Health System Growth Strategies: Increasing Admissions Through the Right Front Door

Growth hinges on volume, but increasing volume often relies on getting patients into your health system through the proper entry point. And that can be more complicated than it initially appears.

When our founder and Chief Medical Officer, Dr. Darin Vercillo, was in the process of growing what would become the Central Logic solutions suite, he worked closely with a hospital system in Utah that kept running into a significant problem:

Volume wasn’t uniform across their health system.

Now, this can happen for any number of reasons. For this particular health system, their flagship hospital strained under the number of referrals and subsequent patient volume sent their way. Their capacity was at its breaking point.

Meanwhile, their “satellite” hospitals would have acute departments that were half-filled at best, staff under-utilized because they didn’t have sufficient patient intake to support a full schedule of top-of-license work.

It didn’t take long before Dr. Vercillo and the Central Logic team were able to sift through the data to find the problem: all patients, no matter the patient’s acuity needs, were being referred to the flagship hospital. This health system’s growth stemmed from that flagship hospital, and thus every provider in the area was conditioned to refer their patients to the facility that started it all.

But as the health system grew and grew, that process was no longer sufficient. What’s more, it wasn’t good for patients or the health system. A habit that had never been corrected or really even considered was creating a drain on hospital resources and negatively impacting the patient experience.

Smart Growth

Nowadays, when people hear the words “health system growth strategies,” their minds will most likely turn to mergers and acquisitions. That’s the fastest ticket to assured growth; you simply absorb the patient volume and resources of another hospital or health system.

This ensures growth, but what it doesn’t necessarily ensure is operational efficiency. It doesn’t ensure systemness. Too often, each hospital will try to continue with business as usual or, at the other extreme, the purchasing organization will decree that all systems and processes they’ve applied will now be applied to the smaller hospital, regardless of that facility’s needs or institutional limits that might make those same systems and processes inefficient or even redundant.

Which brings us to a concept that I think is important to understand: smart growth. Smart growth is purposeful. It’s designed. It’s anticipated and worked toward. It can pertain to mergers and acquisitions, but can also occur naturally through a single entity evolving over time due to the needs of the market and their own careful path-charting.

The health system previously mentioned was growing, and by many accounts was successful. But their growth was strained and limited by factors that prevented them from reaching their full potential. It was only by correcting for these factors that smart growth was achieved and volume was normalized across the health system, with resources accurately deployed and maximized.

So how do you achieve this smart growth in patient volume, particularly if you’re not currently in a merger scenario? Much of it can be accomplished by putting in the work to ensure patients are entering your health system properly.

Affront to Efficiency

The problem we described above is one of many reasons patients may be admitted inefficiently. Other reasons are myriad:

• Patient Habits: Patients have been conditioned for decades to prefer a certain hospital, and it could take just as long to change their habits.
• Physician Accommodation: Physicians and other providers are just as likely to develop referral patterns as patients, and breaking ingrained habits can be difficult.
• Resource Deployment: Specific clinical requirements likely mean that only certain facilities are capable of accepting certain patients, which can be problematic when those resources are concentrated in a single facility
• Transport Inefficiency: Inter- and intra-hospital patient transfers can be limited by lack of transport capabilities and even geography, especially if a patient’s needs dictate a level of care that’s only available hours away.

All of these reasons and more can prevent a patient from getting to where they should be in the first place.

Right now, you might very well be wondering if you suffer from an issue that could be creating stopgaps between providing patients the right care at the right time. And the answer might not be immediately obvious. Something might seem normal until you actually step back to take a high-level look at the data, when you suddenly see that there’s dramatic room for improvement.

So what can be done?

Growth Through Admission

In order to ensure admissions procedures are a growth opportunity for your hospital, a few key steps need to be taken.

• Compile Data: It’s impossible to correct the problem if you don’t have a full and complete assessment of your current procedures. Every improvement must start with a full accounting of patient volume, intake procedures, and transportation processes.
• Identify Shortfalls: Once you have the data at your fingertips, you should have a much better picture of your health system’s patient intake picture. And we do mean the entire health system. In order to identify opportunities for recovery, you need insight into all aspects of your system.
• Correct the Problem: Once you’ve diagnosed where patients are being steered (both literally and figuratively) wrong, you can begin to create standardized processes that create recovery opportunities.

Providing specific guidance is somewhat difficult, as every health system is unique, as are their challenges, but some general recommendations should provide a good window into the types of adjustments you might find necessary.

• Public Relations: If the problem is patients who don’t know, for instance, that their city’s trauma center has been moved, a public relations and marketing campaign might help.
• Internal Marketing: If the problem is with internal staff, an internal marketing campaign can correct inaccurate assumptions and get physicians and other staff members adjusted to the new processes.
• Resource Refresh: Beds may need to be increased at one facility versus another, or resources moved around to accommodate fluctuations in patient intake habits.
• Recategorization: Some departments may need to be rethought from the ground up, moved to a different facility, or restaffed according to population needs.
• Transfer Centralization: The greatest benefit may derive from creation of a department within a health system whose sole duty is to create and coordinate processes related to patient intake and transfer. This will ensure that all patients get where they need to go, regardless of habits or organizational inertia on the topic.

Whatever the recourse, admission should be a cornerstone of achieving intelligent health system growth. By altering the way admission and transfer work at your health system, it’s possible to uncover areas for rapid and smart growth that persists for years to come.