CASE STUDIES

Process Redesign—This hospital provider had seen its Emergency Department grow from 19,000 visits to more than 45,000 visits annually in less than five years. The average throughput time for ED patients was more than six-and-a-half hours and the Left Without Being Seen percentage was at 6.5 percent (annualized) and more than 12 percent in the 90 days preceding engaging Insight Strategies. Insight utilized a methodology which combines group process redesign work (Rapid Redesign for Process Improvement) with computerized simulation over a three-week period to redesign the entire ED process. Nine months after the redesign was completed, the throughput time was reduced by more than half, the staff and patient satisfaction has improved and the Left Without Being Seen is under 1 percent, resulting in a net revenue improvement of nearly $1 million.

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Cultural Integration— This not-for-profit health care provider located in two states in the Midwest acquired an additional site in a third state. While the acquisition made good business sense, the provider wanted to identify potential cultural barriers that might inhibit effective integration of the business. Insight Strategies conducted a cultural assessment of the existing sites and the newly acquired site, and identified potential problems as well as opportunities for shared learning and synergy based on key “cultural anchors” within the organizations. With a focused understanding of differences in practices and behaviors, senior leadership was able to map a seamless and successful integration of the two cultures. This type of engagement can be a critical element of pre-merger/acquisition due diligence.

 

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Preferred Culture Development—This large not-for-profit health care provider was a national leader that, over the course of five years, had seen its market share decline along with its financial performance. Insight Strategies worked with the senior and middle managers to improve their understanding as to why these declines were occurring. As part of this understanding, the executive team recognized that in order to reassert itself in the marketplace, its current culture that relied on its sheer size to drive business needed to be revised to focus on personal and team accountability, innovation and improved service delivery (including a rethinking of its clinical model). Insight Strategies worked with the middle and senior management to develop a set of Agreements of Belonging to improve personal and team accountability, identify characteristics of its preferred culture and develop a detailed implementation plan to bring that preferred culture to life. Additionally, Insight Strategies facilitated specific financial and clinical improvements that have brought the organization back to profitability.

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Organizational Redesign—This $800 million health system was struggling with throughput and bed capacity issues and engaged Insight Strategies to facilitate a restructuring of its case management, quality management and hospitalist functions. Insight worked with the key stakeholders across these areas individually and then with the group as a whole to improve the way in which they worked together. The resulting plan integrated these clinical functions and intentionally moved their role in the care process “upstream.” Specifically, they now influence/intervene in patient care processes in a more proactive, concurrent way; anticipate patient and other customer needs; facilitate education of patients and other clinical personnel; analyze and report trends in care processes; and use information as leverage to modify how patients are cared for. As a result this shift toward more proactive patient care led to more effective resource utilization, improved patient satisfaction, and ultimately an improved bottom line for the entire system.

Strategic Planning—Insight Strategies worked with the City of Mount Clemens, the county seat of the third largest county in Michigan. At the start of the engagement, the city’s general fund had less than 12 months before it would run out of money. Insight worked with the elected city officials, elected county leaders, community leaders, the general community (through facilitated town hall meetings) and the local TV station to develop a plan that would bring the city back from the brink of bankruptcy. As a result, major changes were undertaken and, two years later, the city is no longer in a budget crisis.

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