Due to an ageing population, an increase in treatment possibilities and the economic crisis, the affordability of healthcare has become an issue. Insights from the business world can help hospitals save money, says Kees Ahaus, Professor of Healthcare Management at the University of Groningen/UMCG.
The process that patients go through in Dutch hospitals should be carefully examined. That way, hospitals can save large amounts of money, according to Professor Kees Ahaus. Insights from the business world can be very valuable for hospitals. Ahaus: ‘Luckily, there is more and more interest in this. A growing number of hospitals is using management methods such as Lean and Six Sigma. The conference entitled Lean in de zorg (Lean in the Health Sector), held at our university last month, also drew a lot of interest’.
Lean management, which is gaining increasing interest in the healthcare sector, was developed in the Toyota factories in Japan. The method is designed to minimize waste by mapping the production process in detail and making small changes. Materials and people in factories must be in a continuous 'flow'. If they are not moving, then waste occurs. If Dutch hospitals map out the patient process, it often becomes clear that a lot can be saved. Ahaus: ‘What happens to a patient from the moment they enter the hospital, or even earlier in the healthcare process? If we were able to coordinate the healthcare system better, a patient might not have to visit the hospital three times, for example, but instead would be seen by three different doctors in one visit’.
The power of Lean lies in the way the processes are not analyzed by outsiders, but by the relevant staff members themselves, says Ahaus. ‘Lean can be implemented with only minimal support from consultants. Nurses, doctors and other hospital staff would map out the healthcare process themselves, in small groups. They give themselves a clear goal and begin working in phases, following an agreed-upon approach’. A patient’s entire hospital process is mapped out in stages, from the moment they enter the hospital, until the moment of discharge. At each stage, the group examines whether there is added value, or waste.
Even a few small groups often bring about considerable economization. One of Ahaus' PhD students, Gerard Niemeijer (UMCG), mapped out the patient process at the Emergency department of the UMCG. It turned out that a few small changes led to considerable results. Ahaus: ‘For example, improvements were made by organizing follow-up care at an earlier stage, and by determining whether the patient was in the correct department. This way, the amount of time that a patient remained in the department was reduced, allowing more patients to be admitted and leaving more room for emergency cases. Saving money while improving the healthcare process is possible’.
Research into waste in the business world has shown that some factories waste 25 percent of their added value. This is referred to as hidden factories. Not much academic research has been conducted on waste in the healthcare sector, but Ahaus expects that the research that will be published in the coming years will show a similar situation. Ahaus: ‘Of course we are not certain, but I have no reason to expect the situation to be any different in the healthcare sector. I expect there to be quite a few hidden hospitals’.
Kees Ahaus (1960) is Professor of Healthcare Management at the Faculty of Economics and Business at the University of Groningen, and does work for the UMCG. He is an authority in the field of quality management and has written many books and academic articles on this subject. He manages the expertise centre Research on Healthcare Organisation & Innovation (RHO). In addition to his work at the University, he is also the manager of TNO Management Consultants and chairman of the Central Board of Healthcare Experts (Centraal College van Deskundigen in de Zorg).
More information: Kees Ahaus
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