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Medicine Acute Critical Care Service Line (MACC) Service Line Review Session #1 Dean’s Meeting – January 11, 2010

Medicine Acute Critical Care Service Line (MACC) Service Line Review Session #1 Dean’s Meeting – January 11, 2010. Alice Boylan, MD Service Line Medical Director. Sharon DeGrace RN, MN Service Line Administrator. COM Departments involved in SL. Significant Anesthesia Family Medicine

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Medicine Acute Critical Care Service Line (MACC) Service Line Review Session #1 Dean’s Meeting – January 11, 2010

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  1. Medicine Acute Critical Care Service Line (MACC)Service Line Review Session #1Dean’s Meeting – January 11, 2010 Alice Boylan, MD Service Line Medical Director Sharon DeGrace RN, MN Service Line Administrator

  2. COM Departments involved in SL • Significant • Anesthesia • Family Medicine • Medicine (Pulmonary/CC, Gen Med, Hospital Medicine) • Neurosciences • Others • Lab Med/Pathology • OB/GYN • Radiology • Surgery

  3. MACC Clinical Programs • Medical ICU (17 beds – UH ) • Medical –Surgical ICU (18 beds – ART) • 8 West Medical Acute Care Unit (24 beds – UH) • 8 East Medical Acute Care Unit (26 beds – UH) • Transitional Care Unit (14 beds – UH) • Non-ICU Multi-disciplinary Vent management program • Cystic Fibrosis, Sarcoid, and Pulmonary HTN programs

  4. SL Big Bets (3-5 year strategic goals)in collaboration with SACC SL • Develop nationally recognized CC research program • Establish multidisciplinary CC research group • Increase extra and intramural funding • Collaborate with SCTR and others • National and State Recognition for quality, cost and efficiency • Top decile UHC leader for mortality and LOS indices • Centers of Excellence: Respiratory Health and Adult Sickle Cell • Expansion of hospitalist programs • Unified MUHA Critical Care Environment • Establish SC Critical Care Collaborative • Philanthropy for named centers for clinical and research excellence • Codify joint structure of SACC and MACC SLs

  5. 2010-2011 Progress towards Big Bets • Develop nationally recognized CC research program • Establish multidisciplinary research group: FY2011 • Clinical trials in progress: 6 CF, 7 PH, 4 sarcoid • 4 Translational projects in progress/development • NIH Challenge Grant (CREST-Ford & Fakhry Co-PI) • DOD Grant Rural Outreach (SE-VIEW -Ford Co-Investigator) • Collaborate with SCTR and others: FY2010 • Telemedicine Retreat with SCTR FY • National and State Recognition for quality, cost and efficiency • AACN Beacon designation for MICU CY 2009 • Resubmission for MICU in progress • Initial submission for MSICU in progress • UHC Top Decile for quality, cost and efficiency • 17% cost per case reduction FY09 – FY11 (YTD) • 1.6% growth in discharges FY10 – FY11 (YTD) • Improved coding: educate coders and physicians • Simple pneumonia: 3 months, 22 cases, $164 K • Cystic fibrosis: +7,428/case • Practice Improvement: • Central line BSI and VAP continue downward trend

  6. 2010-2011 Progress towards Big Bets • UHC Top Decile for quality, cost and efficiency • 17% cost per case reduction FY09 – FY11 (YTD) • 1.6% growth in discharges FY10 – FY11 (YTD) • Improved coding: educate coders and physicians • Simple pneumonia: 3 months, 22 cases, $164 K • Cystic fibrosis: +7,428/case • Practice Improvement: • Central line BSI and VAP continue downward trend • Unified MUHA Critical Care Environment • Campus-wide, evidence based Critical Care model • ICU Task Force established: FY2010 • Standardized certification and credentialing • In process with Medical Staff Office: FY2011 • Interdisciplinary collaboration • Interdisciplinary Critical Care Grand Rounds: FY2011 • MSICU added to MACC SL: FY 2011 • Codify joint structure of SACC and MACC SLs • SACC and MACC integrated strategic planning: FY2009 • SACC and MACC weekly meetings: FY2009 • Medical Directors and Administrator: July 2008 • Operations: July 2008

  7. What is going well in SL? (MACC) • Increased MD engagement • More accountable and timely in addressing changes • Cost : 17% reduction in cost per case • Quality: BSI and VAP Reduction • Efficiency 1.6% Growth • Improved dissemination of performance metrics to staff and faculty has improved

  8. Opportunities for improvement in MACC SL • Data • Concurrent information on performance • Standardized definitions across enterprise • Resources for development • Uncertainty over capital investment • Strategic use of Critical Care Task Force • Coordinate all Department and SLs initiatives related to Critical Care

  9. Input on SL as a structure • Provide more tangible reward/incentive to staff and faculty • Align SL and gap contract performance metrics • Opportunity to reinvest percentage of profit back into SL strategy • Continue resourcing department and program medical directors

  10. Tab 2SL Dashboard November 2010 dashboard from Enterprise Analytics

  11. Click on image to open PDF

  12. Tab 3Goal Performance Executive Summary – Annual LEM performance Executive Summary – 2011 Pillar performance YTD 2011 LEM Monthly Report Card

  13. SLL Goal (LEM) PerformanceExecutive Summary - Annual Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

  14. SLL Goal (LEM) PerformanceExecutive Summary – YTD Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

  15. Click on image to open PDF

  16. Tab 4SL 5/10 Performance YTD 5/10 Performance YTD 5/10 Plan Executive Summary

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