Forecasting & Analytics

Diagnostic Imaging Projections

 

Introduction

The following material provides a comprehensive overview of the analytical inputs that were utilized to support the ACC Programming engagement.  Key inputs include current and projected ambulatory patient activity (inclusive of ambulatory visits and minor procedures), Diagnostic Imaging encounters, operational drivers to establish Key Program Units (KPUs) and UCDH staffing analytics to support programmatic decisions.

 

NBBJ’s holistic approach leverages prior UCDH master planning work completed by NBBJ in 2018 while utilizing the most up-to-date 12-month patient activity volumes (FY2019).  This information is paired with academic medical center best practices and enhanced care delivery targets to drive KPU capacity models that were reviewed and approved by the engagements Steering Committee.

 

The document is organized into six subsections:

  1. Exam and Treatment Room Projections

  2. Procedure Room Projections

  3. Diagnostic Imaging Master Plan Validation

  4. Staffing

  5. Additional Supporting Analytics

  6. Future Considerations and Risks

  7. Departmental Analytical Review

Utilization & Throughput

 

Room Turn Calculator

This room turn calculator illustrates the relationship between Utilization and Room Turns per Day. Adjust the sliders below to change the Minutes per exam and the Target Utilization. The volume calculation assumes 8 hours per day, 5 days per week, 50 weeks per year.

In-Room Minutes per Exam

Target Utilization %

Exams per Room per Year

60
65 %

1,250

8AM

12PM

4PM

The information in this table was collected from UCDH's EPIC system, and benchmarked with Vizient data. It represents a conservative estimate of average in-room time per exam, taking into consideration that some types of exams (like new patients exams) require a longer visit.

Download a supplementary presentation about each Service Line's volume and room utilization data below.

Exam & Treatment Projections

 

 

To establish exam room KPU’s per each UCDH ambulatory service line, the following volume and operationally based inputs were utilized.  Each service line required a level of customization to account for unique traits; such as patient acuity, percent new or pediatric patient visits, and additional diagnostic or treatment service utilization (e.g. affinity for Diagnostic Imaging services).

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KPU Calculator

This KPU calculator allows you to adjust the schedule assumptions, growth assumptions, and efficiency targets for UCDH. On the first tab, adjust the assumptions to see the aggregate KPU need over time. On the second tab, see the KP need by Service Line for 2030.

 

 

Procedure Projections

Similar to our comprehensive approach in establishing Exam Room KPU’s, specialized procedure rooms were projected and capacity modeled for five service lines currently performing procedural services.

 

Currently, the ACC procedure rooms are in highly specialized, confined spaces.  Future state space programming pursued modernized space allotments that support flexibility for multiple service lines to utilize/share procedural rooms.

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Diagnostic Imaging Projections

Below is a validation of the forecast created for 2018 DI Strategic Master Plan. It has been updated to forecast a new understanding of growth for on-campus ambulatory service lines.

Notes

  1. Throughput targets based on current ACC-DI operations run M-F 7am-9pm and S-S 8am-5pm

  2. Growth projection based on strongly correlating specialty clinic visit volume growth, through 2030

  3. UCDH DI 2018 Master Plan growth trend maintaining current market share and considering future modality utilization trends, through 2026

  4. UCDH DI 2018 Master Plan growth trend growing current market share and considering future modality utilization trends, through 2026

  5. Decanting volumes or other strategic 'shifts' have not been incorporated in the forecast.  Primarily driven by population growth, correlating ambulatory growth and utilization trends

 

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Workstation Analysis

A comprehensive analysis of clinic staffing and educational ‘occupants’ was completed to understand the day to day activity within each service line. Clinic ‘occupants’ can be defined as:

  • Providers

  • Fellows, Residents, AP/PA/NP

  • Management and Leadership

  • Clinical Staffing (Nurse, MA’s, Care Managers)

  • Students, Shadows, other educational participants

 

Building off current state staffing levels, a balanced future state was developed through establishing occupant ratios per exam room in addition to establishing future state space standards to reduce office dedication and leverage more flexible work stations to support clinic operations.

 

Additionally, UCDH has been pursuing the development of a Patient Contact Center (PCC) that would pull an estimated 75% of non-patient facing MOSC staffing out of the ACC.  This assumption as been incorporated into the ACC programming and would require programming revisions if PCC developments do not capture expectations.

 

Additional future considerations should consider scheduling implications, validation with Human Resources and Union restrictions.

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Additional Supporting Analytics

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Future Considerations & Risks

  • UCDH is continuing to develop off-campus strategy and developments that may impact future volumes. These developments were not included in this forecasting approach.

 

  • UCDH leadership provided direction to test a projection range. Although Sacramento is a “growth” market and ambulatory utilization trends continue to rise (locally and across the country), market share and faculty attrition/recruitment was not considered during this forecasting effort.

 

  • The established Space Program incorporates a standardized clinic template that supports flexible space utilization among varying clinical service lines. To successfully recognize such efficiencies, ongoing process improvements and scheduling/coordination initiatives are required to advance from current state operations to the enhanced future state.