January 2015

by: Karen Wagner Being responsive to the supply needs of a demanding department requires determining who can manage supplies most efficiently and what tools and storage methods can offer the greatest benefits. Here, Texas Children’s Hospital shares four strategies for success. Effectively managing a supply chain is an enormous undertaking for any healthcare organization, but add in the unpredictability of a labor and delivery environment and the challenges multiply. A case in point is the Pavilion for Women at Texas Children’s Hospital, Houston. The 100-bed facility, opened last March, specializes in multiple births and high-risk pregnancies and can accommodate 5,000 births annually. Evidence of the unpredictable environment came one morning last April: One minute, the hospital was quiet; the next, a patient was brought in who gave birth prematurely to sextuplets. According to Rick McFee, Texas Children’s Hospital’s director of supply chain management, being ready for the unexpected is the focus of his department, which also manages supplies for the 555-bed pediatrics hospital and a 24-bed pediatric acute care facility on Houston’s west side. “It’s very difficult to have any kind of consistent supply utilization. You may have three days where you have very low volume activity, and then you may have four days in which you’re really struggling with capacity,” McFee says. “You may have days where supplies are barely used at all; then, you’ll have days where they’ve used everything we’ve got. So we’ve got to be very nimble. We’ve got to be able to respond very quickly.”…

The U.S. stock market rally over the last five-and-a-half years has led to impressive returns across nonprofit investment portfolios. While it is easy to become complacent in a period of outsized returns, fiduciaries must ask themselves two critical questions: • What is the source of these high returns and are they sustainable? • Is recent performance the result of superior asset allocation and manager selection, or simply a rising tide lifting all boats? Importance of Benchmarking Fiduciaries are concerned with growing the assets of their foundation or endowment. Over the last five-and-a-half years, many organizations have seen that goal realized, as the U.S. stock market, international stock markets, global bond markets and real estate have all offered impressive returns. In fact, many organizations have been able to fulfill their spending requirements and still realize substantial appreciation of their portfolio. While it is easy to get comfortable when portfolios continue to grow, fiduciaries should work to ensure that their organization is maximizing opportunities. But how can a nonprofit determine if they are truly maximizing the opportunities in the markets? The answer comes from portfolio performance attribution through relevant benchmarking. Establishing a benchmark is critical for many reasons, the most important of which is understanding the source of performance. For example, an investment portfolio may earn a return of 10% in a given year. A 10% return allows the organization to meet all budgeted spending requirements, keep pace with inflation, and experience real growth. However, over the same period a collection of…

By Christopher Franklin Primary care and urgent care have never been the closest of allies. Concerns about disruptions to care continuity and coordination – not to mention competition – have historically led primary care providers to be tentative about the role of urgent care centers (UCCs) in the care continuum. Yet building a strategic alliance between the two is becoming a necessity as our health needs overwhelm our primary care resources. While population health expectations shift, insurance coverage expands, care delivery models evolve, and the number of available PCPs dwindles, access to primary care services becomes increasingly constrained. At the same time, access to urgent care is ramping up. Since 2008, the number of UCCs has grown from 8,000 to about 9,300 sites across the nation. The expansion of urgent care is more indicative of the growing demand for acute care services than a competitive threat to primary care. Health systems can help ease the burden on PCPs, enhance access to care (particularly non-emergent acute care), and better meet patient demands by integrating UCCs into their primary care networks. The Growth of America’s Aging Population The growth of the country’s aging population is one of the factors restricting the availability of appointments with PCPs. Estimates suggest that 81% of the change in demand for health services from 2010 to 2020 will be the result of aging and population growth. And the over-65 patient population isn’t just growing – they’re also living longer and with an increased prevalence of comorbidities that…