Chief ad­min­is­tra­tive of­fi­cer, mus­cu­loskele­tal and rheuma­tol­ogy Univer­sity of Penn­syl­va­nia Health Sys­tem

Modern Healthcare - - 2015 UP & COMERS - — Beth Kutscher

When Lori Gus­tave took over as head of mus­cu­loskele­tal and

rheuma­tol­ogy, a lead­ing ser­vice line at the Univer­sity of Penn­syl­va­nia Health Sys­tem, she found a depart­ment in dis­ar­ray.

Or­tho­pe­dic surgery, the largest group, was op­er­at­ing at an an­nual loss of more than $500,000 with no re­serves. The depart­ment strug­gled to re­cruit physi­cians in the com­pet­i­tive Philadelphia mar­ket.

But four years later, pa­tient rev­enue has in­creased 90%. Pa­tient vis­its are up 20% and sur­gi­cal cases, 35%. There are 32 op­er­a­tive sur­geons, a 50% in­crease.

As chief ad­min­is­tra­tive of­fi­cer for the ser­vice line, Gus­tave and her team mapped out what hap­pens when pa­tients come in for care.

What she found was a lack of co­or­di­na­tion. Pa­tients with hip frac­tures, for in­stance, were be­ing ad­mit­ted to three dif­fer­ent ser­vice lines, not only ortho­pe­dics, but geri­atrics and in­ter­nal medicine. That cre­ated de­lays. Now the goal is to have hip re­place­ments per­formed within 24 hours.

“Ev­ery pa­tient has a plan; we’re not just fig­ur­ing it out on the fly,” Gus­tave said. “Ev­ery pa­tient is risk-strat­i­fied to de­ter­mine where they should go.”

She also im­ple­mented same-day sched­ul­ing and online self-sched­ul­ing. The ser­vice line ex­pan­sion is ev­i­dent in the depart­ment’s newly built, state-of-theart out­pa­tient cen­ter.

“She has this very com­pelling, re­sults-driven ap­proach,” said Phil Okala, se­nior vice pres­i­dent of busi­ness de­vel­op­ment at Penn Medicine. “It’s been a mirac­u­lous tra­jec­tory. Peo­ple are en­er­gized; peo­ple are very up­beat around our vi­sion.”

“Ev­ery pa­tient has a plan; we’re not just fig­ur­ing it out on the fly.”

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