Background

Because of a successful effort in assisting this four hospital system in achieving the enhanced staffing of their 56 nursing units during a previous engagement, Delta Healthcare Consulting Group was invited to review 29 workstreams (departments) in the four hospitals over a six month period.  Using California benchmarks, mixed with some other industry benchmarks, DHCG consultants were able to identify not only staffing changes in these 29 departments, but also compiled over 300 process improvement opportunities for the hospital system, leading to both cost reductions and revenue enhancements.  The following departments or work streams were included in this herculean effort:

Bio Medical	Business Services
Case Management	Cath Lab
Dietary	Environmental Services
Facilities Management	Finance
Heart Central	Health Information Management
Human Resources	Imaging
Information Technology	Laboratory
Legal	Marketing
Non-Invasive Cardiology	Nursing Administration
Patient Access	PBX
Pharmacy	Plant Operations
Respiratory Therapy	Security
SPD/Central Services	Surgical Services (OR, PACU)
Transportation

Goal of the Project

The overall goal of the project was to determine how effectively each department was utilizing its labor resources and to determine what, if any, processes needed modifying to further enhance the patient/staff experience.  California Hospital benchmarks were used as the underlying foundation of the staffing analysis.  The State of California has been a leader in requiring its hospitals to report rigorous data regarding utilization of resources, labor and non-labor.  This project did not include non-labor.

Approaches

DHCG consultants utilized the following four approaches to analyze the data and make recommendations:

1. Data Analysis:  The revenue and usage and payroll data were provided on each department included in the scope of the project.  Consultants analyzed these data and compared them with data on similar hospitals within the California Benchmarking data set.

2. Interviews:  Interviews with management and key department staff in each workstream were conducted by the consultants.

3. Observations:  A minimum of six hours was spent in each department in each of the four facilities observing the patient flow, work flow, and staffing of those departments.

4. Analysis:  Information gleaned from the previous three steps was compiled and analyzed and recommendations for staffing and process improvements were made.  Cost and benefits were attached to each recommendation.

Outcomes

The following outcomes resulted from this project:

Net Staff savings:  84 FTEs (inclusive of having to add staff in areas of shortfall)

Net Cost Savings (over a three year period): $54 million

Net Revenue Enhancements (over a three year period): $87 million

Client

The client consisted of four hospitals with bed capacities of:

• 368 Beds (including a small Children’s Hospital)
• 349 Beds
• 291 Beds
• 427 Beds