Managerial Case Studies

“The Local Group”

Problem:
Prior to our arrival the hospital had a contract with a local group of CRNAs for years. They were excellent clinicians and well liked in the community. It had become clear to the hospital that they would benefit from some more managerial expertise and billing consultation.

Centrix Tool:
Transition and Implementation Management (TIM)

Approach:
Our first goal in taking a contract is to always try to retain the providers already there at the hospital’s request. We have an 84% employee retention rate. In this case, these partners in the group were making a lot of money previously, but the hospital made it clear that they liked all of them. We discussed the situation with the partners and highlighted the benefits we could provide them as a management company. These included discounted insurance, 401k, malpractice etc. It also meant that they could just show up and do cases leaving the rest of the business and managerial headaches to us.

Solution:
Retention of all current providers.

We offered fair market rates and were honest and up front. We frankly described our desire to work with the providers as well as communicating the benefits to them, and they all stayed on at the hospital.


"Conflict in the Operating Room"

Problem:
When we arrived at the hospital it was clear that there were problems. There was an obvious issue in the OR that had already led to the surgeons leaving the hospital and was the impetus to the hospital’s change in anesthesia groups. One anesthesia provider was replaced but the tension remained. Punctuality, refusing cases, and coverage were some of the reasons behind the bickering.

Centrix Tools:
Compass Team Workshop
Six Sigma Business
Perioperative Anesthesia Service Optimization (PASO)

Approach:
Our workshop provided a healthy environment for team members to voice concerns, clarify misunderstandings and misconceptions and take part in owning solutions to the problems we faced. After Six Sigma process analysis was conducted, new policies were written and agreed upon by all team members creating ownership and accountability.

Solution:
Increased efficiency and case load.
This change in the department drastically reduced managerial concerns and increased the OR efficiency, allowing the hospital to increase its caseload by nearly ten percent. This ten percent in cases allowed the anesthesia department to collect an additional
$135,000. This does not include the additional revenue generated for the facility.


"Quick Implementation"

Problem:
The Hospital decided to employ our services, and gave their current group a 90-day notice. The group quickly told them that there was no need to end the current contract, and maliciously informed the facility the current contract should end immediately. The hospital realized they could be without services and contacted us about the situation.

Centrix Tools:
Transition and Implementation Management (TIM)
Crisis Management Team (CMT)

Approach:
We utilized our relationships with national recruiting agencies as well as internal staffing efforts. We presented candidates to the hospital by the end of the day. The credentialing process began immediately and our contract was realized the following week.

Solution:
Implementation of our services in eighteen days.
We were able to replace the providers and implement our anesthesia services quickly. We took our first case at the hospital 18 days after the current group threatened to pull. We retained eighty percent of the current providers and replaced the remaining providers with ones that were presented the day the facility contacted us with this urgent issue.