P3 Case Studies and Supporting Data
P3 Case Study One:
Outpatient Observation Services Optimization
In October 2006, we worked with a
hospital that had a decentralized observation system estimated to be out of
compliance in excess of $450,000 per month. We evaluated both the model of
care and determined the best options for improved efficiency considering the
current circumstances.
We evaluated observation unit practice and location options, and made recommendations
based on best clinical and business practices, as well as unique hospital
circumstances, given the hospital’s business objectives. We evaluated
clinical quality, patient satisfaction, and communication. We mapped patient
processes, interviewed internal and external subject matter experts, conducted
workflow analyses, reviewed and analyzed best practices throughout the nation
and presented best options.
P3 demonstrated the use of best prevailing practice as evidence, applied industrial
engineering technique for measurement, and human factors engineering for change
management. This method effectively determined the optimal approach to solve
an immediate business problem. P3’s recommendations were aimed at reducing
denials and inappropriate admissions,
optimization of patient throughput and maximizing bed usage. The potential financial
upside was in excess of $9 million.
P3 Case Study Two: Emergency Department Optimization
In 2006, P3 analyzed the revenue and expenses of the ED practice for two hospitals
which total 100k visits. Our work included:
- Business case and study models for replacement options
- Appropriate service level agreements (SLA) and practice standards meeting
all regulatory and compliance issues
- Three options considering all governance structures; (1) internal team,
(2) local physicians assembled in democratic partnership, and (3) contract
management group (CMG)
- All three options consisted of highest caliber leadership and attending
physicians certified in Emergency Medicine
- Aligned incentives to create a shared business interest in achieving increased
productivity and efficiency as well as improved patient and referring physician
satisfaction
- All three recommendations significantly reduced subsidy in excess of $800k
for the hospital system
- All models rewarded the practicing physicians for increased productivity
