Managing and improving clinical performance is now vital to a hospital’s success and bottom line. As value-based reimbursement gains ground and performance data is increasingly available to consumers, hospitals will be penalized for poor quality. Further, organizations can lose revenue and incur extra costs through high readmission rates, excessive length of stay (LOS), inefficient throughput and care variation.

Whether you are concerned about your readmission rates, overutilization of ancillary services, cancelled surgeries, lengthy wait times in your Emergency Department (ED), or excessive patient days, Prism can help optimize clinical performance by customizing best practices to your specific needs.

The Prism difference is our staff’s deep clinical experience. We use our decades of collective clinical expertise to conduct interviews, map your processes, and analyze data to understand not just what isn’t working but why. We can help you pinpoint the causes of variation in indicators such as LOS, by nursing unit, by physician group, and by DRG. And combining analytics with first-hand accounts from providers is what opens the door to sustainable clinical improvement.

Here’s how:

  • Care Management. Within a hospital, the Care Management team should be the leaders in ensuring effective coordination of care and discharge planning. We can help you make sustainable changes to your Care Management Department to reduce LOS, readmissions, and medical denials. In addition, we can help you manage patients across the continuum through strategies in outpatient Care Management, such as embedded Care Coordinators and Health Navigators.By leveraging our team’s decades of real-world experience, we make sure patients receive the right level of care at the right time. Then, we work with your staff to ensure that a coordinated discharge care plan is developed for each patient, whether they are being discharged to home, a nursing home, a skilled nursing facility, or any other setting. Good communication and collaboration with patients and their families will become automatic.
  • Patient Throughput. As the major access point of your hospital, the Emergency Department is often the first impression for patients. But bottlenecks frequently occur, and the ED can be hindered by inefficient bed management processes and inpatient throughput. Perioperative services also suffer from inefficient throughput, potentially driving up costs for your organization and frustrating physicians and patients alike.With Prism’s comprehensive approach, we assess the entire continuum of patient flow to identify and address problems in patient throughput across your hospital. We team up with your staff to improve processes within the ED, perioperative services, and on your inpatient units. By implementing customized communication tools, bed assignment protocols, streamlined workflows, LOS management methods, and ancillary services coordination, we can help improve throughput without disrupting the care team or requiring costly software investments.
  • Practice Variation. Prism’s experts are physicians and clinicians, so we bring unmatched reputability and experience to help your hospital reduce care variation and improve patient outcomes. Evidence-based practices and provider engagement are key to reducing unnecessary and costly variation, and our experts are skilled in getting physicians on board.We can improve results on your high-volume, high-dollar DRGs by implementing clinical protocols based on evidence-based best medical care and post-acute care management programs to minimize the risk of readmissions.
  • Hospitalists. A high-performing hospitalist program is key to effective clinical performance. In many hospitals, hospitalists manage the care of over half of all patients, so engaging them in your organization’s financial and quality goals is essential. A high-functioning hospitalist program is critical to reducing costs and accelerating throughput in the hospital and ED. It also leads to better coordination of care, increased provider and patient satisfaction, and provider/hospital reimbursements that are in sync with pay for performance.

    Aligning the roles and responsibilities of physicians and advanced practice providers is vital to determining the proper hospitalist patient load, performance metrics, compensation model, and overall program effectiveness.
     Prism’s experts can help improve your hospitalist program and integrate it with your organization’s performance goals, such as facilitating throughput, LOS management, and patient engagement.

Insights

An action plan for leaders: Hospital performance improvement in times of political uncertainty

Webinar  |  June 21, 2017

The healthcare executive’s 2-minute read on priorities in 2017: Physician operations, clinical performance, physician engagement and clinical integration

George Whetsell, FACHE, Bonnie Barndt-Maglio, RN, PhD, Barbara Bryan, BSN, Timothy Ogonoski and Douglas Monroe, MD  |  June 2017

The hospital executive’s star rating playbook: The 5-point guide to improving your rating

George Whetsell, FACHE and Douglas Monroe, MD  |  December 2016

The effects of CMS’ star ratings: 5 things hospital leaders should know

George Whetsell, FACHE and Douglas Monroe, MD  | July 2016