Health Case Studies

Scope of Engagement

Review and improve:

  • Pre-admission processes.
  • Theatre booking process.
  • Turnaround time for sterile instruments and consumables provided by the Central Sterile Supply Department.
  • The utilisation of day and inpatient theatre services.
  • Surgical directorate financial performance.

Following the completion of the assessment in collaboration with surgical directorate staff and relevant executives, understanding was achieved of where key inefficiencies and causes of performance issues lay. This enabled a reform programme to be devised and implemented that resulted in:

  • 30% increase in theatre utilisation.
  • A decrease in the number of patients on surgical wait lists.
  • A decrease in the number of same-day surgical cancellations.
  • Increased patient throughput in the pre-admission clinical enabling more patients to be seen and risks to surgery be identified in a timely manner.
  • Optimised the capacity of the Central Sterile Supply Department ensuring all resources were optimally utilised.
  • Commenced generating revenue into the department by providing services to other health services.
  • Provided a framework and developed capability to enable a sustainable process improvement programme to be rolled out to other departments.

Scope of Engagement

  • The acute inpatient journey from the emergency department to them being discharged from inpatient wards.
  • Clinical coding turnaround to enable optimisation of activity based funding.
  • Review of medical services available and provided to inpatients.
  • Theatre utilisation.
  • Facility management services, such as engineering.

The following processes were used to support the review in collaboration with health service staff and the leadership team:

The outcomes of the engagement were:

  • Identification and rectification of key process blocks and process inefficiencies.
  • Increased bed capacity and utilisation as a result of better discharge planning.
  • Optimised revenue from ensuring coding was undertaken accurately in a timely manner.
  • Increased theatre utilisation with subsequent reductions of patients remaining on wait lists.
  • Increased capacity and flow of patients through the emergency department resulting in turn in, better experience, safer care and improved compliance with clinical and operational performance indicators.
  • Discovered other areas where opportunities for service improvements and cost reduction could be leveraged.

Scope of Engagement

  • Identify an appropriate imaging model with supplementary workforce model based on growth caused by changes in outpatient services and activity.
  • Identify opportunities for maximising revenue and decreasing operating costs in an imaging department.
  • Review clinical and operational processes in key services within the health service and identify opportunities to be leveraged resulting in better patient care, improved service utilisation and decreased operating costs.
  • Review specific groups of staff across the network in relation to numbers, roles and governance in comparison with other States and health services with a key aim of improving accountability, consolidating responsibilities appropriately and reducing staff costs.

The Promentor health services team worked collaboratively with health service and governmental staff to provide practical and endorsed recommendations for reform across all the reviewed areas. Additionally, the team provided a robust imaging plan with a staged workforce model that was accepted by the senior clinical and operational teams alike.