22
HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M.

HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

Embed Size (px)

Citation preview

Page 1: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

HEALTHCARE OPERATIONS MANAGEMENT

Bob Castleman

CPIM, CIRM, CSCP, C.P.M.

Page 2: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

HEALTHCARE OPERATIONS MANAGEMENT

• HEALTHCARE OVERVIEW

• HEALTHCARE ISSUES

• OPERATIONS MANAGEMENT IN HOSPITALS

• LINKING WITH HOSPITALS

Page 3: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

HOSPITAL OPERATIONS MANAGEMENT

• Healthcare is the most changing and the most regulated industry today.

• You must know operations management.

• Quality is critical throughout the process.

Page 4: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

HEALTHCARE - OVERVIEW

• Pre-1940s, healthcare was provided in the home. Hospitals were a “place to die”.

• Hospitals then became centralized in city centers and the population came to the hospital.

• Today’s healthcare is:– moving with the population– creating clinics: hospital / freestanding, surgical / non-

surgical, usually specialized and dispersed– Seeing primary hospitals sought for critical care,

major surgery and “no pay” patients

Page 5: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OVERVIEW - US HOSPITALS (2005)

• 5000 Hospitals (5900 in 1981)• 850,000 Beds (1million in 1981)• 4,500,000 Employees

– 26% are nurses

• $500 Billion Revenue

Page 6: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OVERVIEW – Key Resources

• New FACILITIES are getting smaller, specialized, and dispersed.

• There is a growing shortage of SKILLED EMPLOYEES.

• TECHNOLOGY is advancing rapidly – CT, MRI, Robotics, EMR (electronic medical records).

• INFORMATION SYSTEMS infrastructure is a growing focus.

Page 7: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES IN HEALTHCARE

• SHRINKING REVENUE Reimbursement has shifted from

Retrospective (cost plus) to Prospective (set fee for a diagnosis – DRG)

Page 8: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES IN HEALTHCARE

REVENUE– P4P: Pay for Performance – incentive for better

outcomes– EBM: Evidence Based Medicine – scientific

validation of procedures– Bundling: payments (hospital and physician share)– Gain sharing: hospital and physician share savings– “Never Events”: will not be reimbursed for

“avoidable errors

Page 9: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES - Resources

• There is a shortage of DOCTORS– Many Americans do not have a primary

physician – especially in rural areas and compounded by loss of insurance

– A shortage of 50K physicians by 2010– A shortage of 200K physicians by 2020

Page 10: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES - Resources

• There is a shortage of NURSES– In 2005, 115K were needed– 2004 - 2014, an additional 1.2 million nurses

will be needed– By 2020, the shortage may be one million – More nurses are leaving the profession than

are entering– Nursing schools are turning away qualified

applicants due to a lack of instructors

Page 11: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES - Other

• COSTS OF ADVANCING TECHNOLOGY – expensive technology is now the expectation of the patient, physician, employee, …

• GOVERNMENT & OVERSIGHT REPORTING – “8 indicators which must be reported for each patient”

Page 12: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES - Operations

• MANAGING DECENTRALIZED FACILITIES – women’s, urology, spinal, bariatric, minor medical, etc.

• RESOURCE TRACKING AND MANAGEMENT – Capital equipment location and utilization– Consumable inventory location and amount

Page 13: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

ISSUES - Operations

• IMPROVE OPERATIONAL EFFICIENCY– Flows: caregiver, support, lab, physician,

housekeeping, visitors– Processes - routings– Scheduling – resource utilization– Wait Times – ED, at resources

Page 14: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OPERATIONS MANAGEMENT IN HOSPITALS

• Growing focus on Hospital Management• Terms being taught are “APICS friendly”

– Materials management– Supply chain management– CPFR– S&OP– Process / value stream mapping– “De-bottlenecking”– LEAN / JIT / 6 sigma / DMAIC

Page 15: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OPERATIONS MANAGEMENT IN HOSPITALS

• Local Examples (from interviews) – Managing limited resources – surgeons/ORs– Managing inventories in a distributed structure –

clinics– Employee education of cost / revenue and process

improvement – consumable charges– Resource utilization – scheduling clinic surgery suites– Reduced product variety for price leveraging – stents– Process flow and improvement - reduce wait times in

the ED (emergency department)

Page 16: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

LINKING WITH HOSPITALS

• Healthcare’s self-perception: people’s lives and health, “we’re different”

• Trends, issues and drivers

• Roles and environment – administration, physician, nurse, support

• Terminology, operations and processes

• Make contact with a friend (of a friend, of a friend, …)

Page 17: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

LINKING WITH HOSPITALS

• TERMS– Exchange cart: inventory stocked on a cart for a

specific work center for a defined period of time. A replacement cart is delivered and replaces the cart in place (orthopedic floor exchanged twice weekly).

– Par: inventory location and targeted product mix / quantities for a fixed location

– Case management / manager: a diagnosis (hip replacement, heart catherization, child birth) has process steps to follow, monitored by a manager – a routing with timelines (for selected patients)

Page 18: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

LINKING - Terms

• Service line – a grouping of closely related product lines (orthopedic, women’s services, …)

• Diagnostic Related Group (DRG) – standardized reimbursement charges reimbursed for a medical condition and related “codes”

• Charge Description Master (CDM) – price list for material or service charged to the patient

Page 19: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

LINKNG - Terms

• Prospective payment – reimbursement amount for treatment or illness classifications regardless of costs incurred

• Evidence Based Medicine – scientific validation of proven result

• JCAHO (Joint Commission on Accreditation of Hospital Operations) a key auditing group on hospital processes, operations and documentation. Can dictate corrective action and de-certifying hospital for lack of correction

Page 20: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OPERATIONS MANAGEMENT IN HEALTHCARE

• American Hospital Association (AHA)– aha.org

• Association of Healthcare Resources and Materials Management (AHRMM)– ahrmm.org

• Health Industry Group Purchasing Association (HIGPA)– higpa.org

• Institute of Supply Management (ISM)– ism.org

• A plethora of local and regional organizations

Page 21: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

OPERATIONS MANAGEMENT IN HEALTHCARE

• References:– American Hospital Association web-site– Hospitals & Health Networks, American Hospital Association– Interviews by Bob Castleman (various)– Langebeer, James R. II,, Health Care Operations Management,

Sudbury, MA., Jones and Bartlett Publishing– Materials Management In Health Care, American Hospital

Association– MX: Business Strategies for Medical Technology Executives,

Canon Communications, LLC

Page 22: HEALTHCARE OPERATIONS MANAGEMENT Bob Castleman CPIM, CIRM, CSCP, C.P.M

HEALTHCARE OPERATIONS MANAGEMENT

• Bob Castleman

• CPIM, CIRM, CSCP, C.P.M., CMfgT

[email protected]

• 901 854 0198

• 901 277 6684