The Benefits of Moving to a Unified Scheduling Platform at Banner Health
Bethany Bruzzi, D.O., M.B.A., has an interesting title: chief medical officer of clinical efficiency for Banner Health’s two hospitals in Tucson, Ariz. In charge of emergency department volume and all hospital throughput and discharges to post-acute care, Bruzzi recently spoke with Healthcare Innovation about the deployment of an enterprise solution to gain better visibility into provider and on-call schedules.
Healthcare Innovation: I understand that previously Banner Health had 19 different provider scheduling platforms. Could you describe how a situation like that develops in a health system and some of the problems that it creates?
Bruzzi: Absolutely. Our departments within the ultimate Banner University Medical Group, but at the time through the University of Arizona, had been really siloed, so each department had taken on its own schedule, and had the option to choose which scheduling platform they were going to go with. The smaller departments stayed on an Excel file or a Word document, while larger ones had determined that they needed some sort of technology platform, and there were multiple vendors being used.
For several years, I wanted to try to get on a unified scheduling platform, for the end users — the emergency department, the transfer services, the nursing staff, the primary hospitalist teams and those who were having to try to navigate all of the different call schedules. There are lots of hand-offs with those schedules. If there was anything last-minute like someone getting sick, which always happens, it was really difficult to get that information to people who need it in order to get to the right person when they are trying to take care of a patient.
HCI: It also sounds like with what you're trying to accomplish in your position, being able to see what is happening in all the departments from a bird’s-eye view must be crucial.
Bruzzi: Yes, it is absolutely crucial to my role. And as I mentioned, I work through the entirety of the continuum of care. At Banner Health, our transfer service is a central entity, so they're oftentimes trying to navigate who's on call. So it's been super helpful for them to make sure that they are connecting with the right physician.
HCI: If you don't have a good solution in place for this, could that contribute to burnout among the clinicians?
Bruzzi: Yes. I think there are little daily annoyances and those add up. But in addition to that, I've worked in an urgent care setting. I'm a hospitalist, and when you do have more of an emergency situation happening with a patient, if you're not able to get in touch with the correct provider, that is an exorbitant amount of stress to you.
HCI: How did Banner narrow it down and decide which solution to use?
Bruzzi: We already had exposure to multiple different platforms, including QGenda Advanced Scheduling and QGenda On-Call. It just met our needs globally in terms of what we were trying to accomplish. I was really invested in the On-Call, because that is where you're seeing the entire picture. I think that having the app has been something that people would say is a necessity these days. Part of the reason that I have enjoyed working with QGenda is that their technical support and their customer support has been pretty phenomenal.
HCI: Was the transition for the departments that weren't already on QGenda fairly smooth?
Bruzzi: I think it was once we said we're all going to move to one platform. The other thing that we started doing was trying to create standard definitions or languages, because when we had the 19 different ways of doing things and people were siloed, they could use their own language or abbreviations and it was a little bit challenging, I think, trying to get everyone to a place that they understood that there were external end-users and not just their department.
HCI: Is there a way to measure the financial impact of this change?
Bruzzi: I think a financial benefit is difficult to measure, because essentially, what you're trying to do is reduce harm. What we were able to measure is specifically when there are escalations because no one can figure out who's on call. We did look at that, and that was a reduction of about 97%. We were probably getting escalation calls at least once or twice a week; now that's maybe once every couple of months, if that. So that's been certainly a huge benefit.
The other piece of it was we increased clinic utilization by 10%. We’ve been able to minimize how frequently the hospitalists are at their capacity by understanding how many teams that we need to have on at any given moment. So all of those things translate to dollars, but it's a difficult to do the math calculation. I sit in the C-suite, and my CFO hasn't even asked for ROI necessarily. So that's always a good sign. Everyone sees the value of it.
