Bed Throughput Times Down, Productivity and Morale Up

Throughput Effects Patient Care

VHA member Freeman Health System of Joplin, Missouri, respected as a premier heart care specialist, selected Crothall Services Group to manage its Environmental Services, Patient Transportation, and Hospitality Resource Center at three of its facilities in late 2004. Freeman’s initial overture to Crothall was in response to concerns by nursing leadership with existing patient transportation services, which were decentralized and provided by a mix of clinical and nursing staff. Without a central management structure, and lacking control and accountability systems, transports were erratic and untimely, and bed throughput was slow. Administrators, nurses, and physicians pointed to the impacts on patient care; the system’s CFO, alert to the related increase in ER diversions, also worried about the effect on revenues.

“In our process improvement deliberations, we initially focused on patient transport, because in its decentralized format it was failing to meet our needs,” says Philip Willcoxon, CEO of Freeman Health System and Crothall’s primary liaison at the system. “We had nursing and radiology staff handling transports, diverting them from their patient care duties. This was especially annoying on weekends, when staffing levels were lower.”

Shared Common Values

While attending a VHA member conference in early 2004, administration was impressed to learn of the impact Crothall’s program had made on other facilities, and asked for an assessment. “During our explorations, we sensed that we needed a comprehensive solution that extended beyond patient transportation,” continues Phil Willcoxon. “As we drilled into bed throughput, we realized that the solution must integrate all three service components touching on bed turnaround and throughput: Patient Transport, EVS, and Dispatching services. It became clear that aside from the obvious decentralization problem, we lacked the leadership, systems, and technology in all three services to ensure an efficient and integrated response. We also discovered that both productivity and employee morale in these services were far lower than we had thought. VHA had come forward with statistics showing that our EVS Department, for example, was far less productive than those at other similar sized facilities—perhaps by as much as 10%—and yet our quality scores were only average.”

After evaluating all providers, Freeman quickly narrowed the search to Crothall. “We immediately felt comfortable with Crothall’s people and approach,” says Phil Willcoxon. “Their references were impeccable, and there was a strongly-felt sense that we shared common values: integrity, flexibility, responsiveness, and a passion for quality.”

Reorganization

Crothall thoroughly studied the service needs and current performance at each campus, and then designed a strategic plan for re-organizing and modernizing the services into an integrated package. While the centralization of patient transport and the formation of the Hospitality Resource Center would require new positions, there were substantial offsetting savings in housekeeping, just as VHA had predicted. The enhanced program as a package was cost neutral.

“We actually weren’t expecting savings,” acknowledges Steven Graddy, Freeman System CFO. “Given that we are running at nearly 100% capacity, the modernization of these services means that we can provide better quality, faster care—fewer diversions, fewer empty beds, happier customers, greater revenues.”

Consistent with its strategy to focus resources and attention on its core business, and outsource non-core functions to specialist experts, Freeman opted to transfer the hourly staff to the Crothall’s payroll. “It made business sense,” notes Phil Willcoxon, “but it also has been a good move for the employees. Of course, there was some initial apprehension, but Crothall very sensitively continued the current wage and benefits programs, provided training and career development and furnished them with new equipment. The associates now feel bonded to the company, respect and appreciate their new Crothall leaders, and feel that they have a career path. In fact, Crothall retained or promoted several of our former supervisors, and has even appointed a few of the hourly associates to leadership positions. Their sensitivity, continuous communication, and genuine care for the staff has already sparked an increase in productivity and employee morale, and prompted a sharp drop by nearly two thirds in staff turnover—all in the first three months of their program.”

Transport times have fallen dramatically, now at 15 minutes, well within benchmarking guidelines. Crothall has increased cleaning quality, while reducing staff. A smooth transition of the Hospital’s employees to our payroll was completed, and the associates are responding positively to the training, new tools and equipment. Now, everyone is part of a single, united team—all focused on caring for the hospital’s patients. It’s why the hospital hired Crothall, and it’s a mission Crothall takes very seriously.