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VHA Professional Development Program
Advisory Board Meeting

Assessing and Optimizing Operations and Patient Flow

A six-month professional development program for VHA leaders and staff 


Date: June 26 - 27, 2017
Location: Needham, MA

VHA facilities are constantly challenged to steward constrained resources in providing timely, efficient, high quality care for their patient populations. The substantial responsibility for providing excellent care for all veterans under VHA care imposes unique patient flow and access challenges, which affect quality of care and outcomes. VHA acute hospitals exhibit patient flow stress that manifests in high inpatient bed occupancy and delays throughout the system. Difficulties and delays in accessing internal (e.g. surgery, physician, PT/OT, etc.) and external (post-acute care such as rehab, SNF, etc.) resources in a timely manner lead to gridlock within the acute hospitals. In order to sustainably address these vexing challenges patient demand patterns need to be better understood, and inform the design and allocation of operational resources in different parts of the system such as the ED, OR, acute beds and sub-acute beds.  

The Institute for Healthcare Optimization’s (IHO) Variability Methodology has demonstrated dramatic improvements in flow in disparate healthcare settings in the US as well as Canada and the UK. Medical and surgical redesigns have achieved decreased waiting times and internal delays, decreased length of stay, increased throughput, higher quality of care, and improved staff and provider satisfaction. IHO is excited to offer this six-month patient flow assessment and optimization program uniquely tailored to the needs of VHA facilities. 

This six-month program will provide training and specific recommendations on cutting edge operations management strategies and tools to assess and improve your hospital wide patient flow.  The actionable analyses and learning oriented approach will uncover bottlenecks, identify sources and impact and develop detailed recommendations to achieve impressive results in quality improvement and cost reduction. The Guided Patient Flow Assessment (GPFA) will be followed by a detailed two-day ‘how-to’ surgical and medical services redesign implementation training. 


Key Program Features include the following: 

  • In-person professional development sessions to establish your institutional capability to maximize efficiency and optimize patient flow
  • IHO Variability Methodology® assessment toolkit (inpatient, OR, and ED) 
  • A robust data-driven self-assessment and analysis of your hospital's patient flow to understand: 
    • When and where to add resources such as nurses, beds, etc.
    • How to decrease your hospital’s overcrowding, readmissions, and medical errors
    • How to increase your patient throughput without adding capital and human resources 
    • How to prioritize and where to start your patient flow redesign 
  • The interpretation of numerous system performance analyses included in the IHO toolkit Expert coaching on data extraction, analyses and your executive briefing  
  • A one-day meeting for facility Executive Leadership to receive an overview of operations management and Variability Methodology, and for facility participants to present their assessment findings to their executive(s)           
  • A two-day training session providing step-by-step guidance to implement IHO Variability Methodology in the surgical and medical settings including: 
    • Clinician engagement 
    • Practice change management
    • Key data needs and data analytics 
    • Application of queuing theory 
    • Key metrics
    • Standard operating procedures

At the end of this program, VHA participants will have all the information and tools necessary to implement requisite changes at their hospital.


Program Activities

  • Launch Meeting- two day in-person meeting
    • Overview of operations management and Variability Methodology 
    • Preparation for data extraction and analyses
    • Overview of the IHO Variability Methodology® assessment toolkit 
  • Webinar group coaching and guidance –regular biweekly webinars during the GPFA period 
    • Regular group coaching and guidance by IHO faculty on data extraction and analyses 
  • Submissions of each VHA facility assessment analyses to IHO for review one month prior to the Executive Leadership Meeting
  • IHO faculty guidance on prioritizing patient flow redesigns 
  • Senior Executive Meeting- one day in-person meeting 
    • Executive overview of operations management and Variability Methodology 
    • Facility staff present their assessment findings to their leadership 
  • A “Reengineering Patient Flow” training session - two day in-person meeting 
    • “How-to” guidance materials on reengineering surgical and medical patient flow 
    • Overview and application of Queuing Theory, which is a key underpinning of patient flow redesign 
    • An overview of managing flow from acute to sub-acute settings

Note: At the end of the six-month program VHA participants may determine to continue with a second phase program designed to support the redesign changes and measure improvements in throughput, satisfaction, quality and safety. 


IHO Role and Responsibility

IHO will provide training in variability methodology, tools and templates for various patient flow assessment analyses, coaching to perform and present assessment findings and detailed guidance that VHA teams can follow to implement changes at their organizations.   


VHA Role and Responsibility 

Participating VHA sites will ensure team participation in in-person and virtual webinars coaching sessions, active engagement in the professional development process, timely access to data for participating teams and submissions to IHO, and leadership participation in the executive report out session at the end. We suggest that each participating VHA site train a multi-disciplinary team including physicians, surgeons, anesthesiologists, nurses, quality and PI specialists, data analysts and senior administrators. 


Program Fees  

The fee for participation in this six-month professional development program is $6,000 per person.  This fee includes the following: 

  • All materials and resources 
  • Two-day launch meeting 
  • One day Executive Leadership meeting 
  • Virtual webinar training and coaching sessions 
  • A “Reengineering Patient Flow” two-day training 
  • All meeting facilities and breakfasts, lunches and snacks during the in-person meetings


Team Participation 

IHO requires a minimum of 30 participants and a facility participating team of at least three people attending each of the in-person meetings.  We suggest that each participating VHA facility train a multi-disciplinary team including physicians, surgeons, anesthesiologists, nurses, quality and performance improvement specialists, data analysts and senior administrators. Download a copy of the program here »

                                                                                   Register here

For more information, please contact:
Amy Parrella
Phone: (617)-467-3374
Email: aparrella@ihoptimize.org