Service Line/Healthcare

This presentation is about service line in hospital.

1. Healthcare Operation Management SERVICE LINES Nazim Hussain

2. Main topics Service line definition/history Scope of service line Advantage of service line model & possible failure(devolution) Service line creation, implementation & analysis & evaluation. Created service line Compare to Michael Porter’s strategy & with other strategies

3.   Service line Definitions Service line is define as it is a grouping of similar services (clinically related conditions) Or Service line management is defined as patient-centered care related to a specific area of clinically-related conditions or procedures integrated across a system of care. Or Service line in healthcare organizations is a healthcare strategy that involves organizing the programs of the hospital into vertical groupings focused on a particular clinical area. Categories of services often grouped as service lines include women’s services, Cancer services, cardiology, orthopedics and pediatrics, dermatology etc.

4. Health Care S ervice L ine History of service line John Hopkins Hospital introduced service line model. Scope of service line Healthcare organizations Spatiality The field of practice of a specialist i.e.. Oncology, Dermatology etc. Sub-specialty A narrow field of study or work within a specialty i.e. Pediatric Oncology , Pediatric dermatology. Service line team/ management

5. Service Line Model B enefits Service Line Model Benefits Improved patient care/satisfaction Better align the healthcare organization interests with those of physicians & external market. Help out for the re-structuring the healthcare organization Improving the quality of care and patient safety Continuity of care - improving coordination in providing care Creating a common vision and goal Ability to quickly respond to market changes Providing standard care arguments about how to allocate resources (staff, beds, capital, etc.) Increasing accountability Attracting and retaining personnel Efficient spending of resources Limited financial resources management

6. 4 Basic Models of Service L ine S ervice line implementation

7. O rganizational structure to implement service line management

8. How a hospital in growth mode positioned itself for the future Service line analysis Review the market share for each service line Identify which service lines had the most drawing power Study market demographics to forecast volumes for various services in the years ahead Review the hospital’s case-mix index to understand the complexity of the patients it served Calculate the percentage of overall revenues that came from each service line. Assess the profitability of each service line Benchmark the hospital’s financial and operational performance against other facilities.

9. Service Line E valuation Low or decreasing volume + High profitability How can volume be increased? What is the marketing plan? Is there a need for more physicians in this area? High or increasing volume + High profitability High or increasing volume + Low profitability Low or decreasing volume + Low profitability Can reimbursement be improved? Can payer mix be improved? Can costs be decreased? Is it a physician issue Can this service be discontinued? can volume be maintained or increased further ? Will equipment upgrades bring additional volume? Can costs be decreased? Can volume be limited? What is the marketing plan? Is it a physician issue? S L current state Decision points for evaluation Develop further Consider discounting Strategically important Improve profitability

10. Created Service L ine Service Line Specialties Sub Specialties Services Eye ,Ear , Nose & Throat (EENT Service Line) Ophthalmology & Otorhinolaryngology   Otology Otosclerosis  (a condition of the middle ear that causes hearing loss) Otitis media with effusion – a common condition of childhood (also known as glue ear) in which the middle ear becomes blocked with fluid Age related hearing loss Hearing tests (audiology)   Rhinology Sinus infection and rhino-sinusitis, including in children Nasal injuries     Eye, ear, nose & nose care. Head & neck care.     Dedicated group for service line are: Highly trained specialist surgeons, Medical doctors Nurses Technicians. Premises: State-of-the-art hospital with Latest Technology   Eye, Ear, Nose & Throat S ervice Line (EENT-SL) Continue…

11. Eye, Ear, Nose & Throat Service Line (EENT-SL) Service Line Specialties Sub Specialties Eye ,Ear , Nose & Throat (EENT Service Line) Ophthalmology & Otorhinolaryngology   Throat condition includes Tonsillitis, sometimes requiring surgical removal of the tonsils, usually in childhood Swallowing problems Ophthalmology Cataract surgery Corneal transplant surgery Retinal detachment surgery Glaucoma surgery Cosmetic surgery Head & Neck conditions Cancer affecting the mouth, oral cavity, throat (pharynx). Thyroid and parathyroid problems Facial skin lesions including skin cancer Facial cosmetic surgery Rhinoplasty (nose surgery) Otoplasty (ear surgery ) Pediatric conditions Speech therapy Allergies

12. Different types of strategies in healthcare Michael Porter’s VBHDS McLaughlin Strategy Process Mapping Blue Printing strategy Lean Sigma -- Continuous Improvement & Innovation Organized into integrated practice units (IPUs) Measure outcome and cost for every patients Move to bundle payment for care cycles Integrate care delivery across separate facilities Expend excellent services across geography. Build an enabling information technology platform Quality (less errors to increase the quality) Patients flow (proper patient flow . Special form of process mapping. A service blueprint is a diagram that visualizes the relationships between different service components — people, props (physical or digital evidence), and processes — that are directly tied to touchpoints in a specific customer journey. Lean: Relentless pursuit of eliminating WASTE (non-value activities) from a process. It is: A methodology A set of tools A way of thinking! Six Sigma: Process of analyzing data to identify the root cause of defects Purpose Lean Sigma will enhance efficiency, quality and safety all of which drive the patient experience

13. Strategies Comparison C hart Compare & Contrast Points Service Line Michel Porter McLaughlin Strategy Lean Management Similarities Integrated System Integrated   Integrated   ------- ------- Similarities Quality   Quality focus   Quality focus   Quality focus   Quality focus   Similarities Patient centered   Patient centered   Patient centered   Efficiency ----- Similarities Strategy Healthcare Strategy Healthcare Strategy Healthcare Strategy Strategy Similarities Organization re- structure Organization re- structure Organization re- structure Improve process Continuous improvement Differences ( Compare) Cost   Cost effective   Value based (cost)   Patient flow Continuous improvement Differences (Contrast) Cost Cost effective   Value based (cost) Patient flow 4 defects/ millions   Patient flow ---- ----- Patient flow   ---------- Defects ---- ---- ---- 4 defects/ millions   Chain of command   Best redesign     absent   ------ Best design Outcomes /   Better outcomes Better outcomes Better outcomes Superior Result.

14. Thank You