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Our hospital contracted with HRM to assess our ED physician practice group, and determine the source of the problems and bottlenecks in our ED, redesign patient processes to reduce long waits and significant numbers of LWOT’s, and badly managed patient registration and triage steps. The results of this project:
1. Terminated the local practice, offered employment to the physicians, and served as transitional management of the practice,
2. Assumed responsibility of locating and scheduling significant replacement physicians when the preceding group members chose to leave during the practice transition. HRM provided shift by shift coverage so that 100% of all provider shifts were covered throughout transition with highly capable and competent providers,
3. Adjusted services provided post assessment when these circumstances changed, which was very welcomed and appreciated by the senior management team,
4. Proposed very streamlined patient triage and registration steps to improve the patient experience and reduce LWOT walk,
5. Settled ongoing disagreements between the hospitals and its local physician practice group regarding expectations of service, and the costs of these services,
6. Provided physician mentoring of the Medical Director candidate, and helped strengthen reporting and decision making as a team inclusive of physicians, registration, and nursing.
Starting in 2006, HRM has taken an active role in analysis and assessment of a number of the various hospital based physician services at our hospital, including Hospitalists, Intensivists, Anesthesia, House Surgeons, and our large APRN/PA staff. In every case, HRM has identified savings, and helped us frame fair and equitable service agreements with our various providers. We continue to rely on their expertise today.
HRM has worked with me at both my present and previous firms, and has done the following:
1. Salvaged a broken ED and its physician practice, converting the practice from a major “PPM” to a local, hospital controlled group in a two hospital system in Texas, and saved the hospital significant money in the process,
2. Took over the management of two of our company’s Anesthesia practices, and reduced costs, improved staff satisfaction, and provided complete transparency in the process,
3. Assessed one of our most problematic ED’s, fixed the patient processes, and helped replace the poorly provided services of a major “PPM” with a locally based, highly respected physician practice, and identified over $500,000 in missed collections in facility fees as well.
While serving as the COO at a previous system, I contracted with HRM to assess the significant problems and bottlenecks occurring in our three ED’s, and seek ways to reduce the financial costs of our services. The outcomes of their work included the following:
1. Collaborative discussions between the hospitals and its local physician practice group regarding expectations of service, and the costs of these services,
2. Assessed both of the most problematic ED’s, provided action steps to address the issues with the triage and registration processes, and identified major bottlenecks in the use of Observation beds and the Fast Track processes,
3. Analyzed the quality of the facility fee coding in the ED, and identified that over our 122,000 patient visits, we were under-coding over $35 Million in charges, resulting in a $4.5Million improvement in collections – they not only found it, they agreed to do the coding and fixed the bleeding.

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