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Case study: helping a hospital transform

How Christ Hospital rebuilt its operational infrastructure


The Christ Hospital and Accenture teamed to rebuild its entire operational infrastructure from the ground up, including departmental processes and systems for IT; finance; revenue cycle; supply chain; purchasing; human resources; marketing and planning; and payroll.

The Christ Hospital selected Accenture to lead the ambitious transformation program due to its breadth and depth of knowledge; skills and capabilities in hospital operations; building and integrating enterprise-wide operational functions; and supporting infrastructure processes and IT systems. In addition, Accenture brought valuable insights from its ongoing High Performance Business research; in-depth knowledge of the health care industry; and unrivaled experience and capabilities in managing large-scale, complex transformation programs.

Founded in 1888, The Christ Hospital of Cincinnati, Ohio, has earned its reputation as a leader in medical excellence by continuing to plan and innovate for the future. The Christ Hospital is a 555-bed, not-for-profit acute care facility, offering services across a broad range of medical specialties. The hospital has the region’s largest medical staff with more than 1,000 physicians, 3,700 employees and more than 300 volunteers. In addition, the hospital offers The Christ Hospital Medical Associates, a primary care physician practice with several office locations throughout the Greater Cincinnati community.


Since 1995, The Christ Hospital had been operating as a member of a multiple-hospital health care delivery network but over time found its design no longer supported The Christ Hospital’s mission, including its strategic direction and plans for investing in the growth of its urban campus. In January 2006, the hospital’s board of directors decided to sever the ties and become independent.

Engaging Accenture to help review the hospital’s complex business position and develop the overall strategic transition plan, the board was ready to embark on the transition to independence beginning April 2007. The board wanted to complete the separation in less than a year—a dramatically compressed time frame and an unprecedented undertaking that would normally take two to three years or longer.

Considering there were 400-plus patients in beds, the board’s goal of “speed-to-separation” also had to be achieved without compromising the stability of the hospital’s operations and guarantee the provision of continued high quality patient care and safety.

At the same time, the hospital’s vision was to be recognized as a top 10 community hospital nationally by 2010. Achieving this recognition required market-leading systems with advanced user functionality and self-service capabilities.

Adding to the challenge, the hospital had no infrastructure of its own, as it had been fully integrated into a shared-services operating model from its multiple-hospital delivery network for all non-patient care functions. Moreover, the systems provided were heavily customized and difficult to maintain.

In effect, the hospital needed to rebuild its entire operational infrastructure from the ground up, including departmental processes and systems for IT, finance, revenue cycle, supply chain, purchasing, human resources, marketing and planning, and payroll. The hospital also needed to procure additional office space for each of these departmental functions, staff them and hire executive leadership to oversee them.


To develop and enable the hospital-wide strategic transformation plan, Accenture mobilized a multidisciplinary team of highly experienced leadership and skilled consultants across its Health; Systems Integration; Revenue Cycle; Supply Chain Management; and Talent and Organizational Performance groups. Between May and July 2007, Accenture conducted significant due diligence to understand the existing shared-services operating model versus what the hospital needed to build its infrastructure for operating on its own.

Key to achieving independence, The Christ Hospital and Accenture teamed to establish leading practice processes and functions across the infrastructure areas being built. A compelling business case was required to bring in-house previously outsourced services.

After several iterations in determining the hospital’s core functions, the resulting solution plan design included building the internal finance capability, outsourcing billing and creating a hybrid supply chain model. In effect, the team helped select a billing outsourcer, group purchasing organization and prime distributor. The selection of the technology providers occurred in parallel with these strategic infrastructure redesign decisions.

In what would normally take more than one year, The Christ Hospital team, with Accenture’s assistance, conducted a super-accelerated, six-week vendor selection process for the hospital’s clinical information systems, enterprise resource planning systems and technology infrastructure outsourcing providers. Accenture was instrumental in participating and spearheading the request for proposal processes; interviewing vendors; and ultimately selecting partners.

With the technology providers on board, The Christ Hospital team then applied a comprehensive approach to delivering the overall solution, linking the strategy, technology, process and organizational components of the hospital’s operations. Accenture Delivery Methods was leveraged as the overarching methodology framework for managing the end-to-end solution delivery and was customized to support the hospital’s dramatically accelerated separation timeline.

The number of hospital systems was effectively streamlined by nearly 50 percent—from approximately 300 down to 157, reducing its IT systems complexity and total cost of ownership and maintenance. At the same time, the team adhered to the hospital’s edict of preserving all existing functionality in addition to improving information access and sharing across systems; and providing new capabilities essential for achieving top 10 status.


The Christ Hospital’s transformation of its operations for an improved health care facility with solid financial performance and continued growth correlates with Accenture’s High Performance Business research on health organizations. Those leading the industry commit to continuous performance improvement in administrative costs, medical management and technology infrastructure.

The integrated and streamlined operational infrastructure processes, in addition to enterprise and clinical system solutions that Accenture helped deliver, have let The Christ Hospital advance along the path of high performance to achieve its goal of becoming a top 10 community hospital. The project is among the most aggressive transformations and rapid complete IT systems implementations of its kind in American health care history.

Despite the complex, large-scale transformation, the hospital’s business did not decline when the new systems went live. Rather, actual operational performance improved with increases in both patient days (up 2.2 percent) and emergency department visits (up 11 percent).

Among its list of recent achievements, The Christ Hospital has been recognized again by U.S. News & World Report as one of America’s Best Hospitals™ and has been named Cincinnati’s Most Preferred Hospital for 13 consecutive years by National Research Corp.

The Christ Hospital Board of Directors Chairman Mike Keating concludes: “Accenture was the ideal partner. They worked with a sense of urgency and purpose. They were accountable and reported timeously against plan milestones. Accenture brought distinctive value to the discussions and outperformed our expectations. This was an extraordinary undertaking understanding the unprecedented time frame we had to transition our systems and processes. The circumstances demanded that we consistently hit our milestones while we transitioned to an independent platform and Accenture assured that we did. Accenture’s strength is its people and their ability to listen to an organization’s needs and suggest appropriate and creative solutions. We are most appreciative of their efforts.”