Grady Memorial Hospital

The shift: cost containment becomes executable through three teams with clear lag/lead and visible savings

Execution challenge
Grady has two identities: elite trauma center + safety-net system providing massive uncompensated care. Volume is chaotic, and financial gap is constant—making “cost savings” both essential and hard to execute at scale.

Organizational lag measures (WIGs / outcomes)

Grady’s transcript is structured around multiple WIGs across three teams, with a unifying “cost savings/cost avoidance” outcome:

Total cost savings / avoidance: as of that telling, > ~$4M on an investment of ~$100K.
Plus specific team WIGs below.

Team-level decomposition (lag → lead)

Team 1: Fleet / Maintenance cost and readiness

Team lag measure

Reduce costs and improve readiness/quality of vehicles (they reference maintenance quality control, ready vehicles, and cost).

Lead measures / key strategic move

Open an internal shop vs. outsourcing retail service
→ saves cost and improves quality assurance (a structural lead decision).

Team 2: Burn Center patient experience (pain management)

Team lag measure

Increase patient satisfaction with pain management from 4.0 → 4.5 (Press Ganey referenced).

Lead measures

Deliver pain medication within 10 minutes of request.
They cite very high Press Ganey results (95–100 range, as stated).

Team 3: Revenue integrity / denied claims (itemized billing)

Team lag measure

Increase itemized charges by 45% (from 30% itemized → 75% itemized).

Lead measures

Systematically identify and enter missing items into the chargemaster across 14 services and “hundreds of thousands of items”
Break the “insurmountable” task into bites; maintain cadence until claims denials fall dramatically (they cite down to about $66,000 from $2.6M denied in 2008).

What happened along the way:

The through-line is “it provided a template,” a repeatable method for leaders to hold themselves and teams accountable, with scoreboards clarifying goals and progress.

Ancillary benefits
Pride, engagement, improved communication, a stronger leadership style via structure and measurement.