Nobody likes change, the saying goes, unless everyone agrees on what’s being changed, a high bar to achieve.
But that is exactly what doctors, nurses and administration at St. Mary’s Medical Center are trying to accomplish.
Their thinking is that if the hospital and its staff can find ways to lower hospital costs by redesigning medical processes, they can improve patient outcomes without sacrificing quality, resulting in lower medical bills for patients.
From the day that Bryan Johnson became president of St. Mary’s nearly 18 months ago, he’s been talking about ways to reduce waste and duplication of services as a way of lowering the hospital’s bottom line.
If that can be done without negatively impacting quality of medical care, those savings could be passed on to patients, who not only would see better outcomes in their health, but lower medical bills.
The hospital achieved that very thing last year in its imaging pavilion, which resulted in up to 70% reduction in prices for such things as MRIs, CT scans and ultrasounds. That move saved the hospital’s patients — and their insurance carriers — millions of dollars in 2020.
Now, Johnson has begun a five-year process to transform other medical units at the hospital and all of its clinics — one-by-one and slowly over time — to redesign how each operates, with the goal of eliminating waste and reducing redundancies, and doing them in a way that they aren’t just one-time fixes, but long-term foundational shifts in medical care.
“There’s a lot of waste and redundancy in the health care system,” Johnson said. “If you’ve ever been to a physician’s office or a hospital, the mere fact that we designed waiting rooms is a great indication of waste. That’s a waste for a patient. Trying to take that waste out is what this is all about.”
Starting with three units — oncology/hematology, spine center and critical care — doctors, nurses and other staff in each are going through a new thinking process to revamp how each provides care, and discover new ways to do so that are less time-consuming for hospital staff, less onerous on patients and at a lower cost for both.
And it all starts from the bottom up, beginning with what expectations individual patients have, beyond just getting well, that is.
Based on work done by the Boston-based Institute for Healthcare Improvement and with help from Dr. Richard Bohmer, a health care management adviser based in the United Kingdom, the hospital is focused on four main areas: Better quality of service, lower costs, better access and engaging medical professionals to reduce worker burnout.
Under it, each medical unit will meet in their own teams and pore over how their individual processes are working now, and how they can make it better, not only for those medical professionals, but their patients, too.
“It’s really challenging to work in health care these days, this year especially,” said Dr. Andrew Jones, a St. Mary’s physician who is facilitating the redesign program. “The care redesign concept isn’t new, but it’s new to western Colorado. This program provides a deep and foundational education in how operations work. At the same time it empowers the teams to redesign their own work space.”
The plan is to work with three teams at a time, starting with cancer treatment, neurology and critical care. Three more teams will be formed in other medical units later this year, with another trio of teams coming together by year’s end. (And then another six next year.)
Overall, the hospital hopes to get to every medical unit in three to five years.
Those teams aren’t just concerned with their own medical processes either, but expectations of patients, many of whom have expressed an interest in being better educated about their various ailments, what medical options they have, how to get better faster and how to prevent getting sick or injured again.
That’s why the redesign also emphasizes behavioral health, which could be anything from improved nutritional habits for those dealing with cancer or the need to do physical therapy for patients recovering from spinal surgery.
Part of the improvements also calls for improved equipment, such as better telemedicine platforms and more intermediate care beds, which automatically monitors a patient’s vital signs.
Thanks to the ongoing pandemic, which prompted a need to better connect with patients remotely and an increased use of its ICU and recovery units, the hospital has improved both, including adding 11 such beds to its arsenal.
The bottom line of all this for Grand Valley patients and others throughout the Western Slope where the hospital serves?
“The whole concept here is value-based care,” Johnson said. “If you look at it from a patient’s perspective, what they’re looking for is high-quality care that’s affordable. The work that these physicians are doing is foundational to success in value-based health care. That’s what we’re building here in western Colorado.”
