How to Transform Your Orthopedic Program Into A Destination Center
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Right Brain Left Brain specializes in optimizing orthopedic programs by improving patient outcomes and driving business results through customized strategy development and process improvement techniques. They emphasize the importance of patient experience, employee engagement, and operational efficiency to transform facilities into orthopedic destination centers. The organization provides extensive support in training, goal alignment, and market positioning to enhance overall service line performance and financial viability.
How to Transform Your Orthopedic Program Into A Destination Center
- 1. Right Brain Le- Brain VISION Improving the lives of pa#ents and employees wherever we go!
- 2. Why Choose Right Brain Le; Brain? • 100% Vendor Neutral – Our goals are your goals! • Proven Track Record – OpImized mulIple TJR Programs improving paIent outcomes and driving excepIonal business results • Strategy Development Experts – Our unique blend of Process Engineers and Specialized Clinicians work with your team to translate your Vision and Mission Statement into a TacIcal ExecuIon Plan in one event gaining buy-‐in and accountability by the whole team. • Process Improvement Experts – Each program is customized for your facility, your staff and your paIents by uIlizing state-‐of-‐the-‐art process improvement techniques and technologies. • Culture Warriors – Our rapid improvement workshop approach breaks down silos and creates focus, energy and excitement, while enabling swi; and effecIve goal achievement • Knowledge Sharing – Our moXo is to share our knowledge in all aspects of our partnership to create confident team members that will be able to sustain gains and charter new improvements with confidence.
- 3. How Do You Become An Orthopaedic DesInaIon Center? VoC Voice of the Customer VoE Voice of the Employee VoB Voice of the Business
- 4. VoC Voice of the Customer translates to “The PaIent Experience” Highest Quality Excep=onal Service Best Value
- 5. Quality: The New Hospital Shoppers • PaIents are more technology savvy than ever before – if not the paIent themselves, then most certainly their care giver. – InformaIon about your facility is easily available and paIents are accessing it. • HealthGrades • CMS Website: Hospital Compare – HCAHPS, SKIPs and Safety • Physician stats are public • Joint Commission and other CerIficaIons
- 6. Quality: Evidenced Based PracIces & Protocols PAT and Pre-‐OP Pt EducaIon/Experience • ScripIng • guidebooks Pre-‐Admission TesIng Protocols • H&P • Medical and Cardiac Pre-‐Op CommunicaIon Protocol Hair Removal Opera=ng Room Scheduling /Block UIlizaIon Technical Manuals for StandardizaIon Anesthesia Process Back Table Set Up Skin Prep Protocol PosiIoning Draping Staff Trng OR Choreography Wound Closure Protocol Turnover Wellness Joint Clinic Physician Order Set Protocol • VTE • InfecIons Physical Therapy Protocol Blood Management Guidelines JC Annual Training for Staff Pt Rounding Protocols • UIlizing communicaIon board • HCAHPS Anesthesia Protocol Post OP Pain Management Protocol Inventory Discharge Discharge Planning Pt Outcomes; ComplicaIon Management • Falls Post Discharge Pt Call Protocol RBLB brings the research and benchmarking to you. We do not pracIce medicine, but we make it all available to you! AddiIonally, RBLB will help you align everything to enable cerIficaIons and maximum reimbursements.
- 7. RBLB has protocols that enable TJR patients to: Ambulate 2 hours post op Pain never exceeds level 4 PONV minimized or eliminated Falls minimized or eliminated Infec=ons minimized LOS 2.0 days Risk of Re-‐admissions minimized!!!!
- 8. Quality: Same Day Procedures • If you are ready and interested in moving your facility to the forefront of Total Joint Replacement pracIces: – We have same day protocols and pathways! – RBLB can help you get there! • 31% of knee replacements are performed on adults 45-‐55 years of age. • OutpaIent knee replacements cost the payer 41% less than inpaIent procedures.
- 9. VoC Voice of the Customer translates to “The PaIent Experience” Highest Quality Excep=onal Service Best Value
- 10. Service: What Do PaIents Expect Today? Full Implemented Absent Extremely SaIsfied DissaIsfied Delighters Things they didn’t know they wanted or never expected. They set you apart from the crowd! SaIsfiers – Typical expectaIons. Assumed, must be there or you are not even considered! Basics KANO Analysis
- 11. Service: Delighters, SaIsfiers & Basics 11 • Basics • Quality of Care – JC CerIficaIon, CompeIIve HealthGrades, Excellent Safety records • SaIsfiers • PaIent EducaIon • Clear and consistent expectaIons • Happy and friendly staff • Delighters: • Total Joint Wellness Center • Real Ime tablet/smartphone communicaIon throughout conInuum of care, • Group Therapy & Group Dinners • Veterans Reunions • AmeniIes – gi;s, shirts, mugs, etc
- 12. Service: PaIent Experience Extends Across the EnIre Service Line • Pre-‐Admission TesIng (PAT) – What is this experience like? Is it easy? Does the paIent have a guide or point of contact and are they easily available? • Pre-‐OP – Is everyone asked to arrive at 0530, regardless of surgery Ime? Is it quiet, organized? Do they know exactly what to expect? Are they asked all the same quesIons over and over again? You only get 1 chance to make a first impression!
- 13. VoC Voice of the Customer translates to “The PaIent Experience” Highest Quality Excep=onal Service Best Value
- 14. Value: PaIent ExpectaIons? • Cost EffecIve – Is your pricing compeIIve? – Is your hospital known for never ending bills that conInue to trickle in….. – Are wait Imes so excessive, paIents will pay higher prices elsewhere to avoid your experience? – Can you accommodate the huge growth projecIons in TJR in the next few years, or are your paIents already experiencing excessive surgery lead Imes?
- 15. Value: Pricing Must Be CompeIIve • How do you provide the highest quality and also the best pricing?
- 16. How Do You Become An Orthopaedic DesInaIon Center? VoC Voice of the Customer VoE Voice of the Employee VoB Voice of the Business
- 17. Voice of the Employee (VoE) Culture Work Place Environment Professional Development
- 18. VOE: What Do Employees Desire? • Culture – Respect for each other, no maXer the posiIon – A voice that is heard and encouraged – Clear goals and the tools to achieve them • Work Place Environment – Organized, safe and conInuously improving – Efficient and standardized processes with clear and up-‐to-‐ date procedures and protocols – Access to and training for advanced technologies • Professional Development Opportuni=es – Furthering educaIon assistance – CerIficaIons available
- 19. Culture: Starts with the Structure Clinic & Surgery Scheduling PaIent Referrals/ MarkeIng Pa=ent Centric Highest Quality Excep=onal Service Best Value PAT & EducaIon Pre-‐Op & PaIent Prep Cut to Capsule Close Turn Over & PACU Discharge to Home Total Joint Wellness Center Clinic PAT Hospital Centric – Department Goals and Focus Discharge Floor Post OP Peri-‐OP Pre-‐OP Home (20%) Rehab or SNF (70%) Other (10%) PaIent Centric – Same goals for everyone across the Service Line Transforma=on
- 20. VoE: Consistent Goals Across the Service Line • Break down the silos by providing a working venue for team building – Kaizen Events are “rapid improvement events” and are one of the most effecIve Lean Six Sigma (LSS) tools available! • They enable buy-‐in and ownership by uIlizing a cross-‐ funcIonal team across the enIre service line. • They provide an on-‐the-‐job learning environment for LSS tools. • They shorten project compleIon Imes by more than 60% • RBLB experts will develop kaizen facilitators on your team to ensure independence and enable sustained results!
- 21. VoE: Hands On Training of Tools and Techniques • Develop Customized Mktg Strategy • Cost effecIve AmeniIes • PaIent Access and Edu • OpImize Discharge Process • Increase Discharge DisposiIon to Home PaIent Referrals/ MarkeIng Discharge to Home • CommunicaIon Boards • Metric Boards • Inventory Control • PaIent & Staff Flow • Reduce Turn-‐ over Time • Reduce DownIme B/ W Procedures • Reduce Wait Times • Increase Hosp/ Clinic/PaIent CommunicaIon & CoordinaIon • Reduce Case CancellaIons & Late Starts • Reduce PaIent Prep Ime • OR Staff Training • Tech Manuals and Visual Aides for StandardizaIon and Training • Reduce Pat. Wait Time • Improve Scheduling Process RBLB PracIIoners partner with your team to share their extensive LSS knowledge via hands on opImizaIon tools and techniques. OpImized processes are then ready for advanced technology communicaIon and tracking systems like Wellbe! Clinic & Surgery Scheduling PAT & EducaIon Pre-‐Op & PaIent Prep Cut to Capsule Close Turn Over & PACU Total Joint Wellness Center Pa=ent Centric Highest Quality Excep=onal Service Best Value
- 22. VoE: Work Smarter, Not Harder • Breakthroughs in medicine and technology are changing rapidly these days, so a different way to perform must be embraced. • RBLB brings years of experience creaIng and teaching how to use simple and concise work instrucIons and visual aides on the job. We will create them with your team as we idenIfy the needs! • SynchronizaIon of staff during OR paIent prep and turnover greatly reduces Wheels-‐In to Wheels-‐In Time as well as improves uIlizaIon of staff.
- 23. VoE: Program TransformaIon • A typical transformaIon of an Orthopaedic Program for an average size hospital takes approximately 2.5 to 3 years when driven internally • Partnering with RBLB can shrink that Ime to approximately 8-‐10 months – Now that you have aligned the VoC and the VoE, we must determine where to take this endeavor. – How do we know when we have won?
- 24. How Do You Become An Orthopaedic DesInaIon Center? VoC Voice of the Customer VoE Voice of the Employee VoB Voice of the Business
- 25. Voice of the Business -‐ Profitability 25
- 26. VoB: 5 Year Financial Pro Forma RBLB performs a thorough assessment of your facility to determine your baselines and potenIal for improvement goals. We work closely with your finance team so every number is verified and transparent. We treat your Orthopaedic Service Line as a Business, creaIng it’s own P&L report.
- 27. VoB: Cost ReducIon or Revenue GeneraIon Mul=ple scenarios analyzed to assess risk and determine total poten=al Most hospitals assume if they can increase their market share, they will be fine. Unfortunately, that is not the case most of the Ime. RBLB worked with a reIred CFO of an HCA system to develop a mulIple scenario analysis. To date, the results have always been similar, in that, revenue generaIon alone cannot keep up with the pace of inflaIon. Process Op=miza=on is the key!
- 28. VoB: Analyze System Data and Verify with ObservaIon Data Benchmark Dr. A Dr. A Future Dr. B Dr. B Future Dr. C Dr. C Future 39 20 20 35 20 31 20 69 102 99 132 89 119 45 15 15 15 15 10 5 10 5 10 7 10 10 10 31 32 10 31 10 PP S Close TO Down Benchmark: WI to WI = 90 mins Dr. A: Current: WI to WI = 196 mins Future: WI to WI = 141 mins Dr. B: Current: WI to WI = 204 mins Future: WI to WI = 152 mins Dr. C: Current: WI to WI = 166 mins Future: WI to WI = 119 mins Approximately 28% ReducIon for “Wheels In to Wheels In” Time Current data from 142 total Hip & Knee Procedures from 10/1/11 to 3/29/12 PP = Pa=ent Prep Time: Begins when paIent enters O.R. and ends with skin incision S = Surgery Time: Begins with skin incision and ends when surgeon breaks scrub TO = Turnover Time: Begins when wound is closed and ends when turnover team leaves room Down = OR Down Time: Begins when turnover crew is complete and ends when next paIent enters O.R. 28
- 29. VoB: OR Flipping – Are Your Surgeons & Staff Ready? Each block represents cut to capsule close OR 1 Pat 1 OR 2 OpImized Surgeon’s Time Pat 3 Pat 5 Pat 2 Pat 4 Pat 6 • StandardizaIon and synchronizaIon minimizes Surgeon involvement in Pat. Prep, Close and Turn Over. • OpImal Surgeon Ime for flipping is cut to capsule close of approximately 45 minutes or less.
- 30. VoB: Streamline PaIent Flow Across the EnIre Service Line • RBLB process engineers analyze your layout and your equipment using 3D state of the art simulaIon so;ware. • We work with your team to determine streamline opportuniIes to reduce paIent exposure and improve paIent flow. • The analysis determines: – If you should dedicate OR’s? – How to schedule block Ime? – How to level load the schedule? – How to manage busy days and slow days?
- 31. VoB: Can Your Current Unit Handle Increased Volumes Thru the OR? 31 Increase capacity with no capital investment! 2 3/31/201 3/17/201 3/3/2012 2/18/201 2/4/2012 1/21/201 1/7/2012 12/24/20 12/10/20 11/26/20 11/12/20 10/29/20 10/15/20 0 6 4 10/1/201 Date # Surgeries Completed Procedures Done by Date Total Hip & Knee 12/31/20 11/30/20 10/31/20 9/30/201 8/31/201 7/31/201 6/30/201 5/31/201 4/30/201 3/31/201 2/28/201 1/28/201 0 5 10 12/28/20 Date Number of Pa=ents Beds Occupied by Date Avg. LOS Cases per Wk OR Scheduling Max Beds Needed Current = 4 6 Current 9 Current = 4 6 Level Loaded 6 Current = 4 9 Level Loaded 9 Decreased to 3* 9 Level Loaded 6
- 32. VoB: Tier 1 Metric ReporIng 32 Monthly ExecuIve Level Dashboards Physician Level Dashboards
- 33. VoB: Tier 2 & 3 Metrics Daily Floor Level Metric Boards Weekly Management Level Metric Boards
- 34. VoB: Revenue GeneraIon MarkeIng & Branding Electronic (Website, blogs, social media) Trade Show Design Direct Mail & Sales PromoIons PublicaIons Print – Brochure, business card, poster, etc. IdenIty Design – logo, staIonary, newsleXers, etc. BulleIn Boards Radio We will even help you select a theme for your Physical Therapy program and Wellness Joint Center and then brand all of your materials with your customized theme. Pa#ents will always remember their experience at a facility that makes healing and recupera#on fun!
- 35. VoB: Billboard MarkeIng 35
- 36. VoB: Print & Brochure 36
- 37. VoB: Web Design Many hospital markeIng teams are extremely busy and cannot devote Ime to one specific program: We work with your MarkeIng team to incorporate a page in your exisIng site or to build a new site.
- 38. TransformaIon: Become DesInaIon Center Understand and Address: Transform your Orthopedic Program into a DesInaIon Center. VoC Voice of the Customer VoE Voice of the Employee VoB Voice of the Business
- 39. Comprehensive Assessment for Baseline 39 TJR Service Line Assessment Clinic Assessment 1. Market Assessment 2. Best PracIce Clinical Protocol and Pathway EvaluaIon 3. Joint Replacement – Internal Data Assessment 4. OperaIng Room Efficiency: System Data & ObservaIon 5. Efficiency of PAT, Pre-‐OP, Post-‐OP and Discharge Processes 6. Total Joint Wellness Center Gap Analysis 7. Future State PaIent Centered Strategy 8. 5 YR Financial Pro-‐Forma 9. Joint Commission Disease Specific CerIficaIon Gap Analysis 10. Medicare Alignment Analysis 11. MarkeIng & Branding Assessment 1. PaIent Flow Analysis 2. PaIent Sat Survey Scores 3. Office OrganizaIon & CommunicaIon Systems 4. Scheduling PracIces 5. Financials 6. Inventory Handling 7. Surgeon and Staff UIlizaIon
- 40. Thank You for Your Time. Please feel free to contact us if you have any quesIons: Stephanie Allison President & CEO Right Brain Le; Brain steph.allison@rb-‐lb.com 904-‐302-‐2939.