UK HealthCare Builds Foundation of Excellence for Ambulatory Operations

With outpatient services and revenue on track to outpace inpatient care, UK HealthCare needed to grow its ambulatory capacity, improve patient access to care, enhance care coordination, and build consistency in quality and patient experience across the enterprise.

Challenge

Continual ambulatory patient volume and workforce growth coupled with a shift to value-based care was straining UK HealthCare’s processes and systems and threatening significant revenue losses for the organization — all of which challenged its ability to provide excellent patient care.

To position UK HealthCare as a provider of choice and prepare the organization for the future of ambulatory-centric care delivery, leaders identified key initiatives to reduce costs, generate growth and improve the patient and provider experience.

Approach

UK HealthCare and Huron worked together to initiate a multiphased improvement journey to build a strong ambulatory operational foundation capable of delivering consistent, high-quality care across the entire enterprise.

The teams prioritized upfront investments in infrastructure — processes, people and technology — underpinned by ambulatory governance and guiding principles that would allow UK HealthCare to expand improvement across additional specialty care departments following the completion of its work with Huron.

Engagement of medical faculty in the improvement journey and the use of data to create awareness and urgency for change were central to the improvement journey. Data was used throughout the journey to identify and prioritize improvement opportunities, which served to hardwire the behavior of data-driven decision making.

Operational excellence and financial growth. The team focused on foundational process improvements to establish a patient-centric access model that aimed to match every patient with the right provider at the optimal time and location.

Enterprisewide ambulatory access guidelines, simplified and automated scheduling protocols, and provider template optimization as well as technology and workflow enhancements were implemented to improve access and create a more consistent patient experience. Collectively, these initiatives removed barriers to entry for patients seeking care at UK HealthCare and strengthened partnerships across the organization.

Results at the 28-month mark of the journey included a 14-minute reduction in orthopedics patient cycle time, 57% increase in new patient slots in internal medicine and 10% increase in pediatrics template capacity. Scheduling complexity was reduced by streamlining appointment visits and durations for like providers. Access improvements also decreased patient scheduling lags, improved utilization and reduced phone wait times. These operational changes provided critical support to UK HealthCare’s goal of serving the Commonwealth of Kentucky.

Investment in people. Leaders at UK HealthCare understood that enterprisewide changes would significantly impact local providers, physicians and staff. Investments in people, culture and engagement were critical to ambulatory transformation. Working with Huron, the team designed a dyad operating model, which was advanced across the ambulatory enterprise. These administrator-physician leader partnerships, deployed in parallel with governance and operational changes, were critical to leading the organization through change and building consensus for the ambulatory strategic vision.

A UK HealthCare performance improvement team, trained by Huron, was established to assume implementation of ongoing and future ambulatory initiatives. Following the implementation of change initiatives in the first specialty practice, the training of UK HealthCare team members accelerated project implementations in subsequent practice areas.

Data for decision making and accountability. Through implementation of Huron’s proprietary analytics, UK HealthCare was able to gain new, advanced insights into performance results. The data and metrics provided an objective and transparent mechanism to measure outcomes of improvement initiatives and hold teams accountable for sustaining results. In tandem with metrics, an accountability organizational structure and standardized team forums were implemented to reinforce and sustain operational changes.

UK HealthCare is committed to the pillars of academic health care — research, education and clinical care. The system comprises two hospitals (Albert B. Chandler Hospital and Good Samaritan Hospital); over 80 specialized clinics; and a team of 9,000 physicians, nurses, pharmacists and healthcare workers — all dedicated to patient health in the Kentucky region.

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