Deborah Berini, president of Hershey Medical Center, sent the following email to Hershey Medical Center employees on Tuesday:
Dear Colleagues:
Happy New Year! As we approach the midway point of the fiscal year, I am continuing the focus on the work of the operating plan and wanted to share the progress related to our finance pillar. Strong financial outcomes are associated with improved patient safety and quality of care. I am happy to share that together we are achieving our budget for this year and making good progress on the financial tactics within the operating plan. (Keep reading to check out my “selfie video” debut, which focuses on one of them!)
Making Better Use of Our Operating Rooms
This fiscal year, total surgical volumes have increased more than we planned in the budget, making achieving our operating plan goals a challenge. The surgical services team has made incredible strides, including hiring new nursing and support personnel and, in collaboration with the newly formed Surgical Services Governance Team, rolling out a new handbook of Surgical Services Operating Standards. These are important first steps.
If you have the chance to talk with any members of the surgical services team, you will probably hear about the decrease in patient holds in the OR and PACU. Patient holds affect everything –including patient experience and employee satisfaction. Through focused effort to map patient flow, PACU holds are down 10% and OR holds are down 34%. In my first attempt at a “selfie video,” I recently spoke with staff nurse Courtney Bowers about the impact of this change. My camera work is rough, but if you like the video concept, I will promise to get better and do more!
While we are delighted with this progress, we know there is more work to be done. This will continue to be the focus of the Surgical Services Governance Team and our entire surgical services team.
Focus on Value-Based Care
Our private payors and Medicare have shifted some of our payments to value-based care, which means that this reimbursement is at risk based upon achieving quality and cost metrics. To successfully earn back our at-risk payments, Quality Systems Improvement and our Quality Initiatives and Measurement teams are collaborating with Family and Community Medicine, General Internal Medicine, the Breast Center, Ophthalmology and Endoscopy to improve the health of our patients and our financial performance.
One example of this work is the development of team-based care to identify and effectively care for diabetic patients. The diabetic eye screening initiative includes the expansion of remote retinal units within Family and Community Medicine practice sites across the health system and patient education seminars. As a result of this work, diabetic eye screening rates have increased by 23% – allowing early intervention to prevent vision loss. In addition, our care teams have improved hemoglobin A1c control rates by 10% (which means better management of the disease) and nephropathy monitoring rates by 14% (allowing early interventions and better patient engagement).
Better Document Our Care
Improving clinical documentation ensures we accurately reflect the patient’s condition and communicate this to all members of the care team. This same documentation is used in our publically reported quality outcomes and our value-based payments – making it essential that we accurately reflect the acuity of our patients. Proper coding and documentation is like learning a foreign language and requires ongoing training and support. In response, we have instituted onsite documentation support in the Emergency Department, hosted lunch and learns, and provided 148 new physicians and APPs with individual support. We are also rolling out new documentation training on Compass.
The result of this work is over $3 million in additional revenue year to date!
Working in health care is first and foremost about helping people. Our ability to achieve a healthy financial margin is what supports this mission and allows us to invest back into patient care, teaching, research, community health and our people. Thank you for all the work you are doing to ensure our success as we strive to serve our community through the best outcomes, best patient experience and being a great place to work.
Sincerely,
Deborah Berini
President
Penn State Health Milton S. Hershey Medical Center
dberini@pennstatehealth.psu.edu
PS: Look for a message from our Interim Dean Kevin Black on the Operating Plan progress from the college point of view.