Case Study: How Catalyst Makes Tough Decisions Easier

The Problems

The medical center is a medium-sized, full-service, acute care facility that had been doing very well financially for many years. With the reimbursement landscape changing, a new Vice President of Patient Care was confronted with a number of fiscal and systems problems that needed to be solved.

The Process

The hospital needed a new patient classification system and a valid way to assess workload, staff utilization, and productivity. Catalyst Systems was selected because it was the only company that offered both a patient classification system and an objective study methodology to assess patient care workload and staff utilization patterns. An in-house project coordinator worked closely with the Catalyst consulting team and was trained to coordinate the implementation of EVALISYS^® Patient Classification System and FORESIGHT^® Staff Activity Study.

• EVALISYS PCS was implemented throughout the medical-surgical, critical care, and behavioral health units
• A new inter-rater reliability monitoring process was established
• Flexible, budget neutral, activity adjusted staffing matrices were developed for each unit based baseline acuity data
• The FORESIGHT^® Staff Activity Study, was conducted on several units to obtain baseline productivity data that was valid and reliable
• The in-house PCS coordinator was taught how to replicate the Study methodology for future use
• Financial management education was provided to nursing leadership staff

The Outcomes

• The EVALISYS^® PCS was successfully implemented and strongly supported by the RN staff because of its simplicity and ease of use
• Staff had confidence in the flexible new method of staffing by acuity
• On the Study units, a number of opportunities were identified to improve efficiency, streamline systems, shift staff responsibilities, improve productivity, and save money:
  • The cost of licensed staff performing non-clinical activities was $380,000 per year on each unit
  • The cost of charting time on each unit was $750,000 per year
  • Perceptions of staffing adequacy were lower than Catalyst’s benchmark data on units where direct care time was lower then average
• Based on Study results, changes were made to improve efficiency, better utilize personnel, and reduce costs
• To validate the effectiveness of these changes, the two medical-surgical units were restudied a year later, with the following sample results:
  • Licensed staff non-clinical activity was reduced by one-half, saving $190,000 per unit per year
  • Licensed staff charting time was reduced by one-third, saving $250,000 per unit per year
  • Shift report was streamlined, saving $78,000 on each unit each year
  • Perceptions of staffing adequacy were higher than before the changes were made

Based on the organization-wide changes in practice patterns highlighted by the FORESIGHT^® Study process, a total cost reduction of $5,500,000 was achieved in one year. The hospital continued to refine its operations over the years through subsequent restudies of various units, adding exponentially to the accrued savings. Thanks to Catalyst, this hospital has been able to maintain highly efficient systems and staff productivity, keep patient satisfaction levels high, and achieve a return on investment of 13:1.