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Designing a home infusion therapy service at Scott and White.

UNLABELLED: A quality planning team at Scott and White used Juran planning techniques to design a coordinated, cost-effective method for providing home infusion therapy to patients. The team translated customer needs into important product and process features and then designed a home infusion program to meet those features. RESULTS: The program was implemented in late June and is expected to increase customer satisfaction, contain costs, and provide improved coordination of care by all providers. Quantitative results are being tracked. Based on this team's apparent success, two other planning teams have been formed and are nearing completion.

Home Infusion Therapy↗

Maximizing financial returns by meeting employer expectations.

Healthcare providers that understand the needs and priorities of employers that contract for managed care services can more accurately assess what strategies they need to adopt to succeed under managed care. Such strategies include determining which health plans to contract with to best meet employers' needs and which managed care products to be a part of or offer. In addition, because the number of employer self-funded health plans is growing, providers that develop working relationships directly with employers can increase their opportunities to sell and develop additional healthcare services and increase the number of enrollees to whom they provide care.

Capitation Fee↗

Service: the next frontier.

There is a revolution taking place in the U.S. economy, a service revolution. Today, over 70 percent of the gross national product and 75 percent of all jobs can be attributed to the service sector. This monumental change is affecting not only service firms but also manufacturers. It is estimated that anywhere from 30 to 70 percent of the value added by a typical manufacturer is due to the service component. This article discusses the increased importance of services in our economy and on our shop floors. If manufacturers are to prosper in the coming decade, they will need to embrace this change and put services and service operations at the forefront of their strategic plans.

Consumer Behavior↗

Worker's comp meets managed care. In the quest for lower costs, a new niche emerges.

Niche markets such as Medicare, Medicaid and behavioral healthcare are looking to managed care to control costs and increase the quality of care provided. Now workers' compensation officials are looking to managed care with the same goals in mind. As managed care organizations begin marketing to these special populations, the information glut is growing. Information technology can aid managed care officials in the collection, organization and dissemination of the data.

Managed Care Programs↗

Cost accounting in health care: fad or fundamental?

The drastic changes in the environment affecting hospitals have caused management to look toward capturing and reporting cost information to make decisions. These decisions will, in part, shape the way hospitals continue to do business. This article focuses on the data requirements necessary to support product and operational management decisions facing today's hospitals. In addition, the difference in data needed to support product and operational management is explored.

Accounting↗

Better forecasting ensures profitability, quality of care.

Traditional budget forecasting methods for many hospitals are no longer sufficient to accurately project income and expenses or to ensure profitable patient management under managed care contracts. This article, the fourth in a six-part series on "managing managed care," focuses on accurate forecasting methods that integrate clinical and financial data to ensure profitability and high-quality patient care.

Budgets↗

Innovation at the speed of information.

Conventional project-management tools--PERT charts and Gantt charts, for example--were created to help manage sequences of discrete tasks that make up large construction projects. Yet these tools don't capture clearly the back-and-forth of information that takes place in innovative processes, such as product development. Conventional tools are designed to answer the question, "What other tasks must be completed before I begin this one?" But product development planners, especially in high-tech businesses, need tools that answer a very different question: "What information do I need from other tasks before I can complete this one?" The author describes the Design Structure Matrix (DSM), a project management tool that focuses on representing the information flows of a project rather than its work flows. He explains how the DSM works and how to use it to make development processes more efficient. A project DSM can show which information exchanges involve design iteration and how well a process anticipates the need for rework. In addition, the author suggests four ways to improve a company's information flows: rearranging the sequence of tasks, reconsidering the organization of tasks, reducing the number of information exchanges, and managing unplannable work. By stripping away the mystery around information exchange during innovation, the DSM can give managers far more control over their most risky and expensive projects.

Commerce↗

Don't homogenize, synchronize.

To be more responsive to customers, companies often break down organizational walls between their units--setting up all manner of cross-business and cross-functional task forces and working groups and promoting a "one-company" culture. But such attempts can backfire terribly by distracting business and functional units and by contaminating their strategies and processes. Fortunately, there's a better way, says the author. Rather than tear down organizational walls, a company can make them permeable to information. It can synchronize all its data on products, filtering the information through linked databases and applications and delivering it in a coordinated, meaningful form to customers. As a result, the organization can present a single, unified face to the customer--one that can change as market conditions warrant--without imposing homogeneity on its people. Such synchronization can lead not just to stronger customer relationships and more sales but also to greater operational efficiency. It allows a company, for example, to avoid the high costs of maintaining many different information systems with redundant data. The decoupling of product control from customer control in a synchronized company reflects a fundamental fact about business: While companies have to focus on creating great products, customers think in terms of the activities they perform and the benefits they seek. For companies, products are ends, but for customers, products are means. The disconnect between how customers think and how companies organize themselves is what leads to inefficiencies and missed opportunities, and that's exactly the problem that synchronization solves. Synchronized companies can get closer to customers, sustain product innovation, and improve operational efficiency--goals that have traditionally been very difficult to achieve simultaneously.

Commerce↗

Healthcare buyers clubs.

When one shops for a computer or auto insurance, the AHA or the AMA probably isn't the first thing that comes to mind, but associations are getting into the business of product endorsements.

American Hospital Association↗

Ownership and organizational performance. A comparison of technical efficiency across hospital types.

Using a national data base of urban hospitals, the effect of ownership (government, nonprofit, and for-profit) on the technical efficiency of hospitals was examined. Efficiency scores were computed using a method called data envelopment analysis. Controlling for environmental and hospital characteristics, for-profit hospitals were found somewhat less frequently and government hospitals consistently more frequently in the efficient category. When examining highly inefficient hospitals as a percentage of those receiving inefficient scores, for-profit hospitals appeared to be highly inefficient relative to the other ownership forms. Government and nonprofit hospitals were somewhat indistinguishable from one another regarding their percentages of highly inefficient scores. For-profit hospitals also tended to use supply and capital asset (hospital size) inputs less efficiently, and service and labor inputs more efficiently than hospitals in the other ownership categories.

Efficiency↗