At the Yale-SEPT International Healthcare Management Programme session last week, a panel of three health care administrations from Connecticut and New York presented cost-saving innovations that have been implemented in local health management systems.
The first panel member to speak was Gayle Capozzalo, executive vice president, strategy and system development, Yale-New Haven Health System (YNHHS). She explained how the YNHHS – which encompasses three hospitals in diverse demographic regions of the state – was charged with cutting costs that would have resulted in lost jobs. Instead, they hired consultants to observe the hospital staff and determine what changes could be made to increase productivity. Their discoveries – including the fact that more than 50 percent of nurses’ time was wasted on administrative duties – led to an overhaul of procedures, implementation of more efficient technology and standardization of the shift change process. Although administrators faced some resistance to change, staff time is now more productive and patient satisfaction has increased.
Next, on the panel was William Gillespie, senior vice president and chief medical officer of Emblem Health, a not-for-profit health care provider. Mr. Gillespie shared with the audience that Emblem Health is faced with the question of how a health insurer can add value during this time of health care reform. He explained that health care providers need to be patient advocates; helping people coordinate their care and navigate through the sea of information received during medical treatment. Emblem Health’s began by designating nursing personnel, clinical advisors and social workers to assist patients who are transitioning from in-patient to home care. These advisors develop personal relationships with patients and help insure that there are no oversights in a patient’s care. The program has resulted in a reduction in preventable hospital readmissions, saving both money and manpower.
The third panelist was Steven Merz, vice president of administration, Yale-New Haven Hospital (YNHH). Mr. Merz discussed an issue that YNHH faced regarding the care of mentally unstable patients throughout the hospital. The costs of behavioral health services are largely not covered by insurance. Add to those costs, the numerous hours spent by staff trained to service medical and surgical issues trying to assist patients with mental health issues while still trying to keep a safe environment for other patients on the floor. Patients in need of behavior health care were being caught in the middle -- they couldn’t stay in the hospital because insurance wouldn’t pay, and they had nowhere else to go. So, YNHH created Behavioral Intervention Teams. The teams are comprised of psychiatrists, nurses and social workers who accompany the medical and surgical team on rounds to observe patients from admission, essentially upending the consultation process. After a month, the new progress of this innovation was reviewed and revealed that in cases where the behavioral team was involved; there was a significant reduction in the length a patient stay and there haven’t been any denied days by the insurance companies. The team’s involvement also affords each patient better integration between physical and mental health care provision.