The daily challenges facing the healthcare industry can be overwhelming. Hospitals are facing critical operational challenges including: treating patients effectively and in a timely manner, improving the quality of care patients receive, and keeping a watchful eye over the facility’s bottom line. To remain successful, hospitals must maintain a balance between patient service and the cost of operations.
Operating in both inpatient and outpatient environments, Tefen improves operations by redesigning processes to eliminate waste, reducing variation in practice patterns, aligning staffing with demand, effectively measuring key performance indicators, and developing advanced scheduling schemes. The healthcare team implements innovative solutions utilizing Lean, Six Sigma, and simulation tools to help improve access, enhance quality of care, and optimize costs throughout the entire facility.
Tefen improves operations in clinical, ancillary, and support services. Results from our recent projects include: increased patient flow, optimized staffing, improved material utilization, increased capacity, transformed supply chain operations, reduced costs, increased revenue, and enhanced overall quality.
Healthcare value refers to the quality of care administered and the cost of these services. Tefen works with hospitals and healthcare systems around the world to improve the value of the organization’s clinical, ancillary and support services. The variety of solutions offered impact the clinical quality provided to the patient as well as reduce the overall cost of care for the provider. This leads to a reduction in the cost of care for the patient. These improvements can be realized through clinical transformations, variability reduction and also revenue growth, cost control and resource staffing.
The healthcare industry is constantly pressured by increased regulation, consumerism, workforce shortages and an aging population. Healthcare providers must adapt to these changes in order to be able to continuously offer desirable care. Continuous growth and adaptation to the surrounding environment are parts of a clinical transformation. This transformation can help an organization to improve the value of its care, as well as pursue efficiency improvements and cost effective innovations. The value of healthcare service is determined by the quality of the care administered, along with the cost of these services.
Improving the value of healthcare services begins with improving the effectiveness of the care administered. Tefen works with its clients to improve patient safety and reduce readmission rates through increased quality of care. Organizations are then able to reduce complications and hospital acquired conditions. Infection prevention is also improved and patient injuries, while under care, are reduced. Information flow improvements can also help an organization to accomplish these goals, as well as improve healthcare value and the effectiveness of treatment.
Along with care improvements, operating cost reductions are also possible. Tefen helps organizations redesign operational processes and optimize available resources to transform clinical processes. These transformations help to allow better utilization of resources, while lowering costs. Through the combination of decreasing costs and increasing the quality of care, clinical care value is improved.
The value of a healthcare service can be improved through increased accuracy and efficiency throughout the organization. Many providers struggle with clinical variability that inevitably increases costs through wasted time and inaccurate information processing. Tefen works with providers to streamline processes to reduce variability and improve accuracy and patient care. One solution includes implementing systematic data collection and automation to reduce errors. When successfully implemented, it supports the identification of root causes for variance and standardizes data collection to eliminate process output variation for patients with a similar diagnosis.
Tefen works to eliminate variability in provider orders as well, in order to standardize a system for order sets, protocols and delegation orders - It is imperative that an organization has a centralized or standardized method of storage to ensure that all order types adhere to the government regulated documentation. Without adherence to these regulations, clinicians could potentially end up working outside of their scope of practice or operating from orders that haven’t been reviewed in years and are not consistent with current regulations. This may lead to non-current clinical practices being used and, therefore, compliance issues. As a result, when reducing the variability of different types of order sets that exist at an organization, you also increase the quality of patient care through coordination of the entire healthcare team.
The constant potential for cost saving can be easily overlooked, resulting in missed opportunities and wasted or redundant costs. Tefen helps clients examine the bonds between financial performances, the quality of care delivered, patient access and overall throughput. This combination allows an organization to fully understand the opportunities for improvements in their billing processes and their cost realization. Tefen also works with organizations to help integrate diagnostics and technologies to reduce operating costs, as well as to increase efficient usage of resources and assets, resulting in a significant reduction in costs.
Over the last decade the focus on quality, whether during the provision of care or at the outcomes level, has increased. Healthcare quality improvements lead to enhanced service, greater patient satisfaction and reduced costs due to more effective service offerings. Tefen helps organizations increase the quality of their services through strategic thinking, while pursuing efficiency improvements and cost effective innovations. Through the combination of both reactive and proactive approaches, patient safety risks are minimized and the overall quality of services enhanced.
Patient safety involves reporting, analysis and prevention of errors. The Healthcare Quality Consulting realm covers the degree to which programs, policies, services and research increase desired outcomes and conditions in a healthcare organization. Advancements in desired outcomes are challenging if the organizational environment does not support the processes. An example is the error reporting process, which can be seen as confusing, time consuming, and lacking confidentiality, which may discourage staff from reporting errors or to only report errors that lead to punitive action rather than system improvements. In this example there may also be a lack of a specific culture and training to encourage teamwork and there may be excessive professional rules and regulations that negatively affect excellence.
The inability of organizations to identify problems and achieve cultural change also poses significant difficulties when attempting to improve Healthcare quality. Overall, the complexity of an organization results in an obscure route to excellence and allows patient safety and risk to be overlooked.
In addition, the impact of the Patient Protection and Affordable Care Act on the industry intensifies the need to overcome the previously listed barriers. Tefen has worked to develop an innovative methodology which will help healthcare organizations adapt to these changes while continuing to achieve excellent Healthcare quality and patient safety.
Tefen’s methodology culminates in an organization realizing the benefits of a combined proactive and reactive approach to risk management. A reactive approach leads organizations to wait until an adverse event occurs and then they react to this event with ‘local fixing acts,' while a proactive approach is achieved through the implementation of preventive actions before any adverse events have occurred. The combination of both approaches has been determined to be the most practical and suitable implementation.
Analyzing the current state of an organization helps to determine where improvement changes will be the most beneficial and prevents confusion and unfocused goals. In the Quality Maturity Assessment phase, Tefen helps clients use a maturity scale to evaluate a hospital’s current condition in order to focus future improvement initiatives. Through this approach, clients are able to increase the value and quality of their offerings through improvements in strategic and operational approaches throughout the entire system.
When working to improve healthcare quality, it is important to have a system that allows for improvement measurement in order to determine progress. During the Quality Measures Management phase of quality improvement, Tefen helps organizations develop tools and processes for effective measures management and to routinely review measures in order to drive continuous improvement work. The Institute of Medicine has defined 6 categories in Healthcare Quality Consulting: patient safety, safe care, timely care, effective care, equitable care and patient-centered care. These tools can be used as measurable parameters that can help an organization determine if it is improving its quality and patient safety.
Tefen helps organizations improve their provider performance and behavior, from staff to physicians, resulting in a positive environment and culture and enhanced patient satisfaction. Patient satisfaction improvements can be realized through enhancing staff performance, creating a positive environment and culture and increasing accuracy and efficiency. Tefen also works with organizations to improve their patient access by increasing effective capacity and reducing admittance costs, both of which lead to a positive experience for the patient.
Hospital staff has a large effect on patients’ experiences due to constant contact. Therefore it’s important for the staff to provide quality and reliable service at all times. Staff performance can be overlooked during sweeping organizational changes, but Tefen helps to integrate staff performance changes into the overall project. We assist organizations in improving their provider performance, from staff to physicians, supporting the creation of a satisfying workplace and a dedicated work force. At the same time, performance enhancements occur through increased efficiency and productivity of personnel. Tefen works to enhance staff performance by implementing clear and measurable performance processes to balance staff and patient satisfaction. Through performance reviews and the development of planning tools and indicators of performance, measurable and communicable results can be achieved.
Tefen also works with its clients to create an encouraging environment and an enthusiastic and positive culture that result in optimistic staff attitudes. This mindset leads to improved patient satisfaction and quality of care. A cultural change can focus an organization on the customers and their satisfaction.
Hospitals are constantly faced with the challenge of delivering affordable, high-quality healthcare to a wide-variety of consumers. The struggle to provide affordable solutions is made even more challenging by capacity limits and the availability of providers. Tefen helps organizations improve patient services and treatment throughout the admission, stay and discharge processes by streamlining patient flow processes and increasing patient access.
Increasing patient access can have many positive effects on an organization, including enhanced patient satisfaction due to greater ease of admittance. Through the reduction of inefficiencies, hospitals are able to minimize delays, increase procedures on-time starts and therefore, increase scheduling capacity. Increased capacity allows patients to have more flexibility, and better availability of providers. Tefen also works with organizations to lower access costs to hospitals and emergency departments, allowing more affordable treatment, which allows the hospital to offer care to a larger number of people.
Tefen helps clients improve organizational health through transformational changes and process redesign. Through process improvement, many opportunities that lower costs and increase productivity can be realized. Through labor management and effective management systems, Tefen helps organizations reduce redundant tasks and wasteful activities, resulting in increased efficiency.
Overall organizational health is enhanced through organizational design changes such as labor management and the establishment of a Project Management Office. These changes can result in improved patient flow, increased capacity, enhanced physician alignment and an adaptive foundation for future change.
Accompanying these initiatives is the establishment of management systems to monitor performance and encourage continuous improvements. We support our clients to identify current performance metrics and develop future state Key Performance Indicator dashboards. With Tefen, our clients work to develop management routines such as report-outs, reviews, huddles and visual controls such as notice boards and trackers. Organizations are instructed on how to properly use tools and processes that allow day to day and month to month management and performance assessment.
Variability in patient flow often leads to issues with hospital capacity, bed availability and provider-to-patient ratios. We help redesign operational and process procedures to streamline patient flow between departments from admission to discharge. These improvements result in faster turnarounds, better management of materials and better management of active discharge. These things all lead to increased resource utilization and improved hospital wide patient flow and capacity. Furthermore, they contribute to improving the overall organizational performance and perception of patients. Through the redistribution of workload and the elimination of peaks in patient occupancy, hospitals are able to increase patient volume without having to invest in new facilities. These changes improve access throughout the hospital and decrease processing time, wait time and patient lead times, allowing for patients to be treated effectively and in a timely manner.
Tefen also helps its clients focus on reducing the average length of stay (LOS) of patients when working on improving patient flow. Through reduced LOS, effective capacity can be increased, leading to additional scheduling opportunities and increased revenue.
Improving organizational design focuses on the enhanced integration of the assets of an organization: people, information and technology. Through transformational changes, strategic aims are reinforced, ensuring alignment of the corporate design and the organization’s actual functions.
Tefen helps clients improve their organizational design through the development of new working models and major operating processes. We also work with our clients to focus their organizational structure development and to establish a proactive system that forecasts potential failures and addresses them beforehand, in order to ensure lasting results.
Effective change management is important in order to establish a foundation for ongoing change and continuous improvement. One challenge organizations face is achieving equilibrium where all levels of management and staff are willing to accept changes. To support sustainable solutions, Tefen assesses the readiness of organizations to absorb change, anticipates resistance to change, and ensures that organizational infrastructure is capable of sustaining gains. Tefen offers solutions through an analytical approach based on facts and data, with an emphasis on implementation and real transformation. Through partnership and coaching, from diagnostic through implementation, sustainable designs are pursued and implemented. Periodically auditing and reevaluating progress and solutions creates a continuously changing foundation, allowing for adaptive changes in the future. This foundation allows solutions to be easily transferable to other facilities, resulting in further continuous improvement.
All modern organizations face the challenge of utilizing their staff effectively and the healthcare industry is no different. Waiting, transportation, non-conformities and other non-value added activities reduce productivity in an organization immensely. Therefore improvements in staff management and utilization can be extremely beneficial in enhancing staff performance and the organization as a whole.
Tefen offers solutions to help increase efficiency and productivity of processes and staff. Offerings include aligning staff with demand, controlling workload volumes and optimizing single departments, resulting in a streamlined organization-wide process. Balancing staffing according to workload volumes results in greater efficiency overall. Tefen also works with clients to help define the specific roles, tasks and working processes to minimize errors and rework and increase productivity.
In addition, Tefen helps clients create FTE rationalization programs and measurable performance guidelines in order to enhance the organization’s labor management techniques. Solutions include working towards the reduction of paid overtime and the decline of inefficiencies to increase employee satisfaction. Through labor management, Tefen also helps organizations reduce redundant tasks and wasteful activities.
A centralized and coordinated management of initiatives is extremely important in any organization if long term, positive results are to be achieved. It is crucial for ownership to be taken over all projects and this sense of accountability helps support the project leader’s prioritization and decision making process. A Project Management Office must work to balance the challenges of optimizing organizational efficiency, lowering costs, as well as answering to the needs of the stakeholders. It is important for the PMO to oversee the proper management of all initiatives in the healthcare facility. Tefen helps in the establishment of a PMO to provide project governance, prevent wasteful duplication and train project leaders and team members on project execution. The PMO must be able to manage quality projects, direct and guide project execution, promote collaboration and ensure that standardized, best practice processes are utilized on all projects.
In order to optimize the quality of care, hospitals are expected to adhere to a set of core care measures, developed by the Joint Commission. This set of measures is a standardized performance measurement system that has been proven to reduce the risk of complications, prevent recurrences and enhance the treatment of patients. Tefen helps organizations follow these measures in order to improve the quality of care.
The clinical units of a hospital offer large opportunities for increased revenue if patient efficiency and increased capacity can be realized. Tefen helps clients reduce unnecessary costs and waste by leveraging the tools and techniques of Lean, Six Sigma, simulation and change management. Through the standardization of operating processes, patient processing and satisfaction is improved.
In the obstetric ward of a hospital, safety of the mother and infant is the main consideration, and therefore, quality improvement is a main focus. As quality of care is increased, process improvements lead to more efficient services. Further enhancements can then focus on increasing birth volume capacity, while continuing or improving the current level of care. Tefen works with clients to increase birth volume, while improving performance and limiting new capital investment in facility renovation or construction.
In addition, improvements in materials management, provider practice patterns, room utilization and discharge management lead to reduced length of stay and reduced room turnaround time. These solutions, coupled with improvements in procedure scheduling, staffing and facility sizing through forecasting, result in increased effective capacity. As a result, patient wait times are decreased and ultimately, patient satisfaction is increased. In addition, unscheduled staff overtime is decreased through timely performances of scheduled procedures due to improved utilization and scheduling.
Hospitals are often challenged with emergency department admission wait times due to understaffing and inefficient patient flow and processing. Tefen helps organizations realize quality improvements and cost reductions in the emergency department through assisting in the redesign and optimization of operational processes. These improvements lead to increased patient flow and effective capacity, resulting in easier patient access, as well as lower access costs. Tefen also works with clients to improve patient information flow, resulting in an effective, efficient and accurate care administration. Ultimately these changes can help streamline patient flow through the emergency department, resulting in shorter stays and increased admittance rates. Increasing the number of patients seen in one day enhances patient satisfaction, as well as increases revenue.
Surgical services in a hospital account for a large portion of its revenue. However, many health care systems are not fully utilizing their key assets’ space and time and, therefore, are not performing to their potential. Tefen works with hospitals to improve their scheduling process by using block scheduling and capacity planning, in order to reduce staff overtime and improve room and resource utilization.
The effective flow of a patient can be improved through many process changes. Focusing on the OR, improvements can be made in patient preparation and information flow to minimize delays and support on-time starts. Through staff leveling, forecasting and improving access throughout the hospital, processing times, wait times and patient lead times can be decreased. Tefen also helps organizations optimize room-turnover times, in order to minimize case delays. The tools of Lean, Six Sigma and simulation can be leveraged to enhance performance, eliminate redundancies, and improve patient safety.
Materials management solutions can also be examined to reduce inventory holding costs, stock out event occurrences and time spent looking for materials. Tefen also works with organizations to increase accurate and on-time equipment delivery, resulting in quicker instrumentation turnaround time. All of these solutions allow for patients to be treated effectively and in a timely manner, increasing the effective capacity of an operating room and resulting in increased revenue.
Radiology departments face many challenges that result in fewer patients being seen by physicians, lower patient satisfaction scores and overall financial return. Challenges such as on time starts, patient wait time, turn-around time, no shows/cancellations, backlog, cycle time, volume, wrong orders and unread exams all affect the success of a radiology department.
The efficiency and effectiveness of hospital radiology services can be improved through the standardization of operating processes and procedures. Through work flow optimization, the department’s processes and overall flow can be streamlined to eliminate non-value added activities. These changes can help eliminate waste and reduce unnecessary costs, resulting in increased capacity and, therefore, revenue. Tefen utilizes Six Sigma and Lean methodologies and focuses on patient access, patient and provider scheduling, turnaround time and productivity in order to impact capacity flow.
Tefen helps organizations improve their radiology services using a number of tools and approaches. Strategic asset mapping is encouraged in order to understand and optimize equipment locations, selection, distribution and utilization. Tefen also helps clients with evaluating their patient scheduling process to determine the most efficient and economically viable operating model. Tefen can also help with analyzing the impact and performance of patient transportation between the radiology department and other areas of the hospital. Contractual agreements on service level, fees, performance and other key criteria are evaluated to ensure the hospital is receiving maximum value from any existing group contract. Lastly, Tefen helps clients to complete staffing analysis and productivity measurement in order to align staffing patterns to historical patient demand while considering productivity performance measures.
Improvements in an organization’s Laboratory Services, Pharmacy Department and Supply Chain can reduce unnecessary costs through streamlined processes. Using Lean, Six Sigma, simulation, and change management techniques, process enhancements are possible and will lead to more accurate and effective services. Efficiency can be improved, resulting in reduced lab turnaround times and reduced pharmacy RX fill times, which in turn will lead to increased patient satisfaction and increased processing.
Many organizations struggle with inefficiencies in their clinical labs, resulting in decreased productivity and wasted time, both of which negatively impact the organization’s overall bottom line. When a lab is operating effectively, internal processes won't affect patients' responses to service, but once problems arise, patients will directly feel the negative effects.
Improving lab processing, reducing turn-around times, reducing variability and streamlining information flow can help increase efficiency. Variability in laboratory services leads to frequent errors resulting in rework and wasted time. Tefen helps organizations streamline laboratory processes in order to reduce variability and improve accuracy. By identifying the root causes of variances, it is possible to determine which processes need to be standardized in order to eliminate process output variation. Through the standardization of data collection techniques, operating costs can be reduced and accuracy can be enhanced. Systematic data collection and automation can also help eliminate variability and reduce errors.
Information flow and efficiency can be improved through collaboration with institutional entities and research centers—such as the integration of the diagnosis and lab departments—as well as improvements in communication management and the delivery of test results. Tefen also works with clients to leverage the tools and techniques of Lean, Six Sigma, simulation and change management to encourage laboratory transformation. These techniques result in the reduction of inefficiencies, coordination costs and waste throughout the laboratory. Increasing the effectiveness and efficiency of lab services can lead to significant improvements in patient care, due to increased accuracy and improved processing times, along with desirable cost savings. Therefore, through the optimization of operational processes within the lab, the overall quality of services can be enhanced.
Hospital pharmacies strive to improve workflow and reduce waste to achieve timely and quality service at low cost. Pharmacies can increase efficiency and effectiveness through process improvements, resulting in greater patient and physician satisfaction. Tefen offers solutions to increase efficiency, such as improving communication between physicians and pharmacies and reducing idle time by utilizing down-time to perform preoperational activities. Tefen also works with clients to determine optimal working shifts to address fluctuations in demands while maximizing patient units’ coverage. These solutions provide benefits to the operations of the pharmacy such as reducing the average fill time and limiting patient wait time.
Tefen helps hospitals realize cost reductions through examining drug purchases and pharmacy processes and procedures. Improvements in these areas can be achieved through better planning of the pharmacy’s supply chain, in order to optimize stock flows and Par levels. These solutions, along with stock optimization efforts and automation, help to identify ideal inventory levels, resulting in reduced stock-out turnaround times and satellite inventory. Reduced inventory can lead to reduced returns due to outdating and, therefore, additional cost savings and reduced waste.
Inefficiencies in a hospital supply chain can lead to non-value added consumption of resources and assets that could have been used for patient care. The growing complexity of a healthcare system’s supply chain often results in challenges when attempting to manage the entire supply chain as one entity.
Tefen helps organizations streamline their entire supply chain in order to eliminate waste and inefficiencies throughout. Supply chain process optimization can be achieved through the analysis of the entire supply chain and by focusing on alternatives that improve the control of materials. Benefits can be seen from the standardization of supplies and negotiations, using rigorous vendor management policies that regulate vendor access and engagement. In addition, comprehensive systems can be developed to monitor and manage how products are distributed to further improve the product flow through an organization.
Lastly, Tefen works to develop a plan for continuous improvement. This is done by establishing future processes that must be followed, developing alignment with care providers, creating stewardship to ensure support from all levels of the organization and sharing information across all departments.