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A sustainable organisation in healthcare

Executive Summary

In the 21st century, healthcare providers worldwide are challenged to meet increasing patient needs while payer pressure constrains revenues and scope for investment. Updating processes, tools and infrastructure across the patient lifecycle is central to becoming a more sustainable organization (as defined in this paper). This can unlock greater value for patients, from accelerating diagnosis, through facilitating more personalized treatment, to reducing the need for readmission.
By helping you to optimize the service that your clinicians can deliver to patients, Roche Healthcare Consulting can help your organisation to increase return on investment while providing improved patient care and transforming the culture and ways of working to be more growth-focused and resilient.

A heritage of expertise in sustainability

At the heart of every sustainable system is a smooth and optimal flow, whether it be clinical samples, information, finances or even patients.

Understanding a healthcare organization at all levels (from top to bottom, designing organizational structures and processes to deliver smooth flows) is the key skill that Roche Healthcare Consulting can bring to help make your hospital more sustainable. Roche Healthcare Consulting can provide hospitals with the guidance and tools to discover their own organizational and cultural insights. Roche, as one of the world’s great research-based healthcare companies, has its own lengthy heritage in sustainability.

Founded more than 120 years ago, the company has more than 90,000 people working together in 100+ countries and follows a holistic approach when managing sustainability: in addition to improving access to products, the company’s strategy also focuses on achieving continuous progress in areas such as social responsibility, environmental protection, supply chain sustainability, people attraction and retention.1 For nine consecutive years, Roche has been recognized as a Group Leader in the Dow Jones Sustainability Indices (DJSI),which emphasized that Roche performed particularly well in the categories addressing the burden of healthcare costs, ethical marketing practices and climate strategy. Roche is also committed to supporting the United Nations Sustainable Development Goals3 and has received numerous recognitions as a top workplace in many countries.4

Physicians and Consultant

Dimensions of sustainability: An evolution over time

  • Economic dimension

    • Codes of business conduct
    • Corporate governance
    • Innovation management
    • Marketing practices
    • Materiality
    • Product quality & recall management
    • Risk & crisis management
    • Supply chain management
    • Tax strategy

  • Environmental dimension

    • Climate strategy
    • Environmental policy & management systems
    • Environmental reporting
    • Operational eco-efficiency
  • Social dimension

    • Addressing cost burden
    • Corporate citizenship & philanthropy
    • Health outcome distribution
    • Human capital development
    • Labor practices & human rights
    • Social reporting
    • Strategy to improve access to drugs or products

Balanced strategic approach

The primary duty for any Chief Executive is to ensure the sustainability of their organization through the development and execution of an appropriate growth strategy.12 In the healthcare delivery sector, this takes an organization from
ensuring its financial survival to the development and growth required to become a future leading healthcare provider on a national, regional or global scale, delivering valuable health benefits to expanding patient communities. The nuances of this strategic approach to deliver sustainability depend on local market conditions, as each segment has a unique balance of pressures including from government regulations, market constraints on pricing, differences in
funding models (i.e., private vs. public insurance models of healthcare resourcing), potential for consolidation through M&A etc.

In any sector of business, many experts believe this is best achieved by taking a “balanced scorecard” approach13 to set priorities for economic success and profitability alongside goals around the satisfaction of stakeholder groups (e.g. particularly patients, and also payers, employees and investors etc.), building a resilient, growth-oriented culture, optimizing operating efficiencies, and long-term development (e.g., strategic planning, investment etc.).

The prioritization of these aspects depends on the precise situation of the business, but all must be considered to ensure that the organization is both strategically and commercially sustainable. For healthcare organizations, it is important that the concepts of economic success and adding value balances short- and long-term health benefits for patients along with cost containment for payers (e.g. government, insurers etc.). Similarly, some aspects of long-term development are linked to progress in the wider environment around the development and regulation of new treatment paradigms.

Balanced Scorecard

Culture, growth and development

“We have achieved a form of enhanced involvement of all the staff”
Culture, growth and development

Forward-looking culture to support transformation

To support transformation in other aspects of its business, a sustainable hospital needs to build a culture that is resilient to the high stress levels and emotional burden often seen in the healthcare environment, and focused on growth and development.14, 15
A development-focused working environment is one in which:15

  • Staff feel safe in acknowledging vulnerability, taking responsibility for mis-steps, rather than expending energy to preserve their reputation with colleagues
  • Continuous learning is the norm, driven by the individual and supported by line managers and leaders throughout the organization
  • The status quo is regularly challenged with manageable experiments in behaviour and process, that can be rolled out more widely if successful or otherwise concluded without significant impact on patient care
  • People throughout the organization share a commitment to helping each other to improve, by providing continuous, constructive feedback

 

Creating a growth-focused culture

Even the most technologically-focused piece of change management, such as replacing one piece of analytical equipment with another, must also include consideration of cultural aspects, and metrics around personnel retention and motivation are central to any CEO’s dashboard to ensure the balanced running of their organization.

RHC has consultants representing a wide range of backgrounds within healthcare provision and can provide this cultural dimension. Working alongside technical and economic innovation and knowledge, RHC can also help organizations embed new ways of working that reduce personnel turnover while increasing staff satisfaction and mutual trust. This can also improve agility throughout the business and increase the likelihood of success of all other change management processes.

Optimizing Operations

Transforming wider operational and business models 

Being part of a company that is a leader in healthcare, Roche Healthcare Consulting can help hospital executives enhance sustainability in every aspect of their operations by providing a range of options which include: workflow audit, value stream analysis, rapid process optimization, change management and cultural transformation, etc.

In addition, Roche consultants can bring in best practice examples from hospitals around the world, and work in partnership with hospital executives to identify and implement the solution that makes most sense for the specific local health and cultural needs, and still set in place a strategic approach or roadmap that enhances all aspects of an organization’s sustainability.

A smooth and optimal flow, whether of clinical samples, of information, of finances or, indeed, of patients is essential for a sustainable healthcare system. When designing a new hospital or planning major changes to existing infrastructure, there is an opportunity to improve the efficiency of flow throughout the hospital.

This can be something as simple as putting functions or departments that are frequently used together in close proximity. In the same way that modelling approaches can be used to optimize the design of a diagnostic laboratory, a similar process can be used to minimize transit time between key parts of the organization, leading to increased throughput and reduced waiting times.

 

Rethinking financial arrangements for sustainability

Roche consultants can help healthcare executives consider a variety of innovative financial arrangements to better distribute the economic risks and rewards between stakeholders. Several models for Value-Based Payment have been developed and piloted in different countries,27-29 sharing the cost between payors (e.g. health insurers, state-funded healthcare) and suppliers (e.g. pharmaceutical and device manufacturers) based on the proportion of patients who
achieve key outcome targets.

These could be modified to also include the indirect costs associated with treatment and monitoring, as discussed above. As such, while a profitable organization generates short-term value from its customers, a sustainable organization must also generate long-term value for its customers (i.e. not only for patients but also for payers and for society overall).

“We have managed to create a sustainable work environment for the staff and find time for research and development with reduction of manual work and smoother workload distribution during the week”
Optimizing Operations

Tips to increase efficiency of hospital logistics and operations

  • Reducing costs

    Explore value-based pricing arrangements to reduce direct and indirectspending when patients do not achieve desired outcomes

    Better integration with out-patient and external healthcare to reducere-admission and minimize indirect costs around admission

     

  • Unlocking value

    Deep analysis of electronic health recordsto identify likely responders to treatment

    Accelerated diagnosis leading to optimal treatmentand prevention of long-term complications

Conclusion

While the sustainability of healthcare is a societal issue, there is much that can be done at an organizational level to improve sustainability, patient care and return on investment, and much that can be done by working in partnership across healthcare organizations, and more widely with political and technical stakeholders to achieve a shared vision of a better tomorrow.

Whether examining potential efficiency gains stemming from the diagnostic function, or how enhanced diagnostics can unlock greater value for patients and reimbursement bodies, concrete actions can transform the operation of the diagnostic laboratory and its integration with the wider healthcare organization. With a broader scope, the right changes to hospital operating process and business models can also enhance economic sustainability.

At the same time, it is vital that these changes are implemented with deep consideration of maintaining the highest quality standards for patient care. In addition, to make any change in organization or process sustainable, it must be supported by reinforcing the culture to welcome, develop, support and retain personnel who are committed to agile working, transparent communication and continuous professional development, to remain at the forefront of their field and make the most valuable contribution, and lead the change together across the organization.

Combining its leadership in IVD, pharmaceuticals and the hospital environment with expertise in optimizing wider patient flow, health outcomes and business models, the team at Roche Healthcare Consulting offer a wealth of practical experience and can work in partnership with hospital executives to conceive practical solutions. These are based on best practices shared by healthcare organizations around the world, and customized to specific needs of each client, and implemented thoroughly, with wide-reaching cultural, financial and organizational elements to ensure success. In this way, Roche Healthcare Consulting provides a uniquely balanced service that uses all these levers to enhance both the economic and the cultural sustainability of any diagnostic laboratory or hospital.

Authors

Judy Han

Judy Han

International Projects Consultant at Roche Healthcare Consulting

Nicolò Olghi

Nicolò Olghi

International Projects Consultant at Roche Diagnostics International

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