We also considered physician throughput needs as we redesigned our processes. For example, it proved very important to the physicians that we create a central logistics hub and departmental clinical-care coordinators so patient movement and status notifications could be expedited.
In order to effectuate and sustain Mercy St. Vincent’s improvements, the new processes were hardwired into an adaptive logistics software platform so the chaos of hospital operations could be effectively choreographed. By using technology to coordinate and integrate all the clinical and nonclinical patient movements and order executions, we achieved significant value, including removing the burden of logistics and scheduling from nurses; and assuring key performance indicators were reported in real time so adjustments in staffing, flow and other critical components could be made.
In the two years since initiating total hospital efficiency, Mercy St. Vincent reduced its average length of stay from 5.2 to 4.6 days. The ALOS improvements saved us 10,400 days annually, giving us the ability to care for 2,260 more admissions with no additional capital or fixed costs. The total economic impact of these changes was $48.4 million and a significantly improved operating margin. Because of this process change, our quality scores and patient-satisfaction scores went up while our nurse separation rate improved by 41%.
As we work through our third year, we continue to see ALOS measurements decrease and other savings accrue as more inefficiency is removed from the system. Our journey toward total hospital efficiency began with the realization that the disconnected processes and silos we thought were best practices were in fact contributing to work-arounds and wasteful white space. Having identified this waste, we were able to realign our organization and achieve remarkable performance improvement—something that is within reach of every hospital.
Dr. Imran Andrabi is CEO of Mercy St. Vincent Medical Center in Toledo, Ohio.