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Case Study

Organ­i­sa­tion­al Effectiveness

Opti­mis­ing the patient expe­ri­ence in just 15 weeks



Health­care in the Unit­ed States is a com­plex and multi-faceted sys­tem. It is a mix of pri­vate and pub­lic health­care providers and insur­ance options. The Unit­ed States has a wide range of health­care providers, includ­ing hos­pi­tals, clin­ics, physi­cians, spe­cial­ists, and oth­er health­care pro­fes­sion­als. These providers can be part of pri­vate prac­tices, non-profit orga­ni­za­tions, or government-funded institutions.

Our client is one of the most pro­gres­sive and inte­grat­ed health care orga­ni­za­tions in the Unit­ed States. They bring togeth­er more than 720 pri­ma­ry care physi­cians and spe­cial­ists across over 90 clin­ics, pro­vid­ing ded­i­cat­ed physi­cian cov­er­age and high-quality med­ical ser­vices. The client was look­ing for ways to increase per­for­mance of their prac­tices, allow­ing for bet­ter capac­i­ty util­i­sa­tion and increased patient sat­is­fac­tion to deal with the increas­ing demand for services.


Our ini­tial sur­vey of the clien­t’s oper­a­tions iden­ti­fied the fol­low­ing areas of concern:

  1. Struc­tured man­age­ment tools (data dri­ven KPIs, short inter­val con­trol round­ing, vari­a­tion analy­sis, action logs, per­for­mance reviews) were large­ly missing
  2. Sig­nif­i­cant over­lap of respon­si­bil­i­ties and account­abil­i­ty through­out the process
  3. Com­mu­ni­ca­tion between top man­age­ment and the prac­tices was inef­fec­tive and not structured
  4. The flex­i­bil­i­ty of staff var­ied great­ly between practices
  5. Work­load allo­ca­tion was incon­sis­tent between like practices
  6. The admin­is­tra­tive aspects of run­ning the prac­tices were done in a most­ly reac­tive manner
  7. Patient slots in same type prac­tices varied
  8. There were note­wor­thy dif­fer­ences in how wait­ing times were man­aged and how patients were assisted

Project Approach & Implementation

Fol­low­ing the results of our analy­sis, we worked togeth­er with the client to imple­ment the fol­low­ing milestones:

  1. Stan­dard­ise man­age­ment con­trol sys­tems (MCS) across clin­ics and “suit to fit”
  2. Stan­dard­ise work process­es such as check­ing in and rooming
  3. Devel­op dai­ly, week­ly, and month­ly oper­at­ing reports to high­light indi­vid­ual clinic/physician performance
  4. Improve Short Inter­val Con­trol round­ing to focus on stan­dard work times
  5. Increase patient vis­its by improv­ing physi­cian productivity
  6. Imple­ment a gov­er­nance mod­el to cre­ate a con­tin­u­ous improve­ment culture
  7. Resource load clin­ics based on work/time relationships
  8. Devel­op over­time con­trol to min­imise costs
  9. Cre­ate bet­ter del­e­ga­tion and clar­i­ty of roles and responsibilities
  10. Stan­dard­ise refer­ral man­age­ment and review process
  11. Increased per­for­mance of prac­tices allow­ing for bet­ter capac­i­ty util­i­sa­tion and increased patient throughput

To dri­ve the trans­for­ma­tion project, we formed a task force con­sist­ing of our con­sul­tant and client-side staff to over­see the devel­op­ment and imple­men­ta­tion of all the solu­tions in this project. Two man­age­ment action teams (MATs) were also estab­lished to pro­vide a feed­back loop for process changes and ensure data credibility.

One MAT pro­vid­ed open dia­logue among physi­cian cham­pi­ons, senior lead­er­ship, clin­i­cal sup­port per­son­nel, and the task force to dis­cuss process­es iden­ti­fied at the site lev­el, applic­a­ble KPIs to gauge improve­ment, and desired tar­gets for the clin­ics to achieve. The oth­er MAT pro­vid­ed sup­port by address­ing data capa­bil­i­ty queries as well as resolv­ing data cred­i­bil­i­ty concerns.

Active engage­ment with­in the MATs allowed the client’s own lead­er­ship to under­stand the under­ly­ing con­cerns across dif­fer­ent clin­ics. Through our cri­tique ses­sions that took place through­out the dura­tion of the project, the client was able to iden­ti­fy a mod­el con­sis­tent with their exec­u­tive leadership’s vision.

A thor­ough 15-week Focus Process™ allowed the task force (with guid­ance from our peo­ple) to iden­ti­fy 41 best prac­tices preva­lent among the clien­t’s best oper­a­tional­ly per­form­ing clin­ics. These best prac­tices focused on site-level process­es and indi­vid­ual respon­si­bil­i­ties to ensure that the com­plex­i­ties of each patient, in both pri­ma­ry and spe­cial­ty care clin­ics, received the best qual­i­ty of ser­vice, in the most pre­dictable man­ner possible.

Key Results

Up to US$20 mil­lion in savings 


Improve­ment in 1st appoint­ment on-time performance 


Reduc­tion in lob­by wait time 


Reduc­tion in 1st appoint­ment aver­age exam delay department 


Reduc­tion in patient throughput 


Improve­ment in over­all on-time performance 


Reduc­tion in over­all aver­age exam delay 

Patient-centred care enhances trust, com­mu­ni­ca­tion, and shared decision-making between patients and health­care providers. It also increas­es patient sat­is­fac­tion, which pos­i­tive­ly impacts rep­u­ta­tion and attracts new patients. In the long term, our work with the client to pri­ori­tise the patient expe­ri­ence will go a long way in ben­e­fit­ing patients, the client, and the health­care sys­tem as a whole.

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