Optimising Irish healthcare Insight

Introduction

For healthcare organisations worldwide, the concept of operational excellence (OE) has become crucial to success and long-term viability.

In Ireland, where the healthcare sector plays a vital role in safeguarding the population's well-being, it’s essential we develop a comprehensive approach to building consistent operational excellence and value for money within healthcare settings.

OE within healthcare can be defined as an organisation’s consistent demonstration of exceptional performance in its core clinical and operational processes and activities.

At its core, however, is a mindset that creates a culture of continuous improvement in an organisation. The result? Every employee can see, deliver and improve the flow of value to a patient/service user. OE involves the relentless pursuit of quality, efficiency, and effectiveness in all aspects of operations, including planning and delivery of services.

Organisations with an OE mindset strive for the highest levels of service user satisfaction and cost-effectiveness, while minimising waste, clinical errors, and inefficiencies.

We’ll focus on three areas as we explore the importance of OE for healthcare organisations in Ireland:

enhanced patient outcomes
operational effectiveness and efficiency
overall organisational performance.

By focusing on these areas, you can kickstart an organisational mindset shift and consider some practical actions to achieve OE in your organisation.

Enhancing patient outcomes

Every healthcare organisation's mission revolves around the commitment to provide high-quality, safe and affordable care to patients at the right time, within the right setting, and by the right people.

‘Patient is Paramount’, the fundamental principle of Ireland’s healthcare reform programme Sláintecare, speaks directly to this mission statement. By adopting an OE mindset, you lay the foundation for enhancing every facet of healthcare delivery.

As the Irish healthcare system advances toward regionalisation and the integration of health services outlined in the 2023 Sláintecare Action Plan, it becomes imperative to implement efficient operational strategies.

Streamlining processes, minimising errors, and prioritising patient safety are essential to fostering patient-centred care and elevating clinical outcomes. Here are some key steps:

Standardisation: Strive to establish standardised integrated pathways, practices, and protocols grounded in evidence and best practices. The goal? Minimise variations in practice, thereby decreasing the likelihood of errors and delivering a consistent approach that can drive up efficient processes and enhance the patient/customer experience. This approach also allows for tracking and benchmarking of patient progress against agreed pathways, and encourages debate on the reasons for variances and the potential for improvements.

Resource allocation: Optimal resource allocation, efficient scheduling and patient flow management can improve timely and necessary care for patients. Reducing waiting times and alleviating overcrowding not only enhances patient satisfaction but also reduces the potential for adverse events in healthcare organisations.

Data-driven learning: Organisational learning is pivotal in tailoring patient care to evolving best practices. Utilising case studies, supported by data, enables the identification of improvement areas, monitoring of performance indicators, and the tracking of the success of evidence-based clinical and operational interventions.

Operational effectiveness and efficiency

Operational effectiveness is about doing the right things and asking if you are doing them well enough to add value to the patient/customer experience. Ultimately, it is about what you do.

Operational efficiency is about how you do your work and if you are doing it correctly. It is not about cost-cutting, but rather is focused on driving up quality.

Operational effectiveness and operational efficiency both link strongly with OE. As the organisation's strategic approach to improvement, OE combines tactical and strategic activities and demonstrates why you are doing the things you do.

Through our PerformPlus approach to OE, PwC has supported multiple healthcare organisations across the globe on achieving operational effectiveness and efficiency. We have found that it:

Enables healthcare organisations to maximise the use of existing resources: By coaching teams to manage staff schedules effectively, optimise bed occupancy rates, and ensure the appropriate allocation of equipment and supplies, healthcare organisations reduce costs and improve overall efficiency and access to inpatient care.
Facilitates the integration of technology and digitisation: We have used decision support tools (including forms of AI) to streamline processes, enhance communications across teams, and improve data quality, analysis, and management. This includes adopting data visualisation through visual management boards, daily huddles and proactive use of dashboards built from shared electronic health records data.
Improves problem-solving: PwC has utilised one-to-one and team coaching approaches with multidisciplinary teams on targeted areas for improvement. This approach results in a more open and curious mindset between team members and a ‘supportive challenge’ environment can be created.

Why do healthcare clients like the PwC strategic approach?

PwCs PerformPlus methodology, with its 10 fundamental operational efficiency elements, enables clinical and operational teams to target specific areas for improvement. Using a diagnostic approach with these teams helps them prioritise and then focus on the areas that deliver the greatest impact, while eliminating non-value-added activities in the short, medium and long term.

Waste elimination can lead to cost savings and efficiency without compromising patient care. Organisations can identify unnecessary steps in clinical and operational processes, optimising their time and resource allocation for patient care.

PwC’s collaborative approach enhances team performance and capability. This is particularly important when it comes to supporting the ongoing design and implementation of integrated care models, in collaboration with acute and community partners within the Irish health service. From PwC’s experience of working with health clients in the UK, significant efficiency improvements can typically yield between 15% to 25%, and that can span multiple financial years.

Overall organisational performance

To understand how your organisation is performing, you must be relentless in embedding transformational disciplines into business-as-usual processes. Undoubtedly, there’s a need to focus on changing hearts and mindsand you need qualitative and quantitative evidence of how your efforts are yielding results.

Undoubtedly, there’s a need to focus on changing hearts and minds, and you need qualitative and quantitative evidence of how your efforts are yielding results. OE, therefore, needs to be aligned to metrics, data and business processes that enable you to be agile enough to take corrective action when needed.

Combining a focus on people, performance and quality outcomes PwC has supported healthcare organisations to achieve tangible returns:

Organisations with successful transformations are more likely than others to embed transformation disciplines into business-as-usual processes. This includes executive level weekly briefings (results in 2.0x likelihood for successful change), setting targets and regularly reviewing performance (results in 1.5x likelihood for successful change).
A focus on effective executive leadership and line management feedback will lead to a reality check of current change progress. That improves decision-making on how to unlock barriers and increase adaptability to change.
Effective communication drives a culture of openness. This in turn helps to improve employee engagement and satisfaction. By involving frontline staff of all grades and disciplines in process improvement initiatives, they become empowered to contribute to meaningful change and greater ownership of desired outcomes. This leads to increased job satisfaction, improved morale, and reduced burnout, resulting in better retention and a more motivated and productive workforce.

How do you achieve operational excellence?

PwC’s PerformPlus approach, as well as other tried and tested approaches for improvement such as lean operations, business process reengineering or plan-do-study-act cycles can deliver results. But what are those essential ingredients that answer the “how do I” question? As a change leader, consider these steps:

1. Get your strategy right

To tackle the challenge of transformative change, it's vital to craft a well-thought-out strategy. Clearly articulating your priorities is key; it ensures that everyone understands the reasons behind the improvement drive, and its implications in both the short and long run.

A compelling approach to garnering support involves getting people genuinely invested in the strategy, fostering a sense of ownership and influence. To achieve this, you must set precisely defined, measurable goals that are not only focused on outcomes but also developed in collaboration with those spearheading the change. About 20% of transformation programmes fail due to inadequate planning at the outset.

2. Streamline processes to create and add value

Working with your teams will enable you to Identify the critical processes where greatest value can be added. This area involves prioritising to ensure your processes are streamlined and repeatable. Some tools commonly used are:

SIPOC diagrams
value stream mapping and impact effort assessments.

3. Set concrete improvement goals

By focusing on outcomes you need to achieve, linked with quality, timeliness, and responsiveness of service delivery, you can identify your improvement goals. Understand your baseline position by gaining agreement on what it is you need to measure, gathering the data, and work with your teams to establish achievable and stretch targets. This will result in meaningful key performance indicators and a process for tracking and reporting on your metrics and other quantifiable actions.

4. Execute your projects

Communicate your plans and expected milestones and outcomes across the organisation. This will require you to invest in training your employees and coaching them in improvement techniques, as well as clearly defining the roles and responsibilities of improvement team members.

5. Assess the impact from user feedback

Regularly gather and assess the impact that change initiatives are having on the organisation. Consider what you should stop, start, and continue doing so that valuable resources are being deployed effectively. Documenting improvements through visual display boards and regular town hall feedback sessions will help with this. Celebrating successes – regardless of how small or insignificant they seem – is critical to building and maintaining momentum.

6. Consolidate results to foster a culture of continuous improvement

By regularly reviewing progress, you can identify what has worked and what needs to change. This can form the foundation for ongoing improvement initiatives and by having regular engagement with all team members will help to build the culture of continuous improvement. When PwC work with our clients using PerformPlus, the emphasis is on collaboration and engagement with teams on the ground, actively coaching and facilitating knowledge transfer so they can support themselves and build on successes to date. Through this approach, results materialise through changing behaviours, and increasing team leader and member capability and capacity.

Conclusion

A strategic approach to operational excellence holds immense promise for healthcare organisations in Ireland. It can serve as a critical driver in enhancing patient outcomes, improving quality, and bolstering overall organisational performance. By implementing streamlined operational strategies, healthcare organisations can ensure the consistent delivery of standardised data-driven care, optimise resource use, and foster sustainable growth.

As Ireland's healthcare sector continues to evolve, integrating services and embracing enabling technologies, OE will remain a pivotal factor for success. It enables healthcare organisations to provide high-quality care to the population while effectively navigating the challenges posed by a rapidly changing demographic and healthcare landscape.

We are here to help

Supported by deep subject matter expertise and access to the wider PwC network, our multidisciplinary Healthcare team has successfully delivered operational excellence programmes and initiatives for multiple organisations across the Irish health sector.

We focus on achieving results in alignment with an organisation’s strategic objectives and implementing robust programme management practices with attention to effective stakeholder engagement and sustainability of change.