Valley Hospitalist Medical Group, located in the vibrant city of Visalia, California, is a physician group practice partnered with Kaweah Health Medical Center to provide adult hospitalist services.
Valley Assign Case Study
ASSIGN CASE STUDY
Introduction
Over the last 25 years, the team has grown from just 10 healthcare providers to upwards of 25 hospitalists providing unit-based care in the hospital’s medical/surgical departments.
At Medaptus, we’ve been fortunate to work closely with Valley’s Group Administrator, Jackie Croft, for almost a decade. Jackie is passionate about streamlining workflows and finding innovative solutions to simplify administrative tasks, with a strong focus on provider satisfaction and patient care.
Valley uses two of the three Medaptus solutions: Charge Pro and Assign. However, choosing Medaptus Assign wasn't an automatic “yes” or a "just because we already have Charge Pro" choice. Instead, the team identified a critical workflow gap and engaged with a strategic consulting firm to find the right solution; Assign just happened to be the best.
In this case study, we will review:
- The problems Jackie and Valley Hospitalists faced, which led them to look for a new solution
- The solution that the Medaptus Assign software provides to the team at Valley
- The results they’ve seen because of implementing Assign
- Key takeaways to consider if you’re also wondering, “Is there a better way?”
The Problem
The challenge of managing the morning assignment process is that it’s far more complex than initially appears. For those who haven’t been responsible for assigning patients to hospitalists, it might seem like a simple matter of dividing patients randomly among the providers on duty. However, this overlooks the many priorities and factors that can significantly impact patient care.
Some of those factors include:
- Balancing workloads: High or uneven workloads can negatively impact job performance, patient safety, and operational outcomes, including increased length of stay and burnout.
- Continuity of Care: Poor scheduling or frequent handoffs can disrupt continuity, leading to patients seeing different hospitalists and potentially affecting care quality.
- Geography: Unit-based or geographically focused assignments can improve communication and satisfaction but may also present logistical challenges such as bed availability and patients being disbursed across multiple locations, even separate buildings.
- Patient Acuity: Assigning based on patient acuity helps ensure equitable workloads and patient safety, but accurately measuring acuity and distributing patients accordingly can be complex.
- Discharge rates: Timely and efficient discharge processes are essential; delays or poorly managed assignments can increase readmission rates and reduce hospital efficiency.
Upon closer examination, it becomes clear that patient assignment directly and indirectly affects:
- Staff satisfaction and work environment
- Resource utilization and hospital efficiency
- Quality of care and patient satisfaction
- Length of stay
- Readmission rates and more…
Of all the competing reasons for needing an assignment software solution, Jackie emphasizes that their primary motivation for seeking one out was the significant amount of time required to complete assignments manually. Even with a census of 125 patients, Jackie found that the manual assignment process took 2.5 hours each morning.
Prior to Assign, the manual workflow involved Jackie starting her workday at 5 a.m., hitting the ground running. She was greeted by the nocturnists’ face sheets for all the night admissions. After looking at her list of hospitalists working that day and consulting their lists from the previous day, Jackie would go to each hospitalist individually and ask how many patients each could take. She’d then fan out the face cards for them to choose randomly.
Jackie reflects on this process, saying:
“It was kind of like them pulling cards.”
The headaches didn’t end there. Jackie remembers finding that, after a doctor had a chance to look closer at those face sheets and determine the patient’s complexity, they’d return to her looking to negotiate on switching a patient for one with lower acuity.
An additional layer of challenge in Valley’s case is that another group of providers delivers care to a subset of patients within the hospital system. At times, those patients accidentally end up on Valley’s census, and it could be a couple of hours after the list was made for the day before someone notices the patient belonged to the other care network.
Of all the problems with the hospitalist assignment process, Jackie stressed the reason for investing in a real solution was, ultimately, patient safety.
As group administrator, Jackie is always thinking about two things:
- Provider satisfaction—do the doctors feel the process is fair and equitable? Are they happy in their work?
- Patient safety – Is Valley doing everything possible to ensure patients are safe and receiving the best possible care?
The Solution
Jackie recalls the experience of evaluating Medaptus Assign alongside a competing product for assignment purposes. She laughs when she remembers the Medaptus team confidently assuring her that assignments would be completed in a simple four-step process, much more quickly than a manual assignment workflow.
After the Assign demo, Jackie reflected,
“We were all looking at each other thinking, it can’t be this easy.”
Well, as Jackie can now confirm, it is, in fact, that easy.
The Medaptus Assign solution streamlines patient assignments in four simple steps:
- Auto-populate the census from your patient registration/scheduling software in Medaptus Assign.
- Import the physician schedule from your physician scheduling software.
- Initiate the rules engine to make assignments based on your specific configuration-taking into account factors such as continuity, geography, physician ID, and more.
- Review, edit, and distribute the final rounding lists, which sync directly to your EHR, updating the provider so the entire care team can see the updates in real-time.
Census Pull
• Relationship to the hospitalist group defines who is pulled onto the census via inbound ADT feed
• Select ‘refresh census‘ to populate the full census
• Use tabs to look at new patients and discharged patients, helps to quickly validate the census
Physician Schedule Import
• An API interface with your scheduling software (Qgenda, Amion, etc.) provides details on physicians working, when and where
• Consult the schedule for reference
Run Assignment Rules Engine
• Initiate the rules engine based on factors, such as continuity, geography, physician ID, etc.
• Patient weighting and physician workload are accounted for
• Automatically assign patients
The Result
Valley’s results speak for themselves. Since using Assign they’ve cut their morning assignments process from 2.5 hours to no more than 30 minutes each morning, in turn saving 2 hours daily.
Some considerations may arise unexpectedly that impact the length of time required on any given day, such as sudden shifts in rule prioritization. Additionally, situations involving internal knowledge of specific physician preferences, which can be more subjective, may also necessitate changes. In these cases, manual adjustments can be made after the Assign list has been populated.
Jackie highlights, “there are numerous compounding factors specific to each hospital to consider; most of which are addressed by the rules built into the Medaptus Assign onboarding process.”
A few referral clients, with some variation of the problems Valley had pre-Assign, have indicated to Jackie and the Medaptus team their hesitations saying things like, “our situation is more complex”, and “it is not possible to account for every scenario we face.”
Jackie challenges this way of thinking and highlights that the Assign tool is highly configurable to Valley’s workflow and changeable when priorities change. The outlier situations can be addressed manually – quickly and easily – and still, the time savings remain significant. Also, the added peace of mind is priceless.
Medaptus Assign Customer Support
Medaptus may be a small team overall, but the responsiveness and skillfulness are worth highlighting. Many team members have been with Medaptus for a decade or more, much like Jackie at Valley.
Jackie has built strong relationships and often emphasizes the difference it makes working closely with a team that consistently goes the extra mile. She’s quick to point out that in healthcare, there’s no such thing as a true quitting time. Jackie feels confident knowing that Medaptus support is always there for Valley, whether it’s 5:00 a.m. or 11:00 p.m.
Assign Dashboard
Given the number of direct and indirect concerns impacted by assignment decisions, Medaptus is taking morning assignments a step further by introducing a Hospitalist Medicine Analytics Dashboard. This is the first iteration within our larger initiative to offer deeper insights into patient assignments and their broader impact.
Medaptus knows that assigning patients is much more than a daily task- it influences provider and patient satisfaction, scheduling efficiency, hospital throughput, length of stay, readmission rates, all of which impacts revenue.
Other Notable Results
• Attending doctor updates automatically in EHR
• Census Manager module within Assign allows for all-day assigning
• Sign out note feature is available
Key Takeaways
Is Assign right for you?
