At a Glance
- A general medical and surgical facility in the Americas engaged Renoir for an assessment and rapid improvement project focused on improving surgical throughput and optimising scheduling.
- Our project team identified issues ranging from a lack of standardised data collection, underutilisation of hospital market intelligence and gaps in operating room utilisation.
- At the end of the project, we had developed and installed management systems around the operating room and physician scheduling, resulting in a 2,300 hour increase in operating room capacity.
Key results
An additional 4,000 hours available time for physicians
Ellipse training across all regional employee levels
Return on investment (ROI) of
2:1
Background
The healthcare sector is one of the most important and fastest-growing sectors in the world. The sector comprises six industries: medical equipment, pharmaceuticals, biotechnology, managed care, healthcare delivery, and healthcare distribution.
Hospitals are an essential part of the healthcare delivery industry. Their importance was demonstrated during the COVID-19 pandemic when hospital staff worked tirelessly around the clock to ensure that health services and care were available at times of greatest need.
Our client is a general medical and surgical facility in the Americas, providing high-quality healthcare to those in need. They are equipped to deal with the most serious emergencies and provide a full range of hospital services around the clock.
Analysis
Renoir’s initial assessment of the company’s operations identified the following areas for improvement:
Data and Performance Measurement
- Operational Key Performance Indicators (KPIs) were not consistently reviewed or enforced and were not robust for the size of the operation.
- A lack of standardised data collection, interpretation, and reporting resulted in inaccurate and incomplete data across departments.
- Underutilisation of hospital market intelligence information for strategic volume optimisation.
- Lack of structured management tools such as short interval control, area rounding, visual performance boards, performance variance analysis, meeting agendas and action logs and performance reviews.
Operating Rooms (ORs)
- A lack of job role execution and task allocation resulted in prolonged turnaround times in the ORs.
- The service line block method created large gaps in OR utilisation and obscured available time, resulting in schedule overruns, staff overtime, and unclear accountability.
- There was room for improvement in the ORs on-time case start rate, with 59% of cases starting on time.
Project Approach
“This project really enabled us to make massive changes rapidly. The Renoir team supported management and frontline staff every step of the way.”
Director of Surgical & Perioperative Services
After the assessment, Renoir was engaged for a 24-week rapid improvement project, focusing on surgical throughput and scheduling optimisation.
The project kicked off with the Renoir Focus Process® to develop management systems around the OR and physician scheduling. The objective was to maximise resources. To install the required process and data elements to achieve the desired impact on operational delivery, a full-time team of two Renoir consultants and a project manager was placed on site to drive the project and oversee all initiatives.
In addition, four working groups, known as Kaizen teams, were set up to focus on researching and analysing current operating conditions in OR flow, planning and scheduling, as well as data management and business intelligence capabilities. The teams were required to provide a feedback loop for process changes and ensure data credibility.
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Implementation
Data Management and Business Intelligence Committee
This committee played a critical role in verifying the legitimacy and accuracy of the scorecard data and ensuring that it measured the project’s success. After completing this task, the committee transformed into a Business Intelligence unit.
They then began mining and analysing data to develop a strategic volume fill plan. The committee focused on understanding outmigration patterns and outpatient services to reach physicians within the network. These efforts stimulated discussions around long-term volume strategy and service line growth.
OR Flow and Planning and Scheduling Committee
This committee coordinated open dialogue between physician champions, senior leaders, OR staff, and Renoir consultants, to improve site-level processes. Other initiatives included extensive mapping of existing OR patient flow, and planning and scheduling processes. Updated workflows were then implemented, along with the installation of Key Performance Indicators (KPIs) to keep the department on track.
Inter-departmental process flows were also defined to improve handover efficiency. Part of the activity included undertaking a RACI (responsible, accountable, consulted, and informed) exercise to assign specific task execution responsibilities to designated roles.
Results
“There is no way we can capture on a spreadsheet the amount of support, confidence, or encouragement the Renoir team has extended to our staff and management team.”
Assistant Nurse Manager, Surgery
The 24-week project delivered US$1.53 million in time savings, which were translated into additional case volume and revenue. This translated into a 2:1 return on investment during the project lifecycle, with the potential to increase to a 10:1 annualised return when the new capacity is fully utilised.
In addition to the significant financial results, the project had also fostered a culture of continuous improvement within the facility, paving the way for sustainable progress long after the completion of the project.
*We have intentionally omitted client-specific details to maintain strict confidentiality.
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