Ascension Health: Shorter-term Imperatives

Shorter-term Imperatives

We have made significant progress along three dimensions of activity - collaborative initiatives with Healthcare That Is Safe, Current State projects, and Future State projects, as depicted below. All initiatives are either completed, on-track, or naturally incorporated into work to achieve our 2020 Strategic Direction.

Nursing Time and Motion Study

Patient-centered Design Concepts

Combining the experience of several Health Ministries involved in construction projects with the research capabilities of the Regenstrief Center for Healthcare Engineering (RCHE) at Purdue University, we developed a set of evidence-based guidelines around patient-centered design. These guidelines were included in an Ascension Health Capital Toolkit, which assists Health Ministries undertaking major capital projects. The Health Ministries also worked with RCHE to develop a virtual-reality patient room design model to help "feel" the impact of design options, accelerate building schedules and reduce mock-up costs.

Hire for Fit/Hiring & Orientation

A strategic approach to selecting healthcare's most important asset, its people, is critical to building a high-performance, service excellence-focused Health Ministry and reducing the high costs of employee turnover. Using structured processes and tools for hiring and orientation helps to reduce new hire turnover, build a culture of service excellence and increase our level of associate performance.

To help our Health Ministries develop a workforce that delivers patient-centered, holistic care and to reduce turnover that costs Ascension Health $400 million annually, we developed a SharingSolutions report on Hiring & Orientation. The report offers suggestions on how to attract and retain associates whose values and competencies are aligned with our Mission to deliver service and operational excellence.

Patient Flow & Throughput

The Ascension Health Operations Resource Group, in collaboration with Research & Development, has produced three SharingSolutions information packages to help Health Ministries gain a better understanding of their patient flow processes and to design ways to improve patient care as a result. The packages focus on the operating room, emergency department and inpatient units and will help guide associates and physicians to develop solutions that positively impact their patients.

Caregiver Pipeline

Future State initiatives strive to assist the Health Ministries to transform the healthcare experience. But the existing shortage of nurses, pharmacists and other front-line associates threatens our ability to deliver the desired experience - and shortages are expected to worsen. Therefore, working under the guidance of the Chief Nurse Officers (CNO) and Chief Human Resources Officers (CHRO) Advisory Councils, we have been facilitating work to capture current workforce innovations and advance near-term solutions.

To address these challenges, the Caregiver Pipeline strategy is focusing on three areas:

Staffing forecasting, to help Health Ministries ensure they have accurate information on current and projected needs
Traveler/mobility initiatives, to facilitate movement of RNs across Health Ministries in times of extreme need and to make it easier for RNs who decide to leave one of our Health Ministries to stay within Ascension Health
Education models, to increase the pool of qualified, values-driven RNs through increased educational capacity

Staffing Forecasting - A work team composed of associates from several Health Ministries is in the process of testing a Web-based forecasting tool that will help Health Ministries anticipate and plan for their staffing needs through the year 2020. This tool uses current Health Ministry associate demographic data and projected growth in demand to support long-term workforce planning and concurrent workforce strategies. The tool will be rolled out to the Health Ministries late this summer and will be supported by a series of training sessions.

Traveler/Mobility - In this initiative, Research & Development is working closely with Chief Nursing Officers and Chief Human Resources Officers to develop ways to facilitate internal movement of RNs during emergencies, such as 2005's devastating hurricanes, or other times of need. Also being explored is development of an internal nursing traveler group, which would help meet the needs of Health Ministries that rely on traveler, or temporary, agency nurses and support recruitment and retention of nurses who desire to travel.

Education Models - Research & Development is working with several Health Ministries to examine ways to increase the capacity of RN education in this country. One approach involves a partnership between a Health Ministry and local educational providers to expand class offerings, including providing space at the Health Ministry for classes and coordinating clinical education with the education provider. R&D prepared "SharingSolutions" report on this initiative that was made available to our Health Ministry CHRO's and CNO's.

Another education model being explored is development of an "Ascension Health University" for nursing, with a centralized educational component and distance learning opportunities across the System. This concept is in the early stages of development.

The Caregiver Pipeline is one component of a much larger effort across Ascension Health to enhance nursing care models and the care environment under the sponsorship of Ann Hendrich, Vice President, Clinical Excellence, and Marvin Russell, Senior Vice President and Chief Human Resources Officer.

Patient-centered Flow

Another Future State initiative strives to smooth and increase flow of patients and information through an approach similar to that used by Southwest Airlines to promote on-time performance, rapid equipment turns and accurate baggage handling. Working with forward-thinking Health Ministries, other Ascension Health entities and external partners, we hope for significant impact from improved cooperation among different areas of a healthcare facility, near-time information transparency and predictive modeling.

New Care Models Research & Development

Research & Development has launched an initiative to financially support Health Ministry pilot projects and demonstrations targeting special populations of patients that test processes, technology, new relationships, new caregivers and other features that support Ascension Health's Strategic Direction. We received proposals for 13 projects. Following a careful discernment process, four proposals were chosen for support this year.

Some projects will be more successful than others. However, we expect to learn from each and will continue to encourage courageous innovation as we explore ways to transform healthcare and the experience of our patients.

New Care Models – Health Ministry Projects Supported by Research & Development

CARE TEAM, by Providence Hospital, Washington, D.C., is a multidisciplinary, comprehensive team of physicians, nurses, case workers and data managers that will provide medical management for a group of geriatric patients. This project will test the ability to improve the patient experience through this approach.
Tele-Home Care, by St. Vincent Health, Indianapolis, is testing the benefits of a telemedicine approach for home care patients. The goal is to improve patient satisfaction by helping patients maintain better health and to test the use of information technology to improve systems and care.
Pharmacy Navigation, by Genesys Health System, Flint, Mich., seeks to demonstrate and test an approach to share reliable, timely and accurate prescription information among pharmacy benefit managers, physicians, pharmacy car providers, and inpatient and outpatient care settings. The pilot group will be associates of Genesys.
TeleHealth, by Our Lady of Lourdes Memorial Hospital, Binghamton, N.Y., is testing an improved information system in a home care setting as the foundation for an electronic medical record for home care and hospice patients. The goal is to improve patient satisfaction and outcomes.

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