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Format:
PDF
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8.5" x 11"
Intended audience:
Unit-based team members, co-leads, sponsors and consultants
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This quick guide, which includes descriptions of tools available on LMPartnership.org, will help teams plan and carry out projects to reduce waste and improve efficiency of work processes.
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As more and more unit-based teams answer the call to improve affordability for health plan members, they are finding new tools that can help manage their cost-improvement projects.
One such tool, a handy spreadsheet, can help teams track and report their cost savings.
Developed by UBT consultants and financial analysts in Colorado and later adopted by UBTs in the Northwest, the tool can help teams determine the economic benefits of a performance improvement project with little or no assistance from a consultant or sponsor.
“It’s a great add-on to teams’ reporting in UBT Tracker,” says Luanne Petricich, chief pharmacist, Pharmacy Professional Affairs, in Colorado and a sponsor of 12 UBTs in the region. “It can be a very impactful way for co-leads to show their teams and others what their savings were and how they achieved them.”
In addition, teams can now record their financial results directly into UBT Tracker thanks to a new data field, Annual ROI, that allows teams to share how much money a project saved or generated. The field can be found under the Project Details tab (see graphic below).
Petricich sends the spreadsheet to any of her teams working on a cost-reduction or efficiency project to help them document their results.
One team that used the tool was the pharmacy UBT at Baseline Medical Offices in Boulder. The team had completed an inventory-reduction project that far surpassed its goal—which was to reduce its drug inventory by 10 percent, or $50,000, in three months. By adjusting order quantities to better match usage and returning overstocked medication to the mail order pharmacy for use before the expiration date, the team saved $143,000—nearly three times its original goal.
“It’s important to track your results, and this tool can help teams do that in a simple way,” says Don Larson, Baseline’s pharmacy supervisor. “It’s something we would use the next time we do a similar project.”
Format:
PDF
Size:
8.5” x 11”
Intended audience:
Frontline employees, managers and physicians
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Show your staff these money-saving tips to improve workflows, upgrade technology and increase revenue.
Format:
XLS (spreadsheet)
Size:
1 page
Intended audience:
UBT co-leads or team members
Best used:
Use this spreadsheet to track and determine the economic benefits of your team's performance improvement projects—you can easily see the impact of your efforts on the bottom line.
Note: Entries are placeholders; delete them and add your own information.
Format:
PDF
Size:
8.5” x 11”
Intended audience:
Level 2 and higher unit-based teams
Best used:
UBT consultants and UPRs can use these instructions to guide teams on finding projects that solve for affordability. Allow 1½ to 2 hours for the full exercise.
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Format:
PDF (color and black and white)
Size:
8.5” x 11” (two-sided)
Intended audience:
Level 2 and higher unit-based teams
Best used: Download and share this introduction to performance improvement with team members as a guide to the common types of wasted resources that diminish care and service.
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The Colorado Couriers team is busy with 41 Kaiser Permanente facilities, more than 400 non-KP locations, and about 180,000 pickups and deliveries a year.
When it comes to outside contractors, the SEIU Local 105 contract requires that Human Resources provide the union with specific information about outsourcing, including who is doing the work, the affected job classification, the number of hours involved and what facilities were impacted.
That information wasn’t being provided, so Dominic Jones, a courier driver and Local 105 steward, objected.
“I saw that we were contracting out regular courier service, and it didn’t make any sense,” Jones says. “I knew that it was costing the company more money.”
As a result, the unit-based team took a close look at the department’s processes.
Team members collaborated with couriers in Northern California, who had done similar work, and discovered they could hire another employee, improve routes, reduce use of outside contractors—and still save money.
First steps were to work with internal customers to assess their needs, then reconfigure and bring routes in-house that had been contracted out.
They hired an additional employee to reduce overtime and outside courier costs on the weekends, and purchased new technology for central dispatching that enabled better tracking of pickups and deliveries.
Drivers got smartphones to receive information in real time, which made it possible to monitor drivers’ locations using GPS and find the closest driver for an unscheduled pickup.
In addition to new technology, the team worked with the region’s labs to ensure pickup times met the lab workflow.
“I am very supportive of the work our unit-based team has accomplished,” says Jones, who feels his concerns were addressed by the changes. “We are still outsourcing stat work that we can’t get to, but we are in the process of hiring on-call drivers, which will ease that burden.”
The team exceeded its stretch goal and saved an average of $25,577 a month, a cost reduction of 48.2 percent. By the end of 2013, the team’s effort had resulted in a cost savings of $145,165, and projected a savings of more than $375,000 for the following year.
“We had many painful conversations about how to make this work,” says manager Terry Wagner. “But the team’s input was invaluable. Each individual has been a contributor at some point.”
Format:
PDF
Size:
8.5" x 11"
Intended audience:
Unit-based team co-leads and members
Best used:
Post this tip sheet on a team bulletin board, or use it as a starting point to figure out how to determine the savings and/or cost-avoidance of performance improvement efforts.
It started with a question from Oncology RN Tom Fought, a member of the Oregon Federation of Nurses and Health Professionals (OFNHP), at the Interstate Medical Office in the Northwest.
Why, he wondered, was primary tubing used for low-reaction drugs instead of the less-expensive short or secondary tubing?
That prompted the department’s unit-based team to start an improvement project that wound up saving $25,000 a year.
When patients come in for chemotherapy or other infusion medications, the drugs are administered via an IV: The bag holding the medication is hung on a pole, with a line that goes into the patient’s vein. When primary tubing is used, the valve to stop the flow of medication is very close to the patient’s body.
If the drugs being used have a high potential for an adverse reaction, it’s essential to use primary tubing, so that if there is an emergency and the line has to be shut, only a very little additional medication reaches the patient.
When the short tubing or secondary tubing is used, the valve to stop the flow of medication is farther from the patient. In this situation, if the valve is closed, more medication is in the line and will flow into the patient until the tube is empty. These types of tubing are appropriate when the medication has a low potential for a negative reaction.
Primary tubing is $4.10 per unit, short tubing is $3.65 and secondary tubing is 65 cents. The costs add up if primary tubing is used when it’s not necessary.
“I had no idea that we would be saving the unit that much money by conforming the tubing,” Fought says.
This team alone was able to save $25,000 a year. If every Kaiser Permanente oncology infusion department adopted this practice, the savings would be dramatic.
“This was such an easy tweak—we just needed to think outside of the box,” says Lacey Anderson, RN, the Infusion Team Lead and a member of OFNHP, who was involved in the project. “The team realized this was such a great idea and wondered, ‘Why haven’t we been doing this all along?’”
Heidi Rolf, the department manager and the UBT’s management co-lead, is proud of the work the team has accomplished. She attributes the success to the leadership of the team and notes that since the team has advanced to a Level 4 on the Path to Performance, team members have more camaraderie and are more engaged.
“At first it was a little difficult to change the habits of the nursing staff,” Fought says. “Within a few weeks, we had everyone on board and our tubing project took off.”
(3:05)
Unit-based teams across Kaiser Permanente are looking for innovative ways to improve their work and save money, too. Staff members at the Primary Care department at the Bonita Medical Office in San Diego, Calif., found that when they streamlined supply orders, they saved far more than they had expected. And while there were some minor hiccups, it wasn’t as hard as they expected, either. Watch their story and become inspired.
