1. HUNTER BYRNES KATHRYN GOODRIDGE SARAH LEADBEATER BEN MENNIS PUJAN PATEL Improving Physician Productivity in the Emergency Department at VCU Community Memorial Hospital

2. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Agenda Final Take Limitations Recommendations Results Methodology Background Introduction

3. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Introduction Community Memorial Hospital (CMH)  Community-owned, non-profit  Serves South-Central VA & Northern NC  One of the largest employers in the area  Joined VCUHS on July 1st, 2014

4. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Introduction Uncertain and Low Patient Volume Lower-level Acuity Patients Physician Productivity Issues AIM: Improve overall physician productivity of VCU-CMH by increasing patient volume & utilizing resources available to them through VCUHS. CMH Emergency Department Inefficiencies

5. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Background Productivity  Measures the efficiency a person or system has in converting inputs into useful outputs  We focus on Physician Productivity  Forms a basis for comparison between physicians Able to Calculate the Productivity of: Single Operation DepartmentOrganization

6. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Background Successful Use of Productivity Measurements  Consistently Defined  Realistic Expectations  Publicizing Improvements  Creates Healthy Competition  Compare to Benchmarks

7. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Background Variables that Impact Physician Productivity Time of Shifts Worked Patient Volume Organization Characteristics Patient Characteristics & Case Mix Physician Productivity

8. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Methodology  Mr. Scott Burnette, CEO CMH  Dr. Kathy Baker, Director of Resource Management for LifeEvac and the Emergency Department for VCU Health System  Data Sources  Medhost  Monthly/Hourly volume: March 1, 2014 to February 28, 2014  Duva-Sawko  Yearly volume: 2010-2014

9. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Results

10. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Results Hourly Productivity

11. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Results Regression Statistics Multiple R0.187488222 R Square0.035151833 Adjusted R Square -0.44727225 Standard Error81.3185352 Observations4 Forecasting Yearly Volume

12. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Results

13. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Recommendations  CMH must increase patient volume to address physician productivity  Level III Trauma Center Designation  “Golden hour” care  Utilization of Telemedicine with VCUHS  200 vs 30 specialties  Physician Dashboard  Encourage healthy competition and increase physician productivity

14. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Limitations  Absence of permanent ED Director & Data Analyst  Lack of complete data  Leading to assumptions  Inability to retroactively obtain data  Financial constraints  Physician productivity benchmark data  Comparison between Pediatric ED & General ED  Physician’s Views  Physician Availability  Distance between CMH & VCU  Time constraints WARNING! LIMITATIONS AHEAD

15. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take  Increase volume by 1,100 patients annually  Meet benchmark of 2.0 in four years Future Projections

16. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take  Increase Patient Volumes  Level III Trauma Center  Telemedicine  Physician Dashboard

17. AgendaIntroductionBackgroundMethodologyResultsRecommendationsLimitationsFinal Take Questions & Answers