Situation
Service lines can be extraordinary opportunities for systems to enhance integration, build a signature standard of care and provide a seamless patient experience.
Yet, the opportunity to drive a standard of care across systems can often be obstructed by individual hospital margin targets and challenges.
Background
The AMC in this case had a robust surgical cardiac program with the full spectrum of services from moderate acuity CABG through AICDs and transplantation.
Coupled with regional prominence and a statewide transfer center, there are limits on available resources and often a challenge to provide access to beds and operating rooms.
The opportunity: To provide care in less intense settings, if the walls of the hospital can become virtual and both clinical oversight and margin sharing can be established system-wide.
Execution
• A virtual cardiac surgery program was designed and implemented to move moderate complexity cardiac surgery to a network hospital with mechanisms to share program direction and operating margin.
• One program was established whereby the surgical faculty has access to two sites. Higher complexity is managed at the AMC site and moderate complexity at the community-based site.
• A financial model was established to incorporate margin sharing as an incentive to achieve the vision of system integration. The beds became one continuum with moderate complexity patients treated in a lower cost setting than the AMC.
• Physician leadership, staffing, care protocols and program direction became virtual in that they serve both hospital host sites.
Results
Care standardization. Better outcomes. A signature patient experience. And the achievement of the important but elusive goal of system collaboration.