success: Health Care

Intro

Hospitals are the example of Mintzberg's professional bureaucracy: both management and employees are highly educated and equipped to structure work processes. Because this makes hospital organizations less controllable, work processes are far less efficient than at companies. Most regular companies are happy to be able to raise efficiency by a few percent points, whereas it's quite common for hospitals to increase efficiency by 20%.

Working with the European hospital benchmark taught us that small changes can have a large impact on costs and revenues. The challenge for hospital management is not only to find these opportunities but also to implement them while acknowledging the special nature of their hospital organization. As hospitals are professional bureaucracies, improvements tend to fail when the interaction between medical and non-medical staff is not addressed.

For example, we analyzed an outpatient ward with a comparatively high use of abdominal care resources. In the past, the administrative staff had shouldered the reorganizational burdens without any effect on costs. It was discovered that interacting with the medical staff on the actual work floor enabled us to procure some cost-effective measures without sacrificing medical care.

By discussing work processes per diagnosis in comparison with those of peers, we found that a minor change in the medical protocol - omitting one extra visit – actually enabled the ward to lower costs by 25%. Additionally, patient and physician satisfaction was increased. This example showed the importance of truly understanding the medical cultural language and, more importantly, the non-hierarchic communication structures between medical and non-medical staff.

Although medical healthcare systems differ largely throughout the world, the actual work protocols are surprisingly similar. This is because most doctors base their practices on the same Anglo-Saxon medical evidence. The answer to ‘what’ and ‘how’ things should be done is already present in the minds of medical professionals. However, implementation of this knowledge is complicated as the medical culture is difficult for non-medicals to understand.

Hospital managers tend to try to solve this by hiring more staff, both medical and non medical, thereby actually increasing the managerial challenge. It's clear that the real solution lies in improving communication between employees on all levels (not only with management), and in finding their solutions to implement best practices. If we allow ourselves to really understand this notion, we see a tremendous opportunity to lower cost while increasing quality.

Case Study

Productivity improvement and cost reduction project for a Hospital with 2,200 full time employees with a wall to wall scope.