The Medical Society and hospital financing Hagen, Terje P; Kaarbøe, Oddvar
Tidsskrift for den Norske Lægeforening,
2004-Feb-05, 20040205, Volume:
124, Issue:
3
Journal Article
Fast-track decision making (FTD), adapted from the GE Work-Out approach, and GE's Change Acceleration Process (CAP) were combined with the Kaizen event to enhance group sessional effectiveness and ...focus on cultural change and improvement sustainability.0 FTD focuses on the use of facilitation tools to promote team-hased decision making and empower teams to engage in problem solving in focused time frames. The event identified the following improvement strategies: > Creation of a master change ticket, accessible to all stakeholders involved in the process, to eliminate difficulty matching files being worked on with the original change order > Access to and utilization of software for laboratory information services to have a central location for all build/testing information and documentation > Email notification for order changes with weekly updates by a laboratory information systems analyst until the change requested is closed > Publication of frequently asked questions, including common error types and trouble - shooting steps necessary to resolve them at the primary user location > Creation of testing coordination between teams, to be discussed during multidisciplinary monthly meetings for team coordination and knowledge sharing > Analysis of turnaround times for individual reference labs to provide feedback and establish improved relations with the vendors regarding their performance and industry expectation The status of each improvement's implementation was monitored consistently, and accountability for the implementation was maintained to ensure that timelines were achieved through process sponsor involvement and guidance by the IS division.
Cleveland Clinic partnered with Harvard Business School to conduct a pilot project to explore the differences between time-driven activity-based costing (TDABC) and relative value unit costing. The ...goal was to determine whether TDABC could improve the accuracy of cost information and identify value-improvement opportunities for two types of heart-value procedures. Using TDABC, leaders gained a detailed look into process steps that could be consolidated, reduced, or performed with a lower cost mix of personnel.
In the early 1990s, DRG based hospital financing was introduced into some hospital districts in Finland. The 1993 state subsidy reform decentralising all hospital financing to municipalities, and the ...aim of improving productivity, were the driving forces for introducing DRG. This study addresses the pros and cons of DRG in hospital financing in the Finnish health care system and puts forward several solutions to avoid potential problems. We consider the objectives and optimal features of hospital financing systems in the context of the public health care system, where the public sector owns and finances hospitals. We analyse impacts of introducing different types of DRG based hospital financing systems, taking into account earlier experiences in countries such as Sweden and Norway, as well as Finnish system specific features. DRG could assist the Finnish municipalities to compare quality, costs and prices of services between hospitals, and related cost information might help them budget expenditure more accurately. System specific features mean that traditional uses of DRG in hospital pricing are not feasible in Finland. But some benefits of DRG could be exploited, for instance in the controlled contracts between municipalities and hospitals.
Using a resource dependency framework and financial theory, this study assessed the market, mission, operational, and financial factors associated with the level of cash and security investments in ...hospitals. We ranked hospitals in the study sample based on their cash and security investments as a percentage of total assets: hospitals in the high cash/security investment category were in the top 25th percentile of all hospitals; those in the low cash/security investment group were in the bottom 25th percentile. Findings indicate that high cash/security investment hospitals are under either public or private nonprofit ownership and have greater market share. They also serve more complex cases, offer more technology services, generate greater profits, incur a more stable patient revenue base, and maintain less debt.
