September 4, 2017

MBA project guides CCMC’s sleep lab expansion

HBJ Photo | Steve Laschever
HBJ Photo | Steve Laschever
Connecticut Children’s Medical Center’s Alex Rivera inside the Glastonbury sleep lab he helped develop during a 20-month MBA program at UConn.
HBJ Photo | Steve Laschever
A terminal where CCMC doctors and sleep techs read study results.

Last year, with demand and wait times for pediatric sleep tests on the rise, executives at Connecticut Children's Medical Center knew they needed to do something.

So like any business evaluating an investment opportunity, the hospital embarked on an in-depth analysis.

That process ultimately grew CCMC into the largest pediatric sleep lab in the state, with 11 beds in three locations, up from just two beds four years ago.

Hospitals add programs and facilities all the time, but what made Connecticut Children's expansion unique is where the idea gained momentum and a close vetting: A classroom inside UConn's MBA program.

During a 20-month executive MBA program at UConn, CCMC's Manager of Sleep and Neurodiagnostics, Alex Rivera, and two classmates drafted a business plan laying out the case for a sleep lab expansion in Glastonbury.

Managers at CCMC agreed to provide some confidential financial details to Rivera's team for its analysis. Earlier this year, CCMC opened the new lab on Hebron Avenue based on the plan.

"I was pretty excited," said Rivera, a Hartford native and recently retired Air Force reservist who joined CCMC in 2013 after nearly a decade at Hartford Hospital. "I was nervous too. I hadn't done this before."

Rivera arrived at CCMC a year before the hospital's initial sleep lab expansion to Farmington in 2014, which added five beds to the two that existed at its main campus in Hartford.

But even with that additional outpost, sleep lab patients still had to wait as many as 10 weeks to get a sleep test. Prior to that, with beds only in Hartford, the wait time was as long as six months.

With Farmington and Glastonbury open, CCMC now has twice as many pediatric beds as Yale, its largest competitor. Today, wait times are averaging around three weeks, though a recent uptick in demand has more than doubled that, Rivera said.

The Glastonbury location was particularly attractive because it formerly housed a sleep lab run by Gaylord Hospital, which lowered build-out costs.

The business plan was a factor in the hospital's final decision to greenlight the Glastonbury lab, said William Agostinucci, CCMC's vice president for clinical support and corporate services.

During one of Rivera's UConn classes last year, Connecticut Children's CEO Jim Shmerling attended and talked about his career in health care. Rivera said that visit made him feel valued.

"[Rivera] was involved from the beginning of our planning," Agostinucci said. "We wanted to have a business plan for another sleep lab and be prepared where to put it."

Executive MBA students often have years of managerial experience, so it's not uncommon for them to tackle a real-life business problem during the course of their studies, said Michael Bozzi, UConn's director of executive programs, regional business and facilities operations.

What's less common, he said, is for plans to become a reality.

"It depends on the company," Bozzi said. "This was something [Rivera] was passionate about, so he went and did the necessary legwork."

Agostinucci said it's not unusual for CCMC employees to seek more advanced degrees, but he could not recall any other MBA project that helped drive a major expansion.

"Alex is a unique individual with a lot of skill from a clinical and a business perspective," he said. "He understands both."

Sleep study demand rising

Though there are about 30 adult sleep labs in Connecticut, Yale New Haven Health's five-bed lab is the only other one in the state dedicated to children.

Rivera's team found that there's an estimated 26,000 children in Connecticut with sleep disorders, creating a sizeable void they thought the hospital could fill with additional sleep bed capacity.

A larger customer base could mean more negotiating power with insurers, and it would also serve patients by reducing appointment wait times.

In addition, there wasn't a trained workforce ready to step in and work for any competing labs that may open, so that risk was reduced, according to the MBA team's analysis.

An estimated 2 million U.S. children suffer from sleep disorders, such as sleep apnea, which if left untreated can lead to high blood pressure, heart disease, depression and even death, Rivera and his classmates wrote in their final paper.

"There's been more of an understanding of how sleep affects children and how behavioral issues in children can be sleep-related," Agostinucci said.

The expansion will allow CCMC to complete around 1,800 sleep tests this year, up from 300 in 2013, but demand is still high, as evidenced by the recent increase in wait times. If the conditions are right, Agostinucci said CCMC might add more beds in the future.

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