An Instance of Innovation as applied to CHOPlink Projects

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An Instance of Innovation as applied to CHOPlink
Projects

• Presented By
• Edna Volz
• Mary Rewinski
• Process Managers
• The Childrens Hospital of Philadelphia
• May 2007
• CHOP Process Innovation Center Elizabeth
  Fogarty, Mary Fowler, Emily Goyne, Elaine
  Kazlauskas, Leonora Miller, Amy Nelson, Mary
  Rewinski, Amy Rubinstein, Eileen Serpiello, Young
  Shin, Anna Spraycar, Harold Strawbridge, Robert
  Sturmer, Edna Volz, and open positions

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Agenda

• Overview of The Childrens Hospital of
  Philadelphia (CHOP)
• What is The Process Innovation Center (PI Center)
  at CHOP?
• An Instance of Innovation What is CHOPlink?
• Features of Our Approach
• Results
• Lessons Learned
• Q A

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The Childrens Hospital of Philadelphia (CHOP)
Overview

• CHOP was founded in 1855
• CHOP has 512 inpatient beds with more than 1
  million outpatient and inpatient visits annually,
  serving local, national and international
  patients
• In addition to the hospital, The Joseph Stokes
  Jr. Research Institute, one of the largest
  pediatric research facilities in the United
  States and the Children's Seashore House, a
  comprehensive pediatric rehabilitation center are
  located on the main campus
• The largest pediatric healthcare network in the
  United States, with nearly 50 sites located
  throughout Pennsylvania, New Jersey and Delaware

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Organization Mission Statement

• The Children's Hospital of Philadelphia, the
  oldest hospital in the United States dedicated
  exclusively to pediatrics, strives to be the
  world leader in the advancement of healthcare for
  children by integrating excellent patient care,
  innovative research and quality professional
  education into all of its programs.

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CHOP has been the birthplace of many Firsts

• Pediatric Hospital
• Medical Training for Pediatric Medicine
• Neonatal, Surgical and Pediatric ICUs
• Closed Incubators
• Catheter Balloons for Cardiac Defects
• Cause for Infectious Mononucleosis
• Leader in Development of Family Centered Care

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What is the Process Innovation Center?

• The PI Center provides effective process and
  project management to achieve continuous and
  measurable improvements through
• Consulting
• Tools
• Methods
• Coaching
• Working with our internal customers we enable
  process innovation, project implementation, and
  assure skills and knowledge transfer to clinical
  and business operations throughout CHOP.

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What is the Process Innovation Center (PI Center)
at CHOP?

• We offer standard process and project methodology
  training and tools and consulting to three levels
  of CHOP projects
• Strategic projects with an enterprise-wide scope
  that require both process redesign/innovation and
  project implementation
• Tactical, short-term (30-90 day) projects that
  may require PI Center staffing along with
  consulting or training
• Short (30 day or less) projects where we provide
  just consultative support training
• Our team consists of 18 Process and Project
  Managers that serve the entire organization.

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Influences for Change Healthcare Industry

• External Forces
• Government
• Insurers
• Community
• Improve Patient/Family Experience
• Consumer driven healthcare
• One Child, One Record, One Outcome

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An Instance of Innovation What is CHOPlink?

• The vision of CHOPlink is to
• promote a new patient/family centered environment
  by optimizing processes with state of the art
  technologies which deliver secure and ubiquitous
  access to complete, accurate and timely
  patient-related knowledge.
• CHOPlink is designed to
• support excellence in patient care, innovative
  research, quality professional education, child
  and family advocacy.

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Our Starting Point

• Processes Managed Locally
• Work Completed in Silos
• Previous strategy Best of Breed approach
• No integrated solutions
• Disparate sources of data
• Multiple sign-ons
• Multiple handoffs and possible points of failure
• Process compromises
• Proprietary/different data formats
• No economies of scale

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CHOPlink Overview What we planned to do..
We will use process management to create a future
state version of processes with these
characteristics

• From child/family need identified to
  child/family need satisfied
• Integrated, end-to-end, enterprise view
• Future State Focused
• Aligned with Guiding Principles
• Led by Process Owners
• Tested with Family input
• Staged Implementation
• Linked to Technology Implementations

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Process Management Theory
Process Management is.
Identify
Define
Implement
Improve
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Process Overview
Edited for External Distribution
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Examples of Change Scheduling Process
What a Family Gets - One Call Does It All I make
one call and I can get all of my appointments
even though we have some complicated combinations
of services. They gave me various options for
appointments at several times and locations. I
can give my information to the hospital once
during the call so I dont have to repeat it
every where I visit. I know my balance so I can
be ready to pay when I get there. They told me
what information was required for the appointment
and were able to call my Primary Care Provider.
They even gave me instructions on how to get
there! I also got a reminder call a few days
before the appointment.
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Examples of Change Scheduling Process
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Examples of Change Check In Check Out
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Examples of Change Check In Check Out
Enabling the Process Changes via

• Inpatients
• Centralized Bed Management
• Faster Bedside Registration
• Electronic Insurance Verification
• Electronic Signature
• InterQual Criteria
• Integrated Scanning Application
• Primary Care Provider Automated Updating

• Outpatients
• Quick Verification
• Document Scanning
• Electronic Insurance Verification
• Cash Collection
• Incomplete or Missing Registrations Completed in
  3 Working Days or Less

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Examples of Change Clinical Visit Flow
Clinical Visit Flow
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Examples of Change Hospital Billing Process
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Examples of Change Hospital Billing Process
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Examples of Change Physician Billing Process
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A New Way to Look at the Physician Billing Process
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CHOPlink What Weve Accomplished
We created a future state version of processes
with these characteristics

• From child/family need identified to
  child/family need satisfied
• Integrated, end-to-end, enterprise view
• Future State Focused
• Aligned with Guiding Principles
• Led by Process Owners
• Tested with Family input
• Staged Implementation
• Linked to Technology Implementations

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Advantages
Challenges

• Executive support
• Guiding principles
• Ground plowing by trusted advisors
• Thinking blue sky
• Documented process mgmt approach
• Project mgmt discipline
• Focus on ideal patient experience and excellence
  in patient care
• PI team members new to CHOP

• Its an Epic implementation
• Ive got a day job, too.
• Enterprise level vs. department level process
• Language of process management new to CHOP
• Implementing process change an abstract notion
• Fear of change created resistance to blue sky
  thinking
• Clinician involvement

All are lessons learned!
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Some PARC Process Management Facts

• Staffing
• Process owners
• Process managers
• Approx 200 stakeholders across process teams (not
  full time)
• Key participants include Business Architects,
  Application Coordinators, Project Manager, Family
• Current State (Sept 05 Oct 05)
• Process Maps
• Barrier Lists
• Future State (Oct 05 Feb 06 for definition Mar
  06 Aug06 for implementation)
• Strategic and Workflow questions and
  recommendations
• Process Maps
• Critical Workflows
• Role descriptions
• Metric descriptions
• Policies and Procedures
• Integration grid
• Implementation plan for major operational changes
• Portfolio grid for prioritizing operational
  changes

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Summary

• CHOP Overview
• PI Center Overview
• Features of Our Approach
• Lessons Learned
• Q A
• What is your reaction?