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  • Hospital Impact - Healthcare behind the times with electronic data interchange
    and receiving process has been common More To make it worse there s a limited number of companies in healthcare that provide EDI and they work both sides of the fence charging both the buyer and the seller for the privilege of using their EDI services By looking outside of healthcare for best practices we can find proven technology with 20 years of experience that brings healthcare up to date with other industries A best practices checklist for EDI includes Fees should be paid for by the vendors rather than the buyers Fees should be affordable and driven by the actual cost of providing the service as opposed to an arbitrary percentage of the cost of the invoice The process should include a web based portal that is easy and practical for vendors of any size to use There should be a 360 degree electronic process that allows for an automated method to track the complete process of purchase order purchase order acknowledgement invoice creation matching and straight through processing to the accounts payable system A robust dashboard of analytics should be available to efficiently run your business It is time for us in healthcare to reach out to solutions from other industries where the above described process has been standard for decades Kevin L Shrake kevinshrake mdresources net is a 35 year veteran of healthcare a board certified fellow in the American College of Healthcare Executives and a former hospital CEO He currently serves as the executive vice president chief operating officer of MDR based in Fresno California Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction

    Original URL path: http://www.hospitalimpact.org/index.php/2015/03/11/healthcare_behind_the_times_with_electro (2016-02-10)
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  • Hospital Impact - Group purchasing options create significant savings
    savings All of these standard myths are false Not all GPOs are the same They all have different relationships and footprints and you need to assess the value added services that each provide Having protocols in place that establish preference items is key to lowering costs Rather than offering 100 different types of sutures making clinical decisions on stocking a lower number of suture options will enhance quality and lower costs by purchasing higher quantities of the desired items Although most organizations use a GPO and may brag about the high level of compliance they have with their existing contracts a lesser known fact is that often up to 50 percent of an organization s spend is with off contract purchases Let s take that fact and concentrate on the concept of establishing a secondary GPO relationship Secondary GPO relationships There are some distinct advantages of a secondary GPO relationship If a large percentage of spend in every organization is off contract why not let a second GPO concentrate on that spend and bring additional savings This is accomplished without disrupting your current purchasing practices or compromising contract compliance with your primary GPO If you believe that competition is good and are willing to be more disruptive allow the secondary GPO to perform an assessment on your current purchases to determine if they have a better contract or relationship in specific areas For example your primary GPO might have great medical surgical supply contracts but below average contracts for pharmaceuticals Having a second option allows you to pick and choose the best approach for all of your purchases Look for value added services that differentiate one GPO from another when choosing your relationships Some GPOs bring executive solutions to the C suite that involve unique cost savings ideas from inside and outside of healthcare Since not every best practice resides in one industry having a partner dedicated to finding unique margin improvement concepts and bringing them to you can be extremely valuable Case study A 200 bed hospital on the East Coast used a sole GPO approach with the same partner for the past 15 years They were approached by a competitor GPO and agreed to an assessment of their current spend both on contract and off contract The secondary GPO was able to identify an additional saving of 1 2 million by addressing their off contract spend and also brought additional savings of 800 000 on some specific contracted items In addition they bring executive solutions in the areas of revenue cycle and e payables amounting to 600 000 of margin improvement Perhaps it s time to kick the tires The decision to improve your overall GPO value often requires that you consider a secondary GPO relationship This applies across the spectrum of hospital size complexity and whether a stand alone or an integrated delivery network GPOs that are flexible in their approach and that are willing to build a program around the needs of the hospital will likely

    Original URL path: http://www.hospitalimpact.org/index.php/2014/12/11/group_purchasing_options_create_signific (2016-02-10)
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  • Hospital Impact
    2014 by Kevin L Shrake Car dealers make a little money selling you the car and a great deal of money servicing it As a matter of fact Henry Ford stated when he was criticized for offering his new cars at such a low price I d be willing to give the cars away for a guarantee that I would be engaged to service them and provide parts Like the car industry the equipment maintenance market is an area where organizations invest significant portions of their expense dollars It s not uncommon for a medium size facility to spend 5 million per year on equipment maintenance and an average system to spend 50 million The problem with any of these figures is that most organizations don t really know what they spend on an annual basis when all elements are considered and there is a fragmented location of the information and responsibilities Total costs should include maintenance contracts biomedical costs whether on site or outsourced independent service organization ISO costs original equipment manufacturer OEM costs parts sourcing and internal labor to name a few Step one in a best practice process is to perform an inventory of equipment and current practices and consolidate information and responsibility into one centralized location Read more Leave a comment The doughnut dilemma Loyalty vs cost August 14th 2014 by Kevin L Shrake Loyalty is a very desirable trait we should value in our personal and professional lives It is great to have a friend or business colleague you can count on to not only support you but to always create maximum value for you whether you leverage a personal relationship or optimize a business arrangement However as cost pressures intensify in the business setting prudent leaders must evaluate and balance the cost of continuity or loyalty versus the best financial deal for their organizations But she brings doughnuts Linda is the clinical educator for the surgical devices we routinely use in our facility She is so nice and every morning she comes to speak with us she brings doughnuts That is wonderful and Linda undoubtedly is an extremely nice person But what is the cost benefit ratio of the doughnuts if Linda s instruction promotes the overuse of expensive implant devices that costs the organization more than is clinically necessary and exposes patients to unnecessary risks How does the education provided affect value based purchasing criteria such as hospital acquired complications 30 day readmission rates and patient satisfaction Read more Leave a comment Beliefs important to future of healthcare leadership July 10th 2014 by Kevin L Shrake Martin Luther King Jr was able to attract over a quarter million people to the Mall in Washington District of Columbia to hear his famous I Have a Dream speech How was he able to do this without the internet email texting Facebook or Twitter He did this because of how he communicated his beliefs and how those beliefs struck emotions in people of all walks of

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=Kevin%20L%20Shrake&page=1&disp=posts&paged=2 (2016-02-10)
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  • Hospital Impact - 3 ways patient experience affects the bottom line
    healthcare managers an evidence based case for improving the service encounter In considering your opportunities for a return on service I offer some initial suggestions from three distinct perspectives financial marketing and clinical Financial Perspective Satisfied patients lead to higher profitability In a 2008 J D Power study hospitals scoring in the top quartile in satisfaction had more than two times the margin of those at the bottom The 2008 Press Ganey paper Return on Investment Increasing Profitability by Improving Patient Satisfaction supported these findings It revealed that when hospitals were ranked by profitability the most profitable hospitals had the highest average satisfaction scores Marketing Perspective There is significant power found in word of mouth Jacqueline Zimowski shared in a2004 article that a satisfied patient tells three other people about a positive experience In contrast a dissatisfied patient tells up to 25 others about a negative experience The issue worsens as for every patient that complains there are 20 other dissatisfied patients that do not And of those dissatisfied patients who don t complain only one in 10 will return When you run the numbers for every complaint you receive you could be losing a potential 18 patients Clinical Perspective Experience and quality are not distinct efforts but critically interwoven aspects of overall care Patient experience is not just about quiet environments positive service scripting or consistent rounding At the end of the day it is about ensuring our patients leave healthier than when they arrived as often as we can In their 2011 study Boulding et al examined quality factors as defined by The Centers for Medicare Medicaid Services Core Measures specifically on acute myocardial infarction heart failure and pneumonia and satisfaction factors as determined by the two HCAHPS questions How do you rate the hospital overall and Would you recommend the hospital to friends and family in relationship to readmission rates within 30 days of discharge The finding was significant HCAHPS scores i e experience outcomes were reliable and even more predictable indicators of readmissions than quality indicators In essence patient experience in this case measured by HCAHPS was a distinct and measurable driver of readmissions a key quality issue and a significant financial issue for healthcare organizations In addressing patient experience as a new healthcare reality healthcare leaders should recognize there is a case for experience as a must do A proven commitment to patient experience has significant and measurable impact not only in doing what is right but also in ensuring the best quality and most financially sound experience for all who are in and who deliver your care To be responsible stewards for healthcare systems that are both vital and viable it is essential to recognize and be willing to address the bottom line issues influenced by patient experience efforts every day Jason A Wolf Ph D is executive director of The Beryl Institute the global community of practice and premier thoughtleader on improving the patient experience He is a passionate champion and recognized expert

    Original URL path: http://www.hospitalimpact.org/index.php/2011/12/01/title_34 (2016-02-10)
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  • Hospital Impact - 5 tactics for your patient experience strategy
    the impact differently in a hospital setting noise is often a reason for patient complaints and dissatisfaction Discharge Process The concept of effective discharge is another HCAHPS related area According to an Agency for Healthcare Research and Quality AHRQ funded study patients discharged from the hospital who have a clear understanding of their after hospital care instructions including how to take their medicines and when to make follow up appointments are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information Additional research concludes the poor transfer of information to patients lack of timely post discharge physician visits and poor patient knowledge all add to preventable readmissions which have serious implications on overall experience Rounding Rounding has become part of the common vernacular in service excellence and quality care delivery A study conducted by Northeastern Hospital in Philadelphia in conjunction with Studer Group showed that intentional rounding not only reduced call light use and falls but also eliminated pressure ulcers increased patient and staff satisfaction and was even associated with other anecdotal benefits such as a decline in medication errors intravenous complications and overtime costs Responsiveness of Staff Communication Responsiveness also is addressed through the HCAHPS survey Hospitals Health Networks Daily s Haydn Bush suggests that communication trumps amenities or quality in driving patient satisfaction based on the premise that communication allows for strong patient engagement Ultimately he asks the critical questions many of us do Did staff clearly communicate in a respectful manner Were clinical decisions explained in a manner that suggested high quality decision making Communication the most basic of skills can be one of the most critical levers of patient experience success Pain Management Pain management another area at the heart of the HCAHPS survey is only partially about pain itself It also encompasses staff s effectiveness in communicating establishing expectations and ensuring access to needed information to help patients best understand how to manage pain situations In its n urse handbook the AHRQ reinforces the importance of controlling pain suggesting complications related to inadequate pain management negatively affect hospital performance as it drives longer hospital stays and leads to greater readmission rates Pain influences a patient s welfare and overall experience In defining patient experience as the sum of all interactions shaped by an organization s culture that influence patient perceptions across the continuum of care every encounter provides an opportunity for action and impact on the overall experience These five tactics simply propose common areas of focus As you tackle the patient experience in your organization regardless of which tactics you choose remember it is one of the most critical strategic opportunities you have at your disposal to engage your consumer manage the bottomline and strive for quality outcomes Jason A Wolf Ph D is executive director of The Beryl Institute the premier thoughtleader on improving the patient experience He is a recognized expert on organizational effectiveness service excellence and high performance in healthcare Leave a comment

    Original URL path: http://www.hospitalimpact.org/index.php/2012/02/01/5_tactics_for_your_patient_experience_st (2016-02-10)
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  • Hospital Impact - Commit to patient experience in 2012
    July 1 value based purchasing arrived A real and measurable performance period began that would not simply compare healthcare organizations across markets but also would impact the actual reimbursement dollars institutions would receive across a much broader spectrum As one CNO said to me last July Spring training is over and the regular season is on How does this fit into your resolutions for 2012 Last year I wrote about the origins of New Years Janus a mythical king of early Rome and the opportunity we have each year to focus on patient experience resolutions The symbolism of Janus is even more significant this year now that patient experience has taken the hard turn to the practical With two faces Janus could look back on past events and forward to the future This is exactly what we must continue to do in this new era of value based purchasing Three months remain in the performance period July 1 2001 March 31 2012 that will impact every institution s bottom line Three months in which important patient experience efforts should be continued or if need be started to ensure you are not only providing the best care experience possible but also setting yourself up for the greatest reimbursement So what can you be doing I have previously offered numerous considerations from four key organizational strategies to the importance of personal interactions You also could explore the top three tactical priorities outlined in The State of Patient Experience in American Hospitals benchmarking study that healthcare organizations identified as important to consider including a focus on noise reduction a clear and replicable discharge process and a consistent and intentional rounding program at all levels of your organization The key is this In the year ahead patient experience will be as critical if not more so than before and like Janus symbolized it will be important to look back as you plan ahead You also must ensure patient experience is integrated into strategy while balanced as a key tactical effort that drives at the heart of your quality safety and overall care delivery experience In the end most importantly do not simply be led to your goals based one expert s ideas or someone s specific model Find the strategies and tactics that best fit your organization your community your people and your patients It is there you will find the most fulfilling resolutions for the year to come and will realize the greatest results So what are your 2012 patient experience resolutions We all can and should learn from one another in the year ahead Jason A Wolf Ph D is executive director of The Beryl Institute the premier thoughtleader on improving the patient experience He is a recognized expert on organizational effectiveness service excellence and high performance in healthcare Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news

    Original URL path: http://www.hospitalimpact.org/index.php/2012/01/05/improving_patient_experience_in2012 (2016-02-10)
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  • Hospital Impact - Patient experience: 4 strategies of the new healthcare reality
    emerging in support of stronger patient experience performance overall A clear organizational definition for patient experience The Institute s benchmarking study discovered that while almost 70 percent of hospitals have a formal structure for addressing patient experience only 27 percent have a formal definition We would not pursue new service line strategies without a clear purpose so what makes patient experience any different Organizations should consider adopting or adapting the Institute s definition of patient experience the sum of all interactions shaped by an organization s culture that impact patient perceptions across the continuum of care A focused role to support patient experience efforts In our recent paper The Four Cornerstones of an Effective Patient Experience the conventional wisdom that focus leads to outcomes was reinforced as those facilities with a focused role and defined time committed to patient experience efforts tended to outperform on HCAHPS scores by significant margins A recognition that patient experience is more than just a survey My visits to hospitals across the United States have shown me that the greatest outcomes are realized by those facilities that address the actual experience versus just the required survey questions At Inova Fair Oaks Hospital in Virginia by building a foundation of service culture and sharing a broad vision of the patient experience journey it helps patients feel they are individuals to be cared for versus cases to be managed The result a consistent likelihood to recommend score of greater than 80 percent over the last few years A commitment at the highest levels of leadership It may seem cliché to say it starts at the top but the benchmarking study revealed that the top driver of patient experience success recognized by more than 72 percent of respondents was strong visible support from the top This is reinforced by Dr David Feinberg CEO of UCLA Health System who shares that his leadership team takes the time to walk the floors daily engaging staff patients and family as part of its overall commitment to healing humankind one patient at a time These ideas provide a framework for successful efforts taking place throughout healthcare organizations today but it takes more than checking off a list of four actions to achieve success Patient experience performance and yes survey outcomes and financial rewards are all tied to a healthcare organization s willingness to make patient experience more than just an initiative This is our new reality Patient experience as a part of our healthcare environment is here to stay Jason A Wolf Ph D is executive director of The Beryl Institute the global community of practice and premier thoughtleader on improving the patient experience He is a passionate champion and recognized expert on organizational effectiveness service excellence and high performance in healthcare Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid

    Original URL path: http://www.hospitalimpact.org/index.php/2011/11/03/p3391 (2016-02-10)
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  • hospital impact - TIME's 10 world-changing ideas and healthcare
    shelled out stores I can t help but drool just a little bit This is a big opportunity for healthcare providers who have been trying to extend our reach Tons of real estate at bargain prices But we can t do this alone now is the time for creative partnerships Why not have a small clinic within that new community center How about a partnership with a new library setting up a health care resource center How about a retail partnership geared at providing convenience expertise for a certain demographic e g pregnant moms One other broad stroke generalization Hospitals in walkable urban areas will most likely see increased demand for decades to come We are a nation of 80 percent drivable suburbs think The Sopranos and 20 percent walkable urban think Seinfeld or Friends The problem is that the demand is more like 50 50 3 Reinstating the Interstate 4 The Interstate highway is a huge asset in that it s the government s right of way They could add lots of other infrastructure rails broadband power grid smartcar power etc as they already own the land Healthcare Impact Long term this could mean pocket of population growth and new population centers that follow the infrastructure investment This could inevitably mean the relocation renovation and or the removal of hospitals in non strategic areas 4 Amortality 5 Scientific innovation is speeding up exponentially not linearly as each innovation helps scientists come up with the next innovation even faster Some believe science will allow us to live significantly longer 50 100 hundreds of years than we do now Healthcare Impact I ve heard Ray Kurzweil speak and read his book The Singularity is Near Although it sounds outlandish I m becoming a believer because the data itself is compelling We are entering into a period where scientific advancement accelerates exponentially We are 10 to 15 years away from reverse engineering the human brain Folks get ready for some massive changes to healthcare At the right time I would place strategic bets on neuroscience genetics nanotechnology applications for cancer and regenerative medicine It s a long way off still but not as long as most of us think 5 Biobanks 8 We will eventually have massive biobanks storing our blood tissue samples that will facilitate research and also provide genetic based intelligence to biobankers on our risk of disease etc Healthcare Impact Related to the last one the availability of this data will make medicine the three Ps predictive preventive and personalized This kind of mass customization of healthcare delivery will force us to completely rethink our work flow our facilities our personnel strategy everything OK so I know this is probably a little bit of a stretch but it is purposely so Even as we continue to bear down on costs and focus on short term viability these societal trends will inevitably force us to innovate either reactively or proactively It s chaotic times like these where new leaders can

    Original URL path: http://www.hospitalimpact.org/index.php/leadership/2009/03/17/time_s_10_world_changing_ideas_and_healt (2016-02-10)
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