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Transplant Service Line Service Line Review Session #1 Dean’s Meeting – January 11, 2011

Prabhakar Baliga, MD – Service Line Medical Director. Transplant Service Line Service Line Review Session #1 Dean’s Meeting – January 11, 2011. picture. picture. Kim Phillips, MSN, RN, CCTC – Service Line Administrator. COM Departments involved in SL. Significant

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Transplant Service Line Service Line Review Session #1 Dean’s Meeting – January 11, 2011

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  1. Prabhakar Baliga, MD – Service Line Medical Director Transplant Service LineService Line Review Session #1Dean’s Meeting – January 11, 2011 picture picture Kim Phillips, MSN, RN, CCTC – Service Line Administrator

  2. COM Departments involved in SL • Significant • Surgery (Transplant and Cardiothoracic) • Medicine (Cardiology, GI & Hepatology, Hematology / Oncology, Nephrology, and Pulmonary) • Others • Anesthesia: special teams: liver, cardio thoracic • Pediatrics: Nephrology, Cardiology, Gastroenterology, Hematology / Oncology • Pathology: Anatomic Path, HLA, Blood bank • Radiology

  3. Transplant SL Big Bets - 3-5 year strategic goals

  4. 2010-2011 Transplant SL - Progress towards Big Bets Growth

  5. 2010-2011 Transplant SL - Progress towards Big Bets Growth

  6. Transplant SL Progress towards Big Bets - Quality 2010 UNOS Certification – Lung Transplant 2010 Joint Commission Certification – Destination LVAD 2010 ASHP – National Award for Transplant Medication Safety 2010 HHS - Bronze Medal Of Honor – Liver Program 2008 CMS Certification Transplant – Heart, Kidney, Liver, Pancreas 2009 FACT certification – BMT

  7. 2010-2011 Progress towards Big BetsInnovation • Cell injury/Preservation/Regeneration • Transplant Outcomes • Transplant Immunology

  8. What is going well in SL? • Clinical Outcomes • Length of Stay Index • Mortality Index • Transplant rate and median wait time • Service Contract – develops incentives for Dept of Medicine • Transplant Unit Renovation - 6 East Main Hospital • Transplant Pharmacy : Expanded specialty services for transplant medications • Data Transparency between MUHA and UMA: financial and quality • Relationship between Medical Director and Administrator • New Program Development • Destination VAD program – Certification • Lung Transplant Program – UNOS certification • BMT Program – Increased referral / Tx volume

  9. Opportunities for improvement in SL • Institutional Vision and priority • Alignment between SL and COM/UMA priorities • Clear lines of decision making authority between SL and Academic Departments • Increased financial accountability – and authority for resource allocation • Incentives to reinvest in SL priorities • Support for SL initiatives: • Medicare cost report • Pharmacy data project • Physician accountability

  10. SL structure that fosters a shared buy-in and accountability for Service Line success A system to foster support for SL initiatives that may conflict with Dept/Division priorities UMA and Hospital Leadership accountability for definitive and timely response to SL initiatives. Align responsibility with authority Financial resource allocation authority Input on SL as a structure

  11. Tab 2SL Dashboard • November 2010 dashboard from Enterprise Analytics

  12. Click on image to open PDF

  13. Tab 3Goal Performance • Executive Summary – Annual LEM performance • Executive Summary – 2011 Pillar performance YTD • 2011 LEM Monthly Report Card

  14. SLL Goal (LEM) PerformanceExecutive Summary - Annual Scale 1-5; 4 is goal attainment Green – 4; Yellow – 3; Red - <2.5

  15. SLL Goal (LEM) PerformanceExecutive Summary – YTD Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

  16. FY011 Goal Performance (Through December, 2010) MUSC Transplant Service Line Quality UHC LOS Index <.75 Finance Net margin > 5% Growth Through Dec 2010 Service Patient Satisfaction Through October Goal > 75%tile • People • Engagement Score • 75% tile rank REFERRAL Volume Kidney Liver Pancreas: Heart:: BMT: Total All Programs combined 0.8 Transplant Patient Medications Inpt Unit – 10 East 92.29 Mean Staff 17 % tile Supply expense / discharge 10 %tile OutPt – 9RT 86.9 Mean Kidney – 0.82 Liver – 0.84 Pancreas – 0.70 Heart – 0.67 BMT - 1.07 TRANSPLANT Volume Kidney Liver Pancreas: Heart:: BMT: Physician 1 % tile Labor Expense / discharge 38 %tile

  17. Click on image to open PDF

  18. Tab 4SL 5/10 Performance YTD • 5/10 Performance YTD • 5/10 Plan Executive Summary

  19. Transplant SL 5/10 YTD Performance

  20. SL 5/10 Performance Summary OT Reduction Cost Report Analysis Inpatient Liver Costs: Albumin, Blood Products, OR Timing Transplant Pharmacy BMT Blood Utilization Revenue Cycle Review – Account write-offs Campath v Thymo – Post Tx induction therapy Inpatient staffing: RN v LPN

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