Best practices in hospital industry
1. Budgeting and accountability[1]: Many of the health systems like the University of Utah Hospitals & Clinics have struggled to achieve its operating budget targets. For instance, during FY1997-2003, UUHC was successful in meeting its budgeted operating margin targets in only three of those seven years. The procedure in setting and managing healthcare organization budgets include-
i) Using comparative benchmarks
ii) Setting accurate, high-performance department budgets
iii) Establishing a culture of accountability
iv) Managing expenses
v) Monitoring variances and requiring corrective action plans
vi) Employing a balanced scorecard
Thus hospitals like Utah hospitals have adopted a new approach by first setting the volume or revenue side of the budget and then balance it by driving down the cost side and by providing managers with the following year's budgets based on historical performance to hold costs down.
The operating budgeting process comprises two parts--budget setting, in which budgets are established prior to the beginning of each fiscal year, and budget management, in which budgets should be monitored and controlled. If either is not properly executed, year-end financial results can be problematic and expectations can be missed.
Best practice budgeting includes, among other steps, setting accurate budgets, establishing accountability, monitoring variances, and managing expenses, Instilling a Culture of Financial Accountability, and interviews conducted with various healthcare consulting firm executives, hospital CFOs, and hospital budget managers.
The Premier Performance Improvement Portal is a library of performance improvement advice and best practices, and a networking community for knowledge sharing and interaction with industry specialists, hospital and health system peers and Premier's knowledge experts. This can be a great tool to bring the vast pool of knowledge from different institutes and hospitals by sharing it using such a portal. This acts as a virtual library with Customizable tools, forms and templates, Executable methodologies, Success stories and case studies and Resources available 24/7. For this the Portal content is created, validated and maintained.
3. Wired Network Security[3]:
With an ever increasing amount of information in hospitals transmitted electronically, it is important that security be considered in every phase of network design and maintenance. Great care needs to be taken to properly secure it because the wired network is the “nervous system” of a hospital’s Information Systems. Also, with legislation such as the Health Insurance Portability and Accountability Act (HIPAA) requiring security measures in healthcare environments, securing the network infrastructure has become mandatory to ensure compliance.
4. Value teams[4]:
Value teams have evolved throughout the country which are more effective than value analysis committees. Value teams get the job done faster and efficiently by involving customers/patients and experts who understand their services and technologies much better than a committee member or members collectively can or should.
5. Extensive training:
Value analysis is an art and a science having a 63-year history requiring 40 to 80 hours of classroom and just-in-time training to truly become proficient in this discipline. Healthcare organizations that are making this investment in training their value teams are receiving a minimum of41:1 ROI for their efforts.
6. Standardized process:
Hospitals basically adopt value methodology which their value team members follow religiously on each and every value study that they perform. By adding standardized processes like SOP’s to their value analysis program best-practice hospitals are realizing 6 % to 9 % savings annually in addition to greater quality gains.
7. Function oriented:
Value analysis being adopted in hospitals has to be function oriented inorder to evaluate and analyze the costs involved in each function and can be minimized keeping the quality level in mind. Value analysis goes beyond price to identify the true requirements of your customers and meets those requirements at the lowest possible cost. Best-practice hospitals who understand this important differentiation are saving on average 26 percent on each commodity group they study.
8. Customer focused:
Best practice hospitals generally adopt value analysis that begins and ends with the customer. The real challenge is to spell out the exact requirements of the customers which are being met through utilizing techniques, such as, the Value Analysis/Value Engineering Customer Mapping process.
9. Strategic planning driven:
Most value analysis programs focus their efforts on their group purchasing organization contracts and requisition driven offerings, whereas best-practice hospitals strategically plan their value analysis candidates and target their savings. This results in the strategic planning driven value analysis programs saving 10 to 15 times more than GPO and requisition driven value analysis programs.
10. Outcome-based results:
Best-practice hospitals track their value analysis savings and quality gains with their executive management team in order to enforce discipline and ensure that outcome-based goals are met and/or exceeded.
11. Decision support:
Real-time data, in an organized, structured and cleansed format, is provided by best-practice hospitals for their value team members in order to use data mine for the gold nuggets that surface with data driven value studies.
12. Knowledge management:
Best-practice hospitals capture all value studies documentation in a centralized electronic database to be shared with all internal and external collaboration partners, as opposed to reinventing the wheel year after year.
Some hospitals are finding new ways to overcome the emergency department challenges and create safer, more efficient environments. A growing number of hospitals are taking steps to identify and remove bottlenecks or inefficiencies in the system. As a result, they're seeing a positive impact on patients, staff, and the bottom line.
14. Using Six Sigma To Increase Primary Care Office Efficiency and to improve clinical quality and outcomes and to increase primary care office efficiency [6]
Once properly implemented, Six Sigma clearly produces benefits in terms of better operational efficiency, cost effectiveness and higher process quality. Perhaps less obvious -- and until recently less documented -- is the impact it can make in clinical areas such as infection control and medication delivery.
The use of statistical tools to measure and improve quality is not a new concept and certainly not exclusive to Six Sigma. Other quality initiatives, such as TQM (Total Quality Management) or CQI (Continuous Quality Improvement) also involve the use of statistics and data collection.
15. Defining Healthcare Quality and the Need for Improvement
Quality in healthcare meant many things to many stakeholders i.e. from satisfaction with service to the clinical outcome of the patient's treatment.
For a multitude of reasons, improving healthcare quality is paramount. Communities today are not only demanding access to the best technology and treatment available, but also assurances that medical encounters will be both safe and effective.
Next Practices- Hospital Services
1. Integrating Back end activities with other hospitals:
Under the present scenario of economic slump, hospitals need to reduce their expenses so as to increase the profit margins without change in the prices of the services being offered to the patients. Back-end activities include non-core activities like the documentation, purchasing of required supplies.
2. Collaborating ambulance services with other hospitals:
Many a time, hospitals fall short of ambulance in case of emergency and the patients are unable to reach the hospitals on time. This problem can be overcome by integrating the ambulance services of all the hospitals in the city to better services to the patients.
3. Sharing the emergency units with other hospitals in case it’s free:
The emergency cases keep waiting whenever the emergency units are not vacant for the coming cases. Thus, this is a critical issue as the cases being subscribed for emergency units are critical issues and need to be checked immediately. Thus, this issue can be solved by sharing the emergency units with other hospitals in case it’s free and the patient from other hospitals is critical.
4. Medical Billing Software:
The key features covered by this software are related to areas as- administration, billing, and scheduling and revenue management in hospitals. Areas like Prescription Writing, Custom Report Writing and Patient Statements need data which is supplied absolutely exhaustive because the patient's further treatment depends on it. So having software that makes the supply and processing of data easier and more efficient is a good idea. The custom report writing make you flexible enough to let you switch between things like statements, reports or claims whenever you need to. Some of the other advantages of such software are Medical and Revenue Scheduling, Audit and Security.
5. Common database for Patients:
A common database for all the hospitals all over the country can be formed which can be integrated with UID (Unique Identification Number) project presently undertaken by Indian government. This will bring down the cost of systems involved in maintaining huge database in different hospitals.
[1] http://findarticles.com/p/articles/mi_m3257/is_7_59/ai_n14817852/
[2] http://www.premierinc.com/quality-safety/tools-services/performance-suite/improvement-portal.jsp
[4] http://findarticles.com/p/articles/mi_m0BPC/is_7_29/ai_n14735115/
[5] http://healthcare.isixsigma.com/library/content/c030826a.asp
[6] http://healthcare.isixsigma.com/library/content/c030415a.asp
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