Six locations in a tight spot
One of the mid-size hospitals in the Netherlands had the ambition to redefine the profiles of its six locations. Two large and four smaller locations would be affected, with the goal of them aligning with the hospital’s overall strategy. The current situation has existed for 20 years and is no longer fit for the future.
External and internal pressure pointed to a need to increase efficiency. For example, two hospital locations were offering the same type of care and limited e-health. However, by now specialization and optimizing capacity are the norm. In a challenging sector facing a shortage of health professionals and a continuously rising demand for better patient care, IG&H was asked to guide this project.
Sharpening profiles to increase care efficiency
The profile of a hospital is determined by the presence and design of seven types of facilities. For instance, outpatient clinics, same-day discharge or care focusing on mother and child can all factor into the reshuffling of services and specializations. Sharpening a location’s profile leads to greater efficiency but also increases the quality of care the patients receive.
IG&H bases its location profiling approach on three key principles:
1) Care centering around medical conditions
2) Concentrating high-volume elective care
3) Reorganizing emergency care
Care centering around medical conditions: The concentration and organization of care related to a medical condition in multidisciplinary centers leads to improved quality and this quality gain leads to cost savings.
Concentrating high-volume elective care: You can achieve economies of scale by concentrating high-volume elective care, such as surgeries for hip replacement or hernias. This increase in efficiency cannot be fully achieved without the concentration of elective care.
Reorganizing emergency care: It is possible to organize emergency care differently without it negatively affecting the needs of the region’s residents, even if this entails slightly longer traveling time. We suggested concentrating complex emergency care and acute obstetrics in one location and to maintain an acute care department for less complex acute care at the other location. This helps to guarantee quality and affordability, now and in the future.
We developed a model to link healthcare activities, capacity and financials to predict the future needs and performance for the different scenarios. In addition, we organized several events to share success stories within the hospital and took the lead in involving external stakeholders.
Based on the characteristics of the hospital and its region, the key principles and the model, IG&H's advice to the board was establishing two locations. The idea was to create one hospital location for complex and acute care, and one location for less complex, elective care while maintaining a broad base of outpatient clinics at both locations. The two hospitals are complemented by two additional outpatient clinics in the region. An outpatient clinic with a broad base is maintained at both locations, complemented by two additional outpatient clinics. This way we can ensure that most care remains accessible close to home, while improving the quality and affordability of care.
Our client received advice based on different scenarios for location profiling. The board is now deliberating this advice with various stakeholders to reach a decision for location profiling.