Health Care Redesign: UT Helping Improve System through Education

KNOXVILLE — With legislators debating a health care redesign, there is a lot of discussion about what’s wrong with American health care and how it could be fixed.

The College of Business Administration at the University of Tennessee, Knoxville, has been working with health care professionals for more than 10 years, teaching them the business of health care to improve quality, improve patient outcomes and lower costs.

“We have shown that when the health care community understands and implements good business principles, the health care system improves,” said Mike Stahl, William B. Stokely Distinguished Professor in Management and director of UT’s Physician Executive MBA (PEMBA) program. “Physicians are thirsting for knowledge about how to run patient-centered practices that improve patient outcomes, eliminate redundancies, shorten patient wait times, put an end to reworks, simplify paperwork and lower costs.”

PEMBA — which for the past six years has been ranked “the No. 1 preferred MBA program exclusively for physicians” by Modern Healthcare/Modern Physician magazines — teaches physicians to think as physician leaders.

“PEMBA physicians already think of their patients first due to taking the Hippocratic Oath. What they learn in the program enhances the value they add to their patients,” Stahl said.

Jody Crane, a 2004 PEMBA graduate and business director of Fredericksburg Emergency Medical Alliance in Fredericksburg, Va., applied lean principles to improve performance in one of the busiest emergency departments in the country. By applying lean principles in his emergency department, he and his team at Mary Washington Hospital have reduced the length of stay in the emergency department by over 38 percent — from over four hours in 2004 to two hours and 30 minutes in 2009. They also have decreased the rate with which patients leave without being seen by almost 90 percent — from a high of 13 percent in 2003 to 1.5 percent in 2009.

“This tremendous increase in capacity came without significant investments in human resources or costly physical plant modifications, but through creating a learning organization and applying human ingenuity,” Crane said. In essence, the Fredericksburg team created the capacity to treat 38 percent more patients with similar resources.

“Toyota used these principles to improve manufacturing efficiencies in the automotive industry; the concepts are just as applicable in a healthcare environment,” he said.

Crane believes so strongly in lean that he and Chuck Noon, a founding faculty member of PEMBA, encouraged the college to introduce a Lean for Healthcare five-day course as a deep-dive into lean principles, in which he is a lead faculty member. Other college faculty members are working with college staff in developing an entire curriculum of healthcare leadership courses to be available in 2010.

Here are several other examples of healthcare professionals around the country who have used the business principles learned in UT’s Physician Executive MBA program to make changes that increased efficiency and improved patient outcomes:

  • Dr. Ramesh Gandhi practices gastroenterology in Dayton, Ohio, and is president of Digestive Specialists and Digestive Endoscopy Center LLC, an outpatient practice with 20 gastroenterologists, anesthesiologists and pathologists; they perform thousands of colonoscopies yearly. With the implementation of continuous process improvements learned in PEMBA, his center has reduced significantly expected complications from colonoscopies, including an 85 percent reduction in perforation rates. This has led to improved satisfaction among patients and referring physicians, more referrals, and business growth.
  • Dr. Thomas L. “Tim” Stover is president of outpatient services at Akron General Health System in Akron, Ohio. Before the concept of wellness became popular, he developed Akron General Health and Wellness Centers, an outpatient, lower-cost, higher-quality delivery system based around prevention, wellness, rehabilitation and lifestyle change. The Centers offer free-standing, 24/7, full-service emergency departments; outpatient clinical services, including diagnostic and surgical services; physician offices; and an award-winning medical fitness center.
  • Dr. John H. Hajjar, chief executive officer of Urology Specialty Care and Surgicare Surgical Associates in New Jersey, lowered patient costs and improved quality of urology services by moving procedures from an in-patient to an outpatient setting. SurgiCare manages more than 10 ambulatory surgery centers in New Jersey, New York, and Florida.

C O N T A C T :

Amy Blakely (865-974-5034, amy.blakely@tennessee.edu)

Laura Bower (865-599-7152, laurambower@hotmail.com)

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