Thirty-day readmission rates for hip and knee replacements at Indiana University Health Saxony Hospital are at 0.74 percent, more than seven times lower than the national average. Length of stay is also on the extreme low end. So how does the 42-bed hospital in Fishers do it?
The answer stretches back to one surgeon's experience at a hotel. A Ritz-Carlton hotel.
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R. Michael Meneghini, MD, an orthopedic surgeon who directs IU Health Saxony Hospital's joint replacement program, was planning to propose to his now-wife at a Ritz-Carlton, but a snowstorm hampered his plans. Still, staff at the luxury hotel helped his proposal go smoothly despite the setback. "They were with us every step of the way," he says.
Impressed with the customer service, Dr. Meneghini started thinking about how it could translate to his own industry. He had heard that the Ritz-Carlton holds daily meetings with staff to get everyone on the same page for every guest. "If the patient is the customer, why can't we do the same thing in medicine?" he asked himself.
Now, the team at IU Health Saxony Hospital does something similar: Every Friday morning, the entire perioperative team gathers at the hospital to discuss the next week's upcoming patients and scheduled surgeries. The meeting includes internists, surgeons, anesthesiologists, nurses, the OR team and even device company representatives and the hospital chaplain. They discuss all aspects of patient care, like what implants will be used and any medical conditions the upcoming patients might have.
"Everyone is willing to [come in] on their own time, come in early on a Friday," Dr. Meneghini says. "We are very fortunate to have a group of people who truly go the extra mile to care for patients."
While the care-coordinating meetings have positively affected clinical measures like length of stay and readmission rates, patients have also taken notice. Patient satisfaction has been extremely high for several months now, according to Dr. Meneghini. "It's palpable to the patient. It seems like we have our act together," he says. "People aren't asking them the same questions over and over and aren't surprised by an unusual case" since everything has been worked out prior to the surgery.
It's possible elsewhere
IU Health Saxony Hospital's perioperative team has held these meetings since the hospital opened its doors about two and a half years ago. "That's one of the things that facilitated the program the most…there were no preexisting culture or patterns to change," says Dr. Meneghini.
However, for established hospitals considering a similar hospitality-inspired program, a strong surgeon leader is critical. "If you don't have a surgeon leader to drive [the effort], it's not going to go anywhere," he says.
Support from the executive level is also paramount. To gain executive-level buy in, Dr. Meneghini recommends highlighting the cost savings this pre-surgery approach can generate. The meetings can lead to reduced medical errors and shorter hospital stays, both of which impact a hospital's bottom line. He recommends educating the executives on the financial benefits when first presenting the program.
The fact that all of the positive impacts on care coordination, healthcare costs, outcomes and patient satisfaction at IU Health Saxony Hospital stem from one excellent experience at a hotel goes to show that healthcare leaders can learn lessons anywhere. "Maybe the Ritz-Carlton deserves part of the credit for their influence on our program," Dr. Meneghini quips.