Surgeons have control over disposable supply costs but frequently lack insight into how their decisions impact variation for overall costs. Children's Hospital of Orange County (CHOC) suspected increased costs weren’t producing higher-quality outcomes, so to correlate data with clinical outcomes, it leveraged its data platform. Using the high-value data and analytics, the organization was able to effectively reduce surgical supply costs while maintaining high-quality patient outcomes.
Operating room (OR) costs account for 40 percent of hospital costs, and while surgeons have control over disposable supply costs, they frequently lack insight into how their supply decisions impact costs. This leads to supply costs that often vary between surgeons but can’t be explained, depending on case volume, surgery length, or surgeon practice experience.1
CHOC believed it had excessive variation in supply costs for appendectomies—its most commonly performed procedure. CHOC suspected the increased costs weren’t producing higher-quality outcomes, but it couldn’t be confident since it didn’t have a good way to correlate actual cost data with clinical outcomes. Because the organization's cost and clinical systems didn’t “talk” to each other, it impeded improvement efforts. CHOC needed a solution that would allow it to assess and understand drivers of variation and identify opportunities for improvement.
CHOC established an improvement project to make laparoscopic appendectomies safer and more cost-effective. The organization leveraged the Health Catalyst® data platform and a robust suite of analytics applications to integrate cost and clinical data, gaining new insight into the actionable, high-quality data and analytics required for improvement.
The organization identified the highest-cost supply items, comparing the clinical outcomes for patients who received care with high-priced items to those who received care using lower-priced items. There were no meaningful differences in outcomes, increasing confidence that surgeons could move to lower-priced supplies without negatively impacting patient care or outcomes.
CHOC surgeons standardized their surgical supplies and preference cards, adopting lower-priced supplies. It now uses an analytics application to visualize patient outcomes over time, paying particular attention to the impact of supply changes on operative time and complication rates. After implementing the lower-priced supplies, the organization’s cost data didn’t immediately demonstrate a reduction.
Leaders dug into the data, identifying an opportunity to improve documentation and charge capture processes. The organization audited OR charge processes, identifying gaps in the processes, including outdated and missing charges that often resulted in inaccurate charges and underpayment. The organization then redesigned OR documentation processes to ensure that charges accurately reflect supply utilization for each case.
CHOC’s data-informed supply standardization effectively reduced surgical supply costs while maintaining high-quality patient outcomes. Results include:
"The Health Catalyst data platform allowed us to obtain the actual cost data correlated to clinical data in real-time. Without high-quality data and analytics, we wouldn’t have been able to effectively reduce costs and improve charge capture."
David Gibbs, MD, Medical Director Trauma and Pediatric Surgery, Children’s Hospital of Orange County
CHOC plans to roll out this data-informed improvement methodology to more commonly performed procedures. The organization plans to partner with additional surgical medical staff, connecting them to their cost and resource data in a productive and meaningful way, improving the value of the care for the patients they serve.
