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By identifying and mitigating barriers to volume, one university health system was able to restore operating room (OR), invasive procedural, ambulatory and inpatient volumes lost during the onset of the coronavirus pandemic.

Challenge

A large university health system experienced a sudden and significant drop in patient volumes as it suspended normal operations to respond to the coronavirus pandemic. The loss of volume directly impacted the organization’s financial stability. As the organization entered its recovery phase, leaders had to grapple with resuming operations and delivering high-quality care while also maintaining a safe care setting for patients and staff.

Approach

University leaders and Huron developed a strategy to align volumes across care settings, support patient care, stabilize the organization financially and prepare for a resurgence in coronavirus cases. The strategy consisted of understanding the impact of the coronavirus on historical processes and operations, recalculating capacity to account for social distancing, prioritizing the needs of different patient populations and evaluating changes in volumes against pandemic-related constraints.

The university and Huron achieved results by:

Implementing heightened safety measures. In addition to assisting with analytics to predict personal protective equipment (PPE) needs for patients and staff, Huron and university leadership worked together to adjust supply levels, adhering to the latest Centers for Disease Control and Prevention (CDC) safety recommendations. Existing processes were reengineered to allow patients to safely return to care settings, such as reconfiguring waiting areas, creating virtual waiting rooms, and redesigning patient flow for pre- and post-procedural areas. The teams also established point-of-care coronavirus testing of patients on the day of their procedure.

Restoring patient confidence in office visits and surgical and invasive procedural services. With Huron’s support, the university launched a marketing campaign to inform local communities of the newly implemented safety measures and protocols, confirming it was safe for patients to seek care in its facilities again. The university used a variety of communication tools, including letters, emails, videos and a digital social media campaign, to communicate new protocols and care options to keep patients safe, including increased telehealth availability. For example, during nurse screening or scheduling, patients who expressed safety concerns were transferred to the attending physician, who reiterated the safety measures the hospital had in place. This assuaged patient anxiety, and as a result, patients kept their needed care appointments.

Expanding care access and maximizing capacity and volume. Huron collaborated with university leaders to develop a recovery playbook for front-line ambulatory leaders to support clinic expansion and patient prioritization efforts. Scoring tools made it easier to prioritize patient needs in the OR, procedural and outpatient settings, enabling physicians and staff to identify and address the most urgent patients first. The creation of the interdisciplinary surgery leadership team, procedural executive committee and ambulatory leadership committee helped leaders verify that all stakeholder needs were met and that strategic plans were communicated and executed appropriately. The facility also expanded hours to evenings and weekends, which helped to relieve capacity issues throughout the week while ensuring patients could still receive care.

By creating a daily dashboard to reflect incoming admissions and availability of key supplies, leaders were able to understand inpatient capacity for elective surgeries, invasive procedures and external patient transfers. This information was used to prioritize patient and staffing needs, allowing the facility to increase bed availability.

In procedural areas, Huron worked with university leadership to develop, test and recalibrate workflows. This ensured maximization of capacity and increased patient access to pre-procedure testing for the coronavirus.

The university health system and Huron developed a standard telehealth approach for ambulatory services to ensure patient prioritization was consistently defined. The approach defined operational and technical workflows for intake, scheduling, check-in, visit completion, documentation and billing using a standard set of telehealth systems. This ensured the maximum use of telehealth for patient care and improved patient experience.

The teams also completed an assessment of the organization’s readiness and approach for moving applicable teams to a remote workforce model. The review resulted in a new remote workforce agreement that was piloted across revenue cycle, allowing five teams to support a full remote workforce of more than 150 employees with appropriate workflows, training, accountability models and technology.