Академический Документы
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Christoph Bendick Commercial Director since Oct. 2011 I am especially impressed that this project is not only the achievement of physicians, the nursing department or the administration. The collaboration of staff across all departments has made this project a success. I would not have thought these results to be possible. Katrein Amann Bert Hoffmann This project shows once again that substantial positive effects can not only be achieved for the service providers but that the application of lean methodology can optimize resources successfully in the administration of hospitals, too.
Results
Cash ow increased by 2 million Discharge to invoice reduced by 11days (statutory health insurance) and 12days (private health insurance), respectively Quality of invoices, measured by queries resulting in corrected invoices, kept constant Cash outstanding improved by 50 % Response- and wait times decreased in the overall documentation, coding and settlement processes Predictability of human and nancial resources signicantly improved Implementation of internal lean projects reduces cost-intensive external consulting
Initial Situation
Five employees were trained as Lean project managers and seven employees were trained as project staff in Lean Management at the Stryker LeanAcademy in May 2011. The Stryker LeanAcademy was founded in 2006 by Dr. med. Hank Schiffers and is specialized in Lean Management solutions in the health care sector as well as in the cross-functional training of hospital staff. A so-called value stream team, comprising employees along the whole process of accounting, was put together for this training. This team comprised employees of the interfaces: ward, pharmacy, doctors, organization controlling, controlling, IT, laboratory as well as from the divisions: Admission of patients, medical controlling, performance accounting and nancial accounting. The approach according to the Lean methodology was largely unknown territory for project team members. For many team members it was the rst time working together on a problem consequently with colleagues of different occupational background and across divisions.
Authors Ursula Lang**, Katrein Amann*, Sabine Frank**, Bert Hoffmann*, Dr. med. Hank Schiffers, MBA, Alexander Conz, MD, MBA
* Stryker GmbH & Co.KG, * * BG-Unfallklinik Ludwigshafen
Lean Methodology
The Lean methodology was developed in the 1950s by Toyota to optimize processes in the automotive industry. Essential approaches include process
Dr. med. Hank Schiffers, MBA I planned this project in close collaboration with the management of the German BG-Unfallklinik Ludwigshafen in the beginning of 2011. We initiated and accompanied it to show, due to the expected nancial success, that Lean Administration is the second pillar of Lean Hospital. I congratulate the project team for their excellent results. It prooves again true; No money no mission
optimization in small, quick steps implemented by the local employees and the consideration of all processes from the customers perspective. To this end, the individual process steps are analyzed in a structured way and divided into value-added and non-valueadded activities. This approach and staff training in theory and practice based on a specic project is a major investment in building internal expertise in process optimization.
Impact on Cash ow
Index
+2 mio
100
Ursula Lang Head of Department of Patient Services and Finances The project was great fun. We had some really tough wrestle. At the beginning of the project, I could not imagine achieving such sustainable and signicant results with the Lean methodology. The approach to reorganization and the plurality of the project team have made this result possible.
2010
Oct. 2011
By the follow-up project and an on-site coaching led by Mrs. Assmann the efciency could be increased signicantly within the rst ve months. Initial expectations were exceeded by far.
VA L U E S T R E A M O V E R V I E W
admission
admission diagnosis
data / validation
plausibility check
approval
discharge
invoicing
receipt of payment
The entire process of accounting includes all areas from admission to payment reception
Optimization of the interface communication to ensure the uninterrupted processing, the so-called owing system, of billing cases. On the one hand, this was achieved by improved organizational processes instead of optimizing sectors. On the other hand, the colleagues trained each other and developed clearly dened responsibilities (job enrichment), ensuring a clear and competent substitution in case of illness or vacation in order to ascertain continuous work ow. Systematization and structuring of the suppliers in terms of transfer of billing data and documentation.
project work, the process was visualized quickly and vividly depicted. The participants quickly realized that every step in the value stream can intervene in the operations of the predecessor or successor, and that these processes can be inuenced.
Measurable Success
Signicant improvements have been achieved in accounting. Since September, the period from discharging until invoicing, which was identied as key performance indicator, shows a good and stable course below the target value. The development of the secondary control parameters is positive, as well. The overall development of the nancial situation is signicantly positive, showing an increase of 2 million in Cashow with the resulting positive impact on interest rates, liquidity, etc.
Sabine Frank Head of Patient Guidance Department, Provisional Head of Medical Controlling Department None of the participating colleagues could probably have imagined the signicance of the accounting process before beginning the project. Nobody could imagine how complex this process would be. Due to the nature of this