holding the gains

8/12/2019 Holding the Gains

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Healthcare Operations Management 2008 Health Administration Press. All rights reserved.

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Chapter 14

Holding the Gains


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Holding the Gains

Types of projects to select

Backlogs

Revenue less than expense

Poor outcomes

Engage support departments

Tools

HR planning

Managerial accounting

Feedback and control


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Project

identified

Decrease

staffing?Plan for

maintaining staff

Pool or

redeploy

Eliminate vacant

position

FTEs

needed

in otherdepartment?

Vacant

position?

Lay off

No

Yes

Yes

Yes

No

No

Human Resources Planning


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Holding the GainsManagerial Accounting

Understand the source of revenue Per member per month (PMPM)

Diagnosis-related group (DRG) (case mix adjusted)

Unit of servicerelative value unit (RVU)

Retail

Determine costs Fixed

Variable

Overheadallocation methodology

Conduct cost-volume-profit analysis (CVP)


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Holding the GainsControl

Facilities

Clinical Quality

High Touch

Run Chart for Birthing Center Patient Satisfaction


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Process Management Plan

Answerrequest for

appointment

Log on to info

system Current

New

Caller

status

Enroll caller

Make

appointment

Monitoring

Response plan


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Levels of Operational Excellence

Level 1

There are no organized operations monitoring orimprovement efforts at this level.

Quality efforts are aimed at compliance and the

submission of data to regulatory agencies. Level 2

Organization has begun to use operations data fordecision making.

There are pockets of process improvement activities

in which process mapping and PDCA or rapidprototyping are used.

Evidence-based medicine (EBM) guidelines are usedin some clinical activities.


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Level 3 Senior management has identified operations improvement

efforts as a priority.

Organization conducts operations improvement experiments,uses a disciplined project management methodology, andmaintains a comprehensive Balanced Scorecard.

Some P4P bonuses are received, and the organization obtainsabove-average scores on publicly reported quality measures.

Level 4

Organization engages in multiple process improvement efforts,using a combination of project management, Six Sigma, Lean,and simulation tools.

A significant number of employees have been trained in theadvanced use of these tools, and these individuals leadprocess improvement projects.

EBM guidelines are used comprehensively, and all P4Pbonuses are achieved.


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Level 5 Operational excellence is the primary strategic objective of the

organization.

Operations improvement efforts are underway in alldepartments, led by departmental staff who have been trained

in advanced tools. The organization uses real-time simulation to control patient

flow and operations.

The organization develops and publishes new EBM guidelinesand best practices for administrative operations.

The organization scores in the top 5 percent of any national

ranking of quality and operational excellence.


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The Future

Ambulatory

care

model

EBM based

Emergency and

inpatient care

modelEBM

based

Predicted

resource needs:

Facilities

Staff

Supplies

Clinical operations

Real-time data

Real-time control

Supply chain

system

Demand

prediction

system:

Volumeclinical

conditions

Staff scheduling

system


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End of Chapter 14

holding the gains

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