The process these groups are following includes identification of relatively homogenous sets of patients with a given diagnoses or undergoing specific procedures and a description of our present process of care, including a listing of the major resources used to diagnose and treat these patients. The groups then identify areas of wide variation in practice, areas where length of stay may be improved or alternative ways to manage the illness that may improve patient satisfaction or outcome. Each group then identifies the change in the types of products used to treat these patients including days in the hospital and identify any cost savings. A common approach is to develop protocols and pathways that describe a patients course of care in an ideal world. This ideal course of care is compared to historical length of stay and product utilization.
Variances point to opportunities to streamline and reduce costs.
Patient outcomes and satisfaction are an important consideration and are included as part of the Operations Improvement analysis. As the teams have progressed, common obstacles to treating patients efficiently have been identified that affect our patients regardless of disease category, and the Neurosciences Design Team will document resources required to provide the best care at the lowest cost. For example, an observation unit well equipped with monitoring equipment and staffed by neuroscience nurses could allow certain head trauma, mild stroke, MS, headache and other patients to be rigorously evaluated and observed for up to 24 hours, and then safely discharged or admitted, rather than the current norm of a 2 to 4 day admission. We hope to present and discuss the Phase I recommendations with the Neurology Department staff sometime in January, and input on the implementation phase will be welcomed. Dan Hoch, Sherri O'Grady Click on me to return to MGH Neurology's Home Page.