5 Proven Methods to Make Your Hospital More Efficient

Michael Olive, director of performance improvement at RWD Technologies in Baltimore, discusses five proven methods to make your hospital more efficient.

1. Choose intervention or transformation. To get more efficient, a hospital may choose to focus on a particular issue, such as excessive infection costs or an ED that is on divert too often. Or leadership may decide transformation is needed and embrace more systematic change. For example, patient satisfaction rates may be too low and raising it some big-picture changes, such as rethinking duties or revamping service lines, which take a lot longer to implement. "Some thing to ask are: Do I have the right people, right motivation and right partnerships?" Mr. Olive says.

2. Create new positions. New high-level positions may be needed to address evolving demands. For example, as quality requirements become more varied, some hospitals have created the position of chief quality officer. Similarly the new post of chief learning officer, recently created by hospitals in Mississippi, Georgia and New York, recognizes a great deal of learning now goes on in hospitals, including residency training, continuing education for nurses and EMR techniques. Increasing, many skills are demanded by regulations. "Rather than have several different learning strategies, it is more efficient to have one," Mr. Olive says.

3. Rethink duties. When a hospital or system gets bigger, all the duties involved in one particular job may get overwhelming. For example, the person who handles risk management, regulatory compliance, decision management and quality can no longer do all the work. "What frequently happens is other people pick up some of the tasks, in an ad hoc fashion," Mr. Olive says. "That may lead to a domino effect. The person who steps in to help also cannot handle their duties and someone else come in to help them, and so on." This is inefficient and risky, because unqualified people may be doing someone else's work. Someone needs to study the work required for each position and decide what skill sets are needed.

4. Have a system that runs on its own. "There is a lot of turnover in healthcare," Mr. Olive says. "Everyone from the CEO to the floor nurses is constantly coming and going." The average hospital CEO stays 2-3 years. With so little institutional memory, "it's important to have a process and standards in place that function no matter who is in charge," he says. For example, if there is a major patient safety incident, what is the chain of command and who should be held accountable? And how should patients be treated when they step into the ED? You may want to compile written standards that everyone can refer to and hand them out to new hires.

5. Conduct ongoing reviews. Holding a performance review just once a year makes it impossible to fix a problem when it happens. "You are waiting too long to fix it," Mr. Olive says. In exit interviews, former hospital employees often cite lack of feedback and education as a reason for leaving. He advises implementing reviews once a month in an interactive fashion. There should be both coaching, trying to release someone's potential, and mentoring, trying to impart new wisdom on the employee. Monthly reviews have been shown to reduce nursing turnover.

Learn more about RWD Technologies.

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