Maturity test in the hospital company

Together with two Penta+ hospitals (1), the Spitalzen- trum Biel and the Kantonsspital Baden, the University Hospital Basel has developed an assessment to determine the degree of maturity of patient-centredness of departments or entire clinics.

Quality of results is becoming increasingly important
Hospitals are in competition with each other: patients are better and better informed, results can be compared more and more easily and needs are becoming more and more individualised. With increasing pressure for cost efficiency, the demands in the healthcare system are changing. In addition to the service provided, the quality of results is becoming increasingly important. As a result, the patient as a customer is becoming more central to the provision of care (2). In addition to medical and nursing quality, process quality and the efficiency of service provision must also be continuously improved. Many hospitals adapt successful management heuristics from industry as well as Lean Hospital, Lean Six Sigma, ISO Q systems, EFQM, TQM in order to remain successful. What are the prerequisites for patient-centeredness (customer-centeredness) and how do seemingly different management heuristics such as quality management and Lean Hospital complement each other?

Learning from the industry
A look at the industry as a comparison shows: In the automotive industry today, customers expect high quality. Nobody buys a car where the spark plugs have to be replaced every 1000 km or start to rust after seven years. The corresponding quality problems are made visible on customer platforms. The automotive industry's quality system - introduced with the 2017 standard adjustment - calls for continuous improvement with an emphasis on defect prevention by reducing dispersion and waste along the entire supply chain (3). This move towards lean management is captured in the quality norm and established along the entire supply chain. This is new for the western automotive industry, but still a long way to a corporate culture of a common holistic striving for the better like Toyota. Unfortunately, this commitment to betterment only applies to activities that directly create value. Toyota shows us that a holistic lean culture is necessary: All employees are collaboratively responsible for success and failure, regardless of whether they are involved in support and administrative activities or in activities and services that directly add value.

exceed expectations
In order to inspire the customer, the fulfillment of needs alone is no longer sufficient. The result for the customer must exceed expectations. This is how customer numbers increase. Due to the good results for the customer, the company also achieves a better result than its competitors. This also applies to hospitals. Often hospitals are simply not mature enough to exploit their full potential. The patient must be consistently placed at the center of thought and action. Strategic and tactical management decisions are based on this. Across all areas, the patient or the internal customer is placed at the centre of action and optimisation in daily work. The knowledge and experience of all employees are to be used interprofessionally and across hierarchical levels for continuous improvement. Quality management, Lean Hospital and other management techniques work hand in hand to support the organization. All employees are removed from involvement and obliged to participate.

This requires a high degree of maturity of the corporate culture with regard to patient centricity: a culture of openness is demanded across all levels. The more mature a system is able to adapt to constantly changing requirements, the better the starting position to be prepared for future changes or even to anticipate them. As a side effect, the efficiency and motivation of the employees is continuously increased. Furthermore, contribution margins improve and patient numbers will increase in the long term due to the good quality of results. A sustainable competitive advantage can thus be ensured.

Evaluate patient centricity
The Kantonsspital Baden, the Universitätsspital Basel and the Spital- zentrum Biel have developed a patient-centredness maturity level in the form of an assessment. Due to the integrative approach, patient and customer centricity, leadership (management) and culture are included. Independent of applied management heuristics such as Lean Hospital, Lean Six Sigma, ISO-Q-Systems, EFQM, TQM etc., the hospital system can be assessed neutrally "from the outside" for the first time.

The result of the assessment ("maturity test") is a reflection of the received impressions of the hospital in the form of a maturity level for patient-centeredness. Based on the main potentials made visible, inputs were given as to which next steps are possible in order to become more patient- and customer-centred as a hospital. It is an opportunity to receive new impulses in a structured form and to compare oneself with others in the same sector. Further assessments are planned so that neutralized comparisons with the market (benchmark) will be possible in the future. In this way, recipes for success from practice (best practice) for patient centring will be systematically recognised and an indirect exchange made possible. We are confident that patients as customers will thus be placed even more consistently at the centre of our actions.