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Symposium on Delivery Science: Evolution & Application

Symposium on Delivery Science: Evolution & Application. A focus on: The boundaries of Delivery Science Tools and expertise for success in patient care in the reformed health system The role of supply chain in new models of innovation

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Symposium on Delivery Science: Evolution & Application

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  1. Symposium on Delivery Science:Evolution & Application A focus on: • The boundaries of Delivery Science • Tools and expertise for success in patient care in the reformed health system • The role of supply chain in new models of innovation • Meeting the dual demands for clinical and economic integration A panel from academia, practice, and the supplier community including: • Amol Navathe, M.D., Ph.D., Co-Editor, Health Care: The Journal of Delivery Science and Innovation • Keith Lindor, M.D., Executive Vice Provost and Dean, College of Health Solutions, ASU • Terry Loftus, M.D., MBA, Medical Director of Surgical Services and Clinical Resources, Banner Health • Michael Nagel, MBA, President and CEO, Vomaris Innovations • Natalia Wilson, M.D., MPH, Co-Director Health Sector Supply Chain Research Consortium, ASU

  2. The Science of Healthcare Delivery:Moving Beyond Theory Terry Loftus, MD, MBA, FACS Medical Director Surgical Services & Clinical Resources Banner Health, Phoenix, Arizona

  3. Agenda • Challenges • Volume to Value • Transition from High Cost to Low Cost Centers • The Great Migration • Approaches • Contracting • Utilization • Physician Support • Clinical Practice • Patient Safety

  4. Challenges

  5. Volume to Value

  6. Residential Care Assisted Living Acute Care Specialty Clinic Skilled Nursing Facility Community Hospital ICU High Cost to Low Cost Centers Home Care Comfortable setting Independent, Healthy Living Chronic Disease Management Cost Effective Quality of Life $1 $10 $100 $1000 $10,000 Cost of Care / Day Source: IBM ‘Connected Health’ Solution, 2011

  7. The Great Migration

  8. Contracting Value Analysis Program

  9. VAP: EVAR/ELGs Vendor A Vendor B Vendor D Vendor C

  10. Value Analysis Teams • EVAR/ELGs* • Synthetic Mesh* • Biological Mesh* • Hernia & Breast Reconstruction • Spinal Implants • Ortho-biologics • Heart Valves • Urinary Incontinence

  11. Value Analysis Savings $867K Total Savings

  12. Utilization Oral rinse in the icu

  13. CHG Oral Care Case Study • Critical Care Discipline Team identified a variance in supply usage (Q2 vs Q4) • Worked with Supply Chain to reviewed literature to identify best practice (Q4) • Team standardized practice across system and reduced costs • System savings $129K (cut in half)

  14. Utilization Reprocessing

  15. Reprocessing

  16. Utilization All Hands on deck

  17. Aligning Strategies Preventing new non-value added spend just as critical as reducing current non-value added spend

  18. Daily CHG Patient Hygiene Case Study • Care Management and Supply Chain teamed with Infection Prevention • Care Mgt narrowed scope of patient population • Supply Chain lower cost alternative identified and contracted • Potential $1M+ spend down to $300K

  19. Physician Support Energy deviceAdhesion Barrier

  20. Ortho CCG Recommendation $255,570 Savings

  21. OB/Gyn CCG: Adhesion Barriers --OB Clinical Practice* changed to eliminate adhesion barriers --Supply cost was reduced by nearly $1 million annually *Edwards RK, et al. Obstet Gynecol. 2014; 123: 919,923-928.

  22. Clinical Practice Bowel Surgerytotal knee arthroplasty

  23. Clinical Practice Metrics • Bowel Surgery • Key Process Steps: • Early & frequent activity: ambulating 3 or more times on POD #1 • Early alimentation: a minimum of 200cc of liquids on POD #1 • Total Knee Arthroplasty • Key Process Steps: • Early activity: mobilizing patient out of the bed, either to a chair, standing at the bedside or ambulating any distance on POD #0 • Avoidance of continuous urinary catheter: no use of a continuous urinary catheter during their hospital stay

  24. Accelerating Adoption & Sustaining the Gains

  25. Outcomes $3M Savings • * LoftusT, Stelton S, Efaw BW, Bloomstone J. A system wide care pathway for enhanced recovery after bowel surgery focusing on alimentation and ambulation reduces complications and readmissions. J. Healthcare Quality. 2014 Feb 20 (Epub ahead of print). • ** Loftus T, Agee C, Jaffe R, Tao J, Jacofsky D. A simplified pathway for total knee arthroplasty improves outcomes J. Knee Surg. 2013 Nov 14 (Epub ahead of print).

  26. Patient Safety Safe Surgery Program

  27. Patient Safety & SRE • Safe Surgery Program • Implemented in 22 acute and 8 ASC OR’s • Results • Increase in days between SRE: 121% • Reduction in SRE: 52% • Est. 10 year cost avoidance: $5,565,523

  28. Questions

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