Case Studies

Staffing Efficiencies Engagement Achieves $7.2 Million Savings
A 500-bed, tertiary acute care center with a four-state referral base brought in a B. E. Smith interim director of acute medicine and critical care to address daily staffing crises that manifested themselves in many ways and on multiple staffing levels.

Recovering Revenue with Effective Case Management Leadership
At this 1,000 bed, not-for-profit hospital, reimbursements were declining due to process- and system-related problems and costs were high due to staffing challenges and increased length of stay (LOS). Learn how in just nine short months, this formerly chaotic department was completely transformed generating more than $6 million in revenue and more than $2 million in cost savings.

Charge Nurse Leadership Development Leads to Significant Annual Savings
The chief nursing officer (CNO) of this 250-bed, for-profit hospital wanted to improve the quality of care and physician satisfaction in her medical-surgical units. She felt that one of the best strategies to effectively address these issues was to further develop and improve her charge nurses’ skills and job performance. As a result, she initiated a 16-week Charge Nurse Leadership Development engagement with B. E. Smith

Improved Labor Utilization to Save Hospital $1.7 Million
While this not-for-profit hospital has just over 65 licensed beds, its average daily census is between 15 and 20 patients. Appropriate labor utilization and use of proven resource management techniques were lacking at this small community hospital, and as a result, the hospital was operating at a significant financial loss.

Positioning Physicians for a Prosperous Future
This not-for-profit acute care hospital was experiencing typical challenges with its physician relations, those practices managed by the hospital and those with independent physicians. In an effort to improve physician relations, the hospital commissioned an operational assessment that revealed hospital leadership was not adequately staffed to support physician practice management.

Materials Management Lays Foundation for Successful Financial Future
Materials management employees at this not-for-profit, 180-bed community hospital needed to fill a leadership void and have an expert to follow through on several outstanding projects that were hurting the hospital financially.

Remove Barriers to Throughput and Reap the Financial Rewards
This 850-bed, not-for-profit tertiary referral center regularly remained at greater than 90 percent capacity, with patients being held in the ED, the operating room and the post-anesthesia care unit for up to three days. Its case management model was broken at best, and a lack of departmental goals left employees uninspired to strive for performance improvement.

From Problem-Plagued Emergency Department to World-Class ED
This newly redesigned, high-volume, high-acuity, 80-bed emergency department was chaotic and confusing, leading to discontent among its staff. Inpatient holds left as many as 30 patients being held for admission at once. Part of a 750-bed not for-profit hospital in a health system of community-based and academic tertiary facilities, the ED’s other challenges included high “left without being seen rates” and long wait times to be seen by a provider.

450-bed not-for-profit hospital
The Department of Cardiology had no process in place to review purchase contracts to ensure that it was paying the lowest possible price on the costly supplies it uses daily. Other challenges included negotiating local supply contracts to further reduce costs, managing bulk purchases and determining the best methods to collaborate with physicians to provide the highest level of care.

600-bed not-for-profit hospital in the Midwest
In today's healthcare environment, it is imperative that hospitals accurately document case mix index in order to receive appropriate reimbursements. A Chief Nursing Officer in the Midwest was challenged by declining reimbursements, so she contacted B. E. Smith. Within weeks, an Interim Leader with over 20 years of healthcare experience was on-site to turn this critical situation around.

500-bed urban tertiary hospital in the Northeast: Cutting Costs and Improving Patient Satisfaction
A Vice President of Operations was placed by B. E. Smith to improve patient satisfaction and lose no more than $5 million for the fiscal year for this 500-bed hospital in the Northeast. Though quality of care was fundamentally sound, patient satisfaction needed improvement. In addition, a culture of accountability had not been established and fundamental business practices were inconsistent. The results: In the first six months, the Interim Leader created a culture of accountability to increase patient satisfaction and also reduced overall expenses by $3 million creating a sustainable positive bottom line. This was the first positive bottom line since acquisition of the hospital.

197-bed hospital in Ohio: Improving Nursing Leadership
B. E. Smith placed an Interim Chief Nursing Officer to provide leadership and build a strong nursing team, address patient issues and improve regulatory compliance for this 197-bed hospital in Ohio. Results included strengthening the nursing leadership team, improved patient and physician satisfaction, dramatically increased compliance with state regulations and standards and implementation of an expense reduction and revenue-generating plan.

238-bed, full-service community hospital in Michigan: Implementing a Strong Financial Structure
An Interim Chief Financial Officer was placed by B. E. Smith in this 238-bed hospital in Michigan to identify a true financial picture, establish a reality-based budget and decrease overall organizational expenses. Also, decisions regarding a future joint venture required leadership and a true financial position of the hospital needed to be established for bondholders. Results included a successfully engaged leadership with regard to expense reductions, a nearly immediate decrease in contract expenses with the implementation of turnaround strategies and a board that has an accurate understanding of the organization’s financial position.

Nursing Home in Maryland with 69 beds: Nursing Leadership
B. E. Smith placed an Interim Director of Nursing in this Maryland nursing home with 69 licensed beds to identify the need for clearer direction and visibility from leadership along with reasons for director of nursing turnover. Supply and equipment processes needed revision to improve efficiency and decrease cost. Quality-of-care concerns were noted with need for staff education and accountability. Performance improvement, risk management and compliance with regulations required immediate attention. Results included improved nursing on-call rotation programs and cross-training to significantly reduce overtime and agency staff costs, identifying nursing leader potential on staff and development of a program to promote from within, significant improvement in a cost-effective wound care program and development of a strong foundation for care delivery and nursing leadership.

Clarian Health: Success and Satisfaction
“Being new to my role in HR, I needed someone to partner with who would make my job easier, not more complicated,” says Lydia Ostermeier, RN, CHCR, who leads nursing recruitment and retention efforts at Clarian Health, a five-hospital system in Indianapolis. B. E. Smith helped me understand the search process and took care of all the ‘hassle factors’ like travel, marketing and advertising,” she says. “With every search, it has been a pleasure working with them from start to finish.” 

Saratoga Hospital: Coverage in a Crisis
"B. E. Smith bailed me out of a potential crisis," says Cathleen Hamel, MS, RN, CNOR, CNAA, BC, vice president and chief nursing officer of Saratoga Hospital in Saratoga Springs, New York. "The Joint Commission was coming within two weeks, and I needed to have an interim director in place for the women’s health department." Hamel says B. E. Smith responded quickly. "Two consultants visited the hospital to see our environment and culture firsthand," she says. Soon afterward, provided an experienced nursing leader who fit in just right. 

Beaumont Hospital: Taking the Emergency Department to the Next Level
When Beaumont Hospital’s emergency department director and the administrative director of surgical services resigned within two months of each other, Heidi Shepard, vice president of operations, found herself with departments urgently in need of leadership. “I needed to place interims in both departments fairly rapidly,” Shepard says. “Ideally, I was looking for two talented people who we could learn from and gain knowledge from their past experiences. It was incredibly important for us to get the right people in these roles, and we needed the interims to provide stability while taking the departments to the next level.”

Kettering Medical Center: Fast Response and Flexibility
In the touch-and-go world of healthcare, key management positions cannot remain empty for long. When Gloria Ceballos, MS, RN, CNAA, BC, needed to fill a leadership gap quickly, she turned to B. E. Smith for help. According to Ceballos, the director not only took charge of day-to-day OR management, she rallied staff to make needed process changes. "When she arrived, only 19% of cases began on time," said Ceballos. "Our interim director was able to refine some systems, and now on-time starts are up to 70%." 

424-bed Hospital in Texas: Decreased Length of Stay
B. E. Smith placed an Interim Executive Consultant to assist in providing an operational review of the emergency services department's resources and requirements, determine opportunities for workflow changes and assist with establishing an improvement plan from triage to discharge. Results included improved the aesthetics of the client’s services and point of care testing, decreased the length of stay in the Emergency Department, and improved the clinical skill set of the staff.

428-bed Tertiary Care Hospital in Arizona: Improved Regulatory Compliance
B. E. Smith placed a Human Resources Executive Consultant to serve as an on-site change agent and facilitator for this 428-bed tertiary care facility that is part of the largest healthcare system in Arizona. Results included increased Internet advertising of employment opportunities showcasing the attributes of the organization’s unique work environment, identified actions required to actively recruit healthcare professionals being discharged or retiring from the military, implemented initiatives to centralize and routinely audit HR employee files at the facility, thereby improving compliance with regulatory and accrediting agencies and decreased the operating room technician vacancy rate to zero within eight weeks.

262-bed Hospital in Texas: Increased Reimbursement
B. E. Smith placed an experienced Quality Services/Case Management Executive Consultant for this progressive, health-system hospital that serves communities in a three-state area. Results included significantly increased hospital reimbursements for services which had previously been denied payment, decreased readmission rates for defined patient populations, bridged gaps in continuity of patient care and decreased average length of stays, 24/7 case management coverage in the Emergency Department and implemented non-emergent patient transfer policy which decreased bad-debt expenses.

Hospital in Ohio: Increased Reimbursement
A hospital administrative team called B. E. Smith concerned about a frustrated medical staff that was unhappy with all aspects of the surgery department operations. The physicians were frustrated and began moving their surgeries and patients to local competitors or terminating their practice at this facility. Within three weeks of contacting B. E. Smith, an interim professional with 20 years of surgical leadership experience was placed in the organization. Results included elimination of the 100 percent blocked schedule and lowered costs by eliminating over twenty FTEs while improving processes to manage growth without adding FTEs.