Bon Secours St. Mary’s Hospital

Bon Secours St. Mary’s Hospital is an acute-care facility with nearly 400 beds, located in Richmond, Virginia. According to Definitive Healthcare, the hospital’s patient mix is about one-third Medicare, one-tenth Medicaid, and the rest primarily privately insured. Richmond median incomes and home values are below Virginia state averages, 1 and the Richmond population is probably slightly more price sensitive for healthcare services than average for the state. Hospitals such as St. Mary’s must maximize efficiency and productivity to maintain margins in lieu of lifting prices.

Situation: Operational inefficiency and productivity challenges

The St. Mary’s Hospital leadership team was increasingly concerned about the hospital’s competitiveness compared with other local hospitals and newly built ambulatory surgical centers. St. Mary’s had been experiencing a steady decline in surgical case volume, and it was under growing financial pressure as its market share declined.

Solution: Recommend perioperative efficiency improvements and build organizational consensus on change priorities

Bon Secours engaged Surgical Directions to perform an assessment of perioperative service at St. Mary’s Hospital. Surgical Directions began the assessment with detailed data analysis spanning operational, financial, and market reports. Following the analytical phase, the Surgical Directions team held a final conference with key hospital and OR leadership to review the preliminary findings and provide recommendations.


As the work continues, the hospital is carefully tracking progress against multiple key performance indicators. St. Mary’s has achieved significant progress, but the transformation work will continue throughout 2019. Moving from a traditional volume to a value-based system will require extensive ongoing collaborative effort from physicians and the hospital. Robust analytics can support good decision-making and help drive this change. Additional benefits are anticipated as the improvement work continues.

  • Increased surgical volume more than 400 cases compared to prior year
  • Reduced cancellations: Although full results are not in 24-hour and day-of-surgery cancellation has been achieved
  • Improved on-time starts went from 40% to 60% in a few short months
  • Reduced central sterile errors: Tray errors reduced by 0.20%