Ho'okahua Project Update
Posted on Friday, March 29, 2013

The Ho’okahua Project – The Name
The hospital’s ongoing performance improvement project with the Huron Consulting Group is officially known as “Ho’okahua”, which means “to build from the ground up.”  This name indicates the effort needed to construct something that is meant to last, and it was given to the hospital by North Hawaii Hawaiian Practitioner and member of the hospital’s Kaheleaulani Advisory Board, Aunty Ulu Garmon, after much consideration and prayer. 

NHCH is the only small non-profit community hospital in the state of Hawaii, and although this uniqueness has its benefits, it also brings its share of challenges. In an effort to turn around our financial performance in the short term and to lay the groundwork to better position the hospital for the coming changes required by The Patient Protection and Affordable Care Act (PPACA), we have been engaged in a performance improvement process called the “Ho’okahua Project” since January of this year.  This project is led by Interim CEO Lowell Johnson and The Huron Consulting Group, who have worked together seven times, successfully, over the past eight years.

The “Big Board”
Since mid January, a team of consultants from The Huron Consulting Group has been observing and working with each hospital department and service line, focusing on the following four areas:

  • Revenue Cycle—the process of receiving payment for services rendered;
  • Non-Labor—contracts and costs associated with purchasing materials and supplies;
  • Labor—scheduling and use of our human resources, nurses and  administrative support staff for more efficiency; and
  • Physicians—working to better support our physicians and improve the productivity of their practices.

Thus far Huron consultants have identified $3.7 million in potential savings or additional revenue or roughly 74% of their total goal of $5 million.  After further analysis and approval by the hospital’s Board of Directors and Executive Team, $625,612 in cost-saving initiatives or additional revenue has already been implemented at this time. 

The below chart, known as the “big board”, offers more details regarding identified initiatives versus implemented initiatives.  As we move through this process over the coming months, you will see information move from the “Identified and In Process” column to the “Implemented Recommendations" column.

Focus Category

Identified and In Process

Potential Savings and Additional Revenue



Revenue Cycle
how we bill, collect and document for services provided



scheduling, labor utilization, productivity



contracts and costs associated with purchasing materials and supplies



Physician Services
process improvements, productivity and standardization

In progress


Recurring Subtotal
Yearly cost savings



Non-Recurring Subtotal
one-time cost savings




$ 3,723,774


% of $5 million goal




These initiatives will help the hospital achieve revenue enhancements and cost savings while continuing to provide excellent patient care.  The Huron Consulting Group will work with the hospital management team and staff to provide the tools, training and support to set NHCH on a profitable path for the future.  Consultants will remain at NHCH throughout the implementation process to assist management and staff to ensure recommendations actually work and are adopted effectively.  This entire process is currently slated for completion in early September.

Stay Up-to-Date
This is a very important endeavor for the hospital, and we are committed to sharing information in an appropriate and timely manner.  In order to stay up-to-date with our Ho'okahua Project and all happenings related to NHCH, please consider the following:

  • Waimea Community Association (WCA) Meetings – join us on Thursday, April 4th for a brief presentation from NHCH Interim CEO Lowell Johnson.  Meetings are open to the public and held on the first Thursday of each month at 5:15 p.m.  in the Waimea Elementary School cafeteria; please visit www.wca.org for more information.

  • Sign up for our monthly eNewsletter - just click the “Sign-Up for ENews” button found on the bottom left side on our website.

  • Contact Us – if you have a question or comment, ask us or tell us, by contacting the hospital Administration Office at 881-4400 or send an email to nhchinfo@nhch.com.