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
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Symposium on Delivery Science: Evolution & Application A focus on: The boundaries of Delivery Science Tools and expertise for success in patient care in.
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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
The Science of Healthcare Delivery:Moving Beyond Theory
• 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)
REPROCESSINGUtilization
Reprocessing
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec $-
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
Reprocessing SavingsPerioperative + Surgery Centers
20122013
45.4% increase from 2012 to 2013 -> $ 2M Savings
(All -> $4.9M Savings)
ALL HANDS ON DECKUtilization
Aligning Strategies
Preventing new non-value added spend just as critical as reducing current non-value added spend
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
ENERGY DEVICEADHESION BARRIER
Physician Support
Ortho CCG Recommendation
$255,570 Savings
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.
BOWEL SURGERYTOTAL KNEE ARTHROPLASTY
Clinical Practice
• 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
Clinical Practice Metrics
Accelerating Adoption & Sustaining the Gains
OutcomesBowel Surgery Outcomes* Reduction
Complications -27.8%
Gastrointestinal -30.2%
Ileus -29.8%
Pulmonary -34.4%
30-day Readmission -17.5%
TKA Outcomes** Reduction
Complications -10.5%
Cost ($1000) mean -9.7%
30-day Readmission -18.8%
LOS -7.6%
* Loftus T, 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).
$3M Savings
SAFE SURGERY PROGRAM
Patient Safety
Patient Safety & SRE
• Safe Surgery Program– Implemented in 22 acute and 8 ASC OR’s– Results