The Healthcare Flywheel - Alabama Hospital Association · 2019. 10. 17. · í ì l í ó l î ì...
Transcript of The Healthcare Flywheel - Alabama Hospital Association · 2019. 10. 17. · í ì l í ó l î ì...
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The Healthcare Flywheel
UAB Medicine Supply Chain and its Pursuit of Excellence Through Slow and Methodical Change
Laura Kowalczyk, JD, MPH
Vice President, Supply Chain and Support Services
UAB Medicine
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As a healthcare supply chain leader what is your biggest challenge right now?
ow
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Industry Says
The Pace of Change
Healthcare Supply Chain Data/Information Technology Limits Price and Utilization Transparency
“Complex and Fragmented”
Reimbursement Landscape Ever Evolving
Resource Limitations
Supply Chain Leadership Skillset
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Complex and Fragmented – Are We Different?
To complete the healthcare process there are a host of stakeholders
Each has it’s own interests to protect
Managing both upstream and downstream with suppliers and customers –Can’t run out of anything
Vertical structures create data silos
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Supply Chain: The Facilitator
HC Supply Chain
Patient/Consumer
GPOs
Insurers
RegulatoryFinance
Operations
Nursing
Distributors
Vendors
Population Health
Patient Outcomes
Quality Executive Positioning
AmbulatorySocial Determinants
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Patience and Persistence
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SupplyChain
Excellence
The Journey
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UAB Hospital-Inpatient Services
1,157-bed, flagship facility for the UAB Health System and primary teaching site for the UAB School of Medicine – 10th
largest in US
One of the largest AMCs in US - Top 5
Level 1 Trauma Center
Only Magnet Designated Hospital in the State of Alabama
Largest comprehensive transplantation program in the southeastern United States
Level 3 Regional Neonatal Intensive Care Unit
57 Operating Rooms
The nation’s first Level 1 Ocular Trauma Hospital
~400,000+ inpatient days
~ 150,000+ ED visits
~43,164 surgical cases
Occupancy 91.5-% (July 2019)
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UAB Hospital-Ambulatory Services
Over 50 Multispecialty Clinics at UAB Hospital
The Kirklin Clinic of UAB Hospital: A 440,000 square foot ‘super clinic’ designed by the renowned architect, I.M. Pei
UAB Medicine Hospital Based Clinics
Average annual appointments: 650,000+
Rural Hospital Resource Center
Affiliate/ Managed Relationships
Clinical
Supply Chain
Compliance
Managed Care
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UAB Health System Supports Providers in Alabama
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Limited base
Value Analysis – one committee
Supply and Linen management/logistics
Purchasing and Contracting performed by University Procurement
Decentralized contract management
Limited benchmarking
High transaction error rate
Not fully leveraging Lawson automation and ecommerce capabilities
Insufficient resources dedicated to the Supply Chain
Supply costs growing at an unsustainable rate
UAB Medicine Supply Chain – Pre-2012
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Created business case to create a strategic Supply Chain
Received institutional support for the addition of 12 new FTEs to establish Hospital Procurement/Contracting and Analytics Departments
Transitioned:
6 University Procurement staff to a dedicated Hospital Purchasing;
3 Directors (Resource Utilization; Strategic Sourcing and Performance Analytics;
Purchashing Manager;
2 Sourcing agents
Redistributed responsibilities to better orient them with new structure
Began the process of ensuring data integrity
Go-Live January 2012
What Did We Do?
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UAB Medicine Supply Chain Org Structure - 2019
Sr Director Resource Utilization
Sr Director of Contracting and
Sourcing
VP Supply Chain
Manager Hospital Purchasing
James Aldridge
Director SC Informatics
Sr. Director of Materials
Management
Buyers7
Distribution Manager 3
Systems Analyst2
Administrative Assistant
Distribution Supervisor 5
Receiving Supervisor 1
Inventory and Logistics Staff
80
Crothall Linen
Hill-Rom
Stericycle
Product Assessment Committees
(PACs)11
Value Analyst1
Strategic Sourcing Specialist
5
ESM System Analyst
1
Financial Analyst3
Cardinal Distribution
Informatics Analyst1
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Vizient: Ranked in top 5 of all hospitals in price benchmarking
ECRI: Ranked in top 6 nationally and #2 in the Southeast
Centralized procurement and contracting
Consistent annual supply implemented supply savings: $8M-$11M
Instituted consistent price benchmarking in contracting process
Expanded Lawson automation/ecommerce
Manage cost beyond pricing
Created clinical alignment across the organization
What We Have Accomplished?
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Clinically Integrated Supply Chain
Align clinical needs with contracting strategy
Merging cost data with outcomes data to support evidence based decision making
Engage clinicians in the product selection and contracting process
Ensure patient quality, safety, and satisfaction attributes are included in product evaluation - CQO
Integrated With The Clinical Enterprise
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What Is Critical For Our Evolution?
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How
The Flywheel concept
Select the Right Team
Build Consistent Processes
Build Supportive and Collaborative Relationships
Continuous Innovation UAB
Medicine Supply Chain
Services
Be Resilient
Always Strive for Efficiency and Effectiveness
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Amazon’s Flywheel
Lower prices
on more offerings
Increase customer
visits
Attract Third party sellers
Expand the stores, extend
distribution
Grow revenues per fixed costs
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What Does It Take?
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The Role of Discipline
Disciplined People
No Need for Hierarchy
Disciplined Thought
No Need for Bureaucracy
Disciplined Action
No Need for Excessive Controls
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The Team
Get the right
people on the bus!
The Team
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Level Five Leadership
Humility
Ambitious
The organization mission is always first
Motivating through inspired standards
Takes responsibility
Develops Discipline
Finds the right people
Nurturing who need no credit
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Consistent Processes
Time Telling Versus Clock Building
• Shaping a culture that can thrive far beyond any single leader is clock building
Success comes when the organization proves its greatness not just during one leader’s tenure but also
when the next generation of leadership further increases flywheel momentum
- Jim Collins, Built to Last Process
• Building an organization that can generate many great ideas is clock building
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Relationships
Clinical Teams Key Suppliers
Executive Leadership
The Supply Chain Team
Operations
Relationships
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If we only focused on efficiency we would make the most sophisticated
horse drawn carriages and breed faster horses
Efficiency AND Effectiveness
If we only focused on effectiveness we would make cars that no one could afford
EfficiencyDoing things right
EffectivenessDoing the right things
Must HaveBoth
E+E
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Continuous Innovation
Innovation
Dynamic Duality
Core Values
Innovation
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Resilience
“I arise in the morning torn between a desire to save the world and a desire to
savor the world.
- E. B. White
Resilience
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Moving From Time Efficiency to Energy and Resilience
Time Management• Management Focus• Controlling Limited Resources • Goals and Outcomes• Personal/Team/Organizational
Productivity • Trying to Get on Top of Things• Feeling Time Starved and
Disappointed
Energy Leadership• Leadership Focus• Multiplying Energy• Passion and Purpose• Personal/Team/Organizational
Engagement• Being on Top of Things• Feeling Engaged and Satisfied
Managers control resources; leaders multiply energy
- Anne Tessien
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If I Live To Be 100
Optimism: They were not dominated by worry or negativity
Engagement: They were actively involved in life
Mobility: They stayed active physically
Adaptability: Extraordinary ability to stay balanced by accepting and adapting to ands accepting change and loss. Zest for life even after personal losses
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How
The Flywheel concept
Select the Right Team
Build Consistent Processes
Build Supportive and Collaborative Relationships
Continuous Innovation UAB
Medicine Supply Chain
Services
Be Resilient
Always Strive for Efficiency and Effectiveness
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Change will be continuous
What we did yesterday worked yesterday
What we do today will not work tomorrow
We may know where to go but not yet how to get there
We will be asked to do more with less
Our success will open up new opportunities
Embrace the Flywheel and hang on for the ride
Things We Know
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References
Good to Great, Jim Collins
Leadership from the Inside Out, Kevin Cashman
The Success Principles, Jack Canfield
Fail, Fail Again, Fail Better, Pema Chodren
Gratitude and Trust, Tracey Jackson and Paul Williams