Redesigning Work Processes, Work Flow and Management Routines

 Background and Challenges

The Urology department of one of the nation’s leading Hospitals that was in the process of moving to a new clinic space had begun to lose money and was experiencing significant patient leakage due to the long lead times for new patients.

Physicians were spending over 30% of their time on NVA activities while an inefficient schedule and clinic processes weakened the patient experience. Very few support processes had been standardized and the department lacked cohesion.

The client asked for Tefen’s help to perform an in depth diagnostic and use the findings to design a new organizational structure, determine staffing needs, increase revenues, increase the accessibility of care, optimize work flows, create high value management routines, and introduce standard work.

What has been done?

• Conducted in depth diagnostic including interviews of all staff, a MOS study, process mapping, and a market analysis
• Developed a capacity model to determine staffing needs at variable demand levels
• Created new job descriptions for all positions ensuring optimal use of their licensure
• Developed a new organizational structure including a mid-level provider model, a centralized group of administrators for scheduling and incoming calls, and a scribe program
• Optimized the clinic workflows to maximize patients seen per day
• Introduced simplified patient scheduling and modified wave scheduling to create an efficient clinic schedule
• Redesigned processes to remove waste
• Created high value management routines and a balanced scorecard to drive performance
• Developed standardized care pathways for incoming patients

Outcomes

• New job descriptions were created to maximize the use of each positions license to practice
• A new organizational structure was designed including an increase in mid level providers, urology technicians, scribes, and general urologists
• A centralized scheduling department will be created with standardized care pathways and scheduling rules
• Clinic workflow and support processes were designed to maximize patient throughput

Expected Results

• Expected increase in EBITDA of $5.3 M
• Physicians are expected to spend ~90% less time on NVA activities 
• Patient throughput expected to increase 125%
• Lead time to appointment and in clinic wait time expected to decrease by ~40%
• Expected increase in provider and support staff utilization rate of ~40%