. We may have someone leave an hour early, and the rest of us chip in to back up. These must be hours that are not covered by someone else. This is the most difficult as my team have never been on a low-census expectation."

Skagit also eliminated a number of FTEs, the majority through not filling vacancies; however, a small number of staff members did lose their jobs.

"This has been an emotional time," Hill says. "And at this point, I am spending as much time being even more upfront and center with my teams to show my personal support, leadership support, and to be aware of any issues as soon as possible so as to be able to provide assistance, or referral for more than I am able to address. … By involving the team in the decision making processes, on those things that we have power over, I have buy-in, and greater success, because they own it."


Editor's note: This is the fourth in a series of stories on HealthLeaders Media talking to revenue cycle managers about coping in a tough economy. The previous installments were:

Hospital Department Leaders Must Remain Flexible in Difficult Economy

Lessons for Hospitals in a Tight Economy

Hospitals Get Financially Smart in a Tight Economy

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