HealthManagement, Volume 18 - Issue 4, 2018

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Improving experience and overall performance for patients receiving knee and hip replacements at Sultan Bin Abdulaziz Humanitarian City Hospital (SBAHC), Riyadh, Saudi Arabia.

If you’ve ever been a patient or have had a loved one require care, you’ll know that what is valued as a patient – big or small – is unique for each person at every stage of their treatment.

The concept of value-based healthcare doesn’t mean much to patients because getting better as quickly and smoothly as possible of course means everything. Thus, I’ve come to learn that for healthcare to truly deliver value, it must be centered around patients, their experience and ultimately their health outcomes. It’s about putting patients at the heart of decision making to provide greater benefits.

SBAHC hospital wanted to find solutions to ensure care reflected exactly this for its hip and knee replacement patients. There is a growing demand for these procedures in Saudi Arabia with cases referred from government hospitals. Unfortunately, there is a long process ahead for patients, from initial assessment to the operating room (OR), then prolonged postoperative hospital stays for rehabilitation.

Johnson & Johnson were proud to work collaboratively with the 510-bed rehabilitation hospital and medical center to design value-based CareAdvantage solutions that were measurable and sustainable.

Reviewing the patient journey, we identified challenges such as double or triple booking clinic time-slots. Patients needed four hospital visits ahead of surgery yet 30% of patients were appointment ‘no-shows’. Finally, supply chain inefficiencies meant valuable time was lost.

Based on these insights, we co-created a set of aims and objectives, including:

  1. All patients to follow a predefined process when visiting the Out-Patient Department (OPD), aiming for a maximum stay of two hours
  2. All patients to follow a ‘one-stop-shop’ preoperative assessment after financial clearance
  3. Knee and hip replacement surgery demand should be met six months post-implementation

To achieve these ambitious objectives, we worked closely with the hospital and their multidisciplinary team to carry out a comprehensive review using lean management principles – widely acknowledged as a proven and scientifically-based management solution. The results offered a clear picture of the current patient pathway, the biggest hurdles, and what an ideal patient journey could look like. We also co-created measures that would remove non-value adding activities and organize care around the patient.

Following implementation in January 2018, SBAHC has been able to reduce initial patient assessment time (including X-ray) from 3 hours to 1. They’ve streamlined preoperative assessments bringing patient hospital visits down from four to two (including preoperative anesthesia screening). OR optimization has also been achieved through shortened change-over times between surgeries, e.g. while one patient is in theater, the next is already receiving local anesthesia, saving 45mins per patient.

These SBAHC results are testament to what partnerships can achieve with a value-based approach such as CareAdvantage. The results mean real improvements for patients, which is why Johnson & Johnson is committed to translating what is most valued by patients into value-based solutions for hospitals.

To find out more about creating bespoke CareAdvantage solutions for your hospital, contact [email protected].

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