In Health Care, Teams Work

Study on collaborative care is first to show measurable benefits for patients and hospitals

Based on the research of Douglas Morrice

With rising health care costs impacting both patients and providers, collaborative care has arisen as a model for improving outcomes for both groups. It aims to manage treatment for chronic conditions by employing teams of professionals with a unified approach — rather than individual doctors and practitioners who may not interact about a patient’s care.

Although many studies have looked at collaborative care, a new study from Texas McCombs is the first to quantify its benefits in a hospital setting: that it can shorten hospital stays and improve outcomes.

“The outcomes we’re looking at are operational outcomes that are meaningful to both the hospital and the patient,” says Douglas Morrice, professor of operations management and Bobbie and Coulter R. Sublett Centennial Professor. “When you have a team, you’re getting much more expertise to improve outcomes.”

The study comes from an interdisciplinary team of researchers, some of whom have worked for years to apply systems engineering analysis to operations at various kinds of health care facilities. Morrice’s co-authors are McCombs Ph.D. Paul Cronin, Jonathan Bard of the Cockrell School of Engineering, and Dr. Luci Leykum of Dell Medical School.

They analyzed data for more than 7,000 unique patients at The University of Texas Health Science Center at San Antonio’s University Hospital who were discharged between June 2014 and October 2016. Because the collaborative care initiative began halfway through that period, the researchers could capture its debut and estimate its impact.

They measured length of stay, readmission rates, and discharge time of day, finding statistically significant improvements in two key patient and hospital outcomes:

• A 9% decrease in the expected length of stay.
• A 27% increase in the likelihood of early discharge (before 2 p.m., which allows for bed turnover and improved patient throughput).

Readmission rates also showed improvement, although not at a statistically significant level. That’s still a positive, Morrice says. “It showed that by shortening the length of stay, the providers did not compromise care.”

Patient surveys also found high satisfaction among patients cared for by a collaborative care team.

“The whole idea when you talk about collaborative care teams is that it’s an extra coordination effort for hospitals,” says Morrice. “Is the effort worth it? Our conclusion is, it is well worth it.

“If we can come into a system and apply these principles, not just for efficiency but to improve these systems and provide more access to people using the same resources, that increases the value. That’s what motivates me.”

“Empirical Analysis of the Impact of Collaborative Care in Internal Medicine: Applications to Length of Stay, Readmissions, and Discharge Planning” is published in IISE Transactions on Healthcare Systems Engineering.

Story by Sharon Jayson