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March 17, 2011

The Cost of Caring: Overcoming Resistance to Productivity Improvement

Many times, department leaders are reluctant and unwilling to accept the movement towards better productivity as they think it will weaken other areas of the hospital.  This edition of Off the Shelf focuses on how hospital leaders can makeover their ancillary and support services into faster, leaner, and overall better departments. 

To get your organization moving in the right direction, learn how to handle three common arguments you may hear from your department leaders.  We will also discuss some operational efficiency tools to monitor and track improvement.

Don’t work in ancillary or support services?  Read on, as many of these arguments are common facility-wide. 

"We already have a comparative productivity measurement system in place and the department has already achieved excellent productivity."

Productivity benchmarks and databases may not be truly comparative departments when looking at the degree of automation, age and capabilities of the diagnostic equipment, and the populations served.  Comparative metrics are rarely the same from one organization to another, making this a moving target.  For example, RVUs (Relative Value Units) may include department-driven manipulation of this metric such as "weighted" RVUs or "non-billable" RVUs.  Department leaders may also create and add totals into their volume to reflect what they perceive to be their real workload, thus giving a distorted productivity measurement. 

Learn more about improving your facility’s productivity.

"Reduction in my staff will result in decreased patient satisfaction."

The newer imaging and testing technologies provide for shortened turnaround times from test to reporting of results.  But, oftentimes an adjustment of scheduling and workflow processes to account for staffing changes does not take place with the new technology.  By staffing to these changes you can ensure that patients are not backlogged waiting for appointments, that there are no holdups in the ED, and length-of-stay is not increased -- ultimately meaning patient satisfaction remains high.

"My department's test volume has increased between 5-10 percent for the last 2 years, so I need all the staff plus additional staff to meet this continued volume growth."

Rising demand for care accounted for about 34% of the overall growth in spending on hospital care.  For hospitals, a traditional response to the increased demand might be to add more resources, such as more staff.  As our population ages and demand increases for diagnostic services, staffing patterns also need to be adjusted.  Other factors to consider that will hinder this continued growth include:

1. Reimbursement and compliance challenges

2. Recent concerns about radiation exposure

Overutilization of diagnostic imaging
Again, keep in mind that with newer technologies, staff can conduct tests and report results faster without having to quickly increase staff for increased volume.  Bottom line, if you are having an increase in volume it may be more effective to look at technological solutions rather than simply adding an FTE that may be unwarranted later if volume patterns return to "normal" or slightly above "normal."

Operational Efficiency

You can further enhance your facility's operational efficiency by setting up teams to track and monitor process improvement and workflow adjustments.  To sustain newly improved processes as a result of the team's work, make the tools available for managers to continue to monitor and enhance processes.  Examples may include:

1. Balanced scorecards
to monitor process effectiveness (quality, customer satisfaction, operational processes, and financial metrics)

2. Staffing plans
based on volume data by time of day, day of week and seasonal variations from your laboratory and radiology test data systems

3. Productivity comparison database
to monitor and trend productivity daily and biweekly 
Contact Soyring Consulting to learn how to improve your hospital efficiency and systematically reduce weaknesses. 

In the end, planning for success and involving workers in the process increases the prospect of achieving savings.  Efficiency gains should come from everyone at the hospital so there is a surge of support and a hospital-wide commitment to improvement.  The most significant aspect of any healthcare facility is the people.  Without the right people, it is hard for facilities to produce top-quality, efficient care with high patient, employee, and physician satisfaction scores.

Soyring's Solution

Be sure to check out Dollars & Sense, Soyring’s web column of strategies and tips to help healthcare leaders survive in the industry.  

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