The Cost of Operational Blind Spots in Healthcare [PODCAST]

← Back to All Podcasts

The Cost of Operational Blind Spots in Healthcare

In this episode, Allen Cooper, Co-founder and CEO of ReadyList Inc., discusses the cost of operational blind spots in healthcare.

Highlights of this episode include:

• How healthcare finance leaders should think about the financial impact of EVS
• What some of the hidden costs hospitals incur are when EVS operations aren’t standardized
• Where technology creates measurable efficiency gains for EVS teams without adding complexity for frontline staff
• How improvements in room readiness and turnover times translate into financial outcomes for hospitals
• What operational data hospital leaders should be paying closer attention to when evaluating EVS performance
• How operational technology can support goals while also delivering financial value
• Digital hospital operations model of the future
• Where does EVS fit into that future

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Allen Cooper. Allen is the co-founder and CEO of ReadyList Inc., a mobile-friendly software that transforms how hospital, ancillary, and support service teams operate. Allen co-founded ReadyList with a deep passion for helping the behind-the-scenes workers who keep hospitals running smoothly.

ReadyList software modules guide them through best practice cleaning and room prep protocols, resulting in cleaner, safer facilities for both patients and staff. Allen believes the right kind of software can save hospital systems money, time, and even lives. Allen has an MBA from Wisconsin School of Business and resides in Milwaukee.

In this episode, we’re discussing the cost of operational blind spots in healthcare. Welcome, and thank you for joining us, Allen.

Allen Cooper: Thanks for having me on. Appreciate it.

Kelly: Yeah. Well, let’s go ahead and jump in. So Environmental Services, or EVS, can sometimes be viewed as a support function rather than a strategic investment or even a revenue generator. How should healthcare finance leaders think about the financial impact of EVS?

Allen: Yeah. That’s a great question. Based on speaking to many hospitals, whether they’re clients or not, sometimes hospitals view EVS as a cost center only where they want to try to manage their budgets. They want to ensure that they’re right staffed to ensure they don’t spending too much to be able to satisfy the same amount of work. And what sometimes the lens that they’re missing is potentially they are also a revenue producer.

And what I mean by that is if they’re able to– the department itself is able to be able to turn over a room in a quick and more efficient way without redoing and the like, they actually will increase the number of patients that actually go through the hospitals in a given day, given week, and over time, over a year. And if you start to add up the amount of patients that are able to be admitted into an actual room, that actually helps increase their overall revenue and bottom line.

So, we always look at it as you have to look at the revenue aspect of it as well as the cost and making sure there’s a good blend of both. Because if you focus purely on managing the costs and drive your budget to a point where you don’t have enough resources or tools and alike to support it, you’re going to start to get hit on the front end of it, the top line portion of it, of which is something that can be more controlled.

Kelly: Yeah. I never really thought of EVS as a revenue producer, so that’s very interesting. So what are some of the hidden costs hospitals incur when EVS operations aren’t standardized?

Allen: Yeah. What we found is that one of the biggest challenges sometimes EVS can face is the training and the onboarding of their staff. And unfortunately, that space has a higher turnover rate and it is challenging sometimes to find replacements. And so, where we find where there’s some operational standardization is really just on the onboarding. I mean, I think it applies throughout the journey of a clean and the turnovers of rooms. But the nugget that we’ve been kind of focusing on lately is how do we ensure that those that are brought on board are being brought on board where they don’t require extra staff to help support them through a few months? How do they ensure that they don’t have to be retrained? How do they ensure that they try to minimize redos of turning over a room or similar? And focusing on spending enough energy, and again, providing the necessary tools that– we call it kind of the drip campaign where you do a training, and after two or three days of that training, now you’re working with someone. And then after a week or two or maybe five weeks, you’re working with someone, and then you’re on your own. You still may forget things that have been done. The other element is that if your training is not– onboard training isn’t a protocol that’s standard that’s being managed by the training department, ensuring that best practices are followed, you could be trained by a peer that may be following protocols that might be a little bit old or past tense. And now you’re training someone new with protocols that are old. So, we always kind of look at the standardization of the onboarding as one of the nuggets we are focusing on more lately than not.

Kelly: Yeah, I know that standardization is key in a lot of areas, especially that one. Hospital leaders are under pressure to do more with fewer resources. Where have you seen technology create measurable efficiency gains for EVS teams without adding complexity for frontline staff?

Allen: Yeah, it’s a great question. One of the newer tools or modules we’ve released actually helps address a situation like that. So, in today’s world of hospitals– and this is probably not uncommon throughout any industry for that matter, is a lot of organizations to leverage the tools and the technologies across the organization because they purchased it once. It’s a capital cost typically that they want to try to maximize throughout the organization. And in time, I think holistically, that makes sense. However, what they don’t always take account for is each of the areas of a hospital have different workflows to be able to achieve the goals and the tasks that are at hand. And as an example, I know there are communication tools out there that are used for the nursing staff to be able to communicate back to the IT, whether they need certain things fixed up in a given patient room, or the network is down, or sometimes facilities that are managing assets for a given room have to call and get more equipment. And they use the technology that was meant for IT to receive these tickets and the like. And these ticket systems, they go really deep and take a lot of time to be able to communicate something very simple as, “We are missing two pillows,” or, “We are missing a breast pump.” We’re missing certain things for a given patient room that have nothing to do with IT, but they leverage an IT-ish type of system, because it’s already there, to help satisfy that requirement. And the challenge there though is you’re adding on another tool, which we always call technology fatigue to a workforce, that we really want them to focus on very limited tools but maximize those tools that really fit their workflow.

So, we actually ended up building a tool that embeds into our software where, when they get communication or they send communication, it’s two clicks and a QR code and done. It achieves the same outcome, but it’s done in a manner of 5 to 10 minutes– less than– I’m sorry, the existing ones are usually 5 to 10 minutes to actually be able to create a ticket, where ours takes less than a minute. So, we’re always trying to find those efficiencies out there that we believe that can really help out this team do more with less and to minimize these unnecessary complexities that sometimes IT brings to the table. And I don’t think it’s, obviously, intentional to create the complexity, but I do think that sometimes IT tries to balance the capital cost of these things but don’t really look to see, how does that really align to the workflow and is it really, truly being more efficient for that team?

Kelly: Yeah, that makes a lot of sense. I really liked what you said about the technology fatigue. That does seem to make sense for this. So how do improvements in room readiness and turnover times translate into financial outcomes for hospitals?

Allen: Yeah, from our standpoint, it comes down to two things. One is just the increasing of the throughput of the patients and turning over those rooms. At the end of the day, I would say about– I don’t know, statistically, the averages, but there is a fair amount of admission that goes through the ED department. Typically, people go to the hospital for two reasons. One is for some type of surgery operation, or they go through the ED and eventually get admitted into a patient room. And I think getting that throughput down, to ensure that patients aren’t waiting in the waiting room of an ED department because there’s not enough capacity or room available for the patients to get admitted– they sometimes, if it’s not a huge emergency– even though a lot of people go to emergency room that– their emergency varies, right? Some need something now and some may need something within the hour or two. For those latter individuals– and this happened to me with my son, actually, where I went to the ED department, and because his issue wasn’t as severe– and we were told from urgent care that we had to go to the emergency room because he had an allergy situation. But it wasn’t so severe that it needed to be addressed right away. We were there for an hour and a half, and then his symptoms started to get better, and he started to look fine, and we ended up just leaving, right? And at the end of the day, that was great for us as a patient in terms of not having to burn in that cost and additional time. On the flip side, we were kind of disappointed that we couldn’t be addressed a little bit sooner because they just didn’t have enough room to basically admit us into the ED part. And then what if it was something more severe? We wouldn’t know. So from our standpoint, the EVS department to be able to turn over those rooms efficiently and with good quality without redo is really, really important. So from our standpoint, turning over those rooms and readiness turn times really is a big impact.

Kelly: Yeah, it sounds like it. And I love that example, and I’m glad your son is okay. Many health systems are investing heavily in data analytics. What operational data should hospital leaders be paying closer attention to when evaluating EVS performance?

Allen: We look at kind of four or five core metrics. One is compliance. When you have CMS requiring some type of agency like Joint Commission to come in to ensure that they are doing the appropriate things in a given room– like some rooms are required to be cleaned on a frequency more than once a day, some are not. But each of the rooms are defined to be able to meet these types of compliances and be able to document that types of stuff and give that to an agency like Joint Commission is critical. But compliancy is a metric that we really hold highly and then on the other side of the balance of you’re complying to clean those rooms, well, you also have to make sure that the quality is also there as well. Because if you’re getting– and the quality typically will be highlighted through patient satisfaction experience scores, right? Or maybe the Joint Commission himself will take a sample and look at each of those rooms to see are they being done to the quality they expected? Are they looking at the curtains? Are they changing the curtains every six months? How are the linens looking? They evaluate the floors. And that’s one thing that’s kind of interesting for the floors, is I think that sometimes the floors are usually looked at as the last point of review. But what’s kind of funny is that sometimes those are the things that pass on the infections because people aren’t thinking about it. But that’s on the quality aspect of it.

Turnover times is also another element. And again, balancing that with the quality to ensure that discharges or high clean turnovers are being addressed in a timely manner that meets industry standards. What we’ve seen is good practice is, and a lot of it depends on the unit, 45 minutes to 60 minutes is a good standard. Are they meeting those turnover times? And then what we find as a final one is inspection volumes and scores to ensure that each of those elements are being done. And the inspection volumes are important because if the rooms are only being inspected less than 5% of the rooms are inspected on a given day, you’re probably not getting enough samples to ensure that the hospital as a whole is being protected and cleaned for the patient and reducing those infections. And then also managing those scores as well. And all of these things at the end of the day all reside to the patient’s satisfaction. I think Press Ganey is a great quality organization that’s being used a lot as understanding how are they doing compared to their peers. And I think if the hospital doesn’t pay attention internally on those data analytics before it gets more public, that’s where it can be a little bit damaging on reputation.

Kelly: Yeah, thanks for sharing those pieces of operational data with us. It’s very interesting. And healthcare leaders are increasingly focused on patient safety and reducing healthcare-associated infections. How can operational technology support those goals while also delivering financial value?

Allen: Yeah, I think having a technology that helps, at least in this particular area, enforce repeatable workflows is so critical, especially with an area that has a little bit higher turnover than maybe the other types of departments. I think having a technology that ensures that people are doing the right things in the right area. The one thing that isn’t always apparent to the common person, but a hospital has so many different units that has different requirements. And the typical clean for the actual rooms themselves is fairly standard. It’s the setup that ends up being different and takes a little bit more time. And at the end of the day, having a tool that helps support that workflow is so critical because if you don’t have something that does it– because pen and paper at this point in time is not practical anymore and it’s not reliable. And with the protocols possibly changing based on commission making recommendations on protocols that can help increase the safety of the patients, it needs to be agile and it needs to be applied in more real-time focus versus passive or delayed. In some cases, if you don’t have that type of support, some of these things are delayed longer than they ever should be.

Kelly: No, I agree. Definitely needs to be agile. That’s a very, very good call out there. So, Allen, looking ahead, what do you think the quote ‘digital hospital operations model of the future’ looks like? And where does EVS fit into that transformation?

Allen: Yeah, I think that the digital hospital of the future is going to operate more like a modern logistics network than a traditional hospital, where every asset, every room, workflow, and the staff members will be connected through real-time data. So instead of reacting to operational issues after they occur, hospitals will increasingly predict and prevent them. And today, many of the hospital operations still run on a fragmented system. Either there’s manual communication or the reports are delayed. With the future model, it will be driven by unified operational platforms.

Where in today’s world, the clinical aspect of it is definitely being more addressed, but it’s bringing all that together with operations, environmental services. And then at the end of the day, the patient experience, connecting all those in real-time visibility will be critical. And I think that EVS plays a much larger role in that transformation than I think sometimes the hospital realizes. So, at the end of the day, I believe that EVS evolving into a data-driven operational command center, instead of relying on the tactical phone calls and whiteboards and manual status updates, I think will help drive them more into the future as well as the hospital.

Kelly: Appreciate you sharing those insights with us. Well, thank you, Alan, for sharing all of this with us on the cost of operational blind spots in healthcare. If a listener wants to learn more or contact you to discuss this topic further, how best can they do that?

Allen: They can reach me at LinkedIn, Allen Cooper. That’s probably the best source to get to me, and I look forward to anyone reaching out.

Kelly: Thank you for sharing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings.

If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings.

---

---