can an internal housekeeping department compete with ... · can an internal housekeeping department...
TRANSCRIPT
Can an Internal Housekeeping Department Compete with Outsourcing
Companies?
Christy FingerManagement EngineerPhone: 801-357-8141
Email: [email protected]
David D. Clark, FACHERegional Chief Operating Officer
Phone: 801-357-7692Email: [email protected]
2/12/2005 2005 Annual SHS Conference 2
Presentation Outline
1. Project background1. Project background
2. Environmental Services focus2. Environmental Services focus
3. Financial goals3. Financial goals
4. Subcommittees4. Subcommittees
5. Financial results5. Financial results
6. Lessons learned6. Lessons learned
2/12/2005 2005 Annual SHS Conference 3
Project Background
UNR
UCRUSR
Intermountain Health Care
– 21 hospitals throughout Utah and Southern Idaho
– Integrated health system
– Recognized as #1 health system in the United State for 4 of the past 5 years
– Clusters of facilities broken into regions
2/12/2005 2005 Annual SHS Conference 4
Project Background
• January 2004: Operational Best Practice teams formed by corporate leaders based on top 11 company initiatives– Regional COO as Team Leader– Corporate V.P.s as Corporate Support– Management Engineering Support– Public Relations Support– Human Resources Support
Our team’s initiative: Reduce non-clinical services expenses / Outsourcing analysis
2/12/2005 2005 Annual SHS Conference 5
Project Background
• Non-Clinical Best Practices / Outsourcing Analysis Team– Where to focus efforts?
• Review of national benchmarking data– Housekeeping depts throughout the system showed a
$875,000+ opportunity for improvement• IHC internal benchmarking data
– Housekeeping depts showed a $1.1 million opportunity for improvement
• National research– Healthcare Advisory Board, Outsourcing remains on the
rise as hospitals seek to cut costs, improve patient experience
2/12/2005 2005 Annual SHS Conference 6
Project Background
• Environmental Services Task Force Created– Addition of:
• EVS corporate director• Regional Operations Officers responsible for EVS• Directors/Managers of EVS
– Key success factors:• Representation from corporate office & various
regions• Up-front commitment & buy-in• Clear expectations, accountability reporting, &
reasonable timelines for project implementation
2/12/2005 2005 Annual SHS Conference 7
Environmental Services Focus
• Current situation assessment– Survey conducted
• Identify cost effective &/or service excellence processes– Existing best practices to share– Best practices currently developing– Future areas for improvement
2/12/2005 2005 Annual SHS Conference 8
Financial Goals
• Task force members asked to set financial goals for 2005
3.6%$642,898$18,072,832Total0.9%$6,900$727,275Logan1.3%$25,000$1,939,068Dixie1.4%$37,370$2,644,971Primary2.6%$75,000$2,839,519UNR2.6%$158,628$6,057,023UCR8.8%$340,000$3,864,976USR
ExpenseReduction (%)
ExpenseReduction ($)
Current Budgeted Sub-Total Exp
Region/Hospital
2/12/2005 2005 Annual SHS Conference 9
Subcommittees
1. Financial/Quality/Staffing2. Supplies3. Budget Standardization4. H.R. Organization & Policies5. Employee Engagement
2/12/2005 2005 Annual SHS Conference 10
Subcommittees
1. Financial/Quality/Staffing Subcommittee• Outcomes
– Handheld quality inspection program– I.S. request and tracking system (EMMA)– Daily activity report (DAR)– Area staffing analysis
2/12/2005 2005 Annual SHS Conference 11
Financial/Quality/Staffing Subcommittee
• Handheld quality inspection programMANUAL PROCESS (Original)
Document Inspection on Paper
Manually Calculate Score
Enter Summary Results into Excel
File Inspection Paper
Pull Files for Annual Review
PDA PROCESS (After)
Enter Inspection into PDA
Upload into Excel
Access Results, as needed
2/12/2005 2005 Annual SHS Conference 12
Financial/Quality/Staffing Subcommittee
• Handheld quality inspection program– Results:
• Web Access, Standardization throughout IHC• Standardized and Comparable Reports
– Overall score by hospital– Score by employee– Room type score by hospital
• Productivity Increase– Original Process = 1 hour per inspection– New (PDA) Process = 10-15 minutes per inspection
» 4-6 times productivity increase
2/12/2005 2005 Annual SHS Conference 13
Financial/Quality/Staffing Subcommittee
• Electronic request & tracking system (EMMA)
2/12/2005 2005 Annual SHS Conference 14
Financial/Quality/Staffing Subcommittee
• Electronic request & tracking system (EMMA)
Green = call has not been acknowledged 0-5 minutesRed = call has not been acknowledged 10+ minutesTurquoise = housekeeper is off schedule, need to reallocateOrange = suspended call, waiting for something
2/12/2005 2005 Annual SHS Conference 15
Financial/Quality/Staffing Subcommittee
• Electronic request & tracking system (EMMA)– Reports: Call Volume Report
Utah Valley Regional Medical Center: Call Volume Report10/4/04 - 11/5/04
020406080
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2/12/2005 2005 Annual SHS Conference 16
Financial/Quality/Staffing Subcommittee
• Electronic request & tracking system (EMMA)– Reports: Event Report by type & by housekeeper
HousekeeperNamesHere
2/12/2005 2005 Annual SHS Conference 17
Financial/Quality/Staffing Subcommittee
• Daily Activity ReportName Ancillary Time 196.3 3 Hours 16 MinutesDate 12/1/04 12.5 Patient Rooms 13 162.5 2 Hours 42 MinutesArea 6a 25 Discharge 4 100 1 Hour 40 Minutes
25 Transfers 0 0 0 MinutesOther 0 0 0 Minutes
Total time 458.8 7 Hours 38 Minutes
Room #Discharge
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Started Time
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Ancillary Detail ListE660 x x x x x x x x Vacuum maintenanceE661 xx Behind computersE662 x x x x x x x xx Water fountainsE663 x x x x x x x Picture framesE664 xx Defrost FridgeE665 x Elevator TracksE667 x x x x x x x x Elevator TracksE668 x x x x x x x Other:E669 x x x x x x xE670 x x x x x xE671E672 x x x x x x xE673 x x x x x xE674 x x x x x xE675 xx xx xx xx xx xxE676E677
Day Shift Daily Activity Report
Housekeeper
Pt Room Detail List
2/12/2005 2005 Annual SHS Conference 18
Financial/Quality/Staffing Subcommittee
• Daily Activity Report– Results at Utah Valley Regional Medical Center
FTE VarianceActual FTE Usage - Volume Adjusted Budget
-12
-10
-8
-6
-4
-2
0
Aug
-03
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DAR implemented
2/12/2005 2005 Annual SHS Conference 19
Financial/Quality/Staffing Subcommittee
• Area Staffing Analysis– Staffing model comparison across IHC system
• Example: ER staffingSorted by Cost per ER Visit
2003Total ER Visits
2003 ER Sq Ft
Weekly Labor Hours
Labor Expense per Year ER Rooms
ER Cost per Visit
1 Logan 26,313 8,416 46 $22,981.14 13 $0.872 Cottonwood 46,601 10,119 112 $64,355.20 18 $1.383 American Fork 22,330 7,178 67 $32,176.17 9 $1.444 UV (EVS Model) 43,309 7,800 133 $67,776.80 18 $1.565 Alta View 32,510 8,479 112 $62,433.28 11 $1.926 McKay 57,222 19,313 211 $114,218.52 27 $2.007 Primary 40,505 8,131 168 $88,932.48 24 $2.208 LDS 37,950 8,600 168 $94,872.96 14 $2.509 Dixie 31,561 18,159 168 $85,438.08 32 $2.71
10 UV (ER Current Model)** 43,309 7,800 254 $130,862.16 18 $3.02
2/12/2005 2005 Annual SHS Conference 20
Financial/Quality/Staffing Subcommittee
• Area Staffing Analysis– Staffing model comparison across IHC system
• Example: ER staffing -- Results
Note: The FTEs reduced during the change were transferred into open positions already existing in the Environmental Services department.
Table
$39,037$10,121$28,9161.4Comparison(reduction)
$156,147$40,482$115,6655.6New Model
$195,184$50,603$144,5817.0Old Model
Salary + Benefits
Benefits,PTO, etc.Salary $FTEs
2/12/2005 2005 Annual SHS Conference 21
Subcommittees
2. Supplies Subcommittee• Outcomes
– Mop analysis– Floor wax analysis (work in process)
2/12/2005 2005 Annual SHS Conference 22
Supplies Subcommittee
• Mop Analysis– Wet-loop mop vs. Microfiber mop Cost/Benefit Analysis
Wet-Loop Microfiber
Versus
2/12/2005 2005 Annual SHS Conference 23
Supplies Subcommittee
• Mop Analysis
Increased Expenses
Start-up Costs
Replacement Costs
Dec
reas
ed E
xpen
ses
Chemical Costs
Water Costs
Labor Costs
Worker’s Compensation
Overall estimated savings for large IHC hospitals = $521,000
Existing opportunity (facilities using wet-loop mops) = $334,000 with$28,000 start-up cost
2/12/2005 2005 Annual SHS Conference 24
Supplies Subcommittee
• Mop Analysis– Opportunity by IHC hospital
Wet Loop vs. Flat Mop Cost ComparisonPotential Savings Adjusted by Existing Implementation
$30,379 $33,186
$18,860 $8,810$7,988
$37,463
$98,805
$64,368
$20,335
$14,110
$-
$100,000
$200,000
$300,000
$400,000
$500,000
$600,000
$700,000
Wet
Loo
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Mic
rofib
er
Wet
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Mic
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Alta View AmericanFork
Cottonwood Dixie LDS Logan McKay-Dee OremCommunity
PrimaryChildren's
Utah Valley
Facility, Mop Type
Annu
al E
xpen
se
$-
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
Ann
ual P
oten
tial S
avin
gs
Non-EVS Cost
EVS Cost
Potential Savings
2/12/2005 2005 Annual SHS Conference 25
Subcommittees
3. Budget Standardization Subcommittee• Outcomes
– Standardized cleanable square footage calculations
– Consistent budgeting methodology for all facilities (work in process)
2/12/2005 2005 Annual SHS Conference 26
Budget Standardization Subcommittee
• Standardized Cleanable Sq. Ft. CalculationsReport Date: 2003
Building Name Interior Gross AreaVertical Penetrable
Area
Usable Area (Interior - Vertical) Comments
American Fork Hospital 229,256.91 15,227.82 214,029.09Facility Total 229,256.91 15,227.82 214,029.09
Report Total Cleanable Square Footage 214,029
Areas not Cleaned by EVS that are included in the "Space Allocation Analysis"Description of Area not cleaned by EVS Square Footage Date UpdatedVacant Space 9,508.21 Oct-04Telecom 720118 1,198.60 Oct-04 Equipment Rooms not cleaned by EVS
Plant Operations 654118 7,893.40 Nov-04
Maintenance & Repairs 630118 6,727.81 Nov-04Not Cleaned by EVS Total Cleanable Sq Footage 25,328
Additions to "Space Allocation Analysis"Other Areas not Included in Report & cleaned by EVS Square Footage Date UpdatedDaycare 1,870.00 Oct-04Patio 4,469.00 Nov-04ER overhang 1,626.00 Oct-04Gift Shop overhang 272.00 Oct-04Admitting overhang 169.00 Oct-04Rehab overhang 191.00 Oct-04SDS overhang 386.50 Oct-04
Additions Total Cleanable Square Footage 8,984 Total Sq Ft = 773; half maintained by grounds
Comments
Completed by Karen Jackson
All space removed then back offices added back because cleaned by EVS; Completed by Karen Jackson
Data from "Space Allocation Analysis" conducted by IHC corporate office
Comments
All space removed then back offices added back because cleaned by EVS; Completed by Karen Jackson
2/12/2005 2005 Annual SHS Conference 27
Budget Standardization Subcommittee
• Standardized Cleanable Sq. Ft. CalculationsAddition of Vertical Penetration AreasVertical Penetration Areas (Stairways & Elevators) cleaned by EVS Square Footage Date UpdatedAFH Stairways 3,034.00 Nov-04AFH Elevators 336.00 Nov-04Transcription in Southeast Medical Building 2,994.00 Nov-04
Additions Total Cleanable Square Footage 6,364
New Construction not included in "Space Allocation Analysis"
Description of Area Square Footage Budgeted Date UpdatedSquare Footage Comments
Medical Office BuildingFirst Floor Common Area (Stairs, Restrooms, Lobby, Entry) 0.00 Nov-04 2,092.00
Negotiation in progress. If cleaned, budget when cleaning begins.
Pharmacy (Physician Division) 0.00 Nov-04 1,023.00 Negotiation in progress. If cleaned, budget when cleaning begins.
Internal Med (Physician Division) 0.00 Nov-04 4,300.00 Negotiation in progress. If cleaned, budget when cleaning begins.
Lab-phlebotomy (USR Space) 0.00 Nov-04 287.00 Budget when cleaning begins.Physical Therapy (USR Space) 0.00 Nov-04 5,210.00 Budget when cleaning begins.Second Floor Lawrence & Jones (Physician Division) 0.00 Nov-04 5,222.00
Negotiation in progress. If cleaned, budget when cleaning begins.
New Construction Total Cleanable Square Footage -
SUMMARYDescription of Square Footage Square Footage1. Total Sq Ft from "Space Allocation Analysis" 214,0292. Total Not Cleaned by EVS 25,3283. Total Additions 8,9844. Total Vertical Penetration Space Cleaned 6,3645. Total New Construction 0
Grand Total EVS Cleanable Sq Ft (1-2+3+4+5) 204,049Grand Total Cleanable Sq Ft (1+3+4+5) 229,377
Completed by Karen JacksonCompleted by Karen Jackson
Comments
Blue Section
Yellow Section. This number is removed from EVS cl sq ft grand total.Green Section
CommentsOrange Section
For Budget and Internal BenchmarkingFor External Benchmarking
Purple Section
Completed by Karen Jackson
2/12/2005 2005 Annual SHS Conference 28
Subcommittees
4. H.R. Organization & Policies Subcommittee• Work in process
– Organizational structure standardization– Policy standardization– Pre-screening questions
2/12/2005 2005 Annual SHS Conference 29
Subcommittees
5. Employee Engagement Subcommittee• Work in process
– Employee incentive program– Employee safety program
2/12/2005 2005 Annual SHS Conference 30
Financial Results
• 2005 Budget Goals & Results
Region/ Hosptial
Current Budgeted Sub-Total Exp
Projected Expense
Reduction (%)
2005Expense
Reduction Goal ($)
Actual Expense
Reduction (%)
2005 Actual Budgeted
Reduction ($)
USR 3,864,976$ 8.8% 340,000$ 8.8% $340,800
USR EVS ER Staffing 0.0% -$ 20.0% $40,000
UCR 6,057,023$ 2.6% 158,628$ 2.6% $158,628
UNR 2,839,519$ 2.6% 75,000$ 3.0% $83,936
Primary 2,644,971$ 1.4% 37,370$ 1.4% $37,370
Dixie 1,939,068$ 1.3% 25,000$ 2.8% $54,611
Logan 727,275$ 0.9% 6,900$ 1.3% $9,310
Total 18,072,832$ 3.6% 642,898$ 4.0% $724,655
2/12/2005 2005 Annual SHS Conference 31
YTD Financial Results
$46,091Alta View
$107,526LDS
$210,880UVRMC
$72,921CWH
$22,259AFH
$5,622Orem
SubtotalExpensesYTD Nov
$54,139McKay
$13,252Primary
$35,402Logan
$80,246Dixie
SubtotalExpensesYTD Nov
2/12/2005 2005 Annual SHS Conference 32
Lessons Learned
Improvements can be identified when we pull our experiences and knowledge togetherTechnology can assist housekeeping departments in increasing productivity, in both staffing and suppliesIf managers and staff are given the opportunity and support to implement their ideas, they will surpass your expectations
2/12/2005 2005 Annual SHS Conference 33
Summary
• IHC’s Environmental Services (housekeeping) Depts reduced their expenses by $725,000 by adopting Best Practices, mostly achieved through:– I.S. request & tracking system (EMMA)– Daily Activity Report (DAR)– Area Staffing Analysis– Microfiber mops
• The EVS Depts will continue to identify & implement best practices
• Outsourcing possible in the future? Not if the teams keep their momentum.
2/12/2005 2005 Annual SHS Conference 34
Team Members
Task Force, Subcommittees, and Work-teams:• Calvin Allen, Brian Bentley, Greg Parrott, Ron Jones,
Paulette Thomason, Mary Ann Washington, Phyllis Loos, Craig Fitt, Laura Thurston, Ryan Eggleston, Allen Anderson
Council, Task Force, and Subcommittees:• David D. Clark, Bill Prows, Bruce Clark, Christy Finger,
Jami Perrett, Bryant Larsen
Task Force:• Jeff Sanders, Tim Bricker, Marie Prothero/Mike Olson,
Dale Green, Sherman Curtis, John Worley
2/12/2005 2005 Annual SHS Conference 35
Interesting Thought…
2/12/2005 2005 Annual SHS Conference 36
Questions