82 MDG saves $2.7 million through C3 campaign

  • Published
  • By 2nd Lt Meredith Hein
  • 82nd Training Wing Public Affairs
SHEPPARD AIR FORCE BASE, Texas --  In an effort to cut costs in an increasingly constrained fiscal environment, the 82nd Medical Group here has revamped the way they deal with outpatients and saved $2.7 million over nine months in the process.

The new policies took effect in April 2012 and will continue to be refined as additional opportunities for savings emerge. Projected savings over the next year are $3.6 million total.

The medical group came up with the plan during an off-site meeting with representatives from different branches of the clinic.

Col. D. Scott Guermonprez, commander of the 82nd Medical Group, emphasized the need to see "today's patient today." In other words, sick people should not be delayed in receiving the medical care they need.

The Air Force Medical Service, which ultimately funds medical appointments, is affected by the project as well, as patients who are seen off base can result in appointment costs nearly triple those of patients seen on base.

"The goal was to meet the needs of the Air Force Medical Service and our commander's intent," said Lt. Col. Zina Crump, Medical Operations Squadron Commander and team lead for the project. "It's exciting to apply business rules and practices to a medical setting and see the positive outcomes for our patients."

The medical group put together a 17-person team to look at the way many outpatient procedures were being handled, and found much room for improvement.

Patients with minor medical issues were being transported via ambulance to nearby hospitals at increased costs. Further, many of those problems could have been treated at the base clinic.

The medical group sees roughly 20,000 patients every year. Prior to 2012, an average of 329 individuals went to the emergency room every month and 215 to urgent care centers.
When patients have to go downtown, the appointment costs double, Crump explained. Patients are then supposed to follow up with their primary care manager, which is another appointment, creating an overall cost three times that of being seen on base initially.

As a result, operating costs for the medical group increased, patient care was impacted and medical group resources were underutilized.

Under the new program, however, urgent care center visits have been reduced by 74 percent and emergency room visits by 15 percent.

Airmen in training were identified as one of the groups hit hardest by the prior outpatient procedures. They had previously had difficulty getting medical appointments due to training, but are now able to better utilize sick call, with an overall increase in AiT sick call appointments by 142 percent.

"Airmen in training really made us look at how we could provide better care," said Capt. Marie John of Group Practice Management. "Medical appointments, especially if they went off base, would make them miss a lot of training."

Another result of this project is an initiative to open a clinic solely for Airmen in training at the Health and Wellness Center, which is located much closer to their dorms. This clinic would have no additional cost to the medical group and would allow sick Airmen easier access to sick call.

The program also eliminated an unnecessary nurse's phone advice line service. The phone line was replaced with direct contact to primary care managers, who could answer their own patients' questions and provide continuity of care.

"Now, providers can track trends in their patients," said John.

Further, removing the phone line saved $238,000.

The medical group also transitioned to shift work, which enabled extended hours throughout the hospital.

"The feedback we've gotten is that the patients really love it," said Crump. "Kids don't have to miss school for doctor's appointments and that alone helps families. It actually works out for the medical group population, too, because personnel have a little more control over their hours."

Due to booking protocols, sick patients, those with acute medical needs, must be seen within 24 hours. Having nurses available to help triage improves the process.

"It really enhances how we are using our nursing staff and improves patient flow," said John.

Patient satisfaction is on the rise as well, according to Dennis Marquardt, Chief of Quality Services. Sheppard's satisfaction ratings are well above the Air Education and Training Command baseline of 90 percent.

"The bottom line is that if you take care of your patients, the metrics will take care of themselves," said Crump.

"Everyone is looking how to save money, but the bigger push for this program was knowing that we have the capability to provide increased access to our patients," said Maj. Don Rousseaux, resource manager. "Their needs drive everything we do."