Globally, healthcare providers are under pressure to provide better care for lower costs. One way to achieve this is by increasing efficiency in healthcare delivery. Increasing efficiency is often seen as a euphemism for cost-cutting. That’s not entirely wrong. One of the ways to increase efficiency in organisations is to reduce the resources available to accomplish a task. But there are more ways to achieve this goal.
When we assist healthcare providers with increasing efficiency, we look at four different angles:
- Can we improve the current available capacity? Or can the organisation provide care to more patients with the same resources and at the same quality?
- Can we optimise the current available resources? Or can we reorganise the planning to better match the need of the organisation based on data?
- Can we lower the current costs? Or can we remove resources from the process while maintaining the quality of care?
- Can we develop a different process with the same outcome?
Improve current available capacity
One of the most underestimated ways to increase efficiency is looking at the current capacity. Can you maximise the number of patients you can treat over a fixed amount of time? At the same time, you want to keep the differences between busy and quiet moments as small as possible. Of course, not everything is plannable, but if you can treat ten patients per hour, there is no advantage to letting twenty patients register at 8 AM for a consult. The goal is to remain as close as possible but below the maximum capacity daily.
Some people think that maximising capacity means that the most expensive resource in healthcare, often the physician, cannot be idle. One way of achieving this is by ensuring a queue of patients waiting at the doctor’s cabinet. At first, this seems to be a good idea, but there are consequences. For example, if every specialist in a hospital would do this, the hospital needs to build waiting rooms based on patients’ capacity to treat in two or three hours. This reasoning would lead to large waiting areas being used at capacity approximately one or two hours per day. Afterwards, patients start to go home, and the number of patients drops below half of the built capacity.
Ideally, you want that waiting rooms to be used at total capacity during most of the day. This principle reduces the waiting time for patients. In addition, it has many secondary advantages like a reception desk staff member gaining time because patients don’t ask every twenty minutes how long it will take. Or fewer people in the waiting room reduce the risk to transmit contagious diseases.
Optimise currently available resources
Can you improve the current capacity of the process without increasing resources? To do that, you need to look at the bottlenecks in the process and optimise the available (human) resources. Don’t be mistaken. When you solve one bottleneck, another appears. The better you understand the interaction between the different steps in the process, the better you can monitor the procedure afterwards. When you have identified the first bottleneck, the question is relatively simple: how can we speed up the process at this point without adding resources to the process. You can, though, shift resources from one step to another step in the process. Alternatively, you can replace resources with other resources that are less demanded.
An example is if a nurse has to do a specific action that takes five minutes. That nurse can repeat that action only 11 or 12 times per hour. If the action can be split into two parts, vaccinating the patient and registering the vaccine. Then you could consider transferring the vaccine registration to an admin staff member. This frees up time from a nurse and shifts admin work to an admin staff member.
Maximising the time that each staff member works within in their area of expertise creates value for the patient and the healthcare professional.
Lower the current costs
Let’s talk about the elephant in the room. The best-known way of improving efficiency is cost-cutting. But, as you already learned, improving efficiency is much more than cutting costs. So to be most effective at increasing efficiency, we also need to consider this.
Cutting costs, in essence, is simple. You just stop doing a particular action. However, the significant risk is that you actually destroy value instead of creating value. In addition, cost-cutting cannot be done without considering the procedure’s outcome for staff members or patients.
Develop a different process
In general, the most significant gains are not accomplished through incremental changes. Instead, many processes are the sum of many decisions taken over some time. Sometimes this period includes multiple decades. During this time, the reason for certain choices may have changed, but the consequences have not changed. This often results in quotes like: “This is how we always have worked, but I don’t know why we do it like this.” This should be a trigger to consider redesigning the process from scratch.
It does not necessarily mean that you have to change your process, but you should think about it. Then, maybe when you redevelop the process on paper, you come to the same conclusion. That’s ok because now you know why the process looks like it does. If the outcome is significantly different, you can compare the total cost of the process and decide which version of the process you should use in the future.
Increasing efficiency in healthcare
This article is just a brief introduction to increasing efficiency in healthcare. However, there is much more than meets the eye. The complete approach combines analyses that result in an action plan. It’s the combination that creates the intended increase. In a rare case, one or two actions can result in a quick win, but that is an exception.
If you want to increase the efficiency of processes in your organisation and you want assistance, don’t hesitate to contact Coverton. Coverton is a boutique consulting firm run by Jef Hendrickx. Increasing efficiency in healthcare delivery is our core business.