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Mary Ann Yezadzhyan Jonathan Barco Denise Nagaoka Parul Tyagi

Mary Ann Yezadzhyan Jonathan Barco Denise Nagaoka Parul Tyagi. “ While ensuring the financial stability and quality care of Tulare Regional Medical Center (TRMC) today, we must also do the work needed to be a sustainable hospital, prepared to meet

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Mary Ann Yezadzhyan Jonathan Barco Denise Nagaoka Parul Tyagi

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  1. Mary Ann Yezadzhyan Jonathan Barco Denise Nagaoka Parul Tyagi

  2. “While ensuring the financial stability and quality care • of Tulare Regional Medical Center (TRMC) today, • we must also do the work needed • to be a sustainable hospital, prepared to meet • our region’s future medical needs.” • Shawn Bolouki, CEO Source: Tulare Regional Medical Center Annual Report 2011

  3. Situation Analysis • Excess Bed Capacity • Undesirable Payer Mix • Affordable Care Act (ACA) & Reform • Aging Medical Staff • Need: • Physician recruitment and alignment • Primary Care & Chronic Disease Management • Medical Tower Expansion – 2013

  4. Strategic Recommendations • Monitor & Sustain Financial Position • Improve Quality & Operational Effectiveness • Increase Utilization & Enhance Services • Workforce Development & Physician Alignment

  5. Monitor & Sustain Financial Position

  6. Optimal EfficiencyNurse Productivity per Patient Day Source: www.oshpd.ca.gov

  7. Reduction of Waste Solution: • Stockless Systems delivered Just in Time • Limit variety of commonly used supplies • Estimated Savings - $5 million Source: www.oshpd.ca.gov

  8. Market Share Breakdown Source: MDS Consulting – TRMC Case Study Analysis

  9. Improve Quality and Operational Issue

  10. Patient Satisfaction Source: www.hospitalcompare.hhs.gov

  11. Culture of Safety • Institute for Healthcare Improvement Framework: • Conduct Patient Safety Leadership WalkRounds • Create a Reporting System • Designate a Patient Safety Officer • Reenact Real Adverse Events From the Hospital • Involve Patients in Safety Initiatives • Relay Safety Reports at Shift Changes • Appoint a Safety Champion for Every Unit • Simulate Possible Adverse Events • Conduct Safety Briefings • Create an Adverse Event Response Team Source: www.ihi.org

  12. Best Practices • Spread standardization of best practices across hospitals and health clinics • Hospital Mortality Outcome Measures • Death Rate for Heart Attack Patients • Death Rate for Heart Failure Patients • Death Rate for Pneumonia Patients • Hospital Readmission Rates Outcome of Care Measures • Rate of Readmission for Heart Attack Patients • Rate of Readmission for Heart Failure Patients • Rate of Readmission for Pneumonia Patients Source: www.ihi.org

  13. Medical Home Model • 76% of Medicare spending is on patients with chronic diseases • 21% increase in adults 65+ between 2011 - 2016 Great Outcomes Practice Organization  Heath Information Technology Quality Measures PatientExperience Sources: www.aafp.org and MDS Consulting – TRMC Case Study Analysis

  14. Increase UtilizationAnd Enhance Services

  15. Increase Utilization and Enhance Services • Workforce Development • New medical staff to enhance their service portfolio • Broader range of procedures within specialty • More competitive within market share • Medical School affiliation

  16. Strengthen Hospital Physician Alignment

  17. Physician Alignment • Competitive advantage • Transparency • Supports quality, cost and purpose • Starts with upper management and Physician Champions

  18. Physician Hospital Alignment

  19. Conclusion

  20. Conclusion • Future of health care is uncertain • Recommendations will place TRMC at a competitive advantage • Sustainability • Accountability • Growth

  21. Questions?

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