Inside Healthcare - RedCoat Publishing

The Illinois Bone and Joint Institute (IBJI) doesn’t aim to become the largest provider of orthopedic surgery and care in Illinois or the country; David Wold, COO, and his team are instead focusing on high-quality clinical outcomes and customer service. The recession is causing many healthcare providers to dramatically adjust plans for growth, but Wold said IBJI is taking advantage of this opportunity to improve internally and prepare for the future of healthcare.

Last year, IBJI opened a new, 60,000-square-foot medical building to house its new MRI center and an expanded rehabilitation program. But on the whole, Wold said, the company’s focus is internal.

“We’re happy with our geographic penetration right now, and with the economy the way it is, it makes sense to work on improving the quality and convenience of our services so we come out on top after the market turns around,” said Wold.

David Wold, COO

The most significant effect the recession is having on IBJI is an increase in the number of patients who need a procedure but are putting it off to avoid the cost. There are always patients with immediate needs, but even among those with insurance, most people who can put off a knee or hip replacement are doing so.

That’s why, according to Wold, the company launched its first marketing campaign in more than 12 years. Through a combination of billboards and radio ads, IBJI aims to remind current and past patients of its services.

“It’s soft communication to increase our brand awareness,” said Wold. “We want a patient who’s had an assessment with one of our physicians to keep us in mind when he or she decides to go forward with a procedure.”

IBJI is also focusing on internal improvements that will reduce costs and give its physicians an edge over other providers. For example, the company requires all of its physicians to attend regular training sessions focused on CPT-ICD9 coding, which Wold said earned the company a discount from its liability insurance carrier. Another example is the management and customer service training all administrative teams receive on a regular basis through the HR department.

Wold said, however, that the company’s biggest internal improvement program has been what he calls an aggressive customer satisfaction plan that will prepare IBJI clinicians to meet the future demands of Baby Boomers.

“These are patients who place a high value on convenience and do not tolerate long wait times, for example,” he said. “It has taken time, but we’ve gained nearly 100% buy-in from our clinical and administrative staff. All of us are working to step up the level of service at our locations.”

After every visit, IBJI patients get an e-mail survey asking for feedback on the service they received. Wold said after a period of trial and error, the company discovered e-mail surveys brought in the most responses. Company leadership, clinicians, and administrators consider each complaint to represent 20 other patients who also had a negative experience but didn’t speak up. By considering two complaints about one aspect of service at a location to be 40 complaints, Wold said nothing falls through the cracks.

The surveys have also allowed IBJI to build a database of past and current patients that Wold hopes to use to create a newsletter that would be distributed three or four times a year.

New technology
As far as improving quality, IBJI continues to attract some of the best clinicians in the field thanks to a collaborative relationship with University of Illinois’s medical school. Physicians at IBJI are renowned for advances in surgery techniques and innovative care, and Wold attributes that to an emphasis in teaching, research, and continuous improvement. That includes operational improvements.

Wold said, in the last year, IBJI has ramped up adoption of electronic data management systems, including a PAC software system and an electronic transfer program for X-rays, which has been introduced in all but one of the company’s offices.

“The PAC system has been an excellent investment, reducing our costs significantly. But more importantly, the physicians are thrilled because they can send a patient down the hall for an X-ray and have the images on a screen in their office before the patient gets back,” Wold said. “Their ability to diagnose our patients’ conditions has been dramatically improved.”

Both systems have allowed IBJI to eliminate a lot of paper, and the company has nearly eliminated coding errors with a software program it rolled out last year. But that isn’t all; Wold plans to choose an EMR provider soon and roll out a program in the first quarter of 2010.

Having a thoroughly homogenized operations system has been great for IBJI, but Wold understands the organization needs more than high-end technology. “There are many small pieces that, when taken together, build a pattern of success. Technology, a dedicated staff, and the drive for continuous improvement are some of those parts,” said Wold. “The biggest differentiator for us is the strength of our individual physicians and administrators, whose dedication fuels our continuous improvement.”

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