At Mission, this observation and re-engineering work is taking place both in the emergency department and the OR, in time-consuming engagements that trace the patient's experiences throughout the entire continuum of their care.
All of this effort stems from the quality team, which includes performance engineers.
If all of this sounds like a lot of work that's outside the traditional scope of providing healthcare services, Paulus concedes that point. But he counters that this is what's required to orient the system toward a future in which only value will be rewarded.
"Outside of patient safety and our patient safety event mapping algorithm, this is the number one priority, because it's getting into how you fundamentally redesign the care process."
Outside of demonstrating value, this kind of work has dramatic potential applications in right-sizing potential capital projects. For example, Mission Health sees more than a 102,000 ED visits annually with 54 beds.
"We probably should have 85 beds, but we can't have 85 beds unless we build something," he says. "So this is to try to maximize the efficiency and to provide learning insight into what the building should look like once we have the ability to do the optimal design."