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This presentation provides information on the services offered by Insource Healthcare Solutions, as well as examples of successful results.
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We are focused on the way healthcare is delivered…one client at a time.
CONFIDENTIAL: Copyright © 2012 Insource Healthcare Solutions, LLC
A strategic healthcare operations management company that executes customized solutions;
A physician and business partnership with nationally acclaimed & board certified resources & affiliates;
Focused on improving quality, operational, process design and clinical excellence;
Copyright © 2012 Insource Healthcare Solutions, LLC
ER DESIGN, PROCESS IMPROVEMENT, MANAGEMENT & RAPID EVALUATION UNITS
URGENT & CONVENIENCE CARE CENTER; PSO / MSO OFFICE MANAGEMENT
STRATEGIC BUSINESS / NETWORK DEVELOPMENT
Copyright © 2012 Insource Healthcare Solutions, LLC
The first High Performing Emergency Room (HiPER) Solution was created and implemented in 2009. Since implementation, the process has been reducing hospitals millions in unnecessary expansions and on average $1,000,000 each year in captured revenues from unnecessary diversion hours, elimination of most LWOTS (Left Without Treatment), along with increased patient & staff satisfaction and numerous other quality improvement metrics.
Guaranteed to create a Door-To-Provider time of 15 minutes, the HiPER solution is key to hospitals driving cost efficiency and patient satisfaction; and key to preparing for the “Patient Protection and Affordable Health Act”.
Copyright © 2012 Insource Healthcare Solutions, LLC
Copyright © 2012 Insource Healthcare Solutions, LLC
Copyright © 2012 Insource Healthcare Solutions, LLC
Dealing with Emergency Department Over-Crowding and Implementing “Rapid Evaluation Units”
Copyright © 2009 & 2010 INSOURCE HEALTHCARE SOLUTIONS
Multiple attempts to improve have failed Only transient results Pressure and Pain intensifies Externalize causes of failure Become reactionary/creativity wanes Collegiality/Collaboration/Trust erode Finger pointing Administration reviews options
• Traditional
• Patient enters ED
• Signs in triage log
• Waits in queue for triage
• Triaged
• Waits in queue for registration
• Registered
• Patient to WR while chart goes to main ED
• Charge nurse assesses acuity and need for bed
• When patient matches acuity of bed, patient to bed
New Process
Patient enters ED
Mini-registration
Patient to bed
Patients shuffled between WR and triage Triage and registration Registration and WR Then wait for nurse in ED to call
Triage
Registration
Waiting RoomMain ED21 Beds
ED Filters
No filters patients go directly to ED bed Immediate nursing assessment Immediate physician assessment Bedside registration Decision made on need for “stretcher time” Patients that do not need stretcher to Discharge Area Patients requiring longer work-ups or acute care to main ED
Registration
Triage
Waiting Room REU4 Beds
Main ED13 Beds
DC Area4 Beds
12 Chairs
No ED FiltersNo WaitingNo LWBS
Decreased Time Provider
The powerhouse that drives ED performance 80% of ED patients processed here All decisions on “stretcher time” Accountability for and management of processes
Formalizes discharge function (PPS) Identifies bottlenecks and simplifies remedies
REUD/C Area
10-15 Chairs4 Beds
Immediate success Since inception:
No patients in ED waiting room
“0” LWBS
Decreased time to provider 2.5 hrs under 11 mins.
Other benefits Patients held in ED minimized
Eliminated hectic and chaotic feel of ED
ED volume increased 5% so far ($700,000)
On the first day of implementation, average discharge time of REU patients (50% of total daily volume) was approximately down to 45 minutes! Since inception:
No patients in ED waiting room
The target remains: <1%” LWBS (down from 2.7%)
Decreased time to provider 1.25 hrs to under 20 mins.
Other Targeted Benefits: Patient Satisfaction has improved from the 60th%tile
to the 90TH%tile as estimated by Press Gainey
Riddle Hospital (Main Line Health), PA Claremont & Anderson Hospitals, OH
Copyright © 2009 Insource Healthcare Solutions, LLC
3000/2
3000/2
3000/2
Fast Track 3 Beds
4,500/yr
2000
2000
2000
2000
2000
2000
Acute Care15 Beds
30,000/yr
Total Capacity = 32,000(Annualized 86 pts/day)
2000
2000 2000
2000
Traditional ED Approach to ED Volume
Only Utilized ~ 50% of time
2000
2000
2000
2000
2000
18 Beds34,500 Patient
Capacity
Almost80%
Spread
Fast Track8 Beds
12,000/yr
2000
2000
2000
2000
2000
2000
Acute Care21 Beds
42,000/yr
Daily Peak Capacity = 54,000(Annualized 148 pts/day)
2000
2000
2000
2000
2000
2000
Traditional Capacity Model to Accommodate Peak
Only Utilized ~ 50% of time
2000
2000
2000
2000
2000
2000
29 Beds54,000
61% Increase Bed Capacity3000/
23000/
23000/
2
3000/2
3000/2
3000/2
3000/2
3000/2
2000 20002000
4,000
4,000
4,000
4,000
4,000
4,000
REU6 Beds
24,000/yr
2000
2000
2000
2000
2000
2000
Acute Care15 Beds
30,000/yr
Daily Peak Capacity = 54,000(Annualized 148 pts/day)
2000
2000 2000
2000
New REU Concept for High Performance ED Stretchers
24 X 7Utilization of Resources
2000
2000
2000
2000
2000
21 Beds54,000
16% Increase in Bed Capacity
Mark E. Celmer, FACHEPresident
Melissa MarsocciVice President for Operations
Hallie Schneeweiss, RNPractice Consultant
701 Seneca Street, Suite 210Buffalo, New York 14210
716-551-0684
Copyright © 2012 Insource Healthcare Solutions, LLC
