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An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach

In recent years, it has become increasingly important to improve efficiency and economic balance in hospitals. The department chairperson (or Chair) contends with a production function consisting of inputs and outcomes, rife with managerial constraints. These constraints can be reduced with proper m...

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Detalles Bibliográficos
Autores principales: Gil, Ziv, Brammli-Greenberg, Shuli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Rambam Health Care Campus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185998/
https://www.ncbi.nlm.nih.gov/pubmed/30309441
http://dx.doi.org/10.5041/RMMJ.10352
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author Gil, Ziv
Brammli-Greenberg, Shuli
author_facet Gil, Ziv
Brammli-Greenberg, Shuli
author_sort Gil, Ziv
collection PubMed
description In recent years, it has become increasingly important to improve efficiency and economic balance in hospitals. The department chairperson (or Chair) contends with a production function consisting of inputs and outcomes, rife with managerial constraints. These constraints can be reduced with proper management by diverting resources and activity. Lack of a proper management algorithm at the department level is a significant impediment to improving operational efficiency in hospitals without significant additional costs. In this work we aimed to develop and implement a management algorithm in a teaching hospital department, in order to improve performances and quality of care. From September 2012 to December 2017 we developed a novel management algorithm for a surgical department and implemented it in the Head and Neck Surgery Department at Rambam Medical Center, Haifa, Israel. Changes were made to the organization structure and the concept of service provision. We defined core measures reflecting operative actions and outcomes and identified actions that could affect these measures. Based on our analysis of outcomes we constructed a management intervention process that defines operative actions leading to improved performance. The result was over 400% improvement in the department’s outcome measures including quality, activity, and service. Analysis of data from the Israeli Ministry of Health revealed that the department’s ranking in performance measures and volume improved from no. 14 of 23 departments in Israel in 2011, to no. 1 in 2013, which was sustained through 2014–2016. Improvement in efficiency also translated to economic balance and transformation from deficit to profitability. If this algorithm is implemented in the rest of the system, it is expected to improve the function of the hospital as a whole. Our results have the potential to foster the development of a new organizational culture of measurement and improvement in the hospital, and subsequently in the entire health system.
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spelling pubmed-61859982018-10-22 An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach Gil, Ziv Brammli-Greenberg, Shuli Rambam Maimonides Med J Special Issue Celebrating the 80th Anniversary of Rambam Health Care Campus In recent years, it has become increasingly important to improve efficiency and economic balance in hospitals. The department chairperson (or Chair) contends with a production function consisting of inputs and outcomes, rife with managerial constraints. These constraints can be reduced with proper management by diverting resources and activity. Lack of a proper management algorithm at the department level is a significant impediment to improving operational efficiency in hospitals without significant additional costs. In this work we aimed to develop and implement a management algorithm in a teaching hospital department, in order to improve performances and quality of care. From September 2012 to December 2017 we developed a novel management algorithm for a surgical department and implemented it in the Head and Neck Surgery Department at Rambam Medical Center, Haifa, Israel. Changes were made to the organization structure and the concept of service provision. We defined core measures reflecting operative actions and outcomes and identified actions that could affect these measures. Based on our analysis of outcomes we constructed a management intervention process that defines operative actions leading to improved performance. The result was over 400% improvement in the department’s outcome measures including quality, activity, and service. Analysis of data from the Israeli Ministry of Health revealed that the department’s ranking in performance measures and volume improved from no. 14 of 23 departments in Israel in 2011, to no. 1 in 2013, which was sustained through 2014–2016. Improvement in efficiency also translated to economic balance and transformation from deficit to profitability. If this algorithm is implemented in the rest of the system, it is expected to improve the function of the hospital as a whole. Our results have the potential to foster the development of a new organizational culture of measurement and improvement in the hospital, and subsequently in the entire health system. Rambam Health Care Campus 2018-10-04 /pmc/articles/PMC6185998/ /pubmed/30309441 http://dx.doi.org/10.5041/RMMJ.10352 Text en Copyright: © Gil and Brammli-Greenberg. This is an open-access article. All its content, except where otherwise noted, is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Special Issue Celebrating the 80th Anniversary of Rambam Health Care Campus
Gil, Ziv
Brammli-Greenberg, Shuli
An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title_full An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title_fullStr An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title_full_unstemmed An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title_short An Algorithm for Improving Hospital Performance Measures: A Department-centered Approach
title_sort algorithm for improving hospital performance measures: a department-centered approach
topic Special Issue Celebrating the 80th Anniversary of Rambam Health Care Campus
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185998/
https://www.ncbi.nlm.nih.gov/pubmed/30309441
http://dx.doi.org/10.5041/RMMJ.10352
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