Increasing Outpatient Revenue

Situation
In 1994, a 500-bed urban hospital was facing declining revenues and negative cash flow as a result of the introduction of managed care into its marketplace.

Solution
An ESP partner led a concentrated 30-day transformational change effort for the hospital's marketing, communications, and business development team.

Outcome
Within 90 days following the implementation of the change management plan, the hospital realized a cumulative 17% increase in net outpatient income and recovered all costs associated with the transformation.

Managing Charity Care

Situation
Despite two emergency department expansions in five years, a Dallas hospital neighboring a low-income community was confronted with ever-increasing non-emergent charity care volume. The hospital had previously partnered with the county health system to operate a community-oriented primary care clinic to address these health concerns. Disputes between staff, physicians, and local community leaders led to an increasing decline in the clinic’s volume and increasing costs to the hospital.

Solution
An ESP partner undertook the remedy using a series of relationship-building efforts. Acting as both facilitator and moderator, the partner built a series of interlocking collaborations involving private physicians, public health physicians, community leaders, hospital administrators, and competing community groups. Through these collaborations, team members adopted specific action plans, assigned accountability, defined outcome measures, and coordinated efforts.

Outcome
A renewed commitment to the clinic emerged. Operating days and hours were increased, financial support was raised, and patient volumes increased. Over a four-year period, more than $750,000 annually was added to the hospital’s bottom line. As for the human factor, infant mortality decreased, infant birth weights were boosted, and immunization rates increased.

Reorganizing Emergency Medical Services

Situation
Ex-urban, suburban, and rural hospitals had joined with private physicians, municipalities, and transport services to form a medical direction and control agency. Over time the agency grew to provide training for first responders to paramedics, on-line and off-line medical control, and a 24/7 dispatch center. Geographically, the organization’s reach grew to over a 200-mile radius. Costs began to outpace revenues, and the organization faced closure.

Solution
An ESP partner was engaged to either restructure the organization or close it. Gathering customers, vendors, employees, management, physicians, and other key stakeholders, the partner guided them through a five-day action planning and goal setting retreat. Using the work of the group, the ESP partner teamed with key stakeholders on a 90-day reorganization of the agency including project mapping, workflow and workforce planning, and discontinuation of non-performing lines, all without interrupting service delivery.

Outcome
The organization remained open to continue serving the community. Although it emerged from the restructuring with a smaller growth rate, the agency was able to sustain profitability.