NorthShore University HealthSystem has seen a steady return of almost all services since June, and currently the health system is close to 100% of where it was before the coronavirus pandemic.
NorthShore is now charting a course forward, even with the expectation that it will realize a significant decline of about a quarter billion dollars this fiscal year.
But with colder weather settling in and the flu season beginning in earnest, the large, Chicago-based health system of five acute care hospitals and 150 outpatient locations has had to do what many hospitals are now doing – downshifting and reverting back to some of the measures it took in the midst of the initial COVID-19 pandemic.
“The last couple of weeks have shifted things,” said Chief Operating Officer Sean O’Grady. “We now have to scale back some of these things, because we have to free up beds for the high rates of [COVID-19] we’ve seen.”
As in many states in the U.S., the number of COVID-19 cases in Illinois is climbing.
“The next eight weeks will probably be significantly challenging, and then we’ll see a decline,” O’Grady said. “We want to ensure we get back to business as quickly as possible. It will impact our ability to meet budget projections, but we feel comfortable.”
At the beginning of the COVID-19 pandemic, NorthShore weathered a financially dire period from the middle of March to the end of May, according to Chief Operating Officer Sean O’Grady. The system saw a significant recovery in June, July, August and September, but corporate revenue was down 10% as of September.
“We entered 2020 with strong financials, so it was never a question of whether we could survive, but really making sure we adapted,” O’Grady said. “We didn’t want to realize any long-term harm to the organization.”
There were a few different components to NorthShore’s financial mitigation strategy, which began back in March. For one, even though the system canceled a good portion of its clinical portfolios, it kept staff salaries whole for the first several months, because leadership didn’t know where and when people would be needed.
Over time, the system rolled out workforce strategies as it adapted to the decline in revenue. Even though it had to institute some difficult temporary measures, such as pay cuts and furloughs, there were no involuntary layoffs. Some clinicians decided to use the opportunity to sunset their careers, which helped substantially. Through targeted labor strategies, NorthShore was able to right-size its workforce.
It’s a strategy that has also worked for RWJBarnabas in New Jersey, according to CEO Barry Ostrowsky, and for Faith Regional Health System in Nebraska, according to CFO and VP of finance Johnathan Wilker. Having a stable balance sheet to begin with also helped all three systems.
“We had the flexibility to take the long view,” O’Grady said. “Without our strong balance sheet we wouldn’t have had the opportunity to do that.”
Critically, NorthShore’s integrated approach to governance has paid dividends during the pandemic. Rather than operating as a loose conglomeration of hospitals, O’Grady views the system as a single hospital with five locations, functioning cohesively and basing success on system-wide performance, as opposed to the individual performance of each entity.
When a decision is made at the top, it trickles down to the hospitals in a uniform fashion. One hospital’s success is the success of all; one’s failure is the failure of all. The individual constituents sink or swim together.
All of the decisions NorthShore has made during the pandemic have been informed by data, and indeed it’s been the system’s efforts at digital transformation that have truly greased the wheels.
Recently, the health system achieved a rare designation from the HIMSS Analytics Adoption Model for Analytics Maturity, or AMAM, which incorporates methodology and algorithms to automatically score hospitals around the world relative to their analytics capabilities. (HIMSS is the parent company of Healthcare Finance News.)
Parsed into eight stages from 0 to 7, the model is designed to measure and advance an organization’s analytics capabilities. NorthShore was recently given the Stage 7 designation for AMAM, which means the organization has not only established strong analytics capabilities, but is also demonstrating that it’s using the technology in a useful and meaningful way.
Stage 7 represents the apex of leveraging data-driven platforms, such as the Clinical Analytics Prediction Engine and the Electronic Cardiac Arrest Risk Triage, to provide better care and operational performance.
Also, HIMSS revalidated NorthShore’s Stage 7 status on the EMR Adoption Model and Outpatient EMR Adoption Model. Both models are used to improve patient care, while reducing costs in case studies on predicting medical spend – and also developing an inpatient antibiotic stewardship assistance program using real-time EHR data. NorthShore is one of only five organizations worldwide that has achieved Stage 7 status on all three maturity models.