Transforming Care Saves Millions and Improves Patient Outcomes

Thibodaux Regional Health System wanted to further improve the level of physician engagement required for successful healthcare transformation, prompting the organization to launch a targeted initiative. Guided by insights delivered through its data platform and analytics, the newly formed steering team analyzes past performance and determines which care processes require the focus of the care transformation team. Thibodaux Regional’s care transformation initiative has effectively engaged stakeholders to achieve patient-centered excellence. In only three years, the organization has achieved significant results.

IMPROVING CARE REQUIRES ADDRESSING COMPLEX ISSUES

Healthcare leaders are challenged to find growth and cost containment solutions.¹ Thibodaux Regional Health System, a nationally recognized hospital for excellence in patient care located in Thibodaux, Louisiana, has focused on the IHI Triple Aim and has found ways to increase revenue, reduce costs, and improve employee engagement and clinical outcomes. Thibodaux Regional is an organization with strong leadership that starts with its CEO, Greg Stock. A cultural foundation of continuous clinical quality improvement and patient-centered excellence is at its core mission to provide the highest quality, most cost-effective healthcare services possible to the people of Thibodaux and the surrounding areas.

REMOVING EXCESS COST AND VARIATION TO ENHANCE CARE

Thibodaux Regional has long had a culture of continuous improvement. The organization had become proficient at supply and staffing cost management, serving its region as a high-quality, low cost provider.

Leadership realized that to survive and thrive in the complex healthcare environment, it needed to drive growth and eliminate unwarranted variation, removing excess, unnecessary costs from clinical care. Despite its success in process improvement, Thibodaux Regional had not been able to gain the level of physician engagement required to successfully transform clinical care.

ENGAGING PHYSICIANS TO SPUR HEALTHCARE TRANSFORMATION

To enhance physician engagement in the quality and safety improvement process, Thibodaux Regional implemented a solution, internally known as the care transformation initiative. The goal of the initiative is to create a premium value enterprise by achieving patient-centered excellence. The organization’s chief executive officer and executive leadership established a care transformation steering team comprised of key physicians, executive team members, and other key leaders to govern the activities of the care transformation initiative.

Data-driven insights guide program focus

To inform the steering team’s efforts, Thibodaux Regional leverages the Health Catalyst^® Data Operating System (DOS™) and a robust suite of analytics applications as the foundation for its data and analytics. Access to cutting-edge analytics capabilities provides the steering and leadership teams with near real-time data, delivering valuable insights into process and outcome measure performance, including compliance with improvement processes, complication rates, average variable cost, length of stay, patient satisfaction, and virtually any other relevant metric.

Using the data platform, the steering team analyzes past performance and determines which care processes have the highest consumption of resources and variation, requiring the focus of the care transformation team, and establishing goals for the team.

Physician involvement enhances engagement in improvement efforts

The steering team carefully selects a physician to lead each improvement initiative. The physician partners with a clinical leader, and the two work together as a dyad. Improvement teams are interdisciplinary groups of clinical leaders and technical support staff organized to use data to improve the quality of care while reducing costs and creating an exceptional patient experience. Membership within this group includes:

• A physician subject matter expert.
• A subject matter expert from each clinical area impacted by the improvement initiative.
• Technical support staff roles, including a knowledge manager, a clinical analytics team member, a data architect, and an application administrator.

To enhance skills of the improvement teams, the leadership dyad attends the Health Catalyst^® Accelerated Practices (AP) Program, an immersive and project-based experiential course that incorporates real-world application of the tools and knowledge required to achieve significant outcomes improvement.

Armed with the skills and knowledge required to accelerate enhancements, the improvement team develops goals, identifies outcomes and timelines, researches evidence-based practices across multiple disciplines, and evaluates various strategies to improve quality and patient safety, reduce cost, and maintain the highest levels of patient experience.

The improvement team then designs and implements solutions to achieve the desired results. The team uses the data platform and analytics to monitor progress and can immediately see the impact of the teams’ work on outcomes. The data is utilized to help demonstrate the need for change and provide ongoing feedback to stakeholders regarding performance.

Each improvement team is accountable for providing ongoing project status updates to the steering committee, ensuring adequate timelines are met, and resources are available to achieve the expected outcomes.

RESULTS

Thibodaux Regional’s care transformation efforts have nurtured the culture of continuous improvement, enabling transformational change that will continue to pay dividends for the health system and its patients, now and into the future.

In just three years, Thibodaux Regional has achieved more than $6.6 million in financial improvements, and has improved outcomes for thousands of patients across multiple populations, including a:

• 55.2 percent relative reduction in stroke mortality.
• 49.6 percent relative reduction in pneumonia mortality.
• 17.6 percent relative reduction in length of stay for patients with pneumonia, resulting in patients spending 100 more days at home.
• 42.3 percent relative reduction in sepsis mortality.
• 90 percent relative reduction in complications for patients undergoing hip and knee replacement.
• 10.5 percent relative reduction in complications for patients undergoing a partial hip replacement.
• 28.6 percent relative reduction in blood product utilization, avoiding the unnecessary transfusion of 472 units of packed red blood cells.

The organization has effectively engaged physicians in transforming patient care.

• 40 percent of Thibodaux Regional’s employed physicians have been part of an improvement team. Twenty-eight percent of these physicians are graduates of the AP program.
• Thibodaux Regional has 18 different improvement initiatives underway.

“Care transformation has broadened the knowledge base of docs and staff and changed their paradigm. It has proven to them that taking steps to improve care with protocols, bundles, and pathways can save people’s lives in this community. This has convinced them that the process is worth the effort. This is a win throughout the organization.”

– Greg Stock, Chief Executive Officer, Thibodaux Regional Health System

WHAT’S NEXT

The clinical transformation initiative continues to mature, and Thibodaux Regional plans to further expand its improvement efforts. The organization plans to extend these improvements across the entire continuum of care and population health, improving the health and well-being of the people of Thibodaux and the surrounding areas.

REFERENCES

1. Teel, P. (2018). Five top challenges affecting healthcare leaders in the future. Becker’s Hospital Review. Retrieved from www.beckershospitalreview.com/hospital-management-administration/five-top-challenges-affecting-healthcare-leaders-in-the-future.html