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.
Thibodaux Regional Health System
Thibodaux Regional Health System recognized its patients with Type 2 diabetes had hemoglobin A1C (HbA1c) levels that exceeded the evidence-based guidelines for blood glucose control and sought to improve the health of this patient population. Using a data platform and a consistent improvement methodology, Thibodaux Regional learned more about the challenges to diabetes self-management in its population. The organization was then able to improve its outreach and support for patients with diabetes.
Thibodaux Regional Health System sought to transform its blood transfusion practices. Aware that blood transfusions were often over-used, Thibodaux Regional’s leadership prioritized engaging providers to decrease unnecessary transfusions, reduce potential risks to patients, and improve costs of care. The organization leveraged data and analytics to better understand opportunities for improvement.
Thibodaux Regional Health System had implemented evidence-based stroke care interventions in its emergency department. However, the organization was not meeting its established goals for early identification and treatment. With strong leadership support and the help of analytics, the organization’s stroke care transformation team was able to identify opportunities for improvement, culminating in improved care delivery through facility-wide automated alerts and a reduction in the need to transfer patients to other facilities for treatment.
Thibodaux Regional Health System had improved sepsis mortality rates, yet it recognized the challenges associated with sustaining and further improving care outcomes. Driven by a mission of patient-centered excellence that starts with the chief executive officer, the Board, and leadership, Thibodaux Regional’s sepsis care transformation team utilized its data platform and analytics applications to help facilitate data-driven, sustained improvements.
Colorectal cancer (CRC) accounts for $16 billion in healthcare costs, and with 142,250 new cases annually, it’s the second leading cause of cancer deaths in the U.S. Thibodaux Regional Health System had implemented evidence-based screening and oncology treatment guidelines for colon cancer, yet it still needed to meet organizational goals for early diagnosis and colon cancer survival. With support from the CEO and senior executive leadership, a collaborative approach to tackling CRC diagnosis rates, and a robust suite of analytics applications to deliver accurate data, Thibodaux Regional improved CRC outcomes and patient satisfaction.
Thibodaux Regional Medical Center conducted a community health needs assessment (CHNA) as part of its vision for a healthier community. The CHNA reinforced the hospital’s identified need for a data-driven, medically integrated wellness program designed to benefit the health of the community by educating, advocating, and supporting healthy lifestyle changes to address modifiable health risks. Using a wellness analytics application, Thibodaux Regional is able to track program outcomes.
To improve the care of patients with Clostridioides difficile (C. diff), Thibodaux Regional Medical Center used data and analytics to monitor completion of early recognition screening, protocol compliance, antimicrobial stewardship rounds, and probiotic administration. Thibodaux Regional’s leadership, culture, evidence-based practices, and data-driven improvement approach have positively impacted its patients.
Financial challenges rank as the number one issue hospitals face. As a result, these organizations are constantly looking for strategies to improve outcomes, manage costs, and boost revenue. Learn how Thibodaux Regional Medical Center sustained and improved its discharged not final billed (DNFB) efforts.
Total Hip (THA) and Total Knee (TKA) Arthroplasty are the most prevalent surgeries for Medicare patients, numbering over 400,000 cases in 2014, costing more than seven billion dollars annually for the hospitalization alone. Today, more than seven million Americans have hip or knee implants, and the number is rising. Furthermore, substantial variation in the cost per case has raised questions about the quality of care. At Thibodaux Regional Medical Center, total joint replacement for hips and knees emerged as one of the top two cost-driving clinical areas with variation in care processes.
To address this, Thibodaux Regional maintained its focus on the IHI Triple Aim while developing organizational and clinical strategies to transform the care of patients undergoing THA and TKA. It commissioned a Care Transformation Orthopedic Team that set multiple outcome goals. Among its many efforts, the team established standard care processes, created an educational program, redesigned order sets and workflows, and deployed a joint replacement analytics application.
Thibodaux Regional reduced variability and decreased costs significantly while maintaining high levels of patient satisfaction:
76.5 percent relative reduction in complication rate for total hip and total knee replacement.
38.5 percent relative reduction in LOS for patients with total hip replacements.
23.3 percent relative reduction in LOS for patients with total knee replacement.
$815,103 cost savings, achieved in less than two years.
One in three women delivers via cesarean in the U.S., and more than 90 percent of them have repeat operations in subsequent deliveries. Despite numerous evidence-based guidelines and established best practices for labor and delivery, clinical care varies widely for many practices. Labor and delivery care varied at Thibodaux Regional Medical Center, causing the organization to look for ways to standardize care.
To better understand variations in care, and opportunities to reduce its cost, the labor and delivery care transformation team at Thibodaux Regional used the Health Catalyst Labor and Delivery Advanced Application as well as the Financial Management Explorer application, which integrates data from billing and costing, and creates snapshots of current financial metrics.
Informing and educating providers with provider-specific data in conjunction with redesigned workflow, standardized supplies, and new, standardized protocols enabled the labor and delivery care transformation team at Thibodaux Regional to experience cost savings and improved outcomes, including:
24.4 percent relative reduction in the cost of care for uncomplicated vaginal delivery. Projected annual cost savings of $266,067.
22 percent relative reduction in the cost of care for cesarean deliveries. Projected annual cost savings of $346,856.
Admitting a patient to inpatient care is a complex process that, unless carefully managed, can lead to long delays in service and a poor patient experience.
Thibodaux Regional Medical Center’s consistent focus on patient satisfaction has earned the 185-bed community hospital, located one hour southwest of New Orleans, the Healthgrades® Outstanding Patient Experience Award™ every year since 1998. Not surprisingly, when Thibodaux leadership recently analyzed the hospital’s inpatient admit process, they did so from their patients’ point of view and determined to cut admission wait times. Using focused process improvement methodologies, areas of waste were uncovered, exposing problems such as redundant data collection, and inconsistent processes, which would require innovative solutions.
Integrating concepts from the Health Catalyst improvement methodology into its own Lean Six Sigma processes, and with the support of professional services from Health Catalyst, Thibodaux deployed a systematic set of solutions to significantly improve the admission process.
Thibodaux’s efforts are driving measurable improvements in the hospital’s inpatient admission process, including:
55 percent reduction in average inpatient admission time
Ranked 99th percentile for patient experience
A hospital’s core mission is to provide the best care possible. To continue to do so, however, hospitals must be paid promptly. Discharged not final billed (DNFB) cases—where bills remain incomplete due to coding or documentation gaps—represent an ongoing challenge for hospitals around the country.
Thibodaux Regional Medical Center, like other hospitals, faces a myriad of new government regulations that have made hospital bill collection efforts more onerous. Its leaders recognized their inadequate manual DNFB process left hospital staff overburdened and put at risk the necessary cash flow to best serve patients.
The hospital automated and streamlined this process to relieve the burden on physicians, provide an integrated view of data, optimize visibility and workflow, and reduce the need to “downcode” reimbursements due to missing documentation. The hospital leveraged analytics to provide actionable feedback to continuously improve the process.
Thibodaux has already achieved significant improvements to cash flow and operational efficiency:
44.4 percent improvement in delinquency rate
8.2 days reduction in A/R days
70.5 percent decrease in the number of billhold accounts outstanding
50 percent decrease in physician portion of DNFB dollars
97 percent improvement in operational efficiency
Thibodaux Regional Medical Center has always excelled in delivering quality care to its patients, but a fundamental tenet of its culture is continuous improvement.
Driving that continuous improvement is a methodology The Joint Commission called “best practice in how to use data and get physicians engaged.” This quality improvement methodology centers around a three-systems care transformation model that includes best-practice care protocols, analytics, and rapid time-to-value analytics application development and frontline clinician adoption.
We believe healthcare is undergoing a transformation and that CEOs need to promote a culture of dialogue and adaptive learning to drive continuous quality improvement. Thirty years ago Greg Stock, CEO of Thibodaux Regional Medical Center, was seated in a healthcare conference when he heard a presenter say, “Thirty percent of clinical care is waste.” These words triggered something in Stock that sent him down a relentless path to transforming healthcare in his community.
Learn how Stock is leading and sustaining outcomes by establishing a culture of quality with an adaptive leadership style, engaging physicians, and using analytics, best practices and adoption processes that work.
Every year, severe sepsis impacts more than 1 million Americans, and an estimated 25 percent die from the condition. Thibodaux Regional Medical Center is committed to driving and keeping its sepsis mortality rate to less than have the national average. How is this health system achieving these outcomes? Thibodaux formed a sepsis improvement team charged with reducing sepsis mortality and lowering costs while improving the patient experience. The team implemented best-practice care protocols, an analytics system, and an adoption approach that engaged clinicians using education and data. Backed by executive leadership and guided by clear goals, the sepsis improvement initiative has achieved impressive results in just six months that include a decrease in sepsis mortality rate to half of the national average, a 3 percent reduction in average variable cost, a reduction in LOS in the ICU by one day, and a 7 percent improvement in patient satisfaction.