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Denied care, speedy care, by Virginia Mason Medical Center

¶In Seattle, the Virginia Mason Medical Center, once deemed a high-cost provider, has conducted rigorous internal reviews to eliminate waste and inefficiency. It says that after doctors were required to click through a computerized checklist of the medical circumstances needed to justify a costly imaging test, CT scans for sinus conditions dropped by 27 percent and M.R.I.'s for headaches by 23 percent. It placed nursing teams and supplies closer to patients, freeing nurses to spend 90 percent of their time on direct patient care, far more than the 35 percent at most hospitals. The time needed to process insurance claims was sharply cut by consolidating steps. In a tough environment for hospitals, Virginia Mason has been reporting margins of 4 to 5 percent.

¶Virginia Mason also collaborated with Starbucks and the company's insurance provider, Aetna, to find better ways to treat patients with uncomplicated back pain, a costly burden to the company. At the start, all patients complaining of back pain typically waited many weeks to see a specialist, who would then prescribe a costly, unnecessary M.R.I. before finally sending them on to a physical therapist. By finding ways to separate out the uncomplicated cases, Virginia Mason was able to send them directly to a therapist on the day the patient requested an appointment, and the vast majority were able to quickly return to work.

¶The Cincinnati Children's Hospital Medical Center is using computer models to predict the number of intensive-care beds needed for patients having surgery. When necessary, it limits elective surgeries that require access to the intensive-care unit, and the smoother flow of patients has allowed the hospital to avoid $100 million in capital costs to build new bed capacity.


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