In October 2012, Adena Health System, based in
Bambi Huffman, vice president of clinical integration at Adena, says she and the other project heads brought together a group of service line leaders and physicians to ask for their input on the initiative, and they responded enthusiastically. "We realized we were onto something because of the excitement with the staff and the physicians," she says.
Fueled by that excitement, the project grew, and the system began using data analytics software, along with staff feedback, to identify opportunities for savings and improvement. For instance, L. Wayne Coats, DO, chair of the Adena Department of Medicine, says one of their biggest successes was reaching an agreement with the orthopedic surgeons as to what vendor to use for implants. "That gives you a lot of bargaining power when you can do that with the vendors," he says.
They also found opportunities for reducing variation and containing costs by examining the type of catheter equipment used in the cardiology service line and chemotherapy drugs within oncology, according to Dr. Coats.
In 2013, through different projects implemented in seven service lines, the three-hospital system saved $3.4 million - $1.4 million more than expected. The system is continuing its cost-saving efforts and now has 14 teams of service line directors or managers and their staff members participating.
"Any time there's positive motion in an organization, I think people want to hop on board," Dr. Coats says. "In healthcare today…you've got to squeeze out almost every penny to be successful, and I think the staff understands that."
Dr. Coats and Ms. Huffman credit their combination of data analytics and "organic" feedback and reporting as driving the system's success in cutting costs and reducing variation. They shared the following four key insights into Adena's cost-saving strategy.
1. Listen to the staff. An important part of the project has involved meeting with service line team leaders to both identify ways to reduce variation and contain costs as well as to assess how the cost-cutting initiatives for each service line are progressing.
In 2013, Ms. Huffman says, "We were at the table twice a month for a 30-minute huddle where everyone in the room would basically do a 'round robin' to talk about the barriers they were having with their projects."
2. Collect and leverage data to supplement staff suggestions. The project leaders also use data analytics to help identify potential savings. Ms. Huffman says they perform "service line optimization diagnostics," which involves getting feedback from the service line leaders, looking at quality and financial data, conducting a financial analysis, and creating a plan for change.
Dr. Coats says the data also makes it easier to show the initiatives are necessary. "If you can always provide accurate data to providers, it's very hard to argue that," he says. "That empowers us to drive process."
3. Eliminate barriers and obstacles as soon as possible. Ms. Huffman says knocking down barriers to progress (such as reaching a consensus on which surgical implant to use) as soon as staff members identify them can keep a project from losing steam. She says the project leaders got feedback on obstacles from a project champion at their regular huddles and would report back as soon as they moved forward with resolving the issue.
"You've got to move," she says. "If you don't move, and you stifle that excitement and motivation, then you lose the team synergy."
4. Find the right leaders. Ms. Huffman says partnering with a physician on the project leadership team helped the cost-saving initiative achieve success because the physicians can provide a better clinical understanding. "It was helpful having a physician on our team," she says. "Doctors are going to listen to doctors."
Similarly, Dr. Coats says the primary best practice for cutting down on spending is having the right person in charge of the effort.
"You have to find someone who's really engaged and will get down deep in the weeds and find the right players," he says. "Bambi was instrumental in doing that."
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