1. Advocate Health Care, Oak Brook, IL
2. Cape Cod Healthcare, Hyannis, MA
3. CareGroup Healthcare System, Boston
4. Kettering Health Network, Dayton, OH
5. Maury Regional Healthcare System, Columbia, TN
6. Mayo Foundation, Rochester, MN
7. NorthShore University HealthSystem, Evanston, IL
8. OhioHealth, Columbus, OH
9. Partners Healthcare, Boston
10. Spectrum Health, Grand Rapids, MI

Thompson Reuters rated the hospitals on eight key criteria:

• In-hospital mortality
• Medical complications
• Patient safety
• Average length of stay
• 30-day mortality rate (post-discharge)
• 30-day readmission rate (post discharge)
• Adherence to clinical standards of care (evidence-based core measures published by the Centers for Medicare and Medicaid Services
• Hospital Consumer Assessment of Healthcare Providers and Systems patient survey score (part of a national initiative sponsored by the U.S. Department of Health and Human Services to measure the quality of care in hospitals)

A new study by researchers at Arizona State University looked at patient data from the 2006 National Hospital Amublatroy Medical Care Survey.

The research showed that hospitals using advanced EHRs (such as online access to test results, etc.) saw a number of benefits, including:

• treatment times that were 13% shorter
• admitted patients had hospital stays that were 24% shorter, and
• patients who were treated and discharged spent 21% less time in the ER.

Interestingly, simply using basic EHRs wasn’t enough to improve speed. Hospitals without EHRs actually outperformed those with basic EHRs — especially among patients that arrived at the ER with urgent medical problems.

While a factory-style approach to efficiency may seem like the worst thing that could happen to the quality of patient care, the opposite is true.

Hospitals that have adopted continuous improvement programs like those used by manufacturers have found they’ve improved both their bottom lines and the level of care patients receive.

Seattle Children’s Hospital has adapted kaizan, a Japanese theory of business management, to continually make small adjustments that reduce waste and create a better experience for patients. It’s working.

For example, the hospital reorganized the stock room so that there are two constantly rotating bins of supplies. When one is empty, it’s sent to the central supply, where a scan of the bins bar code automatically orders replacements and nurses use the “back-up” bin. The increased efficiency allowed the hospital to cut its stockroom size in half. It also reduced waste, since there are fewer expired or outdated supplies that need to be tossed.

Between that and a number of other, equally small changes, the hospital has seen significant gains. In the past year, Seattle Children’s reduced its costs per patient by 3.7%, saving $23 million. The increased efficiency also allowed the hospital to serve more patients without incurring capital expenses to expand.

In another example, Akron Children’s Hospital spent $20,000 to streamline the sterilization process for surgical instruments and handle more operations each year. While the upfront cost might seem steep, it saved the hospital from spending another $3.5 million to expand the department.

The survey, conducted by Health Intelligence Network, found 67% of respondents were using telehealth for either clinical or non-clinical purposes. Just under half (49%) use it to remotely monitor patients’ health.

For the most part, providers aren’t using hi-tech solutions: 72% cited the phone as the most used medium for telehealth. Another 39% said they offer broadband connections for telehealth services.

Other highlights from the survey:

• The biggest benefit of using telehealth was health care efficiency, cited by 73% of respondents.
• Just under 20% of respondents said their biggest headache in implementing telehealth was getting reimbursed for it.
• Most of those using telehealth made it available to their entire client base. Only 17% focused its use on the chronically ill; 8% primarily targeted rural patients.
• The condition most commonly tracked via telehealth was heart failure.