Waits, delays and cancellations are so common in healthcare industry that patients assume that waiting is an unavoidable part of the system. For years hospitals have been responding to delays by adding more resources – more beds and building or more staff. But it is not the only way to the deal with the increasing demand.
Further as long as the payment for services cover the cost, more staff and more construction lead to more inefficiency in the system. Not all healthcare organizations can afford this solution. Moreover recent research on assessing the reasons for delays suggests that adding resources is not the only answer. In several cases delays are not a resource problem but they are problems relating to efficiency and utilization. The solution is straightforward – use medical resources more appropriately.
In any hospital, the Operation Theatre (OT) is said to be one of the primary source of revenue generation with around 50-60 % of the revenue earned and also represents an area of considerable expenditure in a hospital budget, which calls for maximum utilization to ensure optimum cost-benefit.
Hence OT utilization is one of the areas of attention for many. Also, case cancellations on the day of surgery, due to suboptimal utilization of theatre time, is a well-recognized problem in hospitals, ranging from 10% to 40% across different health care systems worldwide, more than 50% of which could potentially be avoided.
There has been increasing interest in improving turnaround time for OTs via various operational excellence practices to shorten the preparation and other non-value adding (Muda in Lean terminology) times.
To assess OT utilization, a study of utilization of available resource hours via Swim Lane Process Mapping is an important tool. Such a study indicates the factors that need to be improved for optimal utilization of the available operating time. Variability (Mura in Lean terminology) of case duration also makes it difficult to predict the actual utilization. Even for routine operations, actual case time is uncertain. Each patient is different, and the actual time for a given operation cannot be predicted. If scheduling of cases is done according to the available resource hours and communication between pre-operative personnel, i.e. patients, surgeons, nurses, anesthesiologists etc., is improved, the efficiency of OTs can be improved. Additional audits similar to this are required to critically analyze the utilization of available resource hours, keeping in mind the variability of case-mix.
Another important aspect is better utilization of the personnel resources in the hospital be it surgeons, nurses or anesthesiologists. Time is physician’s most important resource. Harnessing time by creating workflows and processes can boost physician and staff productivity, increase revenue and improve patient care. It starts with putting detailed processes in place that physicians and employees can turn to when navigating challenges, allowing each practice member to do the work they are trained to do, and freeing up the physician to do what he or she does best: treat patients. It can be improved by increasing the value adding elements.
A change is needed in the way healthcare is delivered. The key in the change is process optimization. This requires a close alignment between the healthcare process, healthcare organizations and information about the patient. However, current organizational structures and information systems offer only sub-optimal support. Emphasis needs to shift from a physician-oriented, intra-departmental view towards a patient-oriented, end-to-end health chain view.
The need of the industry is optimization of processes and resources. Improving operations and efficiency will not only help the patients but could unlock the largest potential source of income for the organization.
Written by: Faber Mayuri Pandya
Mayuri Pandya is Head Research & Analytics and one of the core members of Faber Infinite Consulting,with operations in Asia Pacific,Africa & Middle East. She holds a masters degree in Marketing Managementwith her 1st degree being in IT Engineering.
This article was originally published on Economic Times – ETHealthworld.com as part of Operational Excellence in Healthcare Industry series. Original link available here.