Massachusetts General Hospital: CABG Surgery (A) case study
Problem:
The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.
Key Issues:
Dr. David Torchiana (Cardiac Surgeon) and Dr. Richard Bohmer (Quality Improvement Administrator) want to improve the process in the hospital by implementing a newly created care path across all the departments in the MGH without affecting the patients. Some of the key issues that MGH is facing are:
Operating expenses are very high. The overall bottom-line profit compared to their operating revenues are very low. Exhibit 1 indicates that it is lower than 2%. This is mainly due to their high operating expense.
Average length of stay in MGH for DRG is highest (Exhibit 7) compared to the other hospitals in the area. One of the reason is due to the operational inefficiencies.
Lack of data to improve outcomes.
No standard procedures or uniformity to improve coordination and communication between various medical disciplines and to improve overall quality. Standardizing the process is expected to reduce the length of stay for the patients by 20 to 30%.
Expected resistance to accept change in process by personal in different areas or departments such as cardiologists, surgeons, physicians, nurses, anthologists, physical therapists, residents, non-medical staff etc.,
Capacity planning does not meet expectations especially such as floor needed for patient overflow, bed availability in Ellison 8 rooms, lack of staff in SICU, handling medical complications that requires longer stay in the
The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.
Key Issues:
Dr. David Torchiana (Cardiac Surgeon) and Dr. Richard Bohmer (Quality Improvement Administrator) want to improve the process in the hospital by implementing a newly created care path across all the departments in the MGH without affecting the patients. Some of the key issues that MGH is facing are:
Operating expenses are very high. The overall bottom-line profit compared to their operating revenues are very low. Exhibit 1 indicates that it is lower than 2%. This is mainly due to their high operating expense.
Average length of stay in MGH for DRG is highest (Exhibit 7) compared to the other hospitals in the area. One of the reason is due to the operational inefficiencies.
Lack of data to improve outcomes.
No standard procedures or uniformity to improve coordination and communication between various medical disciplines and to improve overall quality. Standardizing the process is expected to reduce the length of stay for the patients by 20 to 30%.
Expected resistance to accept change in process by personal in different areas or departments such as cardiologists, surgeons, physicians, nurses, anthologists, physical therapists, residents, non-medical staff etc.,
Capacity planning does not meet expectations especially such as floor needed for patient overflow, bed availability in Ellison 8 rooms, lack of staff in SICU, handling medical complications that requires longer stay in the