March 10, 2011

Assembly outlines strategy to grow patient volumes

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C. Wright Pinson, MBA, M.D., delivers the quarterly performance update during last week’s Leadership Assembly. (photo by Anne Rayner)

Assembly outlines strategy to grow patient volumes

Leaders at Vanderbilt University Medical Center are continuing to take proactive measures to address an anticipated decline in reimbursement for services from both federal and private insurers.

Projected changes to reimbursement have Medical Center officials looking closer than ever at patient volumes and continuously exploring new ways to innovate care delivery across a broad continuum of patient populations.

Clear explanations of organizational goals and a frank assessment of organizational performance continue to set the tone for VUMC's leadership assemblies.

On March 3 at Langford Auditorium, the latest quarterly assembly drew some 700 managers and faculty leaders from across Vanderbilt's hospitals and clinics.

A central theme to the morning's discussion was that when patient volumes rise, fixed operational costs are employed more efficiently, leading to increased net margins. When VUMC's margins rise, patients and the broader community are among the immediate beneficiaries because resources are reinvested to improve facilities and the delivery of care.

In a message delivered by Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, and during the course of the quarterly performance update delivered by C. Wright Pinson, MBA, M.D., deputy vice chancellor for Health Affairs and CEO of the Vanderbilt Health System, the crowd was told that one aspect of the organization needs special attention right now: management of patient capacity and patient throughput in order to increase patient volume within the same physical space.

During coming months, leaders throughout the clinical enterprise are taking a fresh look at processes that help determine capacity and throughput. Pinson specifically mentioned a new initiative to manage outpatient capacity across Vanderbilt Medical Group clinics. This will involve simplified rules for setting appointments, new policies about provider time away from the clinic, and new data reports to allow managers to identify any patient capacity barriers.

“This is an area we have to take very, very seriously,” he said.

Pinson divided his update among the Five Pillar topics of People, Service, Quality, Growth and Finance, and Innovation.

According to Pinson, VUMC's electronic medical records have never been more secure. Since October, all Medical Center employees checking medical records of fellow employees have received a pop-up message alert stating they are reviewing a coworker's chart, and the activity will be audited 100 percent of the time for privacy compliance. Since the pop-up message went into effect, audits have found zero violations in patient privacy.

Pinson gave a major push for Vanderbilt programs supporting employee health and wellbeing, urging the audience to mail suggestions for improving these programs to

In satisfaction surveys, the Pediatric Emergency Department and outpatient testing areas were among the top performers during the second quarter. Urgent Care areas and the Vanderbilt Psychiatric Hospital were also commended for major gains in patient satisfaction.

“When you see this increased satisfaction it means we're meeting people's needs, and that's what it's all about,” Pinson said. He recommended post-discharge and post-clinic-visit phone calls as proven means to higher patient satisfaction.

Recently, teams have achieved significant success reducing hospital-acquired infections, including central line-associated blood stream infections and ventilator-associated pneumonia.

Reviewing this marked improvement, Pinson said, “That's unbelievably good work. Every bedside nurse who works here deserves credit, as does every manager who supported this work and the entire quality team.”

In January, VUMC's hand hygiene compliance reached a new high of 86 percent, which Pinson credited to a new practice of sending letters to non-compliant faculty and staff.

Cost management across the hospitals and clinics has been excellent, but patient volumes have been somewhat lower this fiscal year. January snows contributed to this trend.

A diagnostic management team is helping providers improve anticoagulation management, dramatically lowering costs and shortening lengths of stay for stroke patients and patients with deep vein thrombosis.

If this initiative were expanded to the rest of the country it would save a billion dollars per year. “Ladies and gentlemen, that's real health care reform,” Pinson said.

The assembly also featured a presentation about improving employee retention, delivered by Chief Human Resources Officer Traci Nordberg, and a presentation on organizational culture change, presented by James Franklin, head coach of Vanderbilt football.

To view slides used in all presentations, go to the elevate website (employee login required).

To make a suggestion, visit the vice chancellor's online suggestion box at