Three years after the COVID-19 pandemic, health systems continue to grapple with staffing shortages, clinician burnout and financial challenges. Healthcare has been slower than other industries to leverage technology to solve these issues, but there's still time to catch up.
With great leaders and partners at the helm, health systems can charge forward with the culture, people and process changes needed to transform healthcare delivery. MUSC Health has been on a mission for the last few years to do just that.
MUSC Health's transformation
"The Charleston, S.C.-based health system and Siemens Healthineers, as part of a 10-year Value Partnership, implemented LeanTaaS’ AI/ML-driven workflows to realize the vision of streamlining its perioperative model and optimizing performance." MUSC Health identified the opportunity to improve operating room patient throughput, patient scheduling and data management to become more efficient.
"Every surgeon had their own unique scheduling and workflows, which created huge inefficiency and that led to adverse outcomes," said David Zaas, MD, CEO of the Charleston Division and chief clinical officer of MUSC Health.
MUSC had to align around a common goal and then garner physicians' trust in the data to enact change. The health system worked with LeanTaaS to customize a perioperative platform strategy for more efficient block scheduling. Surgeons were able to open up unused OR block time weeks in advance, allowing others to fill in the gaps.
The partnership led to an additional 1,000+ cases cumulatively over baseline in the first three quarters and proactively releasing more than 6,200 block hours. MUSC Health realized 8 percent growth in orthopedic volume year over year across all campuses once the strategy was implemented.
That didn't happen overnight and it wasn't a top-down transformation.
"As a physician, I'm a huge believer that we need to give the keys to our frontline physicians. If we give them the tools, if we give them the data, and if we give them the decision rights, they're going to make good decisions as long as they're functioning as a group," said Dr. Zaas.
The health system has seven different EHR platforms between hospital and ambulatory surgery centers, so MUSC created local surgeon- and anesthesiologist-led perioperative groups to make decisions. Dr. Zaas and his team oversaw the local divisions and supported their progress. The groups shared best practices and findings for process optimization, and the best ideas cascaded throughout the organization.
"The local teams at each entity, especially as we become larger, have the most innovation. They have the most skin in the game to understand improvements," said Dr. Zaas. "That's part of our cultural transformation. We're used to a very top down approach in how to manage staffing, block time and other things in the OR. We've tried to really push it to surgeon-led teams at the local level, and have trust that they're going to make the right decisions."
Then comes the technology. Systems need flexible partners to customize solutions based on learnings and best practices gained over time.
"ORs have very similar problems, but each health system has different needs in how they approach and solve those problems," said Ashley Walsh, vice president of client services, operating rooms and inpatient flow at LeanTaaS. "If you don't have the team to work hand in hand with that customer, they won't achieve their transformation goals."
Leading culture change
One of the common issues, workforce shortages, have led to fewer clinicians and staff available to serve patients with increasingly complex healthcare needs. Hospitals can leverage technology to more quickly triage patients to the right care, schedule patients, efficiently use OR time and coordinate discharge. But gaining the commitment of all team members to change is hard.
"When you go through a culture transformation, you have to start with the 'why,'" said Dr. Zaas. "We can talk about access and delays in care, but we need to always frame those issues as a quality issue. Evidence shows delays in access to care and surgical times adversely impact quality in addition to patient experience and patient satisfaction."
Once MUSC Health's physicians and clinical staff saw they could do more cases within the regularly scheduled times, be more productive and feel less burnt out, they were excited to continue leveraging technology in similar ways across other departments. The data became trustworthy and engagement soared.
"What's been surprising and exciting for me in this journey working with healthcare organizations is the level of engagement from providers and team members, and the sustained change," said Ms. Walsh. "It's one thing when we work on these improvement projects in hospitals and we're excited to see great success, and then folks move into other roles and things change. But when you really are pairing technology with your services and operations, it becomes the standard."
Future growth and scalability
Technology has to align and integrate with every day workflows so the system can scale as it evolves and leadership changes. LeanTaaS and Siemens Healthineers are taking the technology a step further to engage predictive analytics so clinicians can better prepare and adjust the standard operating model.
"If we know what's going to happen in the future and we have our best practices collectively built together, we can prescribe action and reduce the cognitive load in a very chaotic environment so surgeons and teams can have access to all the information they need," said Ben Sperling, vice president of enterprise intelligence solutions at Siemens Healthineers. "If it's going to be a crazy day the next day, the team can readjust priorities, caseloads or resources accordingly. It takes a lot of stress off the team collectively to have that information ahead of time."
Ms. Walsh sees continued opportunities to further optimize the perioperative process, and LeanTaaS is looking at how perioperative services touch other aspects of the hospital. The company works with inpatient flow teams to optimize capacity so clinicians can see more patients, make sure patients are in the hospital for the appropriate length of time, and optimize care coordination.
MUSC Health has benefitted from the data-driven approach to connecting all aspects of the care continuum.
"What we've done really well together is develop a truly substantive partnership with shared values at the foundation, shared leadership and commitment," said Dr. Zaas. "We don't individually have the right skill sets to improve the care we deliver to our community in a sustainable way, but together, we do. Where else we could leverage the different skills and resources we bring to the table to advance care delivery, our education and research mission, is what excites me about the future. I think digital transformation in healthcare has been too slow, and hospitals alone aren't going to accelerate it. It's going to be through new partnerships."