Process Efficiency in the Healthcare Sector

Healthcare provider organizations of all sizes and types have been struggling with the requirements of the Affordable Care Act for some time.
This includes a changing reimbursement system, new and increasing penalties for readmissions and the strong push for all healthcare organizations to be more accountable or to focus more on improved care outcomes and customer value, just to name a few of the many pressures.

Process Medical Business eBookIn the final analysis much of these general pressures boil down to being more efficient in the future at the process level and to achieve that goal we need good data. But we all know that data is everywhere these days (and gets more and more voluminous every day) so the real challenge is to transform at least some of this data into useful information that can then be used to improve accountability and transparency, specifically related to outcomes. In other words with good information, healthcare providers can better meet growing regulatory and patient requirements and demonstrate much greater insight about the marketplace and what it needs, both in preventive terms and in terms of efficient care when it needs to be rendered.

For many providers, the primary focus in becoming more “information rich” and thereby efficient is to look closely at all the key operational processes and determine where change or improvement is feasible and highly beneficial. Although this is no easy task (and clearly takes time, money and additional resources) the task can be made more manageable by breaking it into 3 basic steps as follows:

  1. Identify the Best Internal/External Resources to Identify/ Map Key Processes

Because caring for people (both in preventive terms and when they become patients) is changing so quickly and dramatically today– and being compensated for offering that care is so different according to the value- and outcome-based model, healthcare providers need to dedicate resources to often completely redesigning systems and processes. And where these resources are not readily available or knowledgeable enough internally to undertake the analysis at the early stages, healthcare providers can turn to advisory services, consultancy firms and even particular solutions vendors (in areas like technology use) to help them analyze their performance and leverage their data to improve service marketing, quality, patient safety, and clinical, financial outcomes, etc.

  1. Prepare the Whole Organization for Change

Although we may argue about the scale of it, change across the healthcare sector has already been enormous in the last 5 years (in technological, system and human terms) but there will be a lot more to come and it will have an impact at every level. Rather than to be defensive about this or try to hold on to past practices for as long as possible, research suggests that better preparation for change and creating a culture in which it can be more quickly embraced is highly beneficial to the business and the people within it. As such, it’s important for all senior healthcare managers and executives to ensure there is a structure in place to continually review and recheck how their organizations’ current performance matches up to current and future needs (mainly by looking at the gaps analysis we should have created at step 1) and to regularly communicate that change and thinking is not only welcome but is the most valuable attitude to take. In practical terms this means that change communication should be discussed every day.

  1. Build in continuous Improvement Systems at all Levels

“Process efficiency” is often seen as a worrisome term in healthcare because it conjures up images of “cutting corners” and “ penny pinching” when we should really be rendering the best care possible whatever it takes. But in reality, process efficiency should be seen as a primary management means by which we can stretch our resources the furthest or for the greatest total good. Put another way, every individual such be constantly thinking about whether the same or equivalent standards of care can be given by using a different or adapted approach which saves on time or money (and means that there will be more left over for others to benefit). This is continuous improvement thinking and if done well and on a widespread basis means that the more hurtful large-scale organizational change initiatives can be less frequent and/or severe. This does take quite a bit of improvement training, especially around task analysis tools and techniques, but the results can be remarkable and in very quick time.

Process efficiency in the healthcare sector will inevitably occur slowly and in only “bite-sized” ways but it needs to be remembered this is just as it should be. Large-scale changes are often dramatic but nowhere near enough by themselves. Many small changes make up 90% of the long-term benefit and that’s why every single person needs to be a contributor.

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Lee Schwartz

Lee Schwartz

Practice Leader-Process/Operational Improvement -RX4 Group

-Taking Care of the Business of Healthcare

Lee is the Process/Operational Practice Leader of RX4 Group based in Los Angeles, California. He can be reached at

Comments 1

  1. Mike Allen

    Perhaps I am being too simple, but when I managed a UK nursing team for Hollister inc in the UK, I deliberately told the nurses, who were paid per domiciliary visit, to provide the best advice and care for the individual regardless of which products were recommended. I could have set the target of maximum sales turnover but culturally that would have been difficult. We already supplied 45% of the market and we were developing some knockout improvements. Because we took that goal, we built systems and opinion leadership to that end. When I left 2 years later we had 55% of the patients and universal support from State nurses. I gues my point is the need to shape processes to the right objectives, aligning values and culture.

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