Surgeons/Hospitals: It’s Time To Sharpen Your Saw

Marshall K. Steele, MD
Orthopedic Product News: September, 2005

Healthcare has its problems and we are all feeling the heat. We’ve got a lot of trees to cut. Our costs continue to rise while reimbursement stagnates or falls. ... Differentiating yourself is a critical challenge as competition continues to intensify with patients shopping for the right surgeon and hospital. Profitability and patient satisfaction are difficult to sustain. Our delivery system is inefficient. ... While on the surface this may seem acceptable it has created a delivery system of complexity, confusion, inconsistency, costliness, and even errors.

This new delivery system I call "The 4 S’s":

• Simplify processes
• Standardize patient interaction and care paths
• Savings will result from improving value AND efficiency
• Satisfaction of patients and staff will improve dramatically

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Case Study at Anne Arundel Medical Center-10 Years

Profile: Anne Arundel Medical Center, Annapolis, MD, 250 Beds

Anne Arundel Medical Center is a perfect example of the transformation of a traditional hospital service line for joint replacement into a Destination Center. In 1995, AAHS did approximately 200 Total Joint Replacements (TJR) with 8 surgeons. TJR was not profitable, inpatient care was inconsistent, patient satisfaction was merely "acceptable, and there was considerable out-migration to other hospitals in Baltimore and Washington, DC.

Led by Marshall Steele, MD, the goal was to establish a "Destination Center of Superior Performance".

The Results:

• Patient satisfaction is in the 98%
• Most patients (80%) return home with outpatient therapy within 3 days
• Hospital costs and length of stay are the lowest in the region
• TJR is the most profitable service line in the hospital
• The volume is now over 1,000 cases per year, with growth rates of 21% per year.
• AAMC is of the top three providers of TJR surgery in Maryland.

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Empowering and Mentoring Leadership: The Key to the Implementation of a New Delivery System for Care of Total Joint Patients

Kyle Prickett, Marshall K. Steele, MD

Increased life span and the aging "Baby Boomer" generation will soon result in an increased number of total joint replacements in the next 20 years. Limited financial resources warrant the need for the implementation of the best possible delivery system in total joint care. The need to create innovative joint centers, that meet all these needs, is more relevant than ever.

In this study, Marshall Steele, MD and Kyle Prickett aimed:

• To obtain an estimate of the implementation success of hospitals attempting to implement a joint program
• To evaluate whether this is a factor in results
• To identify the most common barriers faced by these hospitals during implementation
• To facilitate implementation of joint programs in hospitals

This study reports on a measurement of the success of hospitals in joint program implementations as well as their overall results.

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