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SEMS Says...

Engineering management for healthcare processes

With the challenges facing U.S. healthcare, technically competent industrial engineers and engineering managers can help all types of healthcare organizations identify and make changes to improve how healthcare is provided while improving cost and quality. The urgency of this work is highlighted by the federal efforts to reform healthcare and the fact that multiple governmental agencies have identified the strategic importance of applying process improvement, cost reduction and productivity improvement tools to healthcare organizations.

I worked with two different healthcare organizations during the last year, an inpatient hospital and an outpatient clinic. My expertise in lean, Six Sigma, DMAIC and performance measurement were of great value. Although there are many similarities between applying engineering management and IE tools in manufacturing and healthcare, some differences affect the mechanisms of applying these tools.

First, healthcare organizations, like manufacturing organizations, can find tremendous value in identifying opportunities for standardization, particularly in designing processes that facilitate the flow of patients. Clinical and administrative personnel can identify the “one best way” for processes so patients can enter and leave the system without waiting, non-value-added steps or rework. Waste elimination and process flow can help design a wide range of healthcare processes, such as admissions, treatment room setup and appointment scheduling.

Second, metrics are needed urgently to guide the improvement efforts of both clinical and administrative personnel. While healthcare organizations track metrics closely linked to clinical outcomes and metrics related to the productivity of clinical personnel, operational metrics could help all healthcare workers understand their performance so they can prioritize improvement activities. Using process-centric metrics would allow more healthcare professionals to provide care that is safer, more effective and more efficient. Many organizations do not have process performance metrics available on a real-time basis. Patient wait times, treatment room turnover time, the number of medical orders processed, the number of medical order errors, and/or the number of open appointments can provide critical feedback to help people improve performance.

The culture of healthcare organizations promotes personnel doing the right thing, but they now must focus on doing the right thing in the best way possible. Engineering management professionals and IEs have the skills needed to support this important work.

Toni Doolen is an associate professor in the School of Mechanical, Industrial and Manufacturing Engineering and the associate dean of the University Honors College at Oregon State University. She is a past president of SEMS and is serving as an IIE technical vice president and the IIE Annual Conference 2011 IERC program co-chair.

Meeting customers where they are

Services and solutions must be targeted to customers’ situations. This includes any constraints that may impact the organizations. This seems obvious, but many in professional services practice “push” production: Plan in isolation, build it and hope the customer will be pleased to receive it. The following can help professional services become more customer-driven.

As engineers, we like to provide the most technically advanced or current solution. But a customer may prefer a solution that is simpler, proven, widely understood and requires little training. Provide the customer with a proposal, design or prototype of what they requested and then compare that with a more advanced solution. Then walk the customer through the comparison.

Recognizing the customer’s preferences and political constraints, I’d rather provide an acceptable 80 percent solution than a 100 percent correct solution that faces stiff opposition. Enrolling others in the solution is often the key component of successful deployment. “Technically correct” IT solutions often yield less-than-favorable results because the optimal solution is more than the organization can handle, the underlying processes are not ready for automation, or the users have fundamental IT limitations that prevent them from using the full capability of the proposed solution.

Customer focus means providing customers with products that take into account how they will use them. How many times have you received an Excel spreadsheet that prints on 32 pages? Worse yet, neither the file name nor worksheet tab print, making reconciliation between electronic and hard copy needlessly time-consuming. Adding a footer that auto-inserts the file name and a header that auto-inserts the worksheet name can solve this.

How many times have you received electronic documents with generic file names like “timesheet,” “resume,” or “cost estimate”? It is as if the sender never anticipated you might receive similar documents or might need to file and later retrieve the document. Details count.

How often do minutes or transcripts from meetings attempt to capture everything said? Minutes takers are so busy capturing everything that they miss subtleties in the conversation, obscuring the context. To document meeting output, have a knowledgeable team member summarize the key points, list decisions made, identify and assign action items, share relevant observations, and cite or attach reference material.
Provide your services as if you were providing them to yourself. When your customers realize that you are looking out for their interests as well as they would, they will come to you again and again.

Garry Coleman is executive vice president of Transformation Systems Inc. of Arlington, Va. He is a senior member of IIE, former president of SEMS and former IIE technical vice president.

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