Finding the cure for operational inefficiency

A long list of operational ailments is affecting the health of Canadian hospitals. High demand for services; resources stretched to meet demand; pressure to meet national wait time benchmarks; limited access to advanced diagnostic procedures; and emergency rooms pushed beyond capacity are just some of the serious challenges faced by front-line medical professionals, administrators and support staff.

So how can struggling hospitals achieve operational efficiencies to deliver better patient care in a time of fiscal restraint? No simple answer exists. However, successful organizations have achieved real change through vision, leadership, cultural change, workflow analysis, information technology, and quality improvement programs that continually monitor operations. In short, you must know the people involved, the processes you must deliver and the services required, then apply the complementary technology in the most productive way possible.

Forward-thinking health care providers are improving the connections between people, information and systems to create more capacity by finding efficiencies. Patient flow is aligned with operations and clinical practice. Patient flow and workflow equal process. Operations and clinical practice require knowledge in the right place at the right time to enhance decision support for both patients and the organization.

To support this effort, a proven methodology must be deployed to analyze processes in each work product created. Recently, Lean Methodology, which has had success in other industries, has gained traction in healthcare due to the rigor and ability to justify removal of waste in work outputs. Rouge Valley Health Centre has embraced Lean to create operational efficiencies that effectively eliminated budget deficits.

For testing to occur without disrupting the production environment, other business process mapping and modelling tools allow both current process views as well as future views on how they will affect interdependent systems. More sophisticated platforms also have real-time alerting and analytics to show how well the new process is performing against the targets. The ability to identify and predict bottlenecks in the clinical and administrative processes and to take action immediately optimizes workflows and throughput, and ensures that operational efficiency is maximized.

We can all agree that investments in IT must include solutions, platforms, and mobile networked devices to match patient flow and to support services in an organization. Interoperability, therefore, is critical to fuse enterprise, departmental, and end consumer devices.

Health care organizations often cite the following as priority IT investment areas:

Health care analytics –  Administrators and physicians want to discover and prevent bottlenecks in patient throughput and workflows. Clinical and support data must be readily available and in a useful form to consumers of that information. Analytics’solutions provide operational insight in retrospect, real-time, and prospective views that measure monitor and analyze every aspect of the organization to optimize operations. The ability to present complex enterprise data in simple and meaningful views through dashboards and reports can improve operational efficiency and outcomes.

North York General Hospital (NYGH) in Toronto is one of the first Canadian hospitals to launch a comprehensive health care analytics solution. Their new system gathers patient and business data from across the organization and presents it in real-time to doctors, administrators and certain hospital staff. The hospital uses that information to make necessary changes in practices, programs and services. Eventually, NYGH doctors will have a 360-degree view of a patient’s clinical patterns and outcomes. The hospital also flags for automatic notifications when indicators of interest to them are updated, or tracking in the wrong direction.

Web portals and kiosks. –  Patient, clinical and employee web portals serve as a private, secure gateway to relevant health care resources. Multichannel portals cater to the consumer through tailored views for patients, staff, physicians, and the public to gain organizational insight, communications, or collaboration. Kiosks enable onsite users to interact with information, people, education and training, and services quickly and efficiently.

Both The Ottawa Hospital and Trillium Healthcare Centre in Mississauga use portal-based user interfaces to provide consistent and timely access to information through multiple channels and promote operational efficiency by promoting on-line self-service and patient self-care.

Wireless and mobile technologies – Hand-held communications devices and real-time location devices that track medical assets, equipment, and patients are just two of the emerging technologies that can enhance efficiency. Toronto East General Hospital (TEGH) and Kingston General Hospital use Vocera technology to dramatically improve staff communication across the organization, increase time spent with patients and improve overall productivity and response times.

Deploying radio frequency identification (RFID) tags has been proven to simplify asset management efforts of medical equipment and supplies. However, these edge devices and sensors also have the ability to track resources within the process monitoring chain of events. Although the full potential of these devices has yet to be discovered in clinical operations, TEGH has deployed a number of RFID tags on its medical equipment to simplify its asset management efforts. A central management system now monitors the location data for medical supplies and equipment, making it much easier to locate key hospital assets.

Interconnected systems – Silos of information housed in disparate systems can be addressed through interoperability. Retrieving data from legacy sources and developing aggregated views, real time or retrospectively, is critical to providing efficient decision-making. Leading organizations such as Trillium Healthcare Centre, Manitoba e-Health and others have invested in system interoperability so their data can be combined into a secure, unified view for caregivers and managers.

If your organization believes that operational efficiency is driven by putting patient care first, then investing time and resources in improved processes, ongoing monitoring and communication tools are mechanisms that ensure success. Connected hospitals are able to provide the right information to the right people, in the right place, at the right time, in the right context. Integrating clinical expertise with information technology leads to a smarter, more connected hospital and a more efficiently run organization. It’s a cure worth investigating.