COLLABORATING WITH HOSPITAL SYSTEMS TO DELIVER QUALITY CARE AT A REDUCED COST

Aligning Value Case Study: Maastricht University Medical Centre, the Netherlands

Maastricht University Medical Center, The Netherlands

Healthcare systems around the world face rising costs, increasingly complex disease states, and shrinking reimbursements. By reimagining healthcare delivery, we have the potential to better align value, increase access to care, and improve clinical outcomes.

MUMC+ by the numbers

Maastricht University Medical Centre (MUMC+) is a large academic hospital in the Netherlands with 5,500 employees, 715 beds, and more than 500,000 outpatient clinic visits each year. Like many other hospitals, MUMC+ faced increases in patient volume and complexity of cases, and was under continuous pressure to maintain high-quality care for more patients without increasing costs. In addition, the government’s transition from a budget-based to a pay-per-procedure system intensified competition and incentivised hospitals to work more efficiently in a patient-centric manner.

With this environment in mind, MUMC+ leaders looked to:

  • Improve quality and care outcomes
  • Build a more patient-centric organisation
  • Increase employee engagement and become an employer of choice
  • Optimise processes and foster a culture of continuous improvement

To achieve these goals, they sought an innovative and dedicated partner to help develop solutions that drove clinical and economic value — without sacrificing excellent healthcare delivery. They chose Medtronic Integrated Health Solutions, Europe, and in 2014, the two began a five-year partnership.

“Sometimes you need a sharp, unbiased external eye to visualise the routine mistakes that are obviously made in all big organisations,” says Prof. Dr. Michael Jacobs, Chairman and Professor of Surgery, Executive Director Heart+Vascular Centre, MUMC+.

HOSPITAL-WIDE IMPLEMENTATION

Medtronic Integrated Health Solutions, Europe, deployed its Lean Academy training — a program designed to drive process improvement. Training combined classroom work, mentoring, and on-the-job learning to embed efficiency principles into the hospital and ensure lasting, transformational change. This training:

  • Involved front-line to executive-level staff members
  • Established a central office to manage more than 120 Lean Six Sigma projects
  • Established more than 40 “improvement boards” to capture ideas on how to reduce variability in processes

More than 2,500 employees have been trained through Lean Academy and are now running their own value-creating projects, resulting in a:

  • 36 percent rise in productivity in the orthopaedic outpatient clinic
  • 50 percent decrease in referral-to-diagnosis time in the urology outpatient clinic
  • 90 percent decrease in admission time and 20 percent increase in productivity in the dermatology outpatient clinic

2,500+ Hospital Staff Trained

 

More than 2,500 hospital staff trained in Lean Six Sigma.


HEART+VASCULAR CENTRE IMPLEMENTATION

The Heart+Vascular Centre is strategically important to MUMC+. The hospital’s goal is to have the centre ranked as one of the top 20 “Best in Class” cardiovascular centres in Europe by 2020.

“To become a centre of excellence, you need more than the technical ability of the cardiologist,” says Prof. Dr. Jacobs. “You also need to optimise the whole infrastructure, meaning that any kind of waste should be eliminated to get care optimally organised.”

Medtronic Integrated Health Solutions, Europe, helped the Heart+Vascular Centre execute on a number of its specific objectives, with excellent results that included an overall cost saving of $2.5 million (USD) in one year.


$2.5M in savings

 

$2.5 million (USD) in overall cost savings at the MUMC+ Heart+Vascular Centre in 1 year.

 


Objective: Increase operational excellence by creating a “one-stop shop” known as the Diagnostic Care Street.

  • Redesigned workflows of the outpatient clinic, operating rooms and cath labs
  • Standardised planning processes
  • Implemented daily morning preparation meetings
  • Used improvement boards to tackle process bottlenecks

RESULTS

  • Diagnosis time down from five visits over two months to a single two-hour visit
  • 20 percent capacity increase through better patient triage
  • 30 percent fewer ultrasound echocardiographies requested, resulting in savings of $156,000 (USD)

5 visits > 1 visit

 

Diagnosis time down from 5 visits over 2 months to a single 2-hour visit.


Objective: Optimise the centre’s heart failure and cardiac resynchronisation therapy (CRT), and bypass surgery (CABG) clinical pathways.

  • To optimise the heart failure and CRT pathways, MUMC+ convened leading clinicians from three major European hospitals to design the “ideal” pathway, built consensus on standards of care, and trained a multidisciplinary team on patient identification, among other actions.
  • To optimise the CABG pathway, MUMC+ created a one-stop visit for all involved disciplines to improve efficiency, improve patient communication and preparation, and radically changed its planning schedule and improved on-time starts to increase operating room utilisation.

RESULTS

  • 33 percent shorter patient stays, resulting in: $120,000 (USD) in savings, a 50 percent decrease in time to intervention, and a decrease in the number of consults and administrative costs
  • 50 percent fewer cancellations as part of the CABG pathway optimisation, resulting in: a 30 percent decrease in length of stay unlocking $960,000 (USD) in savings; and an increased number of procedures per year, worth $825,000 (USD)

Objective: Improve cath lab operations by better managing daily operations, and optimising planning and scheduling.

  • Mapped all planning and schedule flows
  • Implemented a time-out, sign-out procedure
  • Stimulated best practice sharing
  • Introduced staff development and education programs

RESULTS

  • 37 percent fewer cancelled procedures through better planning and scheduling
  • 43 percent drop in overtime pay
  • Increased staff efficiency and engagement, and an increase in patient satisfaction

Maastricht University Medical Centre’s motto, Better Than Yesterday, is a tribute to the continuous improvement model at work today. Optimised resources. Increased patient satisfaction. Empowered staff. These are all results of the partnership forged by MUMC+, the Heart+Vascular Centre, and Medtronic Integrated Health Solutions, Europe, to take healthcare Further, Together.