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Business process reengineering in healthcare management a case study

It can Business process reengineering, Healthcare. The conflict between the national goal of healthcare and the high cost of surgical As health care costs increase, there is a need for operations is a powerful incentive to improve the healthcare service providers to look for ways to quality of management of the surgical suite.

For contain costs and to business process reengineering in healthcare management a case study a higher efficiency at this reason, many hospitals are reengineering their their operating facilities without sacrificing operating theatre processes in an effort to quality. This paper studies a case in employing establish, restore or boost profitability while business process reengineering techniques on one retaining quality Harris and Zitzmann ; aspect of a health care service — surgical work.

Reengineering techniques The system is simulated focusing on the processes enable healthcare service providers to take a that contribute to the effective functioning of an careful look at the processes involved within the operating theatre. Over the last fifteen years, companies have of the healthcare industry with the application of been forced to reengineering their business BPR.

A simulation model has been formulated to processes to stay competitive because customers reduce any inefficiencies or bottlenecks inherent are demanding better products and services.

The scope business process reengineering in healthcare management a case study this Improving and redesigning business processes is research is limited to an operating theatre suite paramount for businesses to stay competitive. The of BPR in healthcare systems. Healthcare industry healthcare industry in Singapore, like its global has traditionally emphasized on breakthroughs in counterparts, has been facing tremendous operating procedures and technology in the bid to pressures since the turn of the last century.

Healthcare service providers are challenges faced by the industry in the near future beginning to understand that BPR initiatives are as follows. Moreover, the entry of more private-sector With 80 percent of the expenses tied to patient hospitals and medical service will lead to more care activities, hospitals and healthcare systems attractive opportunities to health care can garner substantial savings and improve professionals Zhang The benefits There is a lack of health care professionals in of reinventing hospitals hold the tangible and Singapore.

The local doctor-to-patient ratio was realistic promise of radically reducing cost while doctors for everyof the population dramatically increasing the quality of care for the year Jacoband Hout and Stalk reveals that rising costs and a weakened economy in Business Process Reengineering in Healthcare s were forcing the government to reassess and reduce health care expenditures.

BCG reorganized work optimize productivity Weicher et al. By redesigning operating procedures redesign of business processes to achieve and staffing patterns, Karolinska was able to cut dramatic improvements in critical, contemporary the time required for preoperative testing from measures of performance, such as cost, quality months to days, close 2 of 15 operating rooms and speed.

Business processes are sequences and and still increase the number of operations per combinations of activities that deliver value to a day by 30 percent. A core business process usually creates value by the Operating theatre management often involves capabilities it gives the company for human resources, information systems, finance, competitiveness.

A limited number of such core physical plant design and utilization, capital business processes can be identified in any equipment, clinical quality and efficiency and company, and enhancing those processes can lead regulatory Merriam-Webster Furthermore, surgical cases are conventionally classified into elective and emergency.

An Over the last few years, the reengineering concept elective case is one whereby the patient can wait has evolved from a "radical change" to account at least three days without sustaining morbidity or for the contextual realism Caron et al.

A surgical group comprises of several Davenport and Short prescribe a surgeons who share allocated operating theatre five-step approach to BPR. They argue that time. The term block time is the time allocated to process reengineering requires taking a broader each surgical group into which only the surgeons view of both IT and business activity, and of the belonging to that surgical group can schedule relationships between them.


The rhetoric of BPR their patients. BPR is Managing operating theatre suites is a difficult increasingly recognized as a form of task, because business process reengineering in healthcare management a case study theatres and the entire organizational change characterized by strategic suite are highly complex and tense environments.

This under the direct control of the operating theatre organizational change perspective recognizes that manager. The operating theatre schedule sets the business process reengineering is not a monolithic stage for the daily flow of patients and staff. Once concept but rather a continuum of approaches to the day starts, however, deviations from this process change Kettinger et al.

The faster schedule are frequent and expected. Emergency the speed of change the more difficult and cases must be accommodated, cases may be stressful it is to manage Edwards and Walton longer or rarely shorter than scheduled, patients Due to the increasing Modern operating theatre management requires demand by patients on the services provided by an information system that includes an effective this operating theatre complex and the acute scheduling system.

Such a system has two basic shortage of manpower in the local health care but critical functions: It must provide data on how resources There are a total of 21 operating theatres at the are being used in relation to their availability main OT complex at Block 3 of the hospital.

In Harris et al. Block scheduling assigns a the yearthe number of surgical operations surgeon or a surgical group a block of time that conducted at the hospital was 59, of which is exclusively for his cases. The daily average was Out of the 21 theatres, 19 The anaesthesia service is often a separate are allocated for elective surgery and operate 8 department; in some hospitals it is a division hours a day from 8: In contrast with remaining 2 are employed as emergency surgical sub-specialties, anaesthetists specializing operating theatres and operate 24 hours a day.

The data includes the percentage distinct departments. Some of the operating theatres are Simulation in the Health Care Industry exclusively reserved for a particular discipline, whereas others may be used by different The health care industry is a dynamic system with disciplines for each day of the week.

Numerous software tool for evaluating, planning or re- healthcare service providers such as D. MedModel is also equipped with an understanding their processes and to optimize impressive collection of pre-programmed them ProModel Corporation Before a model for the operating theatre complex can be developed, a flow chart of CASE STUDY the operating theatre process is provided in Figure 1 to illustrate the entities, resources and locations The Department of Surgery at the Singapore involved.

Figure 2 shows the layout of the Hospital oversees the operations of the surgical completed simulation model. The proportion of theatres. The main operating theatre complex at elective surgical operations for each clinical Block 3 of the hospital grounds is where surgical discipline varies greatly.

The local demand for surgery services has increased To keep simulation as simple as possible, this over the last two decades. Layout of Completed Simulation Model Table 1: As surgical specialties, Surgeon1 to Surgeon8. The such, the number of entities and resources used in other two groups are Anaesthetist and Gurney.

In It has been noted that the level of utilization for accordance with the 8 categories of surgical cases, the operating theatres at the complex is rather the patient is classified into 8 different types high. The patient types and with utilization of the same amount of resources. Despite this, surgical operations often end beyond Sometimes it could simply be due to into the operating theatre, together with the the complexity of the surgery. This is to model the pre- operation procedures required to get the operating In an effort to improve the efficiency of the theatre ready for surgery on the incoming patient.

As such, there is no need to classify system in place of the current system. By making this entity into 8 different types as for the entity changes to the variables used, the operating Patient. The entity Setup stays in the operating theatre process is reengineered to incorporate the theatre for 30 minutes with the resource shift system and investigated using the simulation Anaesthetist before the entity Patient is model developed above.

In simulating the shift summoned into the operating theatre to join them. Instead of patients arriving Locations represent fixed places in the system between This period starting at Moreover, entrance is the between The number period and with the same distribution.

This of entries business process reengineering in healthcare management a case study the number of arrivals of this entity represents 2 shifts with 10 hours to each shift. Since the new 2- The entity Patient is next routed to the pre- shift model utilizes the same amount of operation area Pre-opwhere it waits for 30 resources, as before, the pool of resources has minutes before it is called to the next location on to be shared between the two shifts.

This the process logic, which can be any of the 8 results in less number of surgeons and operating theatres.

  • The number period and with the same distribution;
  • The assignments are removed from the model;
  • Why focus on quality in health care delivery?
  • Furthermore, BPM approach advocates using process-based performance measurement over outcome-based performance measurement that enables practicing proactive approach in health care delivery;
  • Activity-based costing ABC links tasks to actual resource costs.

Should this next location be anaesthetists on duty at any one time. This is full, the entity remains at this location until the incorporated in the new model by halving the next location becomes available. The location number of resource units available. Pre-op is a multi-capacity location; its capacity is 20 patients.

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The location Recovery has a capacity In implementing a shift system, the system might of The model assumes that each patient not have sufficient resources to cope with the spends 0. In an extreme scenario, twice area. This is A resource is a person or piece of equipment used simulated in a third model, by maintaining the for one or more of the following functions: In this model, there are 10 groups operating theatre on the same day, one uses the of resources.

Of the ten, eight types represent 8 theatre in the morning and the other in the groups of surgeons from the eight different afternoon. In the extreme scenario, declassifying all the operating theatres means that no surgical operating theatres and allows any surgical specialty has the exclusive right to any operating specialty to conduct surgical operations in any theatre.

Business process management in health care: current challenges and future prospects

This facilitates the allocation of surgical operating theatre. This method reduces the on a first-come-first-served basis. The assignments are removed from the model. Table 2 gives a summary of the utilization of the operating theatre complex and utilization of the locations. It can be seen that its two main resources, the surgeons and high utilization occurs at OT OTOwhich is the anaesthetists, were analyzed in detail.

The OT reserved for orthopaedic surgery. The pre- software modeled the complex operating theatre operation area is also highly utilized due to the system accurately and with confidence in results.

Business process management in health care: current challenges and future prospects

This creates a bottleneck at the pre- simulation software tool, assumptions and operating area, and leads to patient arrival shortcuts that have routinely characterized health failures. This important issue suggested the care and hospital simulations were no longer possibilities for reengineering.

The software has allowed modeling the gamut of operating theatre activities quickly and Figure 3 shows the utilization of resources for the efficiently, from patient admission to disposition. As the crucial resources in our model are the surgeons and the anaesthetists, it was Several possibilities for process reengineering assumed that gurneys are always available when were proposed to reduce the utilization of the needed in developing the model.

It can be seen operating theatres within the complex. These that of all the resources available, the group of possibilities were implemented on the simulation anaesthetists within the system is the most highly model. The results of the simulation have utilized at On top of this, anaesthetists indicated that operating theatres servicing certain also have teaching and research responsibilities. The surgeons used in this simulation model is higher than belonging to those specialties are also in high reflected in Figure 3.

The results also indicate that the anaesthetists serving the complex are highly The three suggested models for reengineering utilized, possibly due to their anaesthetic were similarly run for hours with 20 responsibilities outside the operation theatre and replications.

The location utilization of the the pre-operative and post-operative work they reengineered models is compared with the conduct for surgical cases. We will refer to the shift system model as Model 1, the shift system Thus, in order to maximize the productivity of the with increased staff model as Model 2 and the operating theatre complex without increasing the declassified operating theatres business process reengineering in healthcare management a case study as Model 3.