Facility: Tennova Healthcare in Cleveland, TN
TeamHealth Services: Hospital Medicine and Emergency Medicine Staffing
Tennova Healthcare – Cleveland is a 351-bed acute care hospital serving Bradley County, Tennessee, and the surrounding communities. In 2016, the hospital leadership met with TeamHealth’s new facility medical director for hospital medicine to discuss top priorities for performance enhancement, including improving relationships with community-based physicians, streamlining patient throughput and raising HCAHPS scores.
The facility medical director devised plans to tackle all three issues, starting with a new process for allowing direct admissions from community physicians. Previously, community physicians would spend as much as 45 minutes on the phone, making multiple calls, before an admission could be arranged. Now a dedicated phone line – which the FMD often answers herself – allows community physicians to make a five-minute call, and TeamHealth handles the rest. Physicians rave about the simple, efficient process to hospital administrators, and direct admissions have increased from about six per month to well over 30 per month.
Additionally, the FMD identified a need to improve the number of patients discharged before noon in order to make beds available for additional patients. Her multi-pronged plan included adjusting physician shifts to begin one hour earlier, setting incremental goals for morning discharges, and sharing and discussing performance metrics with each physician.
Both the direct admission and discharge initiatives have contributed to the hospital’s improvement in patient satisfaction scores — as patients enjoy bypassing the emergency department for admission and leaving the hospital as soon as possible. Additionally, the FMD began tracking individual physician HCHAPS scores, sharing them with each physician and providing one-on-one coaching when necessary to help improve performance.
Through these efforts, TeamHealth strengthened its relationship with the hospital’s administration to allow both parties to truly act as one. An enhanced level of trust has allowed for productive debate and finding common ground on solutions, timing and implementation to achieve shared goals, such as enhanced efficiency and patient experience.
In fact, by working together with hospital leadership, TeamHealth’s FMD helped achieve dramatic improvements in all three areas identified by hospital administration. Community physicians now have a strong relationship with the hospital, enjoy utilizing the new direct admissions process and know they can call the FMD directly with any questions or concerns. The rate of morning discharges has improved from 35% to 62%, allowing the hospital to improve throughput from the emergency department to the inpatient unit. And HCAHPS scores have jumped from a low of 67% to 79% and are continuing to climb.
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