Family Involvement in Healthcare

Your hospital is very often not just dealing with patients, but their families as well. So, family involvement in healthcare is an important point to consider.

Maintaining a high quality of patient care ranked as the number two concern of healthcare executives who responded to our survey, seen as a high priority by 71.9% of them. Our data indicate that 43% of hospital executives who responded to our survey reported that their hospitals had not-for-profit status.

Our VIE Healthcare team understands that it is impossible to offer quality care without fully understanding your patient community. Often, healthcare leaders react to health demands – rather than strategically responding to health needs. Community needs assessments provide powerful tools that industry leaders can use to enhance quality care – and, more importantly, through which they can avoid aimlessly implementing policies, procedures, and practices. Through community needs assessments, VIE Healthcare can offer healthcare leaders a systematic method of identifying and addressing unmet healthcare needs of their populations. Our team employs innovative approaches to capturing local community priorities that consider both clinical and cost perspectives.

VIE Healthcare is committed to helping industry leaders maintain their not-for-profit hospital status. Surveys of community members can be particularly useful for these hospitals, allowing them not only to understand better the populations they serve, but also to gain the foundation for creating content that will engage key stakeholders, prospective patients, and healthcare professionals in their local area. Follow-up surveys of patients to ensure quality care, once those patients are discharged from these hospitals, will also be helpful in understanding the public service of not-for-profit hospitals.

Notably, 85% of these healthcare executives also wanted greater involvement of family members. Indeed, increasing the involvement of families can provide a cost-effective means of ensuring quality care, and possibly increasing patient satisfaction as well.

Here are some key ways in which you can increase family involvement. Click To Tweet

1. Use surveys to identify the core needs and concerns of the patient and family. You cannot meet or exceed their expectations if you do not know what those expectations and concerns are. Supplement these data with qualitative analyses of comments in online reviews and with healthcare mystery shopping. Communicate the findings throughout the organization, to help achieve the other goals outlined below.

2. Listen actively to families’ concerns and needs. “If patient and family input is emphatically built into systems of performance improvement, and if patients and families are taken seriously and are respected for their valuable perspectives about how care can be improved, then organizations can improve at improving. Resources in health care are in short supply, yet the sources of patient and family help and time are almost limitless, are ready to be tapped, and can have a huge impact on improving the reliability and the overall success for any healthcare organization.”

3. Partner with families. Julie Ginn Moretz, associate vice chancellor for patient-and family-centered-care at University of Arkansas for Medical Sciences told the National Association for Healthcare Quality (NAHQ) in 2013 that “involving patients and families in quality improvement initiatives is now considered to be a best practice within forward-thinking health care systems: “Today, patients and families must be considered as full partners in every healthcare system to ensure that we are doing everything possible to enhance safety and quality outcomes.” Moretz characterized the movement for patient and family-centered care as having grown from “token” status to “change agent” status in healthcare, with far-reaching implications not only for hospitals and their cultures, but also for patient outcomes.

4. Although family involvement should be cultivated and developed at the department level, it must also be encouraged and supported across the entire organization. The way in which you address and welcome families into the care of the patients must remain strong and consistent across your institution.

5. Demonstrate empathy for patients and families. Fear, uncertainty, disruption of routine, and other factors make hospitalizations tremendously stressful for patients and their families. Educating staff at all levels of the organization (not just front-line clinical staff) about this stress and teaching them to deal compassionately and effectively with patients and families cannot only improve the experience for patients and families but also increase their satisfaction—and protect your reimbursement.

What’s one benefit you’ve gained by working closely with families to improve your hospital care?

Measuring Patient Satisfaction (Part 2)

We’re continuing our series on measuring patient satisfaction, and getting specific about actions you can take. If you missed part one, click here.

Specifically, there are 10 key improvements to measuring patient satisfaction that can improve accuracy, ensure high-quality patient care, and protect your reimbursement:

1. Leverage multiple methods to administer your surveys (for example, paper-and-pencil, online, mobile, kiosk). This will not only increase response but also broaden the representativeness of your data.

2. Gather real-time information, so you not only ensure your data are timely but also facilitate service recovery.

3. Collect and analyze patient satisfaction data you use internally, to ensure continuous process improvement and protect your reimbursement.

4. Use these internal surveys in departments throughout your hospital, so that (a) patients receive short, focused, specific surveys and (b) all units in your hospital can obtain timely, relevant feedback.

5. Offer patients incentives to complete these surveys. Doing so can increase dramatically the proportion of patients who participate; the benefits of doing so far outweigh the modest financial cost.

6. Report these data and the action items to relevant departments.

7. Include in your internal surveys data that you can use to market your hospital effectively. These include general and specific satisfaction measures, testimonials, and online reviews, the “social proof” that can prove critical in maintaining patient volume.

8. Develop and implement a mechanism to invite patients or family members who are satisfied to leave online reviews, to increase your stock of positive reviews. Far too many hospitals have only negative reviews and may be frighteningly unaware of the implications this has for their patient volume.

9. Use your internal data to develop and implement relevant strategic initiatives in your hospital or practice.

10. Continue to implement these measures and constantly refine your system, so that you continually control and improve service quality.

Perhaps one of the most intriguing aspects of healthcare consumerism is the fact that consumers are likely to solicit information about their health not only from such online sources as Healthgrades but also from other consumers, through blogs, online reviews, and forums that give them other patients’ perspectives about treatment and quality care.

Consumers, therefore, now have the power to impact the choices other consumers make: They can either promote your hospital, by serving as a brand advocate and “referral generator,” or hurt your hospital by posting negative, potentially harmful information about its products and services.

It is important to remember, and to remind your healthcare team—that excellent treatment or service quality, as well as customer service, prove particularly important. Click To Tweet

What’s one thing you do to ensure you’re keeping a pulse on your hospital’s social proof?

Measuring Patient Satisfaction

Don’t underestimate the importance of measuring patient satisfaction.

“Creating or maintaining high patient satisfaction” ranked as the number one challenge that hospitals face. Eighty-two percent of the healthcare executives who participated in our Healthcare Leadership Survey reported that this was a challenge with which they most wanted to to deal with quickly.

With increased access to information and the ability to solicit second opinions easily, patients have become committed advocates for their healthcare—and the satisfaction of those patients now affects your hospital’s reimbursement.

The high level of concern with maintaining patient satisfaction shown in these data underscores just how critically important patient satisfaction is in healthcare today and also suggests strongly that healthcare executives need better solutions to ensure that patient satisfaction remains high.

Given the urgent need to ensure high patient satisfaction, we were not surprised to find that more than 67% of the hospital executives who responded to our survey ranked “measuring patient satisfaction accurately” as one of the top 5 challenges that they needed to face most urgently.

Because patients and prospective patients now have a plethora of information at their fingertips, healthcare has shifted from serving “passive patients” to an industry that must attract and serve discerning “healthcare consumers.”

Those healthcare consumers increasingly conduct their own research (e.g., reading online reviews, comparing prices, and seeking better service) before making healthcare decisions. Thus, healthcare providers must not only create messages that attract these consumers but also provide the “social proof” —in the form of online reviews, testimonials, statistical data, and even case studies from patients — that will persuade prospective patients.

But far too many hospitals have lagged behind their counterparts in other industries in garnering and leveraging that social proof from their patients. In fact, the instruments hospitals typically use to measure patient satisfaction do little to produce social proof.

Our experience has shown us that the inability of providers to (a) measure patient satisfaction thoroughly and to (b) generate the social proof hospitals need has cost them thousands of potential patients and millions of dollars in revenue.

To solve these problems, providers must obtain an accurate picture of what your patients think.

You cannot do so just by increasing the number of survey responses you receive—although that is certainly important. The central problem lies in ensuring that your survey responses represent accurately the various segments of your patient population: different age ranges, treatment levels, occupational categories, and opinions.

Why is that so important?

Because trying to make decisions with anything less than a representative sampling of your patients and their opinions is akin to trying to diagnose and treat an ankle fracture with a diagnostic image that shows only one toe.

Without the right data, you simply cannot make the right decisions. Click To Tweet

Now that we’ve covered the importance of patient satisfaction and measuring it, the continuation of this series will outline actionable steps to get up to speed on this incentive.

What’s one thing you do to ensure patient satisfaction is always at the top of your organization’s mind?

Waste in the Operating Room

The rising cost of healthcare has not only affected patients, it has affected the way in which hospitals operate. While this presents a real challenge to hospitals, it has also led to a serious re-examination of how the healthcare industry is spending its money.

“In 2012 the National Academy of Medicine estimated the U.S. health care system squandered $765 billion a year, more than the entire budget of the Defense Department…The annual waste, the report estimated, could have paid for the insurance coverage of 150 million American workers — both the employer and employee contributions.” (

The Operating Room truly is a double-edged sword when considering profitability for a hospital. Click To Tweet
  1. It is often the biggest generator of revenue for a hospital.
  2. It also tends to be the largest consumer of supply costs and the biggest generator of waste.

“Of all the waste a hospital generates, as much as 20 to 30 percent comes directly from the operating room.” (

According to Kate Huncke, M.D., vice chair of the department of anesthesia at NYU Langone Medical Center, New York City, “The waste generated from the OR is way out of proportion to the footprint it occupies within the hospital. There’s significant opportunity for improvement.” ( It’s an opportunity that many hospitals have yet to take advantage of.

  1. One frequently overlooked factor to consider is the actual cost of OR waste disposal. It is not as simple as taking the trash bags out to be sent to the landfill. State and federal laws require certain operating room waste to be disposed of in very specific ways, which can cost 10 to 15 times as much as ordinary waste disposal. This is a cost that simply cannot be overlooked.
  2. Another opportunity for minimizing waste is to recycle, rather than dispose of items that would normally be thrown out. “Disposing of bio-hazardous waste costs an average of 28 cents a pound, while recycling costs an average of just a penny a pound.” ( Simply recycling the plastic and cardboard that OR equipment is packaged in can lead to cost savings, not to mention minimizing the environmental footprint that your facility is leaving.
  3. An additional factor to consider is the use of disposable equipment. The increase in single-use disposable items in the OR came directly from efforts to decrease the risk of infection and spread of disease in the hospital. However, the advancements in sterilization techniques and cleaning solutions that have been made cannot be ignored. The measures taken to prevent the spread of infection must remain a priority, but we also must use an approach that is cost-effective. If autoclaving or a specific cleaning product has been shown to achieve effective sterilization, the recurring purchase of single-use items for the OR may not be necessary.
  4. The purchase and intentional use of energy-efficient equipment is another way in which operating rooms can save the hospital money. By finding ways to reduce energy waste, ORs can decrease the cost of its operating expenses and at the same time decrease the impact on the environment. Any realized savings can be redirected to improving the patient experience and improving efficiency in other areas of the hospital.
  5. Lastly, a thorough look at the supply chain and how surgical supplies are being packaged can lead to decreased waste and substantial savings. Many hospitals order prepackaged kits for their operating rooms. While this is easier, it definitely leads to increased waste if surgeons consistently use only a portion of what is contained in the prepackaged kit. By assembling your own surgery kits, using trays and surgery kits that can be sterilized and reused, a hospital can ensure that the kits being sent to OR contain only what the surgeon will actually use.


As we consider hospital waste, the key concept to understand is SUSTAINABILITY, which is the ability of a system to continue doing what it is doing over time. If a hospital or health system hopes to succeed, grow, and increase revenue long-term all while providing high-quality patient care, it must focus on sustainability. An essential part of the sustainability equation is recognizing where waste is occurring and finding ways to minimize that waste.

As hospitals and health systems consider their own sustainability, their attention has concentrated on improving efficiency, reducing cost, and improving patient experience. Waste reduction can have an immediate and lasting impact in all three of these areas.

Hospital Cost Improvement Strategy

“As a general principle…about one third (of hospitals) have margins that are above zero, probably about one-third of hospitals are pretty close to zero….and about one-third are running in the red.”

Gary Young, Director of the Center for Health Policy and Healthcare Research at Northeastern University¹

Healthcare costs are on the rise. The latest Health Trends Spending Brief from the Organization for Economic Co-operation and Development (OECD) notes that the US spend per capita on healthcare costs has exceeded $10,000 in 2017.

Healthcare consumption now represents 17.2% of the country’s GDP² but too often, that spend does not equate to improved patient care. Health outcomes are worse in comparison to other countries and hospital closures are predicted to increase this year, particularly in rural locations.

But the financial pressures aren’t limited to smaller or more isolated hospitals. The Harvard Business Review notes a ‘deterioration’ in the financial performance in the sector, with some of the biggest hospitals reporting significant losses as costs soar and revenues remain flat³.

The four steps to financial transformation

One of the biggest obstacles to delivering both better patient care and increasing your operating margin is the absence of a cost improvement culture. Click To Tweet

That can be rectified with the following four steps for a successful cost improvement strategy. In my experience, they are critical to create a high performing healthcare organization and deliver essential cost savings.

1. Leadership

60% of healthcare leaders are concerned about their ability to create a culture of accountability and transparency in their organizations⁴. Successful leadership in a change-oriented industry such as healthcare demands CEO accountability with full Board visibility and support, coupled with implementation, measurement and addressing a cultural shift towards transparency. But it also goes beyond that. Cost improvement must be the responsibility of a dedicated Board member – a VP of Cost Strategy for example – who reports directly to the CEO. This role must be fully accountable for liaising with the CFO, COO, Chief Medical Officer, Chief Nursing Officer, supply chain and managing the disparate components required to successfully implement a cost improvement plan.

2. Prioritization

Prioritization requires your organization to differentiate between what is important and what’s urgent before deciding on execution and process.

Your decision-making process must be aligned with the strategic priorities of your hospital.

Hospital leaders face three fundamental problems in this context:

  • Only 52% believe that their day-to-day activities are aligned with their organization’s strategic priorities⁵.
  • Less than 1 in 10 healthcare executives are satisfied with how they spend their time. Conflicting priorities, unplanned distractions and a lack of vital resources means that high value, meaningful tasks are often neglected⁶.
  • 68% of organizations have no process in place to help them prioritize their projects⁷.

Combined with the lack of strategic alignment these are the major causes of project failure.

3. Project Management

The delivery of a successful cost improvement plan requires a customized, robust project management system to monitor each phase, take a deep dive and gather as much data as possible for future projects. To ensure ongoing buy-in from stakeholders:

  • Evaluate, document and communicate all financial and performance improvements at each stage of the project.
  • Reflect on what works, what doesn’t – and readjust your processes accordingly. An effective project management plan not only enables your organization to anticipate and minimize risk but creates a culture of cost saving.

With these things in mind, we recommend using an externally built system which should be used for the sole purpose of executing your cost improvement plan. This, in turn, allows your organization to focus its time and energy on patient care, patient outcomes, and patient satisfaction.

4. Execution

Execution is the most important phase of achieving your cost-saving potential but in my experience it is often where healthcare organizations fail. My recommendations cover a three-step process:

  • Agree how the core strategy will be implemented. Specify the category, the opportunity gap or the need. For example, your environmental services system may be purchasing janitorial supplies from seven different companies when, for efficiency, you only require one or two suppliers. Carrying out a detailed analysis of everything associated with environmental services will enable you to understand how to standardize processes and identify potential cost savings.

  • Identify a team consisting of a project lead and supporting project sponsors for each individual cost-saving opportunity to monitor and deliver the project. You’ll also need to have a solid definition of what data is needed to better understand and address the issue. The data can be gathered from various places, for example from accounts payable, contracting, your internal information systems and even vendors.
  • Gain stakeholder buy-in. Dealing with change can simultaneously be one of the biggest challenges and opportunities in healthcare. A collaborative implementation strategy requires a well-executed presentation supported with accurate data. In these situations, I recommend implementing the lower hanging fruit first. If your proposal suggests savings of $1m are achievable, demonstrate how to achieve that reduction over two years. Provide clear milestones and deadlines for each phase of implementation and allocate clear lines of responsibility.

Partner with VIE Healthcare to Create a cost improvement plan and strategy for your organization.

Not sure where to start?

  1. Begin the journey toward cost improvement.
  2. Take control of your organization’s spending and start to identify specialized cost-reduction strategies by contacting Lisa Miller at VIE Healthcare today.
  3. Don’t let the rising cost of healthcare determine your future.

Take action and let VIE Healthcare help you control the direction of your organization to reduce non-labor costs, and improve your hospital margins.

Schedule a free consultation with Lisa Miller, CEO and Founder of VIE Healthcare today:


What We Achieve For Clients

We’re often asked about the essence of VIE Healthcare and what we achieve for clients.

That is, more specifically, what’s the focus of our business and how can we help our clients create great results?

As an overview, we work with hospitals to identify and implement operational efficiencies to drive down costs and improve patient satisfaction. We do this in a number of ways. We look at non-labor costs, we ensure the best pricing, and also the best contract development.

We put measurements in place to ensure that the pricing mechanisms that we achieve are sustainable. We also look at the hospital and the health system’s profitability across multiple platforms.

Essentially, we take strategic steps to reduce non-labor expenses, optimize revenue, performance and hospital processes.

An example of this is looking at variation and the variability that exists between hospitals in just pricing alone.

When we look at variability between pricing, waste, and utilization, it represents a tremendous opportunity for your organization. Quantitatively, studies show that this opportunity is approximately $1,200 per discharge. What could this one opportunity mean for your hospital?

There are three primary areas where we achieve great results for clients.

1. Purchased Services Expense Reduction

Purchased services is a very difficult area for hospitals to get their arms around. Typically they’re in disparate locations, they are non-PO driven, and have a difficult time achieving real-time insights to those costs. There are often poor price benchmarks in the marketplace as well. Our strategies help achieve between a 20%-37% reduction in our client’s purchased services spend.

2. Operating Room Opportunities

The second area that we achieve great results for our clients is in the OR. And, our clients typically save between 10%-30% in their pricing spend, waste minimization, and also in their inventory and consignment utilization.

3. Mapping Costs and Spend to Reimbursement

The third primary area is in mapping costs and spend to reimbursement. The conversations today are mapping to Medicare margins. We’ve been on the forefront of that discussion for years, looking at every single possibility that a hospital can map their costs to reimbursement. And, so, mapping to the margin is what hospitals and thought leaders are talking about. And, we are still on the forefront of looking at and optimizing managing costs to managed care.

In our experience, the most successful hospitals are the ones that are always looking for new ways to improve. Click To Tweet

They’re seeking new and innovative ways to reduce costs and improve processes. Often, the biggest distinguishing factor between hospitals that are on the forefront of profitability, and on the forefront of delivering great patient quality care, are simply those that aspire to be.

What’s one area of your organization you are trying to improve? Let us know in the comments!

The audio version of this entry is available at the bottom of this post.

Embracing Innovation

Look at your hospital’s processes and patient services and honestly ask yourself, is it time to innovate?

Let’s face it, each hospital has key differences which either make them successful or make them lag behind. 

One of the key differentiators is innovation.

That is, the successful organizations are the ones that are willing to be creative, take calculated risks, do things outside the norm and look beyond their comfort zone in order to serve their patients and drive results.

Some hospitals avoid innovation, because they simply don’t know where to start. Click To Tweet

Here’s a tip, look at your immediate hospital community. Reach out so that you can get ideas, directly from those who interact and engage with your hospital the most. Each community is different and each hospital has its own set of needs, so getting this perspective is an obvious starting point.

What’s innovative in New York City is likely completely different from what’s innovative in a rural community in Georgia. So realize that the word “innovation” has different meanings and simply copying and pasting another hospital’s procedures likely isn’t flexing your creative muscles to their full capacity and is more-or-less a shortcut to innovation.

An example of specific and strategic innovation is a hospital who has a very large parking lot. We’ve seen a real-life instance where this hospital hired someone to drive around in a golf cart to pick up patients and drop them off at specific areas in the hospital. This was a specific need of their community because of the way the hospital was laid out and is an instance of embracing the kind of innovation they actually needed.

Get creative. Look at everything from parking, to food, to telehealth and telerehab.

Chances are, innovative solutions are sitting right under your nose.

What’s one area of your hospital that you’ve improved by embracing innovation?

Working Against World-Class Supply Chain Superiority

This is the final part of a three-part series on world-class supply chain. Missed the first two? Click here for part 1, and here for part 2.

There are certain things that are simply working against world-class supply chain superiority, and you need to be aware of them.

If you’ve followed our series so far, we’ve provided several ideas and strategies to achieve world-class supply chain superiority in part one and part two. However, just as important, what are the elements working against you?


Let’s start with your staff – specifically the idea that you need to decrease the amount of people working in the organization. This isn’t true, in fact, your employees can be your greatest assets if you know how to leverage them properly.


Not having specializations in your departments is another common obstacle in achieving a world-class supply chain.

You need to make sure that the right people are in the right roles. Click To Tweet


Strategy is the next thing you need to consider. If you don’t have one, and if you’re simply maintaining the status quo, or your entire day consists of putting out fires, chances are you’re not being strategic enough and ensuring you’re following through with the strategy.


A lack of integration is something else you may be lacking. If your different departments aren’t coming together on a consistent basis and collaborating, you’re likely missing out on many opportunities for growth and success.

C-Suite Involvement;

Finally, ensure that your C-Suite is playing a vital role in supply chain initiatives. In order to truly create a successful supply chain, your organization needs to have an “all hands on deck mentality and philosophy.

There you have it! You now have several strategies that help you achieve a world-class supply chain and also common pitfalls to keep an eye on.

What’s another element that either works for or against achieving success with your supply chain? Let us know in the comments.

More on Achieving a World-Class Supply Chain

As promised, we’re continuing our discussion on achieving a world-class supply chain.

If you missed part one, click here for the first post in the series.

Achieving supply chain superiority can be difficult without a better supply cost management system. If you’re unsure of the efficiency of your current arrangement, this might be something you want to reassess sooner rather than later.

You also want to be looking at large companies like Apple, Google and Dell and learn from them. These companies, not surprisingly, have world-class methodologies in place which you can model.

Developing relationships with suppliers is also fundamental. People are willing to go the extra mile for a friendly face, so keep your interactions positive and be easy to work with.

Next, take a look at what you want to outsource versus what you want to handle inside your organization.

Each hospital has its own unique strengths and weaknesses and you need to be able to identify what to keep on your plate and what needs to be delegated elsewhere. Click To Tweet

Finally, commit to asking questions.

  • What can be improved?
  • How can this be done better?
  • What isn’t working?

When you’re asking questions like these, you’re not giving into the day-to-day status quo and keeping growth on your mind.

Which of these suggestions are you committed to implementing? Let us know in the comments.

Look for part 3 of this series where we’ll be discussing things that work against achieving a world-class supply chain.

Achieving World-Class Hospital Supply Chain Superiority

What are the key elements of achieving a world-class hospital supply chain superiority?

This is important, because only a 5%-15% savings in supply costs can equal a 1%-3% improvement in a hospital’s total operating margin. It goes without saying that a keen focus on your supply chain can make a big improvement in your hospital’s finances!

This will be the first of a three-part series dedicated to achieving a world-class hospital supply chain superiority as well as what works against you in achieving it.

Let’s begin with what should be the obvious – your people. Having a great staff and great leadership is fundamental to achieving results. They’re the backbone of your operation, they’re the ones engaging with patients, and they’re the ones making the decisions that impact every area of your hospital. You have to ensure you have the right people in the right roles.

You also want to look at technology. Specifically, investing in it, and then actually using it!

Historically, healthcare providers have invested less in IT to support supply chain than other industries. Click To Tweet

If you walk into any other manufacturing environment anywhere in the world, you will see about 60% of the IT budget devoted specifically to operations and supply chain.

A recent study also showed that healthcare providers that make greater investments in back-office automation and process improvement enjoy operating cost ratios that are 2%-4% better than those of their peers. These percentages support the investment and utilization in technology, specifically in the supply chain.

To round off the first part of this series, you also need to create an environment of innovation. A hospital that doesn’t take the input of their staff and employees seriously is a hospital that isn’t operating to its potential. Their feedback is critical to your success, so promote innovation across your entire workforce.

Our next entry will share further key elements to achieving a world-class hospital supply chain superiority.

In the meantime, what would you say is another important factor to consider here? Share your thoughts in the comments.

The audio version of this entry is available at the bottom of this post.