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Flevy Management Insights Case Study
Operational Efficiency Strategy for Mid-Size Hospital in Urban Market


There are countless scenarios that require Business Process Improvement. Fortune 500 companies typically bring on global consulting firms, like McKinsey, BCG, Bain, Deloitte, and Accenture, or boutique consulting firms specializing in Business Process Improvement to thoroughly analyze their unique business challenges and competitive situations. These firms provide strategic recommendations based on consulting frameworks, subject matter expertise, benchmark data, best practices, and other tools developed from past client work. Let us analyze the following scenario.

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Consider this scenario: A mid-size hospital in a competitive urban market is facing significant challenges with Business Process Improvement, impacting its operational efficiency and patient care delivery.

The hospital is experiencing a 20% increase in patient wait times and a 15% decline in patient satisfaction scores, indicative of internal process inefficiencies and staff burnout. External challenges include rising healthcare costs and increased competition from larger healthcare systems offering a wider range of services. The primary strategic objective of the organization is to improve operational efficiency and patient care quality while reducing costs and wait times.



The hospital is navigating a healthcare landscape marked by rapid technological advancements and evolving patient expectations. To address its strategic challenges effectively, it is essential to explore the underlying factors, which likely include outdated technology systems, inefficient workflow processes, and inadequate staff training and engagement.

Strategic Planning Analysis

The healthcare industry is undergoing significant transformation, driven by digital innovation, regulatory changes, and a shift towards patient-centered care.

Examining the competitive landscape reveals several key forces at play:

  • Internal Rivalry: The level of competition is high, with hospitals vying for patients by offering advanced medical technologies and superior patient experiences.
  • Supplier Power: Suppliers of medical equipment and pharmaceuticals wield significant power, impacting hospital costs and operational efficiency.
  • Buyer Power: Patients, now more than ever, have the power to choose their healthcare providers based on quality of care, cost, and convenience, increasing the pressure on hospitals to improve service delivery.
  • Threat of New Entrants: New entrants, including specialized clinics and telehealth services, pose a threat by offering convenient and often less expensive alternatives to traditional hospital care.
  • Threat of Substitutes: Alternative healthcare delivery models, such as home health services and outpatient surgery centers, challenge the traditional hospital model.

Emergent trends in the industry include the digitalization of healthcare, increasing focus on patient experience, and the rise of personalized medicine. These shifts lead to major changes in industry dynamics:

  • Adoption of Digital Health Technologies: Opportunities to improve patient care and operational efficiency through telehealth, AI, and electronic health records. The risk lies in the substantial investment and change management required.
  • Focus on Patient Experience: This creates an opportunity to differentiate through superior service but requires significant improvements in operational processes and staff training.
  • Increasing Demand for Personalized Medicine: Offers the chance to provide cutting-edge treatments but requires investment in new technologies and capabilities.

Learn more about Change Management Competitive Landscape

For effective implementation, take a look at these Business Process Improvement best practices:

Kaizen (254-slide PowerPoint deck and supporting PDF)
Business Process Improvement (BPI 7) (139-slide PowerPoint deck and supporting Word)
Process Automation & Digitalization Assessment (41-slide PowerPoint deck)
Strategic Process Improvement (180-slide PowerPoint deck)
Business Process Reengineering (BPR) (157-slide PowerPoint deck and supporting PDF)
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Internal Assessment

The hospital has a strong commitment to patient care, with experienced medical staff and a solid community reputation, yet struggles with outdated technology and inefficient processes.

SWOT Analysis

The hospital's strengths include its dedicated staff and strong community ties. Opportunities exist in adopting digital health solutions and improving patient experience. Weaknesses are evident in its reliance on outdated technologies and inefficient workflow processes, which contribute to longer wait times and decreased patient satisfaction. External threats include the competitive pressure from larger healthcare systems and the rapid pace of technological change in healthcare.

VRIO Analysis

The hospital's community reputation and experienced staff are valuable and rare resources that provide a competitive advantage. However, its technology infrastructure and process efficiency do not offer the same advantage, as they are neither rare nor costly to imitate. Focusing on these areas could enhance the hospital's competitive positioning.

Capability Analysis

Success in the current healthcare environment requires competencies in digital health adoption, process optimization, and patient-centric care. The hospital is well-positioned with its skilled staff and community reputation but needs to significantly improve in technology adoption and process efficiency to meet these demands effectively.

Learn more about Competitive Advantage

Strategic Initiatives

Following a thorough analysis, the management has identified several strategic initiatives to be implemented over the next 18 months .

  • Digital Transformation: Implement an integrated digital health platform to streamline patient records, scheduling, and communication. This initiative aims to reduce wait times and improve patient satisfaction. The value creation comes from enhanced efficiency and patient experience, expected to lead to higher patient retention and attraction. Resources required include investment in technology, staff training, and change management.
  • Process Optimization: Redesign workflow processes across patient intake, treatment, and discharge to eliminate bottlenecks and improve efficiency. The intended impact is reduced operational costs and improved patient throughput. Value creation stems from operational savings and increased capacity for patient care. This will necessitate process analysis, redesign expertise, and staff retraining.
  • Staff Development and Engagement Program: Launch a comprehensive program focusing on training staff in new technologies and patient care best practices, coupled with initiatives to improve staff engagement and satisfaction. The goal is to enhance service quality and reduce staff turnover. The value comes from a more motivated and efficient workforce. Required resources include development of training programs, engagement initiatives, and performance monitoring systems.

Learn more about Process Analysis Value Creation Best Practices

Business Process Improvement Implementation KPIs

KPIS are crucial throughout the implementation process. They provide quantifiable checkpoints to validate the alignment of operational activities with our strategic goals, ensuring that execution is not just activity-driven, but results-oriented. Further, these KPIs act as early indicators of progress or deviation, enabling agile decision-making and course correction if needed.


That which is measured improves. That which is measured and reported improves exponentially.
     – Pearson's Law

  • Patient Wait Time Reduction: A critical metric to assess the effectiveness of process optimization and digital transformation efforts.
  • Staff Satisfaction Score: To monitor the impact of the staff development and engagement program.
  • Patient Satisfaction Score: Essential for gauging overall improvements in patient experience.

These KPIs will provide insights into the progress and effectiveness of the strategic initiatives, helping to identify areas for further improvement and ensuring alignment with the hospital's strategic objectives.

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Learn more about Flevy KPI Library KPI Management Performance Management Balanced Scorecard

Business Process Improvement Best Practices

To improve the effectiveness of implementation, we can leverage best practice documents in Business Process Improvement. These resources below were developed by management consulting firms and Business Process Improvement subject matter experts.

Business Process Improvement Deliverables

These deliverables represent the outputs across all the strategic initiatives.
  • Operational Efficiency Roadmap (PPT)
  • Digital Transformation Implementation Plan (PPT)
  • Process Optimization Framework (PPT)
  • Staff Development Program Guidelines (PPT)

Explore more Business Process Improvement deliverables

Digital Transformation Initiative

The implementation team leveraged the Technology Acceptance Model (TAM) and the Balanced Scorecard approach to guide the digital transformation initiative. TAM, developed by Davis in 1989, has been instrumental in understanding how users come to accept and use new technologies. It was particularly useful in this context, as it helped predict how likely employees and patients were to embrace the new digital health platform. Following TAM, the team executed the following steps:

  • Conducted surveys and interviews to identify perceived usefulness and ease of use of the new digital platform among employees and patients.
  • Analyzed feedback to address concerns and enhance the platform’s user interface for better adoption rates.
  • Implemented a series of training sessions focused on demonstrating the benefits and ease of use of the digital platform to all users.

Simultaneously, the Balanced Scorecard, a strategic planning and management system developed by Kaplan and Norton, was used to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organizational performance against strategic goals. The team applied the Balanced Scorecard by:

  • Developing specific metrics under four perspectives: Financial, Customer, Internal Process, and Learning and Growth, directly related to the digital transformation goals.
  • Setting up a dashboard to track these metrics in real-time, allowing for quick adjustments to the digital transformation strategy as needed.
  • Facilitating workshops with department heads to ensure alignment of the digital transformation objectives with overall hospital goals.

The results from implementing TAM and the Balanced Scorecard were significant. The hospital saw a 30% increase in the adoption rate of the digital health platform by both staff and patients within the first six months. Additionally, the Balanced Scorecard helped the hospital to better align its digital transformation efforts with its strategic objectives, leading to a 20% improvement in operational efficiency and patient satisfaction scores.

Learn more about Digital Transformation Strategic Planning Digital Transformation Strategy

Process Optimization Initiative

For the process optimization initiative, the team adopted the Lean Six Sigma framework and the Business Process Reengineering (BPR) approach. Lean Six Sigma, with its focus on reducing waste and improving quality, was perfectly suited to streamline hospital workflows and eliminate inefficiencies. The team implemented Lean Six Sigma through the following steps:

  • Identified and mapped out all existing patient care and administrative processes to pinpoint waste and inefficiencies.
  • Organized training sessions for staff on Lean Six Sigma principles and techniques.
  • Formed cross-functional teams to carry out process improvement projects, using DMAIC (Define, Measure, Analyze, Improve, Control) methodology.

Concurrently, BPR was employed to fundamentally rethink and radically redesign hospital processes to achieve dramatic improvements in critical measures of performance, such as cost, quality, service, and speed. The BPR initiative was executed as follows:

  • Conducted a comprehensive analysis to identify core processes that were candidates for reengineering.
  • Engaged with external consultants to bring in fresh perspectives on best practices in healthcare process management.
  • Implemented new processes, with a focus on maximizing patient value while minimizing resource use.

The combination of Lean Six Sigma and BPR resulted in a 25% reduction in patient wait times and a 15% decrease in operational costs. These process optimization efforts not only enhanced the hospital's efficiency but also significantly improved the patient experience, as reflected in patient satisfaction scores.

Learn more about Process Improvement Six Sigma

Staff Development and Engagement Program

The Kotter’s 8-Step Change Model and the Maslow’s Hierarchy of Needs were pivotal frameworks in the successful implementation of the staff development and engagement program. Kotter’s model provided a comprehensive approach for managing change, which was crucial for introducing new technologies and processes to the hospital staff. The steps undertaken included:

  • Creating a sense of urgency around the need for change to improve patient care and operational efficiency.
  • Forming a powerful coalition of change agents among senior staff and department heads.
  • Developing a vision for change that included specific goals related to staff development and engagement.
  • Communicating the vision and involving staff in the change process to gain their buy-in and participation.

Simultaneously, Maslow’s Hierarchy of Needs was used to understand and address the psychological and safety needs of the hospital staff, which are fundamental for their engagement and motivation. The application of Maslow’s framework involved:

  • Conducting surveys to understand the needs and concerns of the staff at different levels of Maslow’s hierarchy.
  • Designing programs that addressed these needs, such as safety protocols, job security measures, recognition programs, and opportunities for personal growth and advancement.
  • Implementing feedback loops to continually assess and adjust the programs to ensure they remained relevant and effective.

The implementation of Kotter’s 8-Step Change Model and Maslow’s Hierarchy of Needs led to a marked improvement in staff engagement and satisfaction. The hospital recorded a 40% improvement in staff satisfaction scores and a 20% reduction in turnover rates within a year, demonstrating the effectiveness of these frameworks in driving the staff development and engagement program.

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Key Findings and Results

Here is a summary of the key results of this case study:

  • Implemented a digital health platform, leading to a 30% increase in adoption by staff and patients, enhancing operational efficiency and patient satisfaction.
  • Adopted Lean Six Sigma and BPR, resulting in a 25% reduction in patient wait times and a 15% decrease in operational costs.
  • Launched a staff development and engagement program, achieving a 40% improvement in staff satisfaction scores and a 20% reduction in turnover rates.
  • Utilized the Balanced Scorecard to align digital transformation efforts with strategic objectives, contributing to a 20% improvement in operational efficiency and patient satisfaction scores.

The initiative's results are commendable, demonstrating significant improvements in operational efficiency, patient satisfaction, and staff engagement. The 30% increase in the adoption of the digital health platform and the subsequent 20% improvement in operational efficiency and patient satisfaction underscore the success of the digital transformation strategy. The 25% reduction in patient wait times and the 15% decrease in operational costs highlight the effectiveness of the process optimization efforts. The staff development and engagement program's success is evident in the 40% improvement in staff satisfaction scores and the 20% reduction in turnover rates, indicating a positive shift in organizational culture.

However, the initiative faced challenges, particularly in the seamless integration of new digital tools and the initial resistance from some staff members. The results, while successful, also suggest room for further improvement, especially in maximizing the potential of digital health technologies and continuing to reduce operational costs. Alternative strategies, such as more focused training on digital tool usage and enhanced change management practices, could have potentially led to even greater adoption rates and operational efficiencies.

For next steps, it is recommended to focus on refining the digital health platform based on user feedback to ensure it fully meets the needs of staff and patients. Additionally, continuing education and training for staff on the latest digital tools and healthcare practices will be crucial. Finally, exploring advanced analytics and AI to further optimize hospital operations and patient care delivery could drive the next level of improvements in efficiency and satisfaction.

Source: Operational Efficiency Strategy for Mid-Size Hospital in Urban Market, Flevy Management Insights, 2024

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