Planning for Health Cares Unknown Future

The Affordable Care Act

has created angst among health care workers and administrators, not because big changes are coming, but because the impacts of those changes and their accompanying rules are not yet clear. For administrators, this level of uncertainty makes planning seem nearly impossible. Yet, healthcare organizations such as Mayo Clinic and Thedacare are currently developing robust plans for tomorrow, streamlining existing workflows, and delivering better outcomes in careall while cutting costs, increasing cash flow, and growing the bottom line. How? Lean Six Sigma. A Transformational Approach Lean Six Sigma improves hospital operations with datasupported decision making. The goal is to drive continuous improvement throughout the organization, and in a way that aligns with the hospitals strategic plan. In health care, Lean Six Sigma focuses on both the process (workflow) and the service itself. When implemented properly, these practices train health care teams to react and adjust to changes efficiently, and even proactively create solutions to future problems. According to David Callen, WTA Lean Six Sigma Expert, Lean Six Sigma projects yield between three and ten times the health care providers investment. Financial Gains from Lean Six Sigma Result from: n n n n Eliminating rework, materials, and inventory Avoiding or reworking problematic processes Enhancing productivity and patient care quality Improving patient flow and cash flow

A hospital had accumulated $1.5 million in bad debt and called upon Lean Six Sigma experts to help. Working with a health care billing team, the hospital identified problems in the billing cycle and implemented solutions. One year later, the hospital had positive operating margin cash flow, with an increase of 20% from all Lean Six Sigma projects combined.

Lean Six Sigma methodologies make delivering and planning for high-quality care possible, even in the face of great change. Further, these practices prepare hospitals and staff for the coming changes while incorporating existing requirements from Medicare/Medicaid, ACO, avoidable adverse events, and much more.
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Emergency Department Revenue Cycle Improvement: A Success Story

Hospital administrators noticed defects in patient medical and registration entries, which led to excessive rework from auxiliary, medical records, and billing department employees. A group of the hospitals medical, financial, and stakeholder decision makers worked with Lean Six Sigma experts to set a goal of reducing defects and time spent by 50%. They divided into two teams to separately address 1) registration-related account processing issues and 2) medical informationrelated account processing issues. Each team collected data from patient registration and medical information workflows for 5 days. Auxiliary departments (radiology, clinical lab, pharmacy, and respiratory therapy) also tracked information they received from the ER. The data revealed that for every 100 minutes spent processing patient accounts, 55 were for rework. Also, for every 100 patient accounts processed, 75 had defective information, which required rework.

Mapping the Value Stream Working with Lean Six Sigma experts, the teams developed a Value Stream Map to detail the steps involved in registering a patient, from arriving in the ER to mailing the final bill for services. The Value Stream Map served as a point of reference, helping the teams identify waste, long wait times, and defects in their workflow. They learned the causes of waste were 1) insufficient software training and 2) no established standard operating procedure for entering patient data into the software program. A Clear Solution The hospital team worked with Lean Six Sigma Experts, as well as the hospitals technology staff, to create an action plan for developing a software training curriculum and standard operating procedures for employees to follow during registration, billing, and other patient data entries. Measurable Results Minutes of rework were reduced by 75% and the number of defects was reduced more than threefold. As a direct result of these Lean Six Sigma improvements, the hospital saved more than $175,000 in soft dollars or productivity. Further, updates to medical records, which used to take three days, now took only one. This greatly improved quality of care for patients who required follow-up treatment after the ER. This project also led to the formation of a software information team of nurses to address changing medical codes and software applications on a regular basis.
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Doing More with Less

Hospitals and clinical health care settings can reap big rewards from a wide variety of projects. Lean Six Sigma is especially helpful for those ongoing, hard-to-diagnose problems that whittle away at hospital revenue, patient care performance, and caregiver morale. Lean Six Sigma Projects in Healthcare n Increase admissions n Enhance workflow efficiency n Reduce poor use of materials n Minimize deficiencies n Improve planning and scheduling of human resources n Make better use of facilities and equipment

Typically, Lean Six Sigma projects yield between three and ten times the health care providers investment, as well as a 50% improvement in the quality of care.

About WillowTree Advisors, LLC

We are a woman-owned, small business specializing organizational transformations. Headquartered in Denver with services offered across the country, our team comprises over 40 professional advisors and technology experts with significant experience in change management, Lean and Six Sigma improvement, leadership development, and team building. We have worked with state, local, and federal agencies, and private firms, and in industries such as health care, high tech, manufacturing, aviation and transportation. We incorporate best practices from the health care sector and beyond, for a solid, cross-industry solution. Our team members hold numerous certificationsSix Sigma, Lean, PMP ITIL, Certified Purchasing Manager, and othersand work with business and quality methodologies including MBO and TQM management strategies. Many of us are university instructors in quality management, Six Sigma, Lean business transformation, and purchasing/supply chain management. We also volunteer for Rocky Mountain Performance Excellence (RMPEx) and as National Baldrige Award examiners.

I didnt think at my age that I could be shocked, but WillowTree Advisors has shocked me out of my paradigm. - Chief Operating Officer

To learn more about Lean Six Sigma Health Care Projects, contact Kathryn Douglass at (888) 998-0008 or visit www.willowtreeadvisors.com.

Planning for Healthcares Unknown Future

WillowTree Advisors, LLC 2013