Physician Collaboration Earns National Spotlight
Matthew Miller, M.D.
Chief Medical Officer
Danbury Hospital Find a Doctor
New Milford Hospital Find a Doctor
Danbury Hospital has received the 2011 CRIMSON Physician Partnership Award for its efforts to improve clinical outcomes while at the same time documenting a $2.9 million reduction in hospital charges.
The national recognition comes at a time when healthcare reform has intensified the pressure on healthcare providers – hospitals, physicians and others – to manage costs while improving the quality of the care provided to patients.
“The Crimson Physician Partnership Award is another milestone in Danbury Hospital’s ongoing efforts to use the best, evidenced-based practices as a way to improve quality while containing healthcare costs,” said John Murphy, MD, President and Chief Executive Officer of Western Connecticut Health Network (WCHN). The network includes Danbury Hospital, New Milford Hospital and its affiliates.
Matthew Miller, MD, Chief Medical Officer at Danbury Hospital led the hospital-wide multidisciplinary effort that involved scores of physicians, nurses, technicians, pharmacists and others. “It’s our responsibility as healthcare providers to manage the cost, efficiency and quality of healthcare,” said Dr. Miller. “Physicians control the use of clinical resources – what laboratory tests, diagnostic procedures, treatments, medications and other tools we use to care for our patients. It’s really up to us to manage the delivery of healthcare services.”
A New Era of Accountable Care
The award goes to administration-physicians partnerships that use CRIMSON software as a tool to identify unnecessary variations in care. CRIMSON is a division of The Advisory Board Company, which helps hospitals and health systems achieve quality goals and cost savings by eliminating inefficiencies in the delivery of care.
“Danbury Hospital has achieved breath-taking gains in organizational performance by effectively engaging physicians – not just as clinical decision makers but also as business partners,” said Paul Roscoe, Chief Executive Officer of CRIMSON. “Hospital-physician collaboration that produces demonstrable value will be central to success in the coming accountable payment environment. We applaud Danbury Hospital for its ongoing commitment to efficient care that benefits patients and the larger community.”
Reevaluating the Use of Hospital Resources
Danbury Hospital was recognized for its “Diagnosis-Related Group Cost Efficiency Project,” which examined these eight high-volume medical conditions:
- Congestive heart failure
- Chronic Obstructive Pulmonary Disease (COPD)
- Gastrointestinal bleed
- Major joint replacement
- Vascular surgery
“The goal of the project was to improve quality and financial outcomes by identifying unnecessary variations in care. We want to standardize care by identifying the factors that drive best practices,” said Deborah Geambazi, RN, a Senior Clinical Data Analyst at Danbury Hospital. “As a result of these efforts, we were able to achieve dramatic reductions in the use of hospital resources without sacrificing quality.”
The $2.9 million reduction in hospital charges that was documented as a result of the project was just the tip of the iceberg. “We saw a global impact throughout the entire organization,” said Maribeth Cross, RN, a Performance Improvement Coordinator at Danbury Hospital. “Our actions exhibited a halo effect across similar diagnosis and other departments that totaled a $6 million reduction in hospital charges.”
“The process begins the minute the patient arrives at the Emergency Department,” said Geambazi. “Emergency medicine physicians are making important decisions using revised protocols to diagnose and treat patients appropriately.” Re-thinking the process involved all physicians including residents, hospitalists, consulting physicians and community providers.
The project also was a top organization priority supported by monthly reports and quarterly reviews to senior hospital officials and the board of directors.
Among the key results:
- Danbury Hospital improved key measures for stroke, including a 10 percent reduction in the 30-day readmission rate and an 8 percent cut in the length of stay, while trimming actual average charges by 12 percent.
- Significant reductions in the use of telemetry, echocardiograms, laboratory procedures and diagnostic testing for congestive heart failure, pneumonia, COPD, and stroke led to a more appropriate re-allocation of personnel. New policies were implemented clearly defining the criteria for taking appropriate interventions.
- Modification of order sets in the Computerized Physician Order Entry (CPOE) system that require doctors to be more selectivity about the procedures and medications prescribed.
- Significant savings by re-negotiating contracts for implants and other materials used by physicians during total joint surgery and vascular surgery.
- Re-evaluated the types of medications used to treat mental health patients and streamlined the use of “sitters” for patients who require round-the-clock observation.
- Identified the appropriate use of gastrointestinal screening tests on an outpatient basis, rather than during hospitalization.
Looking at Performance Measures
Although Danbury Hospital continuously reviews quality and financial performance measures, it’s never been able to achieve such dramatic results because it lacked a “robust data analysis tool,” said Geambazi, who has been collecting and analyzing performance data for 15 years. “In the past, we could only examine two to three areas a year because it was cumbersome to collect and analyze data from many hospital departments. It was difficult to create a timely, relevant report.”
With Crimson, hospital officials and physicians can easily gather, analyze and retrieve meaningful, real-time information about numerous quality and financial indicators, including infection rates, complication rates, medications, tests and more. Information can be viewed or retrieved by physician, specialty, diagnosis, groups of diagnosis, demographics. “The system allows physicians to track what they are doing and see that quality is maintained or improved as their costs go down,” added Cross. “We can see the data in a timely fashion and immediately see the clinical and financial impact of a certain intervention.”
Having the ability to look at performance measures is more important than ever with healthcare reform. “We can no longer conduct business as usual – it’s not good for patients or the organization,” said Geambazi. ”We must find ways to more appropriately deliver care and improve clinical and financial outcomes at the same time. That is the mantra as we move forward.”
Just the Beginning
Hospital officials expect to expand the use of Crimson across the organization given the success of the initial project. “We’ve made tremendous progress,” said Dr. Miller, “but we are not finished, by any means.”
For more information on Danbury Hospital, or to find a doctor, call 1-800-516-3658 and visit DanburyHospital.org.
About Danbury Hospital
Danbury Hospital is a leader in complex surgical care and minimally invasive technologies for cardiovascular disease, digestive disorders, orthopedics and spine care, breast disease and cancer. Surgeons use the da Vinci robotic surgery system and advanced imaging to perform surgery and interventional procedures together. Key specialty centers at the 371-bed hospital include the Total Joint Replacement Program, the Spine Center, the Praxair Cancer Center, the Praxair Regional Heart and Vascular Center, theCenter for Weight Loss Surgery, and the Family Birth Center, which welcomes 2,500 babies annually. In 2010, it opened the Danbury Hospital Research Institute in 2010 with a world-renowned team to focus initially on women’s reproductive cancers, while maintaining a strong emphasis on health and wellness programming as a Spirit of Women hospital.
The Hospital also embarked on a multi-year $150 million expansion effort in 2011 -- the largest building project in the organization’s history. The project includes a new patient tower with single rooms, an expanded Emergency Department, a new critical care unit, a new Neonatal Intensive Care Unit and additional parking.