Hospital mergers and acquisitions continue to increase at a rapid rate with precedent-setting deals occurring in 2018. Given that this a primary business strategy for a majority of healthcare organizations, this trend is expected to continue into 2019 and beyond. One of the many challenges that newly merged healthcare systems face is eliminating redundant services and surplus capacity. Realigning services and reallocating resources among multiple campuses requires a unique strategic, operations improvement, and facility planning process. The planning team needs to understand the market and patient population, look at alternate ways of allocating resources, and evaluate the impact on operational costs, before recommending investments in bricks and mortar. This article looks at opportunities for improving efficiency and eliminating surplus capacity, separating major issues from less important issues, and other key considerations.
NASA-Like Command Center at Johns Hopkins Hospital
At the Johns Hopkins Hospital (JHH), in the center of their campus in Baltimore, Maryland, is a room with walls made of 22 high-resolution screens. Numbers, charts and live video flash across them as about 24 staff members from different departments scan the screens and make quick decisions to prevent or resolve bottlenecks, reduce patient wait time, coordinate services and reduce risk. During a typical afternoon, the system receives about 500 messages per minute from 14 different Johns Hopkins IT systems generating real-time data to trigger action throughout the hospital.
The technology in the Capacity Command Center — designed and built by GE Healthcare Partners — keeps staff members informed 24/7 about when there is an influx of patients coming into the hospital, which hospital units need additional staff members, the status of how many patients are being treated, the need for and availability of beds across the hospital, the highest-priority admissions and discharges, and other information essential for ensuring high-quality patient care. Since it opened earlier this year, representatives from 50 health systems across the US and from four countries have visited the new Capacity Command Center.
Proton Therapy Is a Growing Business
Proton therapy is a type of stereotactic radiosurgery that uses proton beams instead of X-rays. In proton therapy, a beam of protons is used to blast diseased tissue precisely. It extracts positively charged protons from hydrogen gas and accelerates them through a cyclotron, or particle accelerator, up to nearly two-thirds the speed of light. The protons are guided to the tumor site by powerful magnetic and electrical fields, and carry just enough charge to reach a precise point in the tumor.
Noise in Hospitals is Getting Lots of Media Attention
Everyone knows how loud it can be in the modern hospital. While all that noise was once considered a tolerable byproduct of the high-tech healing process, a growing body of research suggests that the noise by itself is actually harmful to patients — interfering with the healing process, increasing the possibility of medical errors, and increasing the stress level of everyone nearby. Studies have shown that patients sleep poorly and take longer to recover from surgery in noisier hospitals and that noisy neonatal intensive care units may delay the development of premature babies. Multiple studies have shown that noise delays wound healing in mice.
Fluctuating Demand for Hospital Beds
Starting in the 1980s, healthcare strategists and policy experts encouraged hospitals to reduce their surplus inpatient bed capacity in response to declining admissions, use rates, and lengths of stay — as a result of the advent of Medicare’s diagnosis related groups (DRG) payment methodology in the public sector and managed care in the private sector. Hospitals responded to changes in demand by shifting their resources. Between 1980 and 2003, community hospitals in the United States took 175,000 inpatient beds out of service — an 18 percent reduction — through downsizings, consolidations, and closures. At the same time, skilled nursing and subacute care facilities were developed to provide a less expensive and less resource-intensive alternative for patients requiring a lengthy recuperation. Home health agencies also proliferated. Since 2003, the number of hospital beds has declined less dramatically — a reduction of another 12,700 beds. Although, nationally, inpatient admissions rose from 1992 to 2012, both the rate of inpatient admissions per 1,000 population and the average length of stay have declined to an all time low — resulting in an overall decline in the demand for inpatient beds.
Vending Machines Control Medical Supply Costs
With today’s focus on lowering costs while improving outcomes, medical supplies — which account for 30% to 40% of a hospital’s total costs — are a prime target. Automated point-of-use systems for hospital supply chain management offer quick, convenient access to supplies, extensive reporting tools, and can be customized by size, security, and configuration. Inventory and supply usage are recorded, by patient, making charge capture consistent and accurate. With better control over inventory, the risk of running out of essential items is reduced and the clinical staff spend less time looking for supplies when they need them.
For example, the Omnicell® supply management system offers flexible, scalable cabinets that are either stand-alone systems or an adjunct to a medication management system. These cabinets use biometric identification, barcoding technology, and verbal confirmation for log-on, expired products, and latex warnings. A single cabinet can store seven years of data. They can be customized for the surgical suite, the cardiac catheterization lab, and other key clinical areas of the hospital. A two-cell cabinet measures 52” wide by 24” deep by 78” high.