Challenge

In 2017, Main Line Health set an ambitious goal: eliminate disparities and preventable harm while achieving top-decile results around quality and performance, reduce costs through more informed operational decisions, and improve the patient and employee experience.

Main Line Health, a not-for-profit health system serving portions of Philadelphia and its western suburbs, adopted Baldrige as a framework in 2017 to better serve these communities. The health system sought to apply Baldrige best practices to reduce operational costs by millions of dollars and achieve next-level performance excellence throughout the system.

But the work would not be easy. Many of the “low-hanging fruit” in operational cost reduction had been optimized, and Main Line Health needed to change their culture and build new capabilities to achieve their operational goals. It would take strong leadership, dedicated oversight, expertise in change management, and deep familiarity with Baldrige principles and processes to achieve these goals.

Solution

Main Line Health partnered with Guidehouse on the initiative, “Performance Excellence 2020,” due to its deep expertise in assisting healthcare organizations in cultural transformation and operations improvement.

Beginning in 2017, Main Line Health worked with Guidehouse to apply the highly structured Baldrige performance excellence framework to:

• Identify opportunities for performance improvement and cost reduction.
• Connect and coordinate with such ongoing initiatives as installing a new electronic health records system.
• Apply standardized process improvement techniques to create efficiencies, improve operational performance and clinical outcomes, and reduce care disparities.

Early in the initiative, Main Line Health identified $120 million in financial performance improvement opportunities: $60 million in clinical transformation, $28 million in workforce efficiency, $27 million in corporate services, and $5 million in physician enterprise. For its FY 2018, Main Line Health’s goal for cost savings is $33.5 million.

The health system then reviewed their regional Baldrige program feedback and Guidehouse’s Baldrige assessment to determine priorities for improving organizational capabilities. The reviews cited opportunities for improvement around “systemness,” or consistency in processes and services delivered throughout the system:

• Key processes lacked evidence of being systematic, consistently understood, or utilized systemwide. 
• Variation and gaps existed in the deployment of new processes across all campuses and departments.
• Significant opportunities existed to establish and consistently utilize systemwide metrics and indicators to manage day-today operations.

Impact