Finding leaks in hospital workflow

March 1, 2011

The biggest problems can be found where you least expect them.

Scott Fuller

By now it is common knowledge that digitizing and managing workflow electronically can offer a healthcare organization significant savings. But while the benefits of automation are generally focused on clinical information, a hospital's administrative practices will also display noteworthy improvements from a workflow system.

Hospital clinical processes have, in many cases, already been automated by hospital information system (HIS) software. Various clinical workflows are embedded into EHRs and similar systems because vendors have designed their products to help providers meet meaningful-use mandates.

While further examining and automating clinical workflow can offer cost and efficiency improvements, a focus on the automation of hospital administrative processes will result in even greater financial impact. Many hospitals' support and revenue cycle departments are buried in age-old paper-based workflows. While they get the job done, these manual processes, dependant on legible handwriting, accurate forms and the slow passage of the interoffice mail cart, are full of leaks — wasting both time and money.

Flaws associated with standard, manual administrative workflow can be uncovered through collaboration between various departments. Delays resulting from complex forms, mail cart delays and requisitions that require multiple signatures — and issues caused by forms that were never filled out correctly to begin with — may all be fixed through an automated workflow process.

Leaks in manual workflows are plentiful, but they are hard to recognize by employees who have been caught up in these inefficient processes for years. Therefore, it is critical to collaborate with various members of hospital staff to see where inefficiencies lie. For example, the interoffice mail carrier will be able to quickly name the forms that are regularly re-routed and stalled due to incorrect information, and which departments suffer from the most significant paper glut. Similarly, revenue cycle and admissions personnel will be able to describe the snags in their departments' workflow.

One hospital recently examined its PAR (personnel action request) form and associated workflow, for instance, after it stumbled across an employee who spent the majority of her day proofreading and correcting these forms as they were delivered to her department. Because department directors filled out these forms by hand, they would often use an employee's nickname or transpose a work identification number.

Once the PAR process became automated, the form was completed on screen. Employee names were chosen from a drop-down list and all the pertinent fields were automatically filled throughout the form, as each selection was linked to HR data. The form was then automatically and immediately routed to the next person in the workflow order without interruption.

Inefficient workflows may be difficult to identify, especially if they have been in use for many years. Automating leaky administrative hospital processes, however, can do more than simply increase efficiency. The time saved and resources that are productively repurposed may also result in near-immediate return on investment.

Scott Fuller is the director of workflow engineering
for FormFast.
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