New Georgia initiative to improve rural hospitals

Seven rural Georgia hospitals will participate in a new initiative designed to help increase their capacity to serve patients, improve the quality of their services and reduce costs.

The benefits will come from adopting performance improvement techniques that are already widely used in manufacturing industry.

The two-year demonstration project, to be led by the Georgia Institute of Technology through a $349,000 grant from Healthcare Georgia Foundation, will help train hospital staff in "lean" techniques that identify waste in processes and find ways to eliminate it.

Georgia Tech has successfully used the approach with hospitals in Atlanta, Columbus, Newnan and Vidalia. Its "lean health care" training programs have been licensed for use nationwide by the American Hospital Association.

"We want to take the techniques that have proven to be so successful in large hospitals and use them in small, rural hospitals," said Frank Mewborn, director of the Healthcare Performance Group in Georgia Tech's Enterprise Innovation Institute. "Rural hospitals typically don't have the resources to hire outside consultants to help with performance improvement issues, so we very much appreciate the support from Healthcare Georgia Foundation to make this initiative possible."

Georgia Tech project leaders will work with health care professionals at the participating hospitals to conduct lean assessments, teach basic lean concepts, develop value stream maps to analyze the flow of materials and information, and implement rapid process improvement techniques. Because the techniques rely on input from those closest to the processes being improved, each hospital will dedicate staff members to work with Georgia Tech.

"This is a substantial investment on the part of the hospitals because they must pull front-line staff from their normal responsibilities during the process improvement activities," Mewborn noted. "Involvement of these key people is essential to the process, and it pays off long-term through better processes and buy-in from those who are on the front lines of providing patient care."

Beyond direct process improvements, the initiative will also provide long-term benefits through senior leadership and hospital staff who have been trained in the lean techniques and who will share them with other departments and facilities. Success will be measured by improvements made during the process, and by the ability of each hospital to continue the process improvement efforts after the initiative's conclusion.

Rural hospitals in Georgia face a financial crisis because their patients are less likely than those of metropolitan hospitals to have health insurance. At the same time, hospitals in underserved areas face other competitive disadvantages as they confront rising costs.

"A lot of rural hospitals are struggling to make payroll every month," Mewborn noted. "They don't have revenue opportunities from more profitable kinds of surgeries because they may not have a large enough market. They are meeting an essential need for health care in their areas, but their reimbursement rates tend to be low."

Such facilities need to find sustainable ways to become more efficient, which is why Healthcare Georgia Foundation provided the grant to Georgia Tech.

"This grant award represents a tremendous opportunity to achieve greater efficiencies in health care quality and costs," said Gary D. Nelson, president of the Foundation. "By taking this issue on from both clinical and operational perspectives, we can achieve sustainable efficiencies where they are most needed in our state."

One of Georgia Tech's first lean health care projects was with the emergency department at Meadows Regional Medical Center in Vidalia, Ga. As a result of the process improvement activities done there, the average time patients remained in the emergency department was reduced 44 percent and physicians were able to see more patients per hour - all while maintaining a 92 percent patient satisfaction rating.

Other hospital process improvement projects done by Georgia Tech have:

• Shortened the lead time and reduced errors in blood testing,
• Developed a time-saving system for managing intravenous pumps,
• Reduced errors and lead time for collecting and processing tissue samples,
• capacity by reducing room down-times between patients,
• Boosted laboratory capacity and reduced errors through improved organization,
• Increased physician productivity through standardized work processes, and
• Streamlined pre-registration processes.

Hospitals that have agreed to participate in the program include Upson Regional Medical Center in Thomaston, Peach Regional Medical Center in Fort Valley, Monroe County Hospital in Forsyth, Morgan Memorial Hospital in Madison, Banks-Jackson-Commerce Hospital in Commerce, West Georgia Medical Center in LaGrange, and Hutcheson Medical Center in Fort Oglethorpe.

The projects are expected to be completed by June 2010.

About Healthcare Georgia Foundation: Healthcare Georgia Foundation is a statewide, private independent foundation. The Foundation's mission is to advance the health of all Georgians and to expand access to affordable, quality healthcare for underserved individuals and communities. Through its strategic grant-making, Healthcare Georgia Foundation supports organizations that drive positive change, promotes programs that improve health and healthcare among underserved individuals and communities, and connects people, partners and resources across Georgia. For more information, please visit the Foundation online at (www.healthcaregeorgia.org).

About the Enterprise Innovation Institute: The Georgia Tech Enterprise Innovation Institute helps companies, entrepreneurs, economic developers and communities improve their competitiveness through the application of science, technology and innovation. It is one of the most comprehensive university-based programs of business and industry assistance, technology commercialization and economic development in the nation. For more information, please visit (innovate.gatech.edu).