Increasing Patient Loads Without Projects

Posted on July 20, 2011


From what I hear, hospitals need to squeeze more revenue out of what they already have to avoid taking on more debt, or because debt itself is not even available to use. If this is accurate, a few ideas come to mind based on conversations I have had recently.

First, increase the efficiency of the facility. This can be done with better technology, like information systems investments (i.e. electronic health records). It can also be done with lean processes that facilitate flows of people and materials.

I spoke with a consultant who specializes in lean applications in healthcare. We discussed how it was possible, through internal redesign and work process overhaul, to eliminate a project >$50 million that was originally created to address a shortage in patient room capacity.

Scheduling is also underutilized at many hospitals. Physicians and surgeons have preferred schedules for procedures. The assembly line of one-after-another is a good start to minimize turn-over time. Yet, how many ORs are in use five days a week? Seven days a week?

A client of ours was considering adding two more ORs to a hospital we designed and built, which was opened two years ago. We asked some basic questions about scheduling and determined the ORs were simply not being used to capacity even for five days a week.

To illustrate this and get another perspective on adequate scheduling, we discussed how another hospital executive handles his imaging equipment. The MRIs in this particular hospital run from 5:30am until 10pm. This gave our client the idea his ORs were way underutilized, and he did not need more ORs. He just needed to use them more often.

After all, an OR or MRI is really a finite capacity of income potential, much like a hotel room. Every night a hotel does not fill a room is a night of potential income lost. Hospitals should think of their resources similarly.

Construction should be, as I have written before, a last alternative to address an infrastructure shortcoming. In case you are wondering: yes, we talked our client out of a project. Because when it comes time for expansion, a hospital better be able to say ‘we have ’em stacked up two deep in the halls morning to night’!

When every room and person on staff is maxed, and every bottleneck loosened up to where capacity really is holding back revenue generation, then it is time for more room. Until then, there are too many other prudent ways to likely squeeze more capacity from what a hospital already has.