Process Potential Screening

Summary

Objectives: Hospitals are increasingly under pressure to optimize their processes. So far, an instrument to systematically identify the potentials for improvement of a given business process is missing. The aim of this project is to develop such an instrument.

Methods: Initially, central aspects of the quality of a hospital process were identified on the basis of a systematic literature review. Secondary to that, criteria to measure quality aspects were defined: More than 300 criteria from medical and business informatics, economics and quality management publications were gathered and systematically aggregated.

Results: As a result, the Process Potential Screening (PPS) instrument was developed. The PPS is a matrix containing two axes: Axis I comprises 30 quality aspects referring to results, execution and control of hospital processes. Axis II comprises 16 quality criteria (e.g., customer satisfaction, time). The PPS displays approximately 400 relevant combinations of those quality aspects and quality criteria that help to identify potentials for improvement of a given hospital process. It utilizes different methods for the measurement of the criteria and for application by way of individuals or groups.

Conclusions: In using the PPS, relevant potentials for improvement were identified in ten typical hospital processes. The instrument’s practicability must now be examined in further studies by the final target group (e.g., quality or project managers, and the staff responsible for processes).

Keywords

Business process - process management - process evaluation - quality management - health informatics

• References

• 1 Russell JP. Quality Management Benchmark Assessment. Milwaukee, USA: ASQ Quality Press 1997
• 2 Harrington HJ, van Nimwegen H, Esseling EK. Business Process Improvement Workbook: Documentation, Analysis, Design, and Management of Business Process Improvement. Columbus: McGraw-Hill Companies 1997
• 3 Greiling M, Hofstetter J. Patientenbehandlungspfade optimieren - Prozessmanagement im Krankenhaus. Kulmbach: Baumann Fachzeitschriftenverlag 2002
• 4 Kaplan RS, Norton DP. The Balanced Score Card - Measures that drive Performance. Harvard Business Review 1992; 70 (019) 71-9.
• 5 Kaplan RS, Norton DP. Translating Strategy Into Action - The Balanced Score Card. Boston, MA: HBS Press 1997
• 6 McKeon T. Benchmarks and performance indicators: two tools for evaluating organizational results and continuous improvement efforts. J Nurs Care Qual 1996; 10 (03) 12-7.
• 7 Rosenthal GE, Way LE, Shipley SA, Doner D, Wojtala B, Miller J, Harper DL. Using Hospital Performance Data in Quality Improvement: The Cleveland Health Quality Choice Experience. Jt Comm J Qual Improv 1998; 24 (07) 347-60.
• 8 Haux R, Ammenwerth E, Herzog W, Knaup P. Health care in the information society. A prognosis for the year 2013. Int J Med Inform 2002; 66: 3-21.
• 9 Schwegmann A, Laske M. Istmodellierung und Istanalyse. In Becker J, Kugeler M, Rosemann M. (eds.) Prozessmanagement. Berlin, Heidelberg, New York: Springer 2000; pp 121-52.
• 10 Brassard M, Ritter D. The Problem Solving Memory Jogger. GOAL/QPC 2000
• 11 Gierhake O. Integriertes Geschäftsprozessmanagement. Braunschweig, Wiesbaden: Vieweg & Sohn Verlagsgesellschaft 1998
• 12 Riekhof H. Die Idee des Geschäftsprozesses: Basis der lernenden Organisation. In Riekhof H. (ed.) Beschleunigung von Geschäftsprozessen. Stuttgart: Schäffer-Poeschel Verlag für Wirtschaft 1997; pp 7-28.
• 13 Stauss B. Augenblicke der Wahrheit. In Bruhn M, Stauss B. (eds.) Dienstleistungsqualität. Konzepte, Methoden, Erfahrungen. Wiesbaden: Gabel Verlag 2000; pp 379-99.
• 14 Rawlings K. Making it work. Process improvement in medical practices. MGMA Connex 2004; 4 (04) 42-51.
• 15 Büssing A, Herbig B. A work psychological evaluation of the program PIK. In Victor N, Blettner M, Edler L, Haux R, Knaup P, Pritsch M, Wahren- dorf J, Windeler J, Ziegler S. (eds.) Medical Informatics, Biostatistics and Epidemiology for Efficient Health Care and Medical Research - Contributions from the 44th Annual Conference of the GMDS. Heidelberg: Medizin & Wissen 1999; pp 232-3.
• 16 Blendon RJ, Schoen C, Donelan K. et al Physicians’view on quality of care: a five-country comparison. Health Affairs 2001; 20 (03) 234-43.
• 17 Eichhorn S. Integratives Qualitätsmanagement im Krankenhaus. Stuttgart, Berlin, Köln: Kohlhammer 1997
• 18 Kaltenbach T. Qualitätsmanagement im Krankenhaus. Melsungen: Bibliomed 1993
• 19 Ball MJ, Douglas JV. Redefining and Improving Patient Safety. Methods Inf Med 2002; 41: 271-6.
• 20 Donabedian A. Explanations in Quality Assessment and Monitoring. The Definition of Quality and Approaches to its Assessment. Ann Arbor 1980
• 21 Bricon-Souf N, Beuscart R, Renard JM, Geib JM. An asynchronous co-operative model for co-ordinating medical unit activities. Comput Methods Programs Biomed 1997 54. 1-2. 77-83.
• 22 Timpka T, Nyce JM. Dilemmas at a primary health care center: a baseline study for computer-supported cooperative health care work. Methods Inf Med 1992; 31 (03) 204-9.
• 23 Köster C. Medizinische Versorgungsketten - Ihre Wirkung als Informationsverbundsystem am Beispiel der Initiative “Gesundheitsnetzwerk Rhein-Neckar-Dreieck”. In Herrmann G, Haas P, Kuhn K, Prokosch U, Schmücker P, Köhler CO. (eds.) Praxis der Informationsverarbeitung im Krankenhaus. Landsberg: ecomed 1998; pp 25-30.
• 24 Yank G. Quality improvement in health care organizations. A general systems perspective. Behavioral Science 1995; 40: 85-103.
• 25 Coulter A, Cleary PD. Patient’s Experiences with Hospital Care in Five Countries. Patients’ assessments of hospital care are essential to improving its quality. Health Affairs 1988; 20 (03) 244-52.
• 26 Bruhn M. Qualitätsmanagement für Dienstleistungen. Berlin, Heidelberg, New York: Springer 1997
• 27 Hildebrand R. Das bessere Krankenhaus. Total Quality planen, umsetzen, managen. Neuwied, Kriftel: Luchterhand Verlag 1999
• 28 Meyer A, Blümelhuber C, Pfeiffer M. Der Kunde als Co-Produzent und Co-Designer - oder: die Bedeutung der Kundenintegration für die Qualitätspolitik von Dienstleistungsanbietern. In Bruhn M, Stauss B. (eds.) Dienstleistungsqualität. Konzepte - Methoden - Erfahrungen. Wiesbaden: Gabler 2000; pp 49-70.
• 29 Zeithaml VA. How Consumer Evaluation Processes Differ between Goods and Services. In Donnelly JH, George WR. (eds.) Marketing of Services. Chicago: American Marketing Association 1981; pp 186-90.
• 30 Babakus E, Mangold WG. Adapting the SERVQUAL Scale to Hospital Services: An Empirical Investigation. Health Services Research 1992; 2: 767-86.
• 31 Parasuraman A, Zeithaml VA, Berry LL. A Conceptual Model of Service Quality - an Ist Implication for Future Research. Journal of Marketing 1985; 41-50.
• 32 Donabedian A. An Exploration of Structure, Process and Outcome as Approaches to Quality Assessment. In Selbmann K, Überla K. (eds.) Quality Assessment in Medical Care. Gerlingen: Beiträge zur Gesundheitsökonomie; 1982; 15: 69-92.
• 33 European Foundation for Quality Management (EFQM). EFQM Excellence Model Public Sector and Assessing for Excellence. Brussels, Belgium: European Foundation for Quality Management. 2000
• 34 International Organization for Standardization. ISO-Standard 9001:2000 Quality Management Systems; Berlin: Beuth Verlag. 2001
• 35 Deutsche Krankenhausgesellschaft. Kooperation für Transparenz und Qualität im Krankenhaus: KTQ-Katalog 4.0, Deutsche Krankenhausgesellschaft. 2002 http://www.ktq.de
• 36 Joint commission for accreditation for healthcare organizations (JCAHO). 2004 Last accessed http://www.jcaho.org
• 37 Cleary PD, McNeill BJ. Patient Satisfaction as an Indicator of Quality Care. Inquiry 1988; 25: 25-36.
• 38 Delbecq AL, VandeVen AH. A Group Process Model for Problem Identification and Program Planning. Journal Of Applied Behavioral Science 1971; 466-91.
• 39 Beauregard MR, Mikulak J. The Basics of FMEA. New York: Productivity Press; 1996