When his health system launched a new pain management clinic, Mellekate Vishwas, MD, MBA’22, recognized inefficiencies in the operations. Having recently been promoted to medical director of the neuroscience service line at Union Health in Terre Haute, Indiana, Dr. Vishwas enrolled in the Physician MBA Program at the Kelley School of Business to improve his effectiveness as a leader. He decided to examine the pain clinic in a project for the Operations Analysis and Process Improvement course by studying how the clinic and operating room worked together on pain procedures.
“We found there was no streamlined process in the pain clinic. Patients were not scheduled in a standardized way; medical assistants and providers were spending more time in exam rooms, and increased patient wait time resulted in a drop in patient satisfaction scores and fewer patients seen in a day,” said Dr. Vishwas. “Based on that, we found we didn’t need to add any more resources. By simply improving our processes, we could significantly improve throughput time, patient satisfaction and the return on our investment.”
This breakthrough is the goal behind the course, led by Amrou Awaysheh, assistant professor of operations management at the Kelley School. By first understanding their health systems’ processes, physician MBAs can understand what they need to fix and then deploy tools from their course to achieve their goals. Collectively, the projects in this course have resulted in $39.65 million in revenue generated, cost savings and opportunity generation by improving healthcare operations.
“Oftentimes, the first knee-jerk reaction is to install more operating rooms or add expensive assets to increase capacity,” says Awaysheh. “However, by better understanding the operations, we can understand where the inefficiencies exist. We can examine how re-arranging processes within an operation or moving resources from an under-utilized location allows us to effectively increase the overall throughput without increasing any costs.”
“I learned there’s so much more that goes on in any process; people take it for granted,” said Michael Dalsing, MD, MBA’22, a vascular surgeon at IU Health in Indianapolis. “Breaking it down really helps you to figure out how to improve the system overall.”
In Awaysheh’s course, physicians work in groups to identify, analyze and improve a process at one of their healthcare organizations. The exercise allows physicians to lead an improvement project at their practice while also getting firsthand experience applying business skills to actual healthcare problems.
“Amrou’s class helped me change the way I think about workflow within our practice,” said Wanda Estep, MD, MBA’22, medical director and family physician at Unity Healthcare in Lafayette, Indiana. “Finding bottlenecks and addressing them has been an interesting concept that has led to real practice changes.”
Dr. Estep’s team tackled how to efficiently identify throughout the day patients who need preventative care while also treating sick patients. Ultimately, the team found they could more efficiently deploy medical assistants to help with annual wellness visits to increase completion rates and improve the quality of patient care. Lessons such as these can be repeated across a health system to exponentially impact an organization’s bottom line.
“My husband and I have been managing our family medicine practice for 16 years,” says Dr. Estep. “We knew we could make improvements, but we didn’t always have time to think through them. The Kelley Physician MBA Program has inspired me to sit down and lay out improvements that have made our lives better.”
Awaysheh says a key goal of the course is to teach physicians the skills to examine current operations critically.
“Physicians are at the heart of most healthcare processes. By equipping them with the tools to better understand those processes, they can be empowered to solve issues within operations,” said Awaysheh. “Throughout the operations management course, they understand how to leverage tools to execute their strategic goals. It’s easy to think about what you want to do, but operations is where you execute that strategy.”
MiLinda Zabramba, MD, MBA’22, is a program medical director and hospitalist at Miami Valley Hospital in Dayton, Ohio. In her surgical readiness evaluation program, Dr. Zabramba received feedback from nurse practitioners who were concerned about how long it takes patients to get from registration to checkout. She selected this process for an efficiency project in the MBA program.
“We all assumed the issue stemmed from nursing, but after we mapped it out, we realized the bottleneck was with the tech who has to get patients’ vitals and bloodwork. We discovered we could significantly cut process time and double our capacity simply by adding one additional tech—it’s a small cost for such a huge return,” said Dr. Zabramba. “We always assume we know what the problem is, but until you sit down and map it out to see where your time is spent, we don’t really know.”
It’s in that misunderstanding of the problem that many physician leaders get stuck. By implementing core operations management processes, Awaysheh says physicians can understand the impact of various management levers.
“As our physician executives go into leadership positions, they are able to leverage their new skillsets to understand the impact of solutions. They can combine the training across all their coursework, which helps them understand the return on investment of implementing various strategies,” he said. “Thus, they understand how even inexpensive operations can have a substantial impact on revenue or increase patient satisfaction, which improves performance.”
As a medical director, Dr. Zabramba felt she didn’t have much formal training on the business of medicine. She enrolled in the Kelley Physician MBA Program to gain a better understanding of hospital operations and finances within her group.
“In the year of the program I’ve completed so far, I’ve broadened my understanding of why things happen, why things need to be done and how to take care of them,” she said. “You begin to see medicine in a different way that allows you to lead the change your healthcare system needs. The Kelley MBA gives you the tools to make those changes.”