Case Study : Multi-State Integrated Health System

A multi-state integrated health system engaged DCCS to assist with consolidating two hospitals into one new medical center.  The health system needed to validate potential labor savings resulting from the architect’s new hospital design.

DCCS was requested to provide best practice staffing models focusing on shifts and positions for all major departments, as well as all clinical, ancillary support, and physician/hospitalist staffing. Additionally, the project required urgency to facilitate Board decision-making.

DCCS’s Full-Service Capabilities Engaged
Leaders from DCCS service lines provided support and expertise to the project:

• DCCS Nursing Advisory Services
• DCCS Financial/Operational Services
• DCCS Surgery Management Improvement Group
• DCCS Hospital Physician Advisors

DCCS produced best practice staffing models for each department, and each staffing model was built to flex with volume for future planning purposes.
A final product was presented on time and on budget.

  • The Health System was able to assess the number of staff working in two hospitals vs. the total staff needed for the new medical center in key departments by job and shift.
  • DCCS provided the Health System with flexible staffing models to assist with changing volume assumptions.
  • The DCCS staffing models converted labor hours into key productivity indicators (e.g. Hours Per Patient Day) that could be further crossed referenced to industry standards.
  • The Health System gained the ability to validate labor savings attributable to the new hospital design.

If your Health System needs assistance, consider the full-service capabilities of DCCS.

DCCS assists health systems with operational and financial support to improve quality of care, patient and staff satisfaction, while strengthening the bottom line.

To learn more about DCCS Consulting services, visit

Charting a New Course

When a health system needs assistance with charting a new financial course, I often recommend starting with a DCCS Enterprise-Level Assessment.

An Enterprise-Level Assessment can be completed in less than 45 days and produces a master list of potential opportunities, both operational and financial, to include the positive impact the opportunities will have on the health system’s future profitability.

A DCCS Enterprise-Level Assessment will address:

How did we get here?
We will provide a look back at financial trends and identify root cause issues driving current financial results.

Where are we going?
We will roll forward current financial results and trends into a baseline, and incorporate future operational initiatives to produce a best, likely, and worst case financial forecast for a 3-year period.

What is our best Course forward?
We will deliver an executive level report summarizing findings and recommendations supported by various charts, and high-level financial reports to include forecasted P&L, balance sheet, and statement of cash flows.

The health system also receives a final summary presentation in PowerPoint format that will allow a sharing of findings with various management and governance committees.

Chart a New Course with DCCS

If your health system is not hitting financial targets consider an Enterprise-Level Assessment from DCCS

Our team of highly experienced advisors deliver realistic and sustainable solutions for our clients.

DCCS assists health systems with operational and financial support to improve quality of care, patient and staff satisfaction while strengthening the bottom line.

To learn more about DCCS Consulting services, contact:

David Capone, CEO & Founder | Financial Advisor
302.299.7627 |

Debbie Linnes, Partner & COO | Hospital Operational Services
814.777.6179 |

DCCS Welcomes New Strategic Partner

WILMINGTON, DE, March 2018  – DCCS Consulting, LLC (DCCS), A Leader in Healthcare Transformation announced the addition of Patricia Sealing as Vice President of DCCS Nursing Advisory Services and Case Management.

“As a seasoned healthcare executive, Pat has a broad background in inpatient, ambulatory, emergency services and case management,” said Dave Capone, CEO & Founder of DCCS. “She is an accomplished national healthcare consultant offering a unique blend of experience and expertise.”

Serving in academic medical centers, children’s and community hospitals, Pat brings expertise in program development, clinical operations planning, facility design, organizational performance improvement, patient experience, case management and interprofessional team facilitation.

Patricia Sealing
DCCS VP of Nursing Advisory Services

Prior to launching her consulting career, she served as Associate Vice President at Egleston Children’s Health Care System, Atlanta, GA. In addition, she has held the positions of Senior Consultant, Booz-Allen Health Care, Atlanta, GA., Director of Child Health Analysis, National Association of Children’s Hospitals and Related Institutions, Alexandria, VA; Executive Director of the Pennsylvania Perinatal Association, Philadelphia, PA; and Director of Nursing Education and Development, St. Christopher’s Hospital for Children, Philadelphia, PA.

“We are excited to have Pat join the DCCS team.  Her extensive experience and national reputation will be an enormous asset to our DCCS clients,” states Debbie Linnes, COO & Partner at DCCS Consulting.

Click Here to join us in welcoming Pat Sealing to DCCS!

A CFO Lesson Learned

By David Capone, CEO & Founder DCCS Consulting

Working for a large national health system early my career, I was assigned the opportunity to work in the position of CFO for a regional health system that had 5-years of operating losses.  It was a daunting challenge but one I cherished from a career advancement opportunity.

The health system’s annual operating losses ranged from 3% to 5% of revenues.

As I was being oriented to my new position, I was told there was a need for a rapid financial turnaround and my focus needed to be on revenue cycle, managed care rates, financial reporting, etc..
After months of working with revenue cycle, supply chain, productivity, managed care contracts, it became apparent that the operating losses were not coming from financial management, but rather from operations.

This was not a financial turnaround, but rather an operational turnaround due to a poor workforce culture, inadequate IT support, underperforming outpatient/hospital-based physician services, fragmented patient care that included an underperforming ED and Hospitalist service, etc.

Ultimately the health system was returned to profitability; however, it took much longer than it would today.   Failure to properly identify operational issues when evaluating financial losses can be a painful professional experience.

When financial results are not on target there should be a comprehensive Enterprise-Level Assessment that includes evaluating both financial and operational performance.

DCCS assists health systems with operational and financial support to improve quality of care, patient and staff satisfaction while strengthening the bottom line.
To learn more about DCCS Consulting services:

David Capone
CEO & Founder
Financial Advisor

Debbie Linnes
Partner & COO

Challenging the Status Quo –

By: Ann Matherlee,  MHSA | A healthcare executive who dares to ask tough questions…

Why Do We Hire Clinicians to Fill Non-clinical Roles?

Recruitment and retention challenges top the healthcare industry’s “What keeps CEO’s up at night” list, yet it seems we make hiring harder than it has to be.

Why do so many executive healthcare positions have to be filled by an MD? Isn’t there a physician shortage? Aren’t many of our current, talented medical professionals heading for retirement? Wouldn’t it be better to keep physicians practicing medicine and let trained administrators manage?

According to the Association of American Medical Colleges, the United States faces a shortage of as many as 90,000 physicians by 2025. Some of that shortage was created by healthcare institutions themselves, who plucked productive physicians out of the OR or exam room and placed them behind a desk.  Like most legacy issues, if an SVP of Quality position was held by a physician 15 years ago, chances are it still is.

When did this trend start, and why do we perpetuate it?

I’m “seasoned” enough to remember when the rationale was relatability: doctors were more likely to relate to and respect a leader with the same credentials. The danger in this thinking is assuming a physician-leader’s decisions represent consensus among those he/she manages.  Processes generate consensus, not individuals.

Another reason I’ve been told for MD-only positions is that some functions require in-depth clinical knowledge; therefore, only a doctor is qualified to perform it. That’s not true: it’s an outcome of how the position description is structured.

Sure, medicine is complicated, but so are other businesses that have abandoned the staid, traditional likes-leading-likes leadership track long ago. Dan Ammann, President of GM, didn’t grow up in the auto industry, he was an investment banker at Morgan Stanley prior to leading GM.

So before you recruit your next physician or nurse executive:
  • Re-examine the position description and focus on what leadership skills are needed for success. Does the job really require a talented internist, or does it require someone who can relate to and collaborate with internists?
  • Consider eliminating “Qualifications”.  It limits the variety of candidates applying and may unintendedly eliminate a creative, innovative leader from the mix.
  • Engage practicing physicians to participate in leadership committees. This will keep your top performing physicians in your system while allowing them to influence your path to best practice.
Let’s Think Outside the Box

I’m not advocating the elimination of clinicians in leadership roles. I am challenging healthcare’s insistence on requiring an MD for certain positions.  If the best person for a particular job just happens to have a medical license, great. But while we’re stuck in our thought-rut, Bezos, Buffett and Dimon have announced that they will fix healthcare. I don’t think any of them have a medical degree.

While we in healthcare maintain traditional ways of thinking about who can lead whom, we miss the grand opportunity to disrupt the status quo.

Experiencing High Turnover? Lost a key Leader?

Stabilize Surgical Services with DCCS

DCCS Surgery Management Improvement Group provides Perioperative Program Management support via placement of an Interim Leader in conjunction with consulting support.

In addition to providing management services, we conduct a
Perioperative Performance Assessment to identify issues and opportunities for operational improvement and accelerate the initiation of change under the direction of a skilled, trusted leader.

A DCCS SMIG Interim Leader can assist with change management by:

  • Facilitating communication among physicians, staff, and patients
  • Mentoring and support of staff 
  • Coaching and development of leadership
  • Assessing existing programs and systems to identify opportunities and initiate plans for improvement
  • Assisting with recruitment and onboarding a permanent leader
    DCCS Surgery Consulting helps to reduce costs and increase efficiencies while delivering excellence in surgical care.

    Our interim professionals have over twenty years of progressive experience in healthcare surgery clinical operations, including day-to-day operational management, staffing, physician relations, scheduling, pre- and post-op functions, materials programs and systems, etc.

Our team of highly experienced Perioperative consultants deliver realistic and sustainable solutions.

To learn more about DCCS Surgery Consulting services:Contact DCCS ConsultingDebbie Linnes
Partner & COO

Sue Smith, DCCS
Surgery Management
Improvement Group


Stress Test: Flu Season

During this year’s record flu season, many Emergency Departments are experiencing a significant influx of patients causing inpatient and observation units to be overwhelmed.

Improving Inpatient Efficiency

Time Magazine reports that Medical centers are responding to the 2017-2018 flu season with extraordinary measures: asking staff to work overtime, setting up triage tents, restricting friends and family visits and canceling elective surgeries, to name a few. (1)

An efficient hospitalist program is critical to relieving stress across the continuum of care for your patients and staff yet, is often overlooked.

Complex Challenges Require Comprehensive Solutions
DCCS provides tools and support that help health systems develop a hospitalist model that provides a coordinated approach to the care of patients from door to discharge.

DCCS Hospital Physician Advisors works with your leadership team to deploy proven strategies that:

  • Reduce decision to disposition time in the ED
  • Ensure appropriate patient placement
  • Decrease the average length of stay
  • Control costs

Together, we can create an exceptional performing Hospitalist Program.

DCCS has the resources and expertise to support the success of your Health System operationally, clinically, and financially. We specialize in physician practice optimization; revenue cycle management; patient flow and process redesign; interim and permanent leadership support; and quality and safety.

Our experienced healthcare executives can help you decompress the ED, optimize inpatient resources and reduce stress across the health system.

To Reduce Cycle Times, Improve the Patient Experience & Reduce Stress:

Contact DCCS

Debbie Linnes
DCCS Partner & COO

G Scott Dillon
VP DCCS Hospital Physician Advisors

Managing Serendipity for Innovation

By: Avery Cloud

What do the pacemaker, microwave oven, Teflon, saccharin, and the post-it note have in common?

They are all accidental inventions.

In fact, many of the technologies and products we enjoy today were serendipitously discovered during the process of inventing something else. Serendipity can be defined as the faculty of making fortunate discoveries by accident. Since serendipity has produced so many potent and profitable innovations in business, it might be useful if we could figure out how to manage it.  But how do you manage an accident?

Capturing Unintended Opportunity

Many innovation projects produce side benefits that did not come about by design, but were discovered along the way; and sometimes these accidental discoveries produce more value, more business opportunities, and more important functions than the original aims of the innovator. The most famous example of this is the post-it note, the product of a failed attempt to produce a super strong glue.  In 1968, Dr. Spencer Silver, a 3M corporation scientist, accidentally developed a low-tack reusable pressure sensitive adhesive.  Five years later a colleague of his, Art Fry, came up with the idea of using the adhesive to anchor his bookmark in his hymnbook.  Fry then utilized 3M’s officially sanctioned “Permitted Bootlegging” policy to develop the idea. 3M launched the product as “Press ‘n Peel” bookmark in stores in four cities in 1977 and the Post-it note was born.

Fortunately, 3M’s Permitted Bootlegging policy supported serendipity and allowed employees to turn ideas into a business opportunity. A Permitted Bootleg policy provides research time where the technical staff is allowed to spend a certain amount of their time working on ‘pet-projects’ in the hope that there will eventually be a return for the company.  A noteworthy modern example is Google, where employees are allowed to spend up to 20% of their work time in personal projects related to the company’s business. Services such as Gmail and Google News were originally created by employees in their work time. Most companies don’t have a permitted Bootlegging policy, but there are other things innovation leaders can do to avoid wasting serendipitous discoveries.

To manage serendipity, Innovation Leaders must at all times be aware that the product of a failed experiment may have unintended benefits.  There must be a constant questioning at every point along the innovation path as to what unintended purposes might the innovation itself, or associated developments fulfill.  What additional problems are being solved by the experiment that was not part of the original aim?  What jobs are being done, or can be done, in addition to the main job?  What new information is being produced that might be used to support better decisions, or spawn new products and services?

Steps to consider building into your innovation procedure:

  • Examine successful innovation experiments to ensure serendipitous benefits are not overlooked.
  • Examine failed innovation experiments. Pretend the failed outcome was actually intended in order to determine if the product can be used in ways not originally considered.
  • Express all outcomes as:
    • (Failed innovation) “It does not do this, but it does do that.”
    • (Successful Innovation) “It does this, but it also does that.”
  • Encourage analysis from a different perspective by inviting a colleague to review outcomes.

When working on your innovation process, a deeper analysis could discover the ‘that’ is more important than the ‘this’.  It is important to build systems that allow your team to make the most out of each discovery.  Expect serendipity to occur and be prepared to react to it by creating an environment that encourages new ideas and discoveries.

DCCS Supports Turnaround Success

$14 Million Operating Margin improvement within 9 months
Case Study: Acute Care Health System

An acute care Health System with $300 million net revenues had experienced unfavorable operating margin trends over two consecutive years.

The Health System contracted with DCCS to assist their leadership in identifying and implementing financial, operational, and strategic change to improve annual operating margin results by $10 million (target) within the coming fiscal year.

David C. Capone, CEO/Founder DCCS, led the engagement.

The DCCS Enterprise Level Project Management Plan was fully implemented and assisted Health System leadership to identify, measure, and successfully achieve revenue growth and expense reductions that improved the Health System’s operating margin by $14 million.

DCCS Results: Target exceeded by 40%

  • DCCS Assisted leadership to gain Board support for an Enterprise Level
  • Management Action Plan
  • Assisted leadership to achieve $14,000,000 in operating margin improvement within 9 months of start date
  • The Health System continues to maintain profitability years after the successful DCCS engagement

Our team of highly experienced Financial Advisors deliver realistic and sustainable solutions for our clients.

DCCS assists health systems with operational and financial support to improve quality of care, patient and staff satisfaction while strengthening the bottom line.

To learn more about DCCS Consulting services:

David Capone
CEO & Founder, Financial Advisor
302.299.7627 |

Debbie Linnes
Partner & COO, Operations Advisor
814.777.6179 |

What Do We Need to Succeed?

Transforming health care services is a year-over-year campaign. For those on the front lines, resources are dwindling and often fewer people are being asked to do more as a result of financial pressures, mergers, and acquisitions.

David C. Capone
CEO & Founder
DCCS Consulting

2018 looks to be another tough year as health systems find geographic limits to growing market share, wages and benefits continue to rise, and operating margins draw downward.   Most will have to adjust labor to maintain financial stability running the risk of further stressing already exhausted management teams to do more with less.

The challenge is to lower operating costs and perform at a higher level.
To succeed you will need a trusted strategic partner that can reinforce the management team by providing new tools, expertise, and assist with delivering important results, as needed.

At DCCS, we have been assisting our clients to add management bandwidth and expertise since our founding.

The success of DCCS is anchored in its design:

  • DCCS works with experienced healthcare executives in leadership and consulting positions.
  • DCCS has a national network of strategic partners and independent specialists that can be enlisted to address any health system related issue.

The value to our clients is that they have a trusted experienced team of healthcare advisors in DCCS, with deep expert resources, who can create flexible options to support the success of their team.

Our experience has proven that a little additional advisory support at the right time can build confidence, trust, and produce breakthrough results.

To learn more about DCCS Services contact us: 

David C. Capone
CEO & Founder
(302) 299-7627

Debbie Linnes
Partner & COO
(814) 777-6179