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Projects

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The Center provides providers and administrators with resources for special internal projects.  Generally, these are student-led projects in collaboration with a business school faculty member.  In some instances consultants are utilized for more specialized experience.  These special innovation projects are designed to strengthen the financial sustainability of individual departments, clinics and sites at Fletcher Allen.  It is the hope of the Center that by transferring the knowledge, learning and recommendations from these projects across Fletcher Allen that best practices will be continuously improved upon.

7348pen_hand_drop.jpg COMPLETED INNOVATION PROJECTS

MICU:  A Study of Patient Flow and Intensivist Scheduling

Fletcher Allen Lead:  Dr. Anne Dixon and Allen Mead

Summary: The Medicine Intensive Care Unit (MICU) has seen an increase in census of 20% over the past five years.  With increasing usage of the MICU service, the Center was asked to review patient flow through the MICU to identify patterns and trends that could then be translated to more effective usage of limited resources.  The recommendation was to stagger intensivist coverage in the MICU to more adequately cover peak admissions times.  The MICU went live with a pilot program for the revised coverage in November of 2010.  In a post-project survey it was stated; “The work was very helpful and really highlighted a major deficit in our staffing pattern in the ICU. We're working to come up with an appropriate and workable intervention to meet this need, but it has helped to clearly identify the nature of the problem in a way that was not clear before”.  This project recently won a statewide American College of Physicians competition and has been accepted to the national conference.

A Study of Infusion Services

Fletcher Allen Lead:  Dr. Paul Taheri, MD, MBA

Summary:  An engineering management student from UVM was brought in to analyze the current state of infusion services across Fletcher Allen Health Care.  Following an in depth assessment each of the infusion sites, an optimal infusion service delivery plan aimed at minimize costs while improving patient care levels was recommended.  The three recommendations were, first, to have as many infusion drugs pre-ordered as possible, thus decreasing patient stay and providing additional capacity.  Second, to increase continuity between infusion sites and provide similar services to increase patient satisfaction.  Lastly, to standardize the use of the Cancer Center’s “Ticket to Treatment” as a tool to inform patients at all sites.

Analyzing Disruptions in Throughput:  The PRISM Implementation, Phase I, II, and III

Fletcher Allen Lead:  Dr. Paul Taheri, MD, MBA and Diana Scalise

Summary:  This project took place over the course of a year and sought to find a way to model the optimal sequence of implementation of an electronic medical record across numerous sites.  The first phase was to look at the ambulatory clinics and referral patterns to specialty clinics to see if there was a potentially negative downstream effect of non-optimal sequencing.  A model was developed that was then revised to address the Phase II specialty clinic implementation which reviewed effects on the demand for the Operating Room.  In each instance, the sequencing that had been previously chosen was very close to the optimal sequence so no recommendations were required.  In the Phase III portion of the project, an MBA student was brought in as an intern to write the Center’s first case study on the PRISM implementation.  The case will be used in the Center’s educational offerings. 

Personnel Optimization for Traveling Nephrologists

Fletcher Allen Lead:  Dr. Richard Solomon and Kevin Callahan

Summary:  Fletcher Allen operates the only Nephrology unit in Vermont, serving patients at its main facility in Burlington and five offsite facilities around the state.  To support these locations, the Nephrologists must travel to these satellite clinics, providing dialysis and outpatient visits.  A group of UVM MBA students reviewed the Nephrology service from a revenue maximization perspective as well as a patient, employee and community satisfaction perspective.  In order to organize the analysis, a Six Sigma DMAIC methodology was utilized to investigate potential areas for improvement, followed by a causal loop analysis to evaluate the effects of potential changes.  The students build a dynamic model designed to determine the best-case revenue scenarios within certain constraints.  In reviewing the model, Dr. Solomon stated, “The model predictions were outside my expectations and will substantially impact how we formulate a strategic plan for the future.”

Defining the Professional Revenue Department

Fletcher Allen Lead:  Scott Comeau

Summary:  Following a period of consolidation and transition, UVM Medical Finance Group leadership saw an opportunity to improve upon management practices among the department’s supervisory team.  After filling several open positions, the seven-person team had been working together for almost a year. Despite strong performance against industry standards, leadership’s observations and employee satisfaction surveys pointed to areas where the supervisory team needed to focus on management techniques and communication skills.  A consultant from the Center was brought in to help leadership identify areas of team and self-improvement around employee engagement issues; categorize improvement areas to inform recommendations for continuous improvement; and develop a simple tool to measure progress around reaching specific improvement goals. By making incremental changes within the management team, PRD intends to improve employee satisfaction and raise department morale. Following recommendations, the supervisory team has begun monthly luncheons, and engaged outside coaching to aid them in addressing some of the more challenging aspects of management.  The creation of a simple tool to measure employee engagement and satisfaction is underway.

2010 Summer Internships

Areas:  UVM Medical Group Finance and the Physician Career Center

Summary:  Four summer interns from various universities were hired over the course of the summer to work on specific projects in the UVM Medical Group Finance department and at the Physician Career Center.   They interns worked from May through August on a specific project meant to provide value both to Fletcher Allen and the student.  In finance, a model was created to review the “equal playing field” for all payers, and a manual was created to explain complex financial processes and calculations to assist in others in understanding the new P&L statements.  An intern in the Physician Career Center worked on creating an online presence for onboarding practices and collecting data on onboarding and orientation practices.  All of the internships were a great success and the Center is already recruiting for the Summer 2011 season.

Projects Currently Underway

  • Dermatology: A Review of Physician Productivity Post-PRISM
  • Resource Utilization at Women’s Health
  • Understanding the LOS and Potential Quality and Revenue Outcomes in the Pediatric Step Down Unit

If you would like more information on a Center project or would like to conduct your own innovation project please  us.


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