Where Are Our Inpatients Now? — A $23,000,000 Opportunity for Cost-Savings
By Cynthia Keen
Martin Bledsoe described a dilemma at the Johns Hopkins Hospital. As Chief Administrator for the Russell H. Morgan Department of Radiology and Radiological Science, overseeing a staff of 1,000 FTEs, he does not know precisely where any of the 900 in-patients his department may need to image on any given day may be. He is not alone in his dilemma. With the exception of 0700 when patients are still in their beds awakening for the day, and the 1200 hour when they are being fed lunch, no department administrator can be quite certain about the whereabouts of any particular patient.
Marty Bledsoe; Chief Administrator of the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins Medicine, Baltimore, Maryland, United States during his speech "Applying manufacturing models to the radiology subsystem of the inpatient hospitalisation process"
Johns Hopkins occupies nine city blocks. It is in the process of the largest hospital expansion that is taking place in the United States in 2008. Yet because of its inability to keep track of the locations of its patients receiving treatment in this sprawling complex, Johns Hopkins needs an accurate patient tracking system and it is actively seeking a vendor to partner with it.
In his presentation at the Hospital Management Symposium at ECR 2008, Mr. Bledsoe said that the radiology department utilizes technological innovation whenever possible to achieve greater productivity and reduce costs. “We don’t benchmark. We measure what we did last year, and try to achieve better results the next year,” he said.
The department reduced its expenses by 4.4% in 2007. Radiographer productivity increased by 5.3%.
Placement of computed radiography plate readers on patient floors where mobile X-rays are performed enables radiographers to process the plates without having to repeatedly return to the radiology department. “This literally saves hours of their day, which not only increases productivity and saves us money, but allows us to maximize use of a scarce professional resource.,” Mr. Bledsoe explained. 64-slice CT has more than doubled the throughput of patients.
Senior hospital management has determined that the average patient stay of 6 days could be reduced by 1 day if a schedule of medical activities could be created for the patient and adhered to. Inpatient imaging at Johns Hopkins is inefficient because the staff calls the nursing station responsible for the patient to ask if the patient is available for transport to the imaging department. If the patient is having other treatment, another call is made. Minutes are wasted trying to find a patient who is ready to be moved to the diagnostic imaging department, and this process alone takes 15-25 minutes.
Johns Hopkins receives an average of $11,000 per patient for an inpatient stay, regardless of the duration. Thus, if 1 day per patient could be reduced, this would provide an opportunity to increase admissions by 4.2% and generate additional revenue of approximately $23 million per year.
Mr. Bledsoe pointed out that a golf course he visits uses a global satellite positioning device. It allows him to calculate the amount of time he spends on the course. More importantly, it enables the golf course managers to know precisely where every player is located, and assuming 100% capacity, to schedule use of the greens to its optimum level.
Would Johns Hopkins pay $23 million for a device that is this efficient? Yes, because the product would have a return on investment in just one year. Mr. Bledsoe emphasized that what may seem to be an inconvenience within a hospital can, when its total impact is analyzed, represent significant cost savings or lost opportunity costs.
10.03.2008
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