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Visionware® and Innovative Thinking Generate Bottom-line Results for Inova Fairfax Hospital

Inova Fairfax Hospital and Inova Fairfax Hospital for Children is a 753-bed regional medical center serving the Washington D.C. metro area. The hospital provides a full range of medical, surgical, and support services and employs more than 5,500 employees. This medical center's offerings include northern Virginia's only Level One trauma center and the nation's sixth busiest obstetrics program. But recently the largest healthcare employer in Fairfax County, Va. discovered that it needed to more accurately track and monitor productivity and better manage its $300 million payroll.

One specific challenge Inova Fairfax faced was staying within payroll budget limits; one year it even exceeded its salary budget by $16 million. To address the problem, Inova Fairfax turned to Kronos and its Visionware labor analytics software solution. Implementing Visionware and employing some innovative tactics on its own helped Inova Fairfax successfully adhere to budget guidelines. In fact, during the first eight weeks of using Visionware — after being over budget for 37 consecutive pay periods — Inova Fairfax realized a favorable variance, and it now hopes to reduce the $16 million variance to zero.

For Inova Fairfax such impressive results didn't go unnoticed. For generating enthusiasm and organization-wide buy-in, Kronos presented Inova Fairfax with a Best Practices Award. These Best Practices Awards are presented annually to organizations that achieve excellence in the application of Kronos technology.

Addressing salary budget overruns

Bill Nay, Inova Fairfax's director of budget, clearly remembers the challenges his organization faced. "We had problems staying within salary budget limits," he says. "It culminated the year we exceeded budget by $16 million. Needless to say, senior management was not happy about this situation, and when they made it clear that such excess would not be acceptable, we knew we needed a solution."

Visionware is Kronos' industry-leading labor analytics solution for healthcare organizations. Visionware pulls data from multiple information systems, such as billing, payroll, and time and attendance. It then analyzes and reports on exactly the information frontline and senior managers need — based on current patient volume. As a result, they make better-informed, real-time labor decisions on the type, quantity, and mix of labor.

Improved insight leads to improved results

Mr. Nay explains just how valuable this information is. "Visionware gave us the data we needed to create 'dashboard' reports that highlighted salaries, FTEs, and premium hours, all of which helped us compare the productivity of each assistant vice president (AVP)." In turn, this report helped produce a competitive spirit where each AVP could see how he was performing compared to his peers.

Productivity soon surged. "Visionware gave our AVPs daily insight into critical labor information, both for their own department and the rest of the hospital," remembers Mr. Nay. The competitive fervor eventually reached the point where many AVPs called the budget department looking for preliminary results — days before the reports were complete. "All of this demonstrated that a metamorphosis was well underway," says Mr. Nay.

Tools for the transformation

Inova Fairfax continued to push for results by devising another way to get all of its departments involved. "We created a top ten list — although some would call it a bottom ten list — of the worst performers," Mr. Nay says. "This was nothing more than a graph listing the bottom ten productivity indices for a two-pay period average."

But it was really much more than that. Mr. Nay elaborates on how this list quickly generated some impressive results. "If a department dropped into the bottom ten, it could get out by having two positive pay periods in a row," he says. "When we started this program, it only took an index in the high 80s (percentile) to avoid making the list, but now this number has jumped to 95 percent. We now hope that this bottom ten list will become just a bottom five because no one else will be eligible."

Inova Fairfax's department directors dreaded making this list because the result was a meeting with the budget office to plan a corrective course of action. During the meeting, department managers learned that the difference between operating at 90 percent and 100 percent is actually very small when you look at it on a daily basis. For example, many times the required action plan is to reduce less than 12 hours of labor a day. With Visionware's productivity reports, department managers have the tools they need to control labor on a daily basis — before it's too late.

While this program was extremely effective at reforming the worst performers, Inova Fairfax was concerned complacency could set in if its departments only strived to avoid the bottom ten list. "After all, there are forty-five departments other than these bottom ten," says Mr. Nay. So again Inova Fairfax invented a creative way to increase overall performance.

The Kronos Kickoff Classic

An upcoming football season inspired a unique and popular 64-team tournament, dubbed the Kronos Kickoff Classic, to drive results. Mr. Nay explains. "We established four sixteenteam brackets that pitted the most natural rivals against each other in the early rounds. The prize for each bracket winner was two tickets to a preseason NFL game as well as other great prizes. All of this helped create a level of enthusiasm for Visionware and generated heightened awareness of the importance of salary and FTE control."

"After the first round of the tournament, the senior director of finance was able to announce that after being over budget for 37 consecutive pay periods, the hospital had a favorable variance of $33,000," recalls Mr. Nay. "This favorable variance jumped to $95,000 and has grown ever since. The end result is that we may reduce our $16 million variance to zero in one year."

Next steps

In addition to upgrading to the latest version of Visionware in the coming year, Inova Fairfax is also going to give all senior directors and AVPs access to Visionware's management exception desktop feature. "This will prove to be a popular and powerful tool for them to use in reviewing each of their department's performances," states Mr. Nay. The management exception desktop displays real-time productivity data. This information is rolled up by each department, but they can drill-down to see as much detail as required.

Mr. Nay is extremely pleased with Inova Fairfax's improvement. "It took time, but the results, due to the spirit of competition and management buy-in, have been far greater than anyone could have imagined."

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