The alarming rise in the number of Swine Flu cases and resulting criticism of hospitals for not handling them fast enough has brought to light two key issues plaguing the health care industry today – lost capacity and inefficient processes that result in unpredictable outcomes, long wait times, unsatisfied patients and ultimately an unsustainable business model for hospitals. Further, issues such as a rising demand in doctors & medical staff and an increase in lifestyle-induced diseases are straining the health care industry. Injecting a new thinking is what’s needed in this industry.
The current set of challenges demand nothing less than a fundamental rethinking of the hospital operations to improve outcome, increase capacity and meet the growing demand of users. A powerful way is to look at end-to-end individual processes of a hospital and work out solutions to optimize them.
Over the years, we have learnt that most major hospitals have 18 major processes, out of which, 5 are focused on core medical areas such as treatment and clinical processes. The rest are all related to support functions – the efficiency of which directly impacts the effectiveness of the clinical processes and the hospital as a whole.
Across these 18 processes, there are three workflows that impact hospitals: 1) flow of people, 2) flow of money 3) flow of supplies with enough opportunities in each of these work-flows to optimize them for effectiveness.
Here are some examples of what can be applied to most key processes in hospitals:
- Stitch-to-Cut cycle times impacting surgical suite availability can be improved by 4-6% in 90 days by improving the patient flow process.
- Pharmaceutical and non-pharmaceutical stock levels can be reduced within the first 90 days to prevent over-stocking without impacting care-giving processes. This can be done by deploying Lean tools – similar to those used in other industries like manufacturing.
- Overall supply costs can be further optimized by 8-12% by moving from physician preference items to standardized supplies.
- Payer denials can be reduced on account of upstream challenges like Patient referral systems. These can be improved by fixing the processes upsteam by having an end-to-end view.
- Patient walk times can be reduced by 20% by optimizing process flow and ergonomics.
- Potential exists to improve First Time Right in Billing by up to 25-30% each by fixing avoidable and manageable root causes.
- Expiration of Medication and obsolescence of supplies contribute 1-3% of total operating costs of wards and can be reduced by 30% within 90 days.
For a leading US children’s hospital, Genpact achieved the following improvements using process optimization techniques:
- Reduced length of patient stay (in ER) by 30%
- Reduced Overall Discharge Cycle Time by 30%
- Increased Overall Equipment Efficiency (MRI) by 24%
- Improved Asset Utilization (Cath lab–Surgical Suites) by 60%
- Reduced Perishable consumables Wastage by 68%
The benefits of these techniques are multifold; they improve patient care, optimize hospital equipment and reduce costs significantly.
How a hospital manages its logistics greatly impacts its cost and as technology becomes more advanced, medicines become more expensive and human resources come at a higher price, rendering advanced health care with modern diagnostic tools, medicines and trained professionals comes at a very high cost.
One of the most popular strategies in the past has been implementing expensive technology fixes to a poorly designed delivery process which drives further inefficiency and suboptimizes the benefit that a large IT investment would have had otherwise – The philosophy of Process before IT has helped forward-thinking hospitals gain multifold benefits from IT investments – digitizing a bad process now means “Bad Transactions” flow faster.
Demanding customers and increasing pressures of cost are forcing more and more health-care providers to realize the importance of improving quality and safety and eliminating waste as strategies for responding to the challenges. As the health-care sector re-invests itself it is clear that survival will now depend on not doing more of the same but rather viewing the challenges differently and applying newer paradigms to how hospitals are structured to deliver care. Hospitals will have to move from departmental “silos” to “value flows” and process thinking is going to be the most important lever for the hospital’s CEO.
Genpact can apply the right tools to cut out wastes and standardize processes and procedures leading to dramatic improvements in the areas of quality of care, cost-effectiveness, and patient satisfaction. We do this through a unique approach that brings science to the management of business processes and provides a granular frame-work based on our detailed mapping and analysis of key processes. This enables us to test the effectiveness of processes by measuring points of leakage at each level of the end-to-end process and apply best-in-class bench-marks that we have collated over the last 12 years from within and across industries. The result is a client specific road map for maximizing process effectiveness.
At Genpact, we focus on business outcomes like patient wait times, cash flow and total spend. The focus is on effectiveness of a process to drive business results vs. the traditional view of measuring process efficiency. We combine our deep domain knowledge of process, key insights and best practices with execution support including focused IT and technology applications, targeted analytics and global delivery.
Article by Tajinder Vohra