AUGMENTING HOSPITAL PRACTICES

Most hospitals are facing exceptional business challenges. With selective and better-informed patients several hospitals are stressed to meet the following as their fundamental business model.

•      Escalating dictates for validated quality and performance
•      Deceit and corruption avoidance
•      Risk management  
•      Competence

Hospitals could cede to several legitimate ways to augment their practice competences, resulting in improved financial margins. It is strictly a matter of cohesive effort by the hospital management as well as the medical staff to both improve quality as well as augment the physicians' practice, the latter translating into enhanced hospital revenue.

Many a times hospitals shy away from certain practices owing to the fear of probable liability that could befall them under the garb of malpractice. This results in an absence of innovative thinking.

Competing hospitals and medical practitioners affiliations are very often impacted by anti-trust laws. Some of these are related to the tariff structures. On the other hand ghoulish competition seems to go unnoticed. Joint activities tend to be better understood and gain support from financial amalgamation and financial risk. However, clinical integration does not get the same support despite the fact that it can improve quality.

Doctors today are more concerned about their own time management and hence are not much enthused by participating in organised medical staff whose value they seem to have partially discounted. It is only the hospital that is significant to them as it complements their own practice. It is imperative that the medical staff lays emphasis in improving productivities for doctors, which also means streamlining their environment. This would not only improve quality of care but also positively impact the professional subsistence of the medical staff. 

Many a time insurance reimbursement claims by hospitals get delayed. Insurance companies, at times, tend to challenge the authentic cost of healthcare delivery. The one way to counter this is `cost containment’. One of the ways in which this can be done is by bringing in standardisation in clinical practice with relation to hospital operations. Clinical integration is yet another way to improve performance. Though competing, physicians could come together, without jeopardizing their practices and cooperatively bargain with health insurance companies, etc.     

For clinical integration it is of utmost importance that:

•          Standardised processes are followed in clinical practice guidelines
•          Standard processes and protocols are applied
•          A method is adopted for monitoring of medical practitioner performance in adherence to guidelines
•          Appropriate infrastructure is available for these activities
•          Doctors who are underperforming should be assisted to improve
•          Data is shared with insurance companies, corporates supporting their staff

 If such a practice is adopted, it is very likely that a collective effort in bargaining for fees may result in positive outcomes.

Other than this hospitals must adopt the following essential strategies and practices that to enhance their practice:

 Accreditation with recognised bodies viz. NABH, JCI, etc. gives immense recognition by patients seeking healthcare as well as by health insurance companies. It also helps in promoting medical tourism, as the hospital would get recognised for good standards and practices.

There is a great anomaly in statistical claims of shortage of beds all over the country. On the other hand hospitals are vying with each other to attract patients. The `missing link’ to this fallacy is the term “affordable healthcare” where patients are not pressurized by high costs of healthcare delivery. A simple answer could be ‘volume’ of patients (rather than high value) to generate reasonable revenues. 

The mannerism in which hospitals and medical specialists get referrals has always been in the eye of the storm owing to the `kick-back’ practice. Yet some healthcare providers find ingenious ways to circumvent the storm and continue this practice blatantly in some form or the other. Those who refer patients to consultants and hospitals get obviously preferential treatment and favours, which are often beyond the realm of questioning and challenge. This brings us to the question – do you join them when you can’t beat them? Do you legalise this practice, which is here to stay, such that the patient does not atleast become the victim. So for instance does the referring GP or nursing home get a referral fee for accepting his limitations in treating the patient and sending him to a specialist or a hospital that in turn equally, honestly treats him with compassion and honesty. 

 In conclusion one can say that the following principles are essential to augment both quality and business for a hospital:

• Standardize the science
• Simplify the working environment
• Make administrative processes and payment clinically relevant
• Engage the patient in the process
• Fix accountability at the point of control

Dhanraj Chandriani

Managing Director

Technecon Healthcare Pvt. Ltd.