Mass General Hospital Cabg

Opportunity

Rising costs was a growing concern in the healthcare industry and for Massachusetts General Hospital (MGH) it was no exception. Although the average length of stay (LOS) for the patients in MGH was declining (Exhibit 10) (Wheelwright & Weber, 2004), it was still the highest compared to their competitors (Exhibit 6) (Wheelwright & Weber, 2004). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital.

The implementation of care path or critical path method could help to provide standard, modified, and better care to all the patients before and after the coronary artery bypass graft (CABG) surgery. The use of standardized treatment procedure could also reduce the operating cost by bringing down the average length of stay (LOS).

Key Issues

• The overall bottom-line profit compared to their operating revenues are very low. Exhibit 1 indicates that it is lower than 2%. This is mainly due to their high operating expense.

• Average length of stay in MGH for DRG is highest (Exhibit 7) compared to the other hospitals in the area. Patients spend on an average 2 to 4 days more at MGH than any other hospital (Exhibit 6 and 7).

• No standard procedures or uniformity to improve coordination and communication between various medical disciplines exist. Standardizing the process is expected to reduce the length of stay for the patients by 20 to 30% and improve overall quality.

• Significant resistance in implementing any changes in process is expected from the personnel in different areas or departments such as cardiologists, surgeons, physicians, nurses, anthologists, physical therapists, residents, non-medical staff etc.

• Capacity planning does not meet expectations, especially such as floor needed for patient overflow, bed availability in Ellison 8 rooms etc.

Possible solutions

• Do Nothing - doing nothing is not a solution. With increased cost pressure and competition, MGH must do something; it must rethink its way of curing its patients, its way of doing business.

• Reallocate/ Reduce staff – Internal analysis showed that poor staff allocation was a shortcoming of MGH. Nurses and highly trained, highly paid technicians were performing functions that could be done by less-expensive personnel. To help reduce cost one