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Helix begins study of how to reorganize 3-year project expected to save up to $80 million; 'Best practices' sought; Adding to services, pooling others among changes considered


Helix Health yesterday announced a three-year project to re-examine how it operates. Called Building Helix Health, the project could result in savings of $65 million to $80 million and a staff reduction of about 1,000 from the current 12,000, according to Steven S. Cohen, vice president for operational development at Helix.

Any staff reductions, Cohen said, would "depend on the market" and could probably be accomplished through attrition, since normal turnover is about 1,000 employees a year.

James A. Oakey, president and chief executive, said Helix might even wind up with more employees as it expands some services and moves others "outside the hospital but not outside the [Helix] system."

In addition to five hospitals -- Church, Franklin Square, Good Samaritan, Harbor and Union Memorial -- Helix offers a growing range of services, including adult day care, home health, hospice care, senior assisted living, long-term care and rehabilitation. It is also a part owner of HelixCare, a physician organization with more than 800 doctors in offices throughout the area.

As changes in medical care and in insurance have moved more patients from hospitals to outpatient treatment or to "subacute" settings where care is less expensive than in a traditional hospital, most hospitals, nationally and in Maryland, have responded with some type of "re-engineering."

"A lot of them are looking at patient volume, inpatient and outpatient, and adjusting their businesses and their staffing," said Catherine Crowley, assistant vice president of the Maryland Hospital Association.

While staff reductions have prompted fears that there will be degradation in patient care, Crowley said, the size of the staff is not shrinking as fast as the patient population. Thus, she said, while the number of nurses employed at Maryland hospitals has gone down slightly, the number per patient day has increased between 2 percent and 3 percent over the last year to year and a half.

Nationally, some hospitals in "panic mode" resorted to large-scale layoffs in the past few years, but found themselves left with "work functions and no one to do them," said Clark W. Bell, editor and associate publisher of the trade publication Modern Healthcare. "Now, hospitals are taking a more patient approach, doing over two or three years rather than just lopping off 20 percent of the work force."

But, Bell continued, there is a "trade-off, with cross-training and revision of job function part of the scenario."

Oakey emphasized, "The whole concept of Building Helix Health, or re-engineering or repositioning or whatever you want to call it, doesn't mean care will go down." He said the goal of the process is to look at hospitals in the Helix system and elsewhere and find "best practices" that will provide quality care and keep Helix price-competitive.

The process will involve Helix staff on an array of committees and task forces, and will include an outside consultant. Planning began in November, the project is in its "design phase," and implementation should be completed by early 1998, Helix officials said.

Cohen said the changes in Helix should make it more attractive to patients and to insurers.

For example, he said, the system hoped to have in place in about 18 months an information system that would tie together all Helix hospitals, doctors and other facilities. A patient would only have to give basic information once to be registered in the system, and doctors would have access to previous lab tests and other information.

Consolidation of services -- centralizing a certain type of care in one hospital -- "is on the table for discussion," Cohen said. But while research "suggests it can and should be done, and it has been done in other markets, no decision had been made to consolidate services," he said.

As part of its planning process, Cohen continued, Helix had identified some "service needs -- we prefer to think of them as opportunities." Accordingly, he said, the system will be looking to expand some services, such as rehabilitation, geriatrics, oncology and cardiology.

Cohen said Helix would be moving to standardize equipment -- for example, all hospitals and units would use the same type of cardiac monitor.

Pub Date: 8/20/96

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