Large systems with nationwide reach have the potential to be national healthcare hubs, but are also susceptible to operating as disparate entities with differing cultures, processes and performance levels simply functioning under the same name.
At Becker's Hospital Review's 6th Annual Meeting in Chicago, Patricia Maryland, DrPH, president of healthcare operations and COO of St. Louis-based Ascension Health, and Gayle Trupiano, vice president of performance excellence of Ascension Health, discussed how by focusing on labor optimization efforts, Ascension was able to save millions in annual performance and standardize culture across its 1,900 locations.
Ascension Health, the nation's largest Catholic nonprofit health system, employs more than 150,000 people across its locations in 23 states and the District of Columbia. However, aside from its shared mission of providing quality care for the poor and vulnerable, each of Ascension Health's locations was functioning as a relatively autonomous entity.
"There was relative independence across our health ministries and system office departments," said Dr. Maryland. "There was variation in underlying data systems, lack of agility in decision making and change management and a lack of clarity on roles and responsibilities."
The system's leadership determined an imperative for change after forecasting local changes in utilization, payer mix and reimbursement rates in fiscal year 2013. After mapping out these forecasts against projected integrated strategic operational and financial plans, they were able to identify a collective five-year $5.2 billion gap in performance.
A new goal for the health system became to create a sustainable and standardized platform across its locations while upholding its mission to care for those in need. According to Dr. Maryland and Ms. Trupiano, labor optimization would close the gap.
This goal would be realized through a series of efforts, the first being to create a sustainable person-centric delivery system to serve individuals throughout their lifetimes.
"We needed to embrace the reality that we are one national health ministry," said Dr. Maryland. "It is critical to consolidate, standardize, streamline and decrease variability in order to bring our advantages to our local communities."
Crucial to attaining this goal is an emphasis on creating value, which, according to Dr. Maryland, includes quality and patient safety, efficiency and effectiveness, financial impact and patient and associate satisfaction.
However, the only way for Ascension to achieve its goals on a system-wide level was to have buy-in from all employees. The health system responded with a standard practice labor optimization model that includes more timely, intentional and transparent management of labor costs and data and accountability in design and delivery models.
"This cultural change enabled the improvement of patient care," said Ms. Trupiano. "In our aim for excellence, we had to figure out how to provide the right tools at the right level and time. It was by engaging the hearts and minds of associates and health partners to deliver ever-increasing value to those we serve."
In doing so, Ascension Health has achieved a quadruple aim: Improved health outcomes, enhanced patient experience and better provider experience, all at a lower cost.