Our Mission: To Make Hospitals Healthier
Hospital Physician Partners’ unwavering dedication to world-class personal service is core to our mission. By remaining “local” and providing our clients with unfettered access to our resources and leadership, we deliver on our promise to Partner For Results.
Bethesda Memorial Hospital
Bethesda Memorial Hospital is a 401-bed, nonprofit hospital with an ED patient census of 60,000/yr. In 2010, they were faced with the challenge of improving ED patient throughput. Located in a very competitive market near two for profit hospitals, Executive Vice President and Chief Operating Officer Roger Kirk knew that strong on-site medical leadership was critical to accomplishing this goal and delivering “quality care in a caring manner.” HPP hired Dr. Craig Kushnir as the new Medical Director in 2010 and the team implemented a series of strategies to improve performance including building strong relationships with the Nursing Director and medical staff. Holding quarterly events between ED Physicians and Nurses. Dr. Kushnir and his team called all pertinent consults directly and he established physician accountability through individual performance metrics. The results of these strategies? Bethesda’s 2010 ED Throughput Performance vastly improved. Left Without Being Seen Averaged .14%, far below the benchmark of 2%.Patient arrival to Doctor Time averaged just 27.1 minutes, nearly 3 minutes under the 30 minute benchmark. And, the average Length Of Stay for Discharged ED Patients was 2.53 hours while the benchmark was 3 hours. Kirk says that the success in the ED is a direct result of collaboration between the ED and rest of the medical staff. “The ED is the front door to the hospital and it takes everyone working together on one page,” says Kirk.
Beckley ARH Hospital
As an expanding hospital in a growing region, Beckley ARH instituted its Hospitalist program three and a half years ago before changing to HPP in 2010. With goals of customer service excellence, and improving cost containment, utilization management and patient outcomes, Assistant Administrator Robb Williams knew he needed to gain medical staff buy-in to achieve success. Williams first sought to strengthen the relationships between the ED and Hospitalist teams. He had previously located the Hospitalist offices in the emergency department. Next on the agenda, he worked with HPP’s team to have the IM physicians shadow the ED physicians. “HPP was engaged from day one to help us move our initiatives forward. They recruited the right people for the right job and we had their buy-in from the start,” says Williams. HPP’s Hospitalists actually began working shifts in the ED which according to Williams, helped foster a true team atmosphere and build trust. “The hospital medical staff has taken notice of what we’re trying to accomplish and have gotten on board. This is due largely in part to the willingness of HPP and their team to partner here on a local level.” In 2010, Beckley’s patient census improved from 14 patients/day to an average of 20-23/day. While short of their 25-30/day target, Williams says things have been moving in a positive direction. “I’ve worked with a number of different management groups and they’re not as engaged as HPP is. I can pick up the phone at any time and call my HPP team. I know them all by name and they all know me and that’s important. They’ve all been involved consistently in helping to try and grow the program.”
Johnston Medical Center-Smithfield
An emergency department management client since 2009, Johnston Medical Center-Smithfield (JMC-S) contracted with HPP in 2010 to implement a new Hospitalist program. There had already been success in the ED. Patient Satisfaction scores had improved, reductions in LWBS continued, dropping from 6.2% in 2008, to 4.9% in 2009 and again improving to 3.9% in 2010. Direct bedding had also been implemented along with the piloting of extended hours in the Minor Treatment area. The next step according to Ruth Marler, JMC-S Chief Operating Officer, was to strengthen the continuity of care for patients. “We really wanted to deal with one partner in relationship to patients coming into the ED who need to flow into the in-patient arena. Our goal is to mobilize a team approach where the ED group and Hospitalist group are caregivers who trust one another working together in the best interest of the patient.” Although relatively new in 2010, Marler says she will be excited to see what progress the Hospitalist program will make with patient care and outcomes. “Our patients are going to continue to experience seamless care where their physicians are communicating together and managing each other up,” says Marler. “This will raise the level of confidence our patients have from the very beginning that they are in excellent hands.” Marler added that HPP’s involvement in the entire hospital team culture has been crucial, noting committee participation by HPP leadership on such entities as JMC’s Quality and Credentialing committees as well as the hospital’s Medical Leadership Council.
Southwest General Hospital
Southwest General Hospital is a 40,000 visit Emergency Department (ED) on the south side of San Antonio, TX. The emergency department sees a relatively high acuity and had difficulty moving patients through the department into patient beds.The percentage of patients leaving without seeing a physician (LWBS) was over 20% and length of stay (LOS) exceeded 6 hours. With leadership of the on-site ED Medical Director and support from Hospital Physician Partners’ corporate clinical leaders, dramatic changes occurred. While progress took several months, results were impactful. Adjustments to staffing patterns to match peak volumes assisted in moving patients. LWBS was reduced to 3%. The development of a 6 bed in-patient admissions unit dramatically decreased the LOS for patients being admitted to the hospital to under 3 hours. The improved working conditions in the ED made it easier for the hospital to recruit both physicians and nursing staff in other departments. Additionally, Hospital Physician Partners assisted in the purchase and development of an EDIS so accurate and real time measurement of ED performance could be reported against targeted goals. The end result was increased through-put, enhanced efficiency and the implemention of performance tracking processes.
Missouri Southern Hospital
Missouri Southern Hospital is a rural community hospital in southern Missouri. The Emergency Department (ED) census is approximately 10,000 patients a year. When Hospital Physician Partners first became associated with the facility, there was a concern that patients who were better served in an inpatient setting were being discharged. Attending staff had several instances of admitting patients from their offices just a day or two after an ED visit. Hospital Physician Partners created and implemented a performance improvement program focusing on high risk discharged patients. Corporate Clinical leadership met with the local physician group on several occasions reviewing a risk aversive perspective in patient care and encouraging physicians to focus on patient safety. Individual benchmarks and statistics were reported to the providers; transparency within the group had a large impact on performance. Over a 6 month period, risk taking practice patterns decreased. The admission rate climbed into a range projected on a proprietary risk monitoring system. This pattern has been sustained over several years.
North Vista Medical Center
North Vista Medical Center is a community hospital on the northern edge of downtown Las Vegas, NV with an annual emergency department volume of approximately 35K. Length of Stay (LOS) and Left without Being Seen (LWBS) rates were unacceptably (>20%) high despite the opening of a new ED. A significant percentage of the patient population is mental health patients who require psychiatric assessment before they are discharged after medical clearance. Because of a limited number of available psychiatric beds throughout the Las Vegas community, patients often waited days until an available bed opened up for their transfer. The ED was often holding upwards of seven or eight mental health patients a day (30% of the ED beds). The number of mental health patients decreased in the ED as did the overall LOS. Hospital Physician Partners clinical staff, in conjunction with the local leadership encouraged the hospital to seek the services of a psychiatrist to round once a day in the ED to clear those patients that did not require an inpatient unit. Additionally, the psychiatric patients were sequestered to one area of the ED, utilizing only 2 or 3 rooms and having security posted nearby. With more beds available to the general ED population, the percentage of patients that LWBS decreased to 3%. In addition, an EDIS was implemented with Hospital Physician Partners’ direction which provided measurable department and individual provider performance reporting. Today, bedside registration, electronic medical records and computerized patient tracking systems combined with a dedicated and talented ED staff, the average LOS in the ED is more than 1-1/2 hours faster than the state average and continues to improve.