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Private Sector ACO Models Rooted in Rugged Individualism

Philip Betbeze, for HealthLeaders Media, September 13, 2011
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In fact, their occupancy averaged around 75%. 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?”

She adds that this question gained traction under the prospect of healthcare reform, where efficiency and quality is rewarded.

“We shouldn’t put more into plants and operations than we need to,” she says.

That meant some extensive process reengineering was in order.

St. Luke’s is one of 14 hospitals (and three medical schools) that make up some of the 49 healthcare institutions collected at the Texas Medical Center in Houston. Even though the system has plenty of space for expansion outside the central downtown location of TMC, options for replacement and expansion are limited on the TMC campus. That forced leaders to make the decision to improve processes to get more out of the space they already have, says Van Bree. GE Healthcare Performance Solutions was brought in to consult about ways to optimize the space and time constraints at the hospital. Leadership on the project is heavily populated by physicians, who agreed with Van Bree that their time spent at St. Luke’s was less productive than it could be. Though there are lots of components in the exercise, big gains stand to be made by doing a better job of patient care management and block scheduling for the physicians, Van Bree says.

“Some of the initial work has been on smoothing out variability in the elective operating room schedule,” she says. “Variability there is six times greater than in our emergency room.”

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