- Topic:Increase quality, decrease stress in a hospital
- Speaker:Gijs Andrea, The Netherlands
- Occupation:Consultant, implementor, trainer at House of TOC, Education Implementation Management Consultancy
- About speaker:Gijs is a founding partner of the International House of TOC (iHOT), an organization dedicated to education and implementation of the Theory of Constraints and working closely together with TOC Resultants in The Netherlands. Prior to setting up iHOT, Gijs worked as the head of IT in a large Dutch hospital, and then as an IT consultant where he worked with over fifty healthcare organizations across The Netherlands.
Gijs was introduced to the Theory of Constraints over 25 years ago. He has successfully gained the TOCICO Fundamentals accreditation and has trained in the TOC Thinking Processes and project management. Gijs has completed his MSc in TOC for Healthcare Management in 2010.
Gijs is playing a leading role in the introduction of the Theory of Constraints into the healthcare system in The Netherlands. His particular interest is in training and developing staff in applying the Theory of Constraints. He educated and trained more than 100 consultants and 500 people in Healthcare industry.
Gijs has worked on many TOC implementations, including Maasstad Ziekenhuis (The Netherlands), St Antonius Hospital (The Netherlands), Nij Smellinghe (The Netherlands), Barking Havering and Redbridge University Hospitals NHS Trust (UK) and University Hospitals Coventry and Warwickshire NHS Trust (UK).
Topic of the presentation
Increase quality, decrease stress in a hospital
This presentation will demonstrate what management principles were applied in a general hospital that improved the quality of care AND decreased the workload on nurses and doctors, while the same amount of patients was treated. This implementation took place in a Dutch hospital and is still in the process of completion. The implementation strategy is used in several hospitals in The Netherlands and abroad and delivers similar results over and over again.
What was the problem?
Clinical wards in most hospitals, at least in The Netherlands, are usually occupied for more than 90% on average on a yearly basis. This average occupation means that from time to time wards are fully occupied, resulting in some major negative effects: patients cannot be admitted, operations are cancelled, patients are admitted on the wrong ward, nurses and doctors experience a lot of stress.
Before our implementation started, the average occupation in this particular hospital was well over 90% and the amount of patients admitted on wrong wards was almost 1000 per year on a total of 8000 admissions for the concerning wards (5 in total in this case). On top of that, 10 to 15 times a year the hospital was completely full, resulting in patients being sent through to other hospitals in the region. The average length of stay was at the time of the beginning of the project (2010) 7,3 days per patient.
What had to be changed?
The goal of the implementation was to eliminate guest-admissions and to prevent a full-house situation during normal market demand (i.e. not taking into account winter crises or disasters). The way to achieve this was to reduce the length of stay for each patient by eliminating non-medical waiting times.
These non-medical waiting times are often caused by mis-synchronization of resources inside and outside the hospital: diagnostic departments, such as Radiology, Physiotherapy and the like, also suffer from fully planned schedules, resulting in not being available at the right time for clinically admitted patients. But also nursing homes and rehab clinics tend to be occupied for almost 100%, also resulting in blocking patients to be discharged from the hospital.
Occupation of beds decreased by 20%.
Length of stay decreased by 15%.
Ongoing improvement on daily basis.
Decisions based on performance.
Management focus on improvement.
Speakers’ role in the project
Pieter Buwalda is the manager of patient logistics and thus responsible for the appropriate infrastructure of resources and procedures in order to establish an optimal flow of patients throughout the hospital. As such he was the internal project-leader of the implementation of Buffer Management in Hospital Nij Smellinghe in Drachten, The Netherlands. During the project Pieter managed the scope, time and budget of the project by working closely together with nurses, management, doctors and the external project-leader, Gijs Andrea.