|By Wall, J K|
It can be as simple as getting all the players in the room.
That's what the joint replacement team at
That's no easy task, due to the byzantine way the industry is structured and financed. But unprecedented pressures now force all health care providers to follow
IU Health Saxony credits the teamwork for cutting costs and producing its nation leading results.
Most wear scrubs; some wear white lab coats. They fill up the rows of tables, most with small stacks of papers in front of them, although some bring laptops instead. Several have
There are two surgeons, an internist, nurses, pharmacists, anesthesiologists, the operating room team, therapists, salesmen from two orthopedic-implant makers and even the hospital chaplain. Anyone who will have any contact with the patients is asked to attend.
"No one is paid extra to attend. They believe in this model," said Dr.
They discuss in detail every patient who will come in the following week for surgery: their heights, weights, medical histories, reason for needing a joint replacement (most of the patients are obese, diabetic or nearly so).
The goal is not only high-quality surgeries - although IU Saxony is doing that. It had the eighth-lowest rate of readmissions last year out of the 120 academic medical centers and 307 affiliated hospitals that are part of the
Just 0.74 percent of Saxony's joint replacement patients had to come back for do-over surgery within 30 days of the first surgery. That compares with a national average of 5.4 percent, according to the
But the IU Saxony team is also striving to catch anything that might delay completion of a surgery or postpone it altogether. Handling unforeseen issues on the day of surgery, which Meneghini calls "fire drills," can lead to overtime for staff or to fewer surgeries per day. Postponements waste staff and OR time.
Delays can also keep patients in the hospital longer. But IU Saxony has been doing a good job of getting patients on their way. It ranked sixth nationally among the
When Meneghini and his partner, Dr.
That's because, Meneghini said, they had not instituted the care coordination that they now do at their Friday morning meetings.
"The coordination of care is getting the whole team on the same page. There's less errors, there's less confusion. So the patients are ready to go home faster," Meneghini said. "Every minute in a hospital is hugely expensive."
Meneghini is trying to figure out exactly how much IU Health Saxony is saving, compared with market averages. In a study published this year by researchers at