How much underutilized capacity can you convert to productivity?

Sue Feury

If your practice chooses to fly an EMR fighter jet and embrace change, you can find out.

I had the pleasure of visiting one of our customers last month, Ortho Northeast. They are a high-performing independent orthopedic practice that received the Gold-Level Productivity Award during Centricity Live user conference last spring.

A few of us from GE met with their clinical team, led by Rhonda Draper, their Director of Patient Care Services, who everyone affectionately calls “Mom”. Rhonda was hired several years ago to be their “change agent” to take full advantage of their EMR system, Centricity™ EMR. As Ray Kusisto, their CEO, put it, “What good is it to own a fighter jet, just to taxi around the runway?”

Over the years, Rhonda and a team of clinicians and IT gurus have implemented a number of productivity-enhancing programs.  I’ll highlight one here.

Recently, the practice was seeking to grow the number of physicians substantially. To handle the additional volume, it first seemed they needed to add a fourth X-ray room. Melissa Renninger, who runs the X-ray department, believed that by changing how they tracked, triaged, and escorted patients in need of imaging through their practice, that they could increase utilization to achieve their growth targets without an additional X-ray room.

With the opportunity to save the practice a significant capital investment, the team began their analysis. They dissected the patient journey for different types of patients and discovered the X-ray rooms lay vacant during several times when patients needing imaging were available to be imaged. For example, recheck patients with open orders could be imaged before seeing their physician if any of the X-ray rooms were open. In addition, imaging equipment sat idle while X ray techs escorted patients to and from the X-ray room.  It was clear more could be done to increase utilization of their existing facilities.

So the team set to work to modify their workflows and their EMR.  By implementing an intelligent operational decision support algorithm in their EMR that prompted the staff to more efficiently room recheck patients, the practice could better resource-level the imaging queue for the day. In addition, they realized they could be more efficient if they worked together as a team.  They customized their EMR to implement a new patient status system particular to their practice and create a real-time, shared queue of patients in need of imaging.  Runners efficiently collaborating on the imaging and rooming effort were then able to nearly eliminate down time between patients in the X ray rooms.

What were the results? Ortho Northeast was able to redeploy 3 radiology FTEs, avoid the addition of a new X-ray room, and reallocate the extra footprint to the therapy department.  As a result, X-ray and therapy throughput increased 49%.

Why did this work? Because Rhonda, the change agent, and her team realized you have to manage change carefully. Disruption is stressful. Her team piloted test cases to address through any glitches in the workflow and to demonstrate success before rolling new processes out to the whole site.  In addition, the CEO has driven a cultural shift throughout the organization to embrace change.

How much wasted capacity can your practice reclaim with an EMR like a fighter jet and a team that embraces change?


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