Session #9:
Texas Children’s Hospital: Applying a ThreeSystems Approach to Improving Surgical
Outcomes
Pre-Session Poll Question
How long does it take to do an
appendectomy (the operation itself)
at your organization?
Kathy Carberry, RN
a)
b)
c)
d)
1 to 2 hours
2 to 3 hours
4 to 5 hours
Unsure or not applicable
Poll Question #2
How long does it take for a patient who arrives in the
emergency center with appendicitis to get to the OR
in your organization?
a) 2 to 4 hours
b) 4 to 6 hours
c) 6 to 8 hours
d) 8 to 10 hours
e) Unsure or not applicable
2
About the organization
Non-for-profit
children’s
healthcare
Using
technology to
provide higher
quality, lower
cost care
Improve and
streamline
appendectomy
care
3
Industry Background
Research has shown that the mean length of stay (LOS) for
appendectomy procedures can vary significantly based on a number of
factors, including severity of appendicitis, operating room availability,
surgeon preferences, nursing policies, and hospital systems.
4
Pain Points
Lack of data
and lack of a
prospective
system for
measurement
Lack of
teamwork and
consistency in
treatment of
appendectomy
cases
Current
methods
involve after
the fact data
collection in
postoperative
cases
No specific
guidelines to
apply to each
appendectomy
case
5
Our Approach
and Results
6
Goals
•
Improve quality of care while reducing costs
•
Create a streamlined approach to each specific appendectomy case
to ensure continuity of care
•
Demonstrate how order sets and variation can change culture
7
The Tools
EDW
A late-binding
data warehouse
platform
Population
Analytics
Advanced
Application –
Appendectomy
Module
Permanent,
integrated
workgroup
teams
Evidencebased best
practices
8
Applying a Three Systems
Approach…
Improves
measurement and
analytics (an analytics
system)
Creates permanent
cross-functional
workgroup teams
focused on identifying,
deploying, and
monitoring the
effectiveness of quality
improvements (a
deployment system)
Deploys a data-driven
approach to
implementing
evidence-based best
practices (a content
system)
9
Monitoring Appendectomy
10
Wound Classification
11
Appendectomy Dashboard
12
Results
•
Developed appendectomy population health analytics platform
•
Improved patient outcomes and reduced costs through cultural
transformation
•
End-to-end workflow optimization
13
Measureable Results
36%
19%
36%
Reduced
postoperative
length of stay
Reduced average
variable direct
costs
Increased order
set adoption rates
53%
19%
Increased the
percentage of
patients receiving
recommended
antibiotic as first
antibiotic
Decreased the
time from
diagnosis to
surgery
30%
Increased the
accuracy of
surgical wound
classifications
14
Future Plans
© Used with permission. Texas Children’s Hospital.
Surgical
hospitalist
pilot in EC
EC triage
protocol based
on PAS
Same-day
discharge
from PACU
Shared
savings
program
pilot
15
Lessons Learned
•
•
•
•
•
Cultural transformation takes time
It is critically important to build relationships
Multidisciplinary teams are critical to success
A physician champion is essential
Data is essential to know the truth
16
Analytic
Insights
Questions &
Answers
A
17
Choose one thing…
Write down one thing will you do differently
after hearing this presentation
18
Thank
You
19
Session Feedback Survey
1. On a scale of 1-5, how satisfied were you overall with this session?
1)
Not at all satisfied
2)
Somewhat satisfied
3)
Moderately satisfied
4)
Very satisfied
5)
Extremely satisfied
2. What feedback or suggestions do you have?
20
Upcoming Sessions
Breakout Sessions – Wave 2 (2:30 PM – 3:15 PM)
10) Is Big Data a Big Deal…or Not?
Location
Grand Salon
Dale Sanders, Senior Vice President, Health Catalyst
Richard Proctor, General Manager, Global Healthcare & Life Sciences, Hortonworks
11) Partners Healthcare Analytic Strategy for bundled Payments and
Risk Management
Grand Ballroom A
Sreekanth Chaguturu, MD, Vice President for Population Health Management, Partners
HealthCare
Helen Chan, Senior Manager, Business Planning, Partners HealthCare
12) Sneak Peek: Improving Patient Engagement and Outcomes with
Predictive Analytics
Grand Ballroom D
Gregory A. Spencer, MD, CMO & CMIO, Crystal Run Healthcare
Louis G. Cervone, Jr., Director of Business Intelligence, Crystal Run Healthcare
13) How a Pioneer ACO is Using Analytics to Change Heart Failure
Savoy
Spencer H. Kubo, MD, CMO of BioControl Medical, United Heart &Vascular Clinic, Allina
Integrated Medical Network
14) Entering Shared Risk for Community Hospitals Through Physician
Engagement
Murano
Greg Stock, CEO, Thibodaux Regional Medical Center
Mark F. Hebert, MD, FACS, Surgical Specialist, Thibodaux Regional Medical Center
15) Panel – Children’s Hospitals: “Tike-mares”…Are the Monsters Under Venezia
the Bed For Real?
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