Efficiency programs
Bringing the horsepower onto the road: Recognizing potential and purposefully controlling the result
Often, the potential to reduce costs or increase revenue in mature structures leads to inefficiencies in daily work. Insufficient processes, unclear organizational structures in collaboration and decision-making processes, as well as the use or improvement of existing tools. Often it is "small" changes that lead to sustainable improvement.
The analysis and optimization of business processes is our hobby. Along a tried-and-tested approach to classical methods, we go through the structural and procedural organization with the participants and carry out structured interviews and process analyzes based on the Six Sigma SIPOC method from Lean Management. For standard processes, prefabricated templates are used, which we compare against best practice experiences from our projects.
We consolidate the analysis in a meaningful health check, which ultimately creates a roadmap and shows valuable solutions for aligning processes, roles and responsibilities in a clear target image so that concrete work packages and implementation measures can be derived. The measures adopted are consistently transferred to an efficiency program, tracked and brought to a conclusion through transparent project management.
Experience shows that the efficiency potentials along the main business processes and the associated support processes have to be analyzed. It is important to address the specific questions from the core areas of hospital management:
- Is the admission of the patients and the occupancy control in a defined process transparently regulated (eg pre-hospital recordings, recordings the day before, "dismissal until", avoidance of surcharges / discounts)? Is it possible to plan the development and achieve the set goals? Are there any deviations and how are they justified?
- Is the length of stay at department as well as at DRG level recorded, evaluated and controlled via standardized reporting? Are the analyzes understood and applied in everyday life? Are concrete measures with regard to optimizing the length of stay in the context of chief physician talks controlled?
- Is the case documentation completely and error-free (surgical reports, findings, nursing documentation and doctor's letter)? Does monitoring ensure the quality for revenue assurance and optimization? How promptly is the complete case release (final coding) for release?
- Do layoffs basically plan? How soon after the discharge does the billing of the various benefits (cash benefits, private liquidation and optional benefits) take place? Are all services included in the HIS? What is the process knowledge of the participants (guidelines, instructions and training)? Will there be documentation gaps, billing arrears and open items?
- Are MDK cases recorded in a structured manner and reasons analyzed? Are examination quotas, amounts in dispute and loss quotas known and are these regularly reported on the basis of key figures and underpinned with measures / goals per department? Is MDK management anchored in the organization and given clear responsibilities (DRG representative per department)?
- Are key performance indicators used as the basis for profit planning (number of cases, CM, CMI, VWD, surgery times, ventilation hours, etc.) and regularly reported in plan / actual reporting by cockpits? Will the achievement of objectives be analyzed with the responsible persons and a coordinated preview with measures at departmental level decided?
- Is actual data available quickly and in a sensible structure, detailing and quality? Can the actual data in all areas be compared with the planning data and analyzed? Are interim financial statements usable and meaningful for the analysis of results due to the delimitation of positions, allocations and further calculations?
These questions usually provide a basket of measures that opens up immediate potential for results, which must be anchored in different places in the clinic and which must be coordinated and raised through a centrally managed efficiency program. The interaction of the individual topics is crucial for the efficient orientation of the hospital. For transparent implementation, individual and clear objectives and the procedure must be defined for each measure.
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