California Investments Could Reap 5-to-1 Return

A University of California center that fosters healthcare innovation at UC’s five medical centers is proving to be a boon to both patient health and the bottom line.


A University of California center that fosters healthcare innovation at UC's five medical centers is proving to be a boon to both patient health and the bottom line.

Grants made by UC’s Center for Health Quality and Innovation to fund projects that improve patient care and satisfaction at UC hospitals are paying off with positive results, including fewer blood clots and better post-surgical care at UC hospitals.

Based on current cost savings, revenues and additional funds received, according to a new report, the projected net financial gain in 2016 of the center’s 50 grants will be about $40 million from a $7.3 million allocation from UC medical centers — a return on investment of more than 5 to 1.

One example of an initiative that has paid off with net revenues of more than $800,000 per month is a UCLA elective surgery discharge program that has made the patient discharge process much more efficient and gets patients being discharged by their doctors out of the hospital faster and with a better understanding of how to take their post-surgery medication, said Michael Yeh, M.D., associate professor of surgery at UCLA. He worked with an interdisciplinary team at Reagan UCLA Medical Center, where there is a constant demand for beds, to examine every step in the discharge process, identify logjams that were clogging up the system and then expediting it.

One major improvement was reducing the time it took for patients to get their discharge medication, said Yeh, who collaborated with pharmacists Kerry MenMuir and Diane Zalba. To do this, the hospital set up a specific pharmacy with dedicated staff to fill discharge prescriptions submitted online for post-surgical patients. Now physicians’ orders can be filled and delivered to a patient’s bedside in roughly 45 minutes by the pharmacy staff, who can then instruct patients on how to take their medicine and answer any questions. A handheld device is used to swipe the patient’s credit card to cover any co-payments.

Other examples include:

• A five-campus project to reduce dangerous blood clots (venous thromboembolism, or VTE) prevented an estimated 140 VTE occurrences in 2013 for an annual savings of $1.45 million.

• A project at UC Irvine reduced the median length of stay for high-risk abdominal surgery patients by two days, resulting in fewer complications and projected annual savings of $816,000.

• The 2012 UC San Diego colorectal postoperative program reduced the length of a patient's stay by 4.5 days for high-risk surgical patients and 0.9 days for moderate-risk patients, resulting in projected annual savings of $553,000.

• A 2012 UCSF palliative care intervention resulted in 45 additional palliative care consults in the intensive care unit, generating $167,000 in annual savings from reduced ICU bed-days.

• A 2012 UC Davis specialty pharmacy initiative led to contracts that generated $18,000 in revenue at UC Davis and $1.36 million in revenue at UCSF during a CHQI fellowship.

The report projects at least $25 million in grant-generated cost savings and revenues by the end of 2016. Also, seven project teams have received an additional $16 million in external funding based on their CHQI work. In addition, 16 papers in national journals have been published based on work funded by the center.

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