Business process reengineering at the hospitals: A case study at Singapore hospital

ABSTRACT K KE EY YW WO OR RD DS S B Bu us si in ne es ss s p pr ro oc ce es ss s r re ee en ng gi in ne ee er ri in ng g, , H He ea al lt th hc ca ar re e. . A AB BS ST TR RA AC CT T As health care costs increase, there is a need for healthcare service providers to look for ways to contain costs and to achieve a higher efficiency at their operating facilities without sacrificing quality. This paper studies a case in employing business process reengineering techniques on one aspect of a health care service – surgical work. The system is simulated focusing on the processes that contribute to the effective functioning of an operating theatre. I IN NT TR RO OD DU UC CT TI IO ON N Business process reengineering (BPR) has become increasingly important in recent years. Customers now have the choice of different product and service providers, to provide them with the same core product or service that they want. Over the last fifteen years, companies have been forced to reengineering their business processes to stay competitive because customers are demanding better products and services. Improving and redesigning business processes is paramount for businesses to stay competitive. With the escalating health care costs, healthcare service providers in Singapore are also continuously seeking ways to stay competitive and provide quality service to the customers. Little research has been done on the employment of BPR in healthcare systems. Healthcare industry has traditionally emphasized on breakthroughs in operating procedures and technology in the bid to stay competitive. Healthcare service providers are beginning to understand that BPR initiatives could be a better solution to achieving competitive advantage.

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    ABSTRACT: Purpose – The purpose of this paper is to present a case study of a hospital nursing unit that has evaluated and approved a two-bin “e-kanban” replenishment system based on passive high frequency radio-frequency identification (RFID) technology. Design/methodology/approach – The case study analysis is based on both qualitative and quantitative data that were collected using semi-structured interviews, on-site observations and experience from previous implementations. The data and simulation analysis presented in this paper were validated by key respondents thereby increasing their reliability. Findings – Results indicate that implementing the e-kanban RFID solution in conjunction with the redesign of the ward floor and of the roles and functions can substantially improve business and operational performance. The most important benefits for the hospital are derived from the time saved from non-value-added activities that can be transferred to patient care activities and the significant reduction of on-hand inventory at distributed storage locations. The solution is considered an alternative that requires less initial investment than RFID-enabled cabinets used in the replenishment of consignment and high-value supplies in operating rooms and cardiac catheterization laboratories. Research limitations/implications – There is a need to conduct further research on RFID supply chain management (SCM) applications in the healthcare sector as this area holds a great potential for performance improvements. Additionally, there is a need to conduct more in-depth research into the isolated impact of RFID technology in comparison to the change management and process redesign that it generates. One key limitation of this research is the case study approach based on a single case. This paper, therefore provides direction for practitioners on how to assess RFID's potential impact in the healthcare supply chain. Originality/value – While most of the research on RFID in healthcare sector focuses on active RFID technology for asset management, this research presents a novel RFID application and contributes to our understanding of RFID's potential in intra-organizational SCM processes.
    Business Process Management Journal 11/2010; 16(6):991-1013. DOI:10.1108/14637151011093035
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    ABSTRACT: Discrete-event process simulation, originally the benefactor of the manufacturing sector of the economy, has expanded aggressively into the service sector of the economy, much to the benefit and gratitude of its new cadre of industrial engineers and management strategists. The study documented in this paper originated within a large health-care insurance provider seeking optimal strategies relative to target inventories of pending inquiries concerning insurance policy coverage and concomitant staffing levels of policy analysts. Since several clients of this insurance provider were large companies within the automotive industry, the provider dedicated significant staffing segments to the service of these accounts (hence to the employees of those automotive companies who thereby held insurance coverage). The simulation study worked within this constraint to provide management valuable strategic recommendations. Most specifically, the insurance provider wished to develop a model capable of predicting service levels (average time required to answer specific questions submitted on behalf of two major clients and average inventory level of these questions pending) as a function of number of full-time equivalent analysts assigned to each of those clients.
    Proceedings of the 20th European Conference on Modelling and Simulation, Bonn, Germany; 05/2006
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    ABSTRACT: The health care industry in the United States, and in many other countries as well, is undergoing unremitting pressures to improve standards of patient care and service, reduce costs, and increase efficiency. These pressures stem from higher expectations by health-care consumers, increased demands stemming from changing demographics (particularly the “graying” of populations), and more rigorous auditing of expenditures by both private insurers and government. In response, health-care industry practitioners, managers, and administrators are increasingly availing themselves of the analytical techniques, including simulation, provided by the discipline of industrial engineering. In this paper, we document a simulation study undertaken to improve patient service at a dental clinic. The simulation analysis validated innovative ways to improve patient throughput and decrease patient waiting times with zero incremental cost.
    Proceedings of the 21st European Conference on Modelling and Simulation, Prague, Czech Republic; 06/2007

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