As with all hospitals in Germany, the introduction of Diagnostic Related Groups (DRG) has posed a significant challenge for the organization of Ruppin Hospitals Corporation. To ensure a secure future for the hospital, management has focused on continually improving the quality of medical care, while building controlling mechanisms to monitor costs and revenues at the DRG level at the same time. Thereby, a main focus is on transparency of the cost drivers in the performance of service. In order to achieve this Ruppin Hospitals Corporation contracted a consulting team from Siemens Healthcare to analyze the cardiac cath lab, the most cost and revenue-intensive area in the hospital.

Benefits from Cost and Process Analysis

Ruppin Holspitals have greatly profited from the recommendations made by the consultants of Siemens. Cost analysis and benchmarking of three primary activities in the cardiac cath lab resulted in a higher degree of transparency with respect to efficiency in this core area of the hospital. Workshops, interviews, and process monitoring played from a neutral party an important role in confirming that an experienced, well-coordinated team works in the cath lab efficiently showing a strong patient orientation. A further insight brought the analysis of primary and secondary data, which enabled the consultants to identify the potential for optimization and to derive concrete recommendations for actions regarding the process flows, which could then be implemented by the hospitals.

The Key to Effectiveness: Process Optimization

Through interviews with several employee groups both in the cardiac cath lab and the wards, the process flows in and at the interfaces to the cardiac cath lab were analyzed and documented in detail for three primary services. The objectives hereby were to identify the existing referrers (internal and external), to determine the different types of examinations carried out, as well as to prove the completeness degree of the documentation from the physicians' and nurses' point of views and the reasons why possible delays before, during, or after the intervention occur.

Both the processes and associated process barriers were documented during the interviews. The focus was placed on barriers in the organizational structure, in workflows within the lab itself, as well as on delays at the interfaces to other areas of the hospital and to external referrers.

Interdisciplinary Team
By collecting this data the consultants were able to organize and present the documented problem areas. An interdisciplinary team consisting of the Siemens consultants, representatives from the physicians, nursing management, lab and ward nurses, and transport services, jointly developed solutions and prioritized them based on required implementation effort and effectiveness. In this way, optimizations were identified and concrete recommendations for actions could be derived. Professor Kurt J.G. Schmailzl, MD, Chief Physician at Medical Clinic A, is convinced of the Siemens consultants’ work, “The depth of the analyses in this project far exceeded my expectations.”