 |
Cutting Costs While Improving Performance |
|
Cutting Costs While Improving Performance |
After an inspection by The Joint Commission, an ARUP client was cited for problems related to inadequate lab space and insufficient documentation of proficiency testing, instrument maintenance, and competency.
The client—a rehabilitation hospital in a health system with multiple hospital laboratories—engaged the ARUP Healthcare Advisory Services team to determine if continuing to perform testing on-site would be financially and operationally practical. Healthcare consultants were asked to assess space, help address The Joint Commission’s findings, and offer general recommendations to improve workflow.
ARUP conducted an assessment by touring the laboratory space, interviewing key stakeholders from laboratory and clinical areas, and analyzing operational data. Initial data analyses focused on test volume by hour, day of week, and performing location, as well as turnaround time (TAT) needs.
Consultants identified barriers to quality care and possible causes of The Joint Commission’s citations regarding quality control, lab space, and documentation.
ARUP experts considered total costs, TAT impacts, staffing and workload effects, equipment needs, patient experience, and provider satisfaction in their analysis.
After obtaining additional laboratory costs, ARUP consultants developed three solutions to resolve the inadequate space issue with varying levels of construction, process disruption, and cost savings:
1. Renovate the existing laboratory to maximize space, reduce clutter, and replace aging infrastructure.
2. Decommission the rehabilitation laboratory and replace it with point-of-care testing performed by clinical care staff.
3. Refer all testing to another system laboratory and maintain limited point-of-care testing instrumentation at the rehabilitation hospital for emergent needs.
Option one would involve minor adjustments to the client’s current practices to address The Joint Commission’s findings while avoiding any drastic changes to the client’s care models.
Options two and three would reduce total laboratory costs by 12% and 27%, respectively, corresponding to five-year savings of $803K and $1.9M, respectively. The client preferred option three because it didn’t rely on patient care labor to perform most tests. Both options allowed laboratory staff to relocate to other system laboratories during a period of severe healthcare staffing shortages.
ARUP also urged lab leadership to require presurgical testing one to two days before surgery to reduce the load of STAT tests and, in turn, help the lab meet more STAT TATs. To address The Joint Commission’s citations regarding documentation practices, ARUP consultants recommended that quality assurance responsibilities, including instrument maintenance, ongoing competency, and proficiency testing, be assigned to a single coordinator.
The ARUP Healthcare Advisory Services team provided an objective look into this client’s current and potential future states using proprietary data and industry benchmarks to provide comprehensive analyses and high-level action steps forward.