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The client is a general hospital and trauma center located in Mississippi, US, that provides regional health services. Its Emergency Department contains more than 50 rooms for patients and serves more than 80,000 of them each year.
Consulting’s initial analysis determined that issues in the client’s emergency department were mainly in the following areas, all of which had an adverse effect on patient length of stay, patient satisfaction, and staff satisfaction.
The operational data produced by the client’s main IT system, EPIC, was not actively used, and performance data was difficult to obtain.
Many of the hospital processes lacked consistency across departments and channels of communication were limited, creating inefficiencies and silos.
Staff responsibilities were unclear and did not accurately reflect job descriptions.
Key performance indicators were absent, resulting in a lack of performance reviews.
As a result, patient length of stay and patients left without treatment (LWT) were increasing, and the root causes impacting length of stay were not fully understood. Meanwhile, all this also led to a decline in patient satisfaction scores over the previous two years, as well as staff satisfaction dropping, resulting in a high registered nurse (RN) turnover rate.
Post-analysis, the project was structured into two phases, an 8-week Focus Process® and an implementation phase lasting 32 weeks. During the Focus Process®, four Management Action Teams (MATs) met weekly to identify opportunities for improvement in four key areas that affected the patient’s length of stay, namely entry and admission, patient care and coordination, discharge and admits and support services.
Once the teams identified the top areas for improvement, they concentrated on developing solutions as well as realization plans that incorporated achievable time commitments. Planning, training, compliance, and root cause analysis became the primary focus points of the four MAT teams, which were eventually consolidated into a single team.
To guide the initiative, a customized opportunity ranking system was created, prioritizing initiatives based on their expected return to ensure high-impact changes were addressed first. The approach also emphasized cross-functional collaboration, actively involving department leaders in the transformation process.
During the weekly MAT meetings, the client task force, along with the Consulting project manager, delivered presentations to the group regarding KPI performances, key achievements, and any action items raised from the previous week.
Root cause analysis of any issues raised was also discussed during these meetings, and suggestions were shared by both Consulting and the MAT for continuous improvement. Action items were then assigned for team members to report back during the following weekly meeting.
By the end of the project, the following solutions had been implemented for streamlined performance management:
After the 32-week implementation and continuous improvements to performance, the results were as follows:
Average length of stay
Average Leave Without Treatment (LWT)
Patient satisfaction scores
Registered nurse staff completed acuity training
The project successfully delivered significant efficiency improvements across the client’s back-office operations. The introduction of the BI system proved crucial, enabling real-time performance tracking that significantly improved visibility and decision-making capabilities.
Process standardization, alongside workload optimization initiatives, effectively reduced administrative inefficiencies, leading to better resource utilization and enhanced cost control. Furthermore, the transformation established a scalable governance framework, which strategically positions the client for sustainable operational excellence and supports long-term business growth.
*We have intentionally omitted client-specific details to maintain strict confidentiality.
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