With the development of for-profit medical institutions, the importance of department operation has become more and more prominent, and more and more institutions have begun to set up dedicated department operation teams. So, what is department operation, and how can the concept of department operation be implemented into specific daily work?
The goal of the department's operation is very clear: to achieve the business goal. Specifically, it can be carried out in seven aspects: development planning, resource allocation, process improvement, cost control, operation analysis, performance management and cross-departmental collaboration.
01. Development planning
The department development plan is the most important and difficult part, which can be done once a year and corrected once in the middle of the year. Planning should not only set goals, but also consider the basic path to them.
1. What is planning? There are 3 elements to the plan:
(1) Know where the target is
(2) Know where you are
(3) Know where the road ahead is
As a specialized operation talent, the responsibility of the department operation manager is to plan from the source, make the operation of the department orderly, and finally achieve the goal.
2. The role of the goal: There is no high or low goal, but it must be clear. The SMART principle of goal setting will not be repeated, but only the measurable in it will be emphasized, and if one goal is not clear and measurable, all other principles will be meaningless.
3. About the path. The so-called basic path mainly considers three aspects:
(1) The method and time schedule for obtaining resources.
and (2) the basic structure of the patient's origin.
(3) What are the differentiating points of competition to choose.
The design path should be as detailed as possible from the execution level. For example, new projects need to add equipment, and the time cost from project establishment, model selection to installation and commissioning must be considered. In addition to the patient's characteristics from the perspective of the disease, it is also necessary to consider how to design a targeted plan in terms of geography or treatment habits (for example, a local specialized hospital).
4. How to plan. Generally speaking, we can start from the following three aspects:
(1) The development goals of the department: describe the short-term, medium-term and long-term discipline development goals from multiple dimensions such as medical technology development, talent training, business and financial quantitative indicators.
(2) Target market analysis of the department: according to the nature of the specialty, around the analysis of the market size at the district, county, municipal, provincial, and even regional levels, the market analysis of subdivided diseases, the analysis of typical customer medical treatment behavior patterns, the analysis of consumption potential and payment modes such as medical insurance, self-payment, and commercial insurance.
(3) Competitor analysis of departments: Conduct basic data analysis and analysis of advantages and disadvantages with corresponding specialized institutions and general hospitals with strong specialties as competitors.
5. What to pay attention to. Beware of two extremes in the planning process
- Too academic: "big words" such as SWOT, Boston matrix, and Porter's five forces model must be called "big words", but it is difficult to connect with daily landing business.
- Too much charlatanism: no logic and impatience with the detailed analysis process, little data and unwilling to dig deep into the data in multiple dimensions, and firmly believe in their own experience and intuition.
02. Resource allocation
There are five main types of resources: equipment, materials, medicines, space, people, and specific skills or qualifications.
There are three main differences between resource allocation and cost control
(1) Reducing costs is not the main goal of resource allocation, but increasing revenue
(2) Resource allocation occurs in stages, and cost control is a daily management behavior
(3) Resource allocation affects the cost structure, and cost control is optimized within this structure
03. Process improvement
We will first briefly introduce the current mainstream process management in the healthcare industry, and then focus on the limitations of this model and possible expansion directions.
1. Conventional thinking. With the flow of patients as the basic direction of the process, it mainly includes: outpatient, emergency, hospitalization, surgery, examination and other medical business processes, as well as auxiliary medical business processes such as charge settlement, drug delivery, food supply, medical waste disposal, and supply of goods. The goal of improvement is to increase the proportion of value added. Department operations managers should be mentally prepared and are likely to encounter great difficulties in collecting and obtaining data.
2. Reflect on existing ideas. The above-mentioned process management system is patient-centered and value-added. So what is value-added? At present, there are two major schools of thought:
The first is the Chang Gung system, starting from the five-person group at the beginning of the business, and gradually introducing the management mechanism of Formosa Plastics into Chang Gung, forming a basic governance model of medical management division of labor and management, and profit and loss of different departments. One of the key points is the introduction of Formosa Plastics Trimpo, which includes "continuous improvement of operations", and the methodology of improvement is also born from Formosa Plastics.
The second is the lean medical model in the United States, which has been implemented in some hospitals in China.
In fact, these two schools of thought have the same origin: they both originate from manufacturing, and they can even be said to have a direct relationship with the Toyota model and even Deming's thought. In this sense, the improvement of the medical process lies in increasing the proportion of links that change the diagnosis and treatment status of patients, and minimizing waiting, moving, etc.
3. Expand your knowledge of the process. And what is the current situation facing China's medical industry? Both public and private are fighting for self-paying patients. When the payer shifts from insurance to individual patients, the standard of "value appreciation" changes.
- Is a good-looking hospital gown considered value-added?
- Is a hospital meal with exquisite desserts value-added?
- Is it value-added to pick up and drop off patients with inconvenient legs and feet?
From the perspective of customer experience, as long as the price is acceptable and the service is satisfied, I think it will generate value added. Therefore, as long as it is legal and compliant, the links that can improve the experience for patients and families can be included in the process, and they all belong to the scope of process improvement.
04. Cost control
Cost control is not the blind pursuit of cost minimization or even expenditure minimization, nor is it "give full play to the spirit of ownership, save every piece of paper, every kilowatt-hour of electricity", but a management behavior. Cost control is not simply a post-event audit, but a logical and systematic system.
1. Cost management cycle. The basic roadbed of cost control is a management cycle, which generally has the following steps:
(1) Set a baseline
(2) Compare differences regularly
(3) Analyze the causes of differences
(4) Implement improvement plans
(5) Revise the new target benchmark
2. Accounting of department costs. The cost is mainly nothing more than people, money and materials, and the main difficulty of accounting is generally how to split the "common" project. The main accounting items are as follows:
(1) Labor costs
(2) Eisai and drug fees
(3) Equipment costs
(4) Other consumption expenses
(5) Indirect cost allocation
3. Get started with a low threshold and gradually seek refinement. It is difficult to carry out department cost control according to the above introduction, and there are two main difficulties:
(1) It is difficult to obtain accurate data, especially the data to be split and apportioned, so that everyone can reach a complete consensus.
(2) It is difficult to set a reasonable baseline, especially for newly established institutions, whose business is still in the exploratory period, and it is difficult to establish a set of appropriate cost standard values at once.
Therefore, it is recommended to quickly build a framework, "do not seek a solution", "do not seek a complete solution", and first establish the cost management cycle. Choose some important cost items that are relatively easy to obtain accurate figures, lower the threshold, and form a minimized cost management habit first. According to the business development and the maturity of the team, we will gradually cover more medical items and cost items horizontally, and iterate more accurately and improve methods vertically.
A quick start-up with a low threshold and quick results allows the team to see the results and build confidence, which may be more pragmatic for the new organization and the new department operation manager.
05. Operational Analysis
First of all, it should be clear that the department operation analysis led by the department operation manager or department assistant is only a part of the department management analysis, and it does not involve the issue of medical quality. The primary objective of operational analytics is operational performance, including revenue, costs, and profits.
06. Performance management
Many times, hospital managers confuse the difference between performance management and compensation management. For example, when you want to improve the performance of the department, you will often ask the department director and the human resources department to "make a performance (plan)". If you search for "hospital performance" on the Internet, the content you get is often focused on "making money".
The purpose of performance management is to achieve the strategic and tactical goals of the organization, and from the perspective of the specific organization of the hospital, it includes at least several dimensions such as medical quality, skill level, social reputation, and business efficiency.
Performance management is the basis of compensation management, and performance results are an important reference for formulating compensation plans, but the two are not the same thing.
1. Performance management cycle. Performance management follows a cycle consisting of four parts: performance planning, performance monitoring, performance evaluation and performance feedback.
(1) Performance plan
(2) Performance monitoring
(3) Performance evaluation
(4) Performance feedback
2. The purpose of business performance. Under the premise of legal operation and compliant medical behavior, business performance should have only one purpose: to make profits.
Depending on the actual situation of the institution, it is possible to set different business performance indicators with different emphasis, such as revenue, number of patients, number of surgeries, etc. But at the end of the day, the ultimate goal of business can only be profit. Thinking about profit means not evaluating profits, but using profits as a baton when designing performance plans.
3. The distribution principle of business performance compensation
- Earnings or balances
- According to the rate commission or according to the fixed amount of commission
- What are the important exclusions
In more cases, there are not many performance accrual items that are strictly excluded, and more of them are adjusted in the commission figure.
4. The object of business performance incentive. A general medical management book will introduce this part of the content as follows:
(1) the doctor's remuneration package;
(2) the remuneration plan of the medical technology department;
and (3) the remuneration scheme of other auxiliary departments, or more simply divided into "physician remuneration and non-physician remuneration scheme".
There may be only a handful of for-profit medical institutions in China today that apply this idea, namely hospitals and clinics that rely primarily on big-name doctors to attract patients. For the vast majority of organizations that require the collaboration of all departments to make a performance, incentives should be considered at the source for all links in the value chain, especially those that are directly involved in market operations and directly provide services to patients.
5. Salary plan corresponding to business performance. First of all, it is important to understand that the compensation plan is the most important and complex module of the HR profession. There is nothing special about the basic model of the salary plan of medical institutions, which is basically fixed salary + variable salary. There are at least 3 aspects to consider in the change section:
(1) Ex-ante or ex-post type
(2) There is no threshold for accrual or there is a threshold to meet the standard.
(3) Commission system or year-end bonus system.
07. Horizontal collaboration
1. Role positioning of operation personnel. Whether the position of department operation personnel is the "manager" or "assistant" of department operations is fundamentally different. The former is the manager of the cost center, and the latter is the assistant to the section director and is the staff member.
In most cases, the hospital adopts the department director responsibility system, and the specialist operation personnel are basically professional staff.
However, the actual situation of the current development of private medical care may not be able to achieve this governance model, and there will be the following situations:
(1) There is no big director in the department, but the business still has to be done
(2) The director of the department is from a public hospital and has basically no business experience
In this case, the department operations manager becomes the de facto person in charge of the department's business results.
2. Collaboration within the department
(1) Collaborate with the section head
(2) Collaborate with clinicians
(3) Collaborate with the head nurse
3. Collaborate with finance, IT, and human resources. The collaboration with these three units has one thing in common: data. Collaboration can also be broken down into several levels. The most basic collaboration can provide the original data required for operation in a timely manner, not too late, and do not omit the data given. At this level of cooperation, the department operations manager should ensure that his or her requirements are clear and accurate.
If the first two levels are department-based, and the collaboration department is more passive in accepting and responding to needs, then a higher level of collaboration should allow these departments to provide more thinking and actions from their business perspectives.
They can analyze whether there is room for improvement in the operational data and reporting requirements raised by the department, and more importantly, they can help establish some methods for reading and processing data.
4. Collaborate with customer service. The customer service department is already the standard configuration of for-profit medical institutions, and close cooperation with the customer service department is indispensable if the department operation is to do well. There are multiple value directions for this collaboration.
(1) Department to customer service
(2) Customer service to the department
(3) Interaction mechanism
5. Cooperate with logistics. The definition of logistics is not exactly the same in each medical institution, and there is not such a strong systematic logic for collaboration with logistics, but there are some empirical points for reference.
(1) Be polite and polite
(2) Active ventilation
(3) Ask for advice
6. Collaborate with marketing. Different organizations have different settings for marketing functional positions, and the collaboration between departments and marketing is mainly in two directions: one is to tell the marketing side to understand "who I am", and the other is to ask the marketing side to accurately find "who I want".
(1) Business edification
(2) Target user portraits