Dr. William Schumacher says a successful ED must focus more on statistics and team work than individual players.

You wouldn’t think a hospital ED and a sports team have much in common, but after talking with Dr. William Schumacher, you’d realize you were wrong. Schumacher is CEO of The Schumacher Group, an ED staffing and consultancy firm he founded in Lafayette, La. after practicing emergency medicine for 20 years.

Dr. William Schumacher, CEO

Schumacher said one of the first things the company does for clients is help them improve their patient satisfaction scores. “A big part of that is having some objective metrics to monitor,” he said. If a hospital already has patient satisfaction data, Schumacher’s team helps it develop customer service programs to improve its scores; if it does not, the team develops the necessary surveys.

The group also works with the hospital administration and medical staff on guideline development to improve core-measure performance for patient care delivered in the ED. Another potential area for improvement is documentation of conditions that are present on admission. Because CMS no longer pays for conditions that develop in the hospital (a policy now being adopted by many payors), hospitals must make sure their admission processes are spot-on.

Up and running
Last year, The Schumacher Group began offering a hospitalist service to clients and currently has 10 programs running. Schumacher said it’s a natural progression for the company and that many of the same techniques (such as performance-based reporting) used in ED management can be used to improve existing hospitalist programs or create successful new ones.

“The first thing we do is make sure we have good metrics that tell us about physician performance on an individual physician basis. Examples include length of stay, percentage of patients who leave without being seen, and core measures,” Schumacher said. “These are the measurements that can make a huge difference for the hospital’s cost structure.”

Although most hospitals already measure many of these items, Schumacher said it usually is not made available to physicians in a form that can help them improve performance. “We put the data in a format that allows our doctors to be better partners for the hospitals,” he said, adding that much of the data is provided in the form of easy-to-read dashboards showing the status of key statistics.

There is also important synergy in hospitals where the group runs both the ED and the hospitalist program. “The patient hand-off is a critical part of healthcare management, and the combination of the ED and hospitalist businesses allow it to be more effective and safe.

“The ED physician is handing the baton to someone and hoping he or she is trained well enough to know when to put their hand back and catch it,” said Schumacher. “The opportunity for us, if we have both the ED and the hospitalist business, is to be more actively involved in that critical hand-off.”

Making a connection
Schumacher said the trend most affecting EDs these days is the rise in patients using the ED as their primary care network, either because they’re uninsured or can’t get a timely appointment with their primary care physician.

To meet this challenge, Schumacher’s team works with clients to help them improve efficiency in patient flow. It also helps them put stronger programs in place to help non-emergent patients.

“Often, people show up in the ED because they don’t know about other community based programs they qualify for,” said Schumacher. In the past, hospitals have been somewhat lax about developing ties with local government-supported programs, when, in fact, patients would be better off at a clinic where they would receive some continuity of care. “Identifying non-emergent patients and referring them out of the ED is an important strategy to address the ED overcrowding experienced in most communities,” said Schumacher.

This approach is reflective of the overall mission of The Schumacher Group, where employees want to make a difference in the industry along with providing high quality service to their customers.

“There is so much going on in healthcare that it’s easy for people to forget that we’re in the business of taking care of the patient,” said Schumacher. “They become callous and stop caring. Here, every employee knows exactly how he or she is connected to our mission.”