MAASTRICHT CASE STUDY Saving Millions in Operational Costs in One Year

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

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.

Maastricht University Medical Center (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 incentivized 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 organization
Increase employee engagement and become an employer of choice
Optimize 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^SM, and in 2014, the two began a five-year partnership.

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

HOSPITAL-WIDE IMPLEMENTATION

Medtronic Integrated Health Solutions 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:

36 percent rise in productivity in the orthopedics 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

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

HEART+VASCULAR CENTER IMPLEMENTATION

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

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

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

$2.5 million (USD) in overall cost savings at the MUMC+ Heart+Vascular Center 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 CathLabs
Standardized 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 a savings of $156,000 (USD)

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

Objective: Optimize the center’s heart failure and cardiac resynchronization therapy (CRT), and bypass surgery (CABG) clinical pathways.

To optimize 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 optimize the CABG pathway, MUMC+ created a one-stop visit for all involved disciplines to improve efficiency, improved patient communication and preparation, and radically changed its planning schedule and improved on-time starts to increase operating room utilization.

RESULTS

33 percent shorter patient stays, resulting in: $120,000 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 optimization, resulting in: a 30 percent decrease in length of stay for $960,000 in savings; and an increased number of procedures per year, worth $825,000

Objective: Improve CathLab operations by better managing daily operations, and optimizing 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 canceled 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 Center’s motto, Better Than Yesterday, is a tribute to the continuous improvement model at work today. Optimized resources. Increased patient satisfaction. Empowered staff. These are all results of the partnership forged by MUMC+, the Heart+Vascular Center, and Medtronic Integrated Health Solutions to take healthcare Further, Together.

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