Your feedback and suggestions...

Many of you have offered your suggestions and advice to me as we have undertaken this process to maintain the health of our hospital in these tough economic times.  Perhaps one of the most genuine questions I was asked was this..."How come it takes an economy shift to develop ideas to cut costs in departments?  With this change, I hope our company culture will change as well."  I couldn't agree more, and I believe it will!  

Hundreds of you have participated in our town-hall meetings, contributed suggestions, and made your opinions known about how we can improve our organization even in these uncertain economic times.  The level of openness and transparency that has been exhibited through this process is encouraging to me and I believe that it will continue to help strengthen our hospital as we move forward.  

Below is a summary of the key themes and suggestions that I received throughout this process. While we cannot or will not want to implement every idea that is listed here, I was impressed with the creativity and innovation shown in helping us to think through all of the options that we have to choose from.  While the list is not complete with every suggestion received, please understand that all ideas have been captured and I am working with our leadership team to prioritize those ideas that we can act upon.  We will also create an ongoing process so that we can continue to solicit and make good on your suggestions where possible. 

Without further ado, your suggestions...

Revenue/Growth

• Encourage all team members to utilize JHSMH facilities and physicians for their family healthcare needs.  Caring for our own will help us to grow our organization. 
• Focus on getting the word out in the community about the positive patient interest stories that happen at JH every day!
• Grow outpatient infusion and chemotherapy services throughout the system. 
• Ensure all ancillary testing from JHSMH facilities stays within our system (lab tests, MRI's, TPG physician referrals, etc...)
• Consider offering retail services to go along with inpatient and outpatient services offered at the hospital (ex. DME, women's boutique services, orthopedic supplies)
• Grow research program and patient accruals into approved protocols.
• Improve medical record process to ensure we are not losing charges throughout departments. 
• Consider adding new services downtown like bariatrics.
• Educate team members about the benefits of Pharmacy Plus.  Does everyone know that they will match the discounts and $4 prescriptions offered at Walmart, Meijer, etc?
• Adjust processes to fit in more patients into existing schedule.  Computer system won't let us do this now, even though we have the time to see more patients.  

Efficiency

• Decrease the number of meetings and length of time involved!
• Work with physicians to move patients through hospital to improve length-of-stay. 
• Improve turn-over time in the operating rooms so that more cases can be done during the day vs late add-ons.
• Have better screening process to stop inappropriate transfers from outside of organization.
• Better coordinate test schedules so results are available to discharge patients in a more timely manner. 
• Fix process of turning over beds after discharge so that next patient can be admitted. 
• Coordinate referral process at Frazier from inpatient to outpatient therapy.
• Streamline transfer process for psychiatric patients.  Patients stay longer at JH waiting for bed or acceptance at OPOP.  

Supply/Discretionary Cost Savings

• Post the cost of supplies we order and use on a regular basis so we can make informed decisions on helping to contain costs.
• Standardize types of equipment and supplies we use in the OR.   We will buy anything a physician wants even if we have another item that will do the same job.  
• Eliminate "Holiday Meal" for team members in 2009.
• No more turkeys or t-shirts!
• Cancel company picnic this year.
• Cut charitable donations made to outside organizations.
• Reduce choices in cafeteria and catering and reduce amount of money we spend on food.
• Don't allow departments to order non-essential luxury items like gourmet coffee, soda's, hot chocolates, etc.  I would hate to be DTO'd or lose my job while another department is drinking gourmet coffee!
• Consider eliminating meals in the physician lounges.
• Have individual supplies available along with kits.  Often we have to open a brand new kit when we only need one item from it.  
• Reduce paper consumption!  Excess PCARs, newsletters, computer reports, etc are printed out daily that are not needed and waste money.   Don't print off copies for meetings, make available online instead.
• Repair computers vs replacing them when broken. 
• Reduce office supplies that we use throughout hospital.  Standardize items that can be ordered so that all areas are using same supplies.
• Radiology films are printed out for each case in the OR and then thrown away.  Get PACs system in OR for viewing films online.
• Fix supply ordering process so we don't have to order more product than we need.  Sometimes we have to order a box or case when we only need a few items. 
• Reduce cell phone, pagers and blackberries costs.
• Utilize less linens.  We end up sending a lot of clean linen back to be washed because we take to much into patient rooms that doesn't get used.  Consider adopting policy like they have in hotels to clean linens.
• Ensure that we are charging for all supplies that we use!
• Look at the floor wax we purchase for cleaning, it is very expensive and there are cheaper cleaners available today.
• Change to paper medicine cups instead of more expensive plastic ones.
• Create a way for departments who have a stockpile of supplies to give them to other areas vs ordering new.

Facilities

• Start a "green" program for the hospital.  We don't recycle enough!
• Turn off lights and computers at night to conserve electricity.  Install motion detectors in bathrooms so lights don't stay on all day.
• Make sure equipment works so we don't lose productivity.
• Turn off power to eICU cameras that are no longer being utilized.
• Keep the hospital clean and in good repair so that patients will want to come back.
• Lock thermostats so that we aren't paying extra to heat or cool hospital in areas that aren't occupied.
• Understand whether it makes sense to build new facilities when we still have capacity elsewhere in the system.
• Stop the automatic sprinklers when its raining out.  
• Plant perennials vs annuals for landscaping so we don't have to replace each year. 

Personnel & Benefits

• Delay or cancel raises for 2009 for all team members.  [Note: It has already been decided and communicated that Leaders will not be given raises this year.]
• Pay "Best in Care" loans to nurses that government stopped paying.
• Offer early retirement/health benefit option to team members that are interested in this opportunity.
• Eliminate pension contribution and 403b match funds this year. 
• Protect pension plan benefits for those vested in program. 
• Cancel Baylor (+1) program.  
• Cancel Healthy Choices benefit reimbursement/discount.  
• Create pay-for-performance program for team member raises going forward. 
• Have everyone give back $X per pay-period to organization.
• Start a program where team members can donate money or PTO to help organization.
• Require non-clinical personnel to take time off without pay like the city government was made to do. 
• Reduce number of days accrued for PTO. 
• Charge team members to park in garage.  [I'm not touching this one!]
  

Staffing

• Make sure that we offer staff that are being DTO'd in one area the opportunity to work in other areas where they are short staffed.  We may not need to hire as many people if we do this! 
  
• Reduce overtime and agency personnel utilization.
• Allow part-time team members to sign-up for shifts before full-time team members get overtime.  
• Eliminate incentive pay for working weekends/holidays.  Everyone should have to work their fair share and a select few shouldn't get extra when most others do not.  
• Be more selective in hiring process.  We keep hiring people that are not a good fit and they leave in a few months after we have spent time and money training and orientating them.
• Reduce corporate overhead and management positions.

As you can see, the comments run far and wide, and we will not be implementing every idea that is listed here.  Nonetheless, there were several areas where we seemed to have a strong consensus throughout our meetings and suggestions.  This will be very helpful as we work to finalize the plan that we will commit to as an organization.  While I would hope that we could achieve all of our savings through non-labor related initiatives, it is unlikely that this will be the case.  However, as a result of all the ideas that have been generated, I am confident that we will be successful in our goal to preserve jobs and minimize the need for layoffs.  I look forward to your continued thoughts, ideas, and support as we put the finishing touches on our plan...thank you! 

Your feedback and suggestions...