Skip to 0 minutes and 5 secondsJOHN RASA: Clearly, there has been significant change in medical technology in the last 20 years. Can you give me an example of where you've levered medical technology and information management to actually produce those changes?

Skip to 0 minutes and 17 secondsDAMIAN ARMOUR: Yeah. So we have a device in every single patient room throughout all of Epworth that is next to the patient bed. And that's multi-use device. So our clinicians can use it. So our doctors use it. Our nurses use it. Our non-clinical staff, in terms of our environmental services team, use it. And the patient uses it.

Skip to 0 minutes and 38 secondsJOHN RASA: Pharmacy?

Skip to 0 minutes and 39 secondsDAMIAN ARMOUR: Not yet in terms of pharmacy. But you know that it's a-- now that the technology's been implemented-- it's there-- we're looking at all sorts of different ways of leveraging that investment. So the clinician can use it to go and view results, bang a biometric review-- tap, tap, tap, tap. And there's their imaging results on the screen. The patient uses it from an entertainment perspective. The nursing staff can use it to refer on to rehabilitation. The medical staff can use it to refer for an image downstairs. The patient uses it to order their meals-- so no more paper menus. And they've been collated and moved downstairs. They order their menu downstairs. So that's an efficiency improvement.

Skip to 1 minute and 18 secondsThey can see their menu and order at the same time. We have a room-ready component to the point-of-care device, where the patient's being discharged. The nurse goes into the room and says, it's ready for environmental services team. And that buzzes someone downstairs. And they come up and make the bed.

Skip to 1 minute and 33 secondsJOHN RASA: Must be a tremendous time savings from all those things you mentioned.

Skip to 1 minute and 36 secondsDAMIAN ARMOUR: Absolutely. And it's one device with various applications that are evolving. And we're learning as we go. And we're finding that the patient experience is great. There's time savings for staff because the staff aren't having to do laborious tasks. I could not possibly imagine that-- those devices being taken out of our rooms because I think it would just add a whole new layer of inefficiencies back in, like we did back in the-- some of the good old days.

Skip to 2 minutes and 1 secondJOHN RASA: Yeah. One of the things that-- I guess the education process of our health professionals tends to be very functional. And so to what degree does that add to the fragmentation of the process, the fact that they are educated separately and take their own view on what should be happening with the patient process?

Skip to 2 minutes and 20 secondsDAMIAN ARMOUR: We do train them to be great in particular things. That is the ultimate goal. But then how do we then-- when they're involved in a particular system or process that they play a part in, how do we encourage them to broaden that thinking and look beyond just their part? Again, I come back to, I suppose-- to the engagement process at the start about identifying the cause, providing the data, telling the story about what the impact of this system going wrong, identify and articulate what their role is in that process and, I suppose, what their role may well be in identifying it.

Skip to 2 minutes and 54 secondsSo I think it's management's responsibility and role to take a group of people who are very specific on certain parts of a process, gather them together, tell them the story about what's not right, and facilitate a process where we collectively identify a revised process is going to lead to an improved outcome.

Skip to 3 minutes and 15 secondsJOHN RASA: Can you give me example of where you've encouraged that team work so that they are working across their disciplines to get a good outcome for the patient experience?

Skip to 3 minutes and 23 secondsDAMIAN ARMOUR: So we're going through a process now where they're working together on a particular project with some of our nursing staff to try and figure out how do we accumulate information about someone's admission during the admission. So when it comes to the discharge process, the creation of the discharge summary is as easy as it can possibly be for that VMO to sign off on. And then we have electronic processes, once they press the button, that it can get to the GP ideally within 48 hours because, typically, the patient will be from hospital to the GP in a two- or three-day range. So we want that information to the GP as soon as we can.

Skip to 3 minutes and 57 secondsSo if we can be more of a team-- the nursing staff, the allied health staff, the VMOs-- clearly accumulating information during the admission, being ready for the discharge itself, and therefore presenting discharge documentation, getting it to the GP as quickly as we can, that will be a great outcome. And we're involving a GP, a physician, nursing staff, and some IT people, as well, in trying to resolve that particular challenge, which every hospital in the country will want to deal with.

Skip to 4 minutes and 26 secondsJOHN RASA: Absolutely. They certainly do.

BPR in hospitals

Research identifies a strong link between business process and the success of an organisation and is a key reason that BPR is becoming more and more popular in the hospital and healthcare sector.

As outlined in the previous step, the definition of a process involves a set of activities to produce a specified output.

This is similar to a clinical process where resources are utilised to create appropriate services for patients.

Improving hospital operations

Since the early 1980s, quality management methods have been employed in healthcare settings to improve clinical processes.

One of the main management techniques that has been applied is BPR (other tools being total quality management and activity-based management).

BPR is not only used to enhance the productivity and quality of healthcare service delivery, but also to identify new technological advances and incorporate them into service.

As hospitals face significant challenges to deliver services with limited resources, harnessing technology, including IT, to achieve outcomes has become necessary.

Along with technological innovations, in BPR there is a focus on eliminating non-value-added tasks to reduce waiting times and expenses, and treat more patients.

Adapting BPR for hospital settings

Many of the BPR implementation techniques employed in hospitals are derived from techniques used in manufacturing.

However, these are not always suited to hospital environments, which mean some BPR techniques need to be adjusted to accommodate the unique operating challenges faced by hospitals.

In the next few steps we’ll discuss the application of BPR techniques in healthcare settings via some case studies.

For the moment, we need to be aware that along with the many benefits of BPR for hospitals, there are also some limitations. For example, if BPR techniques are employed without proper planning and training, there is a high chance of failure.

We must also be aware that the customisation of BPR techniques to particular settings is required as research has shown employment of the same BPR method in different settings has led to contradictory results.

For this reason, experts have argued that for the successful implementation of BPR to occur in hospitals, visibility into previous BPR exercises and adoption of methodological support is vital.

Your task

Watch the video to hear John discuss the development and implementation of BPR in hospitals with Damian Armour, CEO at Epworth Geelong Hospital.

When you’re done, use the comments to share your thoughts about implementing BPR in hospitals.

  • What are the relative advantages and challenges?
  • How could you adapt BPR to benefit your organisation?

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This video is from the free online course:

Hospital Operations: Improving Patient Experience

Deakin University

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Find out what this course is like by previewing some of the course steps before you join: