Graham Regional Medical Center, Graham, Texas
Supporting a Champion CEO….guiding his team to overcome tough challenges, the CEO of this growing hospital trusted QHR’s expertise to step up the pace of progress.
What’s Next, After Success!
What’s next, after success? Growing fast, and developing in professionalism, efficiency, service and profitability, Graham Regional Medical Center prospered under CEO Blake Kretz’s leadership. But his commitment to the hospital’s well-being wouldn’t let him stop there. He recognized it was time for outside help.
“Just a few years ago, we’d write checks, put them in a drawer… and wait until we could mail them,” remembers CEO Blake Kretz.“We made tremendous progress on our own, but we’d
reached a plateau.To get to the next level, we needed expertise not available locally… and only in bits and pieces everywhere else. QHR was the answer.”
Building Leadership
Kretz began by using QHR’s Learning Institute programs to raise his team’s expertise. “We had good middle management employees, but they had little formal training,” asserts Kretz.The hospital’s culture recognized merit: the best nurses and technicians rose to manager roles; they knew their departments, but lacked the skills to effectively manage people or budgets.
“QHR education expanded our managers’ perspective,” conveys Kretz, “and heightened their perceptions of what they could do.”
The senior leaders also availed themselves of education and networking opportunities.
“Personally, I’ve really grown as a result of QHR’s CFO programs and regional advisory support,” newly promoted CFO Bonnie Blevins reports. “And visiting a QHR hospital, I saw other ways of doing things. I came away with new ideas, new goals… and new enthusiasm.”
Building on Excellence
- Prioritizing areas of focus, Kretz selected specific QHR consulting services to refine processes in:
- Chargemaster/pricing
- Medical records/coding
- Supply chain
- Business office
- Strategic planning
- Nursing/case management
“The chargemaster and Q-rate analysis were extremely helpful,” points out CFO Bonnie Blevins. “We found out we were not coding some charges accurately. The results have already netted us $170,000 in improved reimbursements.”
Not just writing reports, QHR’s consultants took time to explain the changes to Graham staff.
“The QHR specialist brought people together – sitting down with each department to show people how to appropriately code accounts,” describes Blevins. “So we know we can sustain the improvement.”
Tracking Progress, Making Progress
To measure the effectiveness of changes, Kretz used QHR’s reporting tools, database and benchmarking capabilities. Putting the information to work, the team set goals and trended results.
“Our financial reporting is much more useful now, as a tool to help improve performance” affirms Blevins. “QHR established MORs (monthly operations reviews) to keep us all – senior team, board and department managers – focused on the same targets.”
Since most of the first year’s goals were financial, Bonnie Blevins played a big role in the process. Meeting with her weekly or more often, Kretz helped remove roadblocks to progress. He found QHR’s action plans a useful tool.
“QHR does a great job of not only evaluating a problem but of laying out the steps to fix it. The action plans also give us suggestions on how to get things done, and examples of what’s worked in other hospitals around the country.”
Already lean in staffing, with only four FTEs/AOB, the hospital had to find improvement in other, more complex ways. Reviewing revenue cycle processes, QHR’s team worked with Blevins to reduce the time it takes to get bills out. Improving accuracy and timeliness of coding and medical records completion, the team expedited billing and reduced denials. “At twelve days, we’re still above benchmarks,” Blevins admits, “but we’re on track. The improvement will continue, and we’re already seeing good results.”
Kretz asked QHR to assist with clinical effectiveness as well, with a review of med/surg and OB units.“They looked at how our units are structured, productivity and acuity levels,” he describes. “Our CNO has attended QHR’s CNO conferences, and benefited from networking as well as education.” Refinement of nursing and case management are goals for year two; but first year results are impressive:
- Cash is up from 51 to 90 days
- A/R is down from 80 days to 54
- Discharged-not-final-billed (DNFB) days are down from 12 to nine
- EBDITA margin has improved from 9.6% to 15.8%
Working Together, Planning Together
Blake Kretz has learned from experience. “We grew almost too fast at one point – with plenty of business but not enough cash,” he remembers.“Now we’re in a better position. Planning will help us steadily improve.” Accessing QHR’s strategic planning facilitation, he brought his stakeholders together to think through challenges and opportunities.“We’d been successful recruiting, but in that retreat we learned that our new physicians were concerned about their businesses,” Bonnie Blevins remembers.
“Discussing options, we quickly evolved the idea of a rural health clinic. In just a few months, it was a reality. The community has a service it needs, and the staff is satisfied.”
The Secret of Success
Graham Regional Medical Center’s leadership relied on
QHR to help reach a new level of performance. Kretz
isn’t completely satisfied yet. But he’s pleased with
progress.
Leaders share their insight…
“Rural hospitals can get pigeonholed,” points out CEO Blake Kretz. “But networking with a national corporation gave our managers the ability to see what else is out there. With QHR’s help, we’re changing our culture to one of education, development and support.”
“We’d made big improvements,” explains CFO Bonnie Blevins, “But QHR sped up the process. They set us on the right path, changed how we look at things – even changed the things we look at. Some of those, like overtime, go right to our bottom line.”
““Before choosing QHR, I researched our options. I learned QHR wouldn’t try to take over, and were willing to help us on a consulting basis. The board agreed...and QHR came through for us.”
