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FEATURE


add value. Originally developed by Japanese carmaker Toyota, three Lean methodologies are directly applicable to today’s health care businesses: Kaizen: A Sino-Japanese word for “good change,” it describes a mindset of continual improvement in the workplace. In this practice, teams gather regularly to analyze shared processes, brainstorm improvements and propose removing non-value-added steps. Kaizen also empowers individual employees to identify inefficiencies and independently improve processes. 5S: An ASC’s work environment could quickly become disorganized if left unchecked. This methodology encourages teams to step back from their workstations, analyze what is necessary to complete daily tasks and eliminate clutter such as unnecessary paperwork and equipment. For example, ASCs often need to manage large quantities of paperwork. If rigid parameters are not set for what should be kept, documentation can quickly pile up and threaten efficiency. 5S principles allow employees to set requirements to optimize efficiency in busy health care workstations. Process mapping: Perhaps the most popular Lean tool with health care businesses, process mapping allows employees to visualize workflow, remove non-value-added steps and provide other recommendations for improvement.


Pick the Right Tool While many of these process improve- ment tools appear similar, there are subtle differences that can produce unintended consequences. For exam- ple, applying Six Sigma methodol- ogy to an inefficient process will not streamline it; it will only make the pro- cess less prone to error. Likewise, pro- cess mapping will not fix an error- prone process; it will only make the process more efficient at producing errors. How a particular ASC’s staff works best also should play a role in selecting a process improvement


ASC FOCUS APRIL 2015 15


tool. According to the Social Science Research Network study, 65 percent of the US population learns visually. For visual learners, process mapping likely offers the most effective starting point for assessing and improving efficiency. Process maps also can be utilized to address one of the most critical financial issues facing ASCs today: increased patient responsibility. According to Aon Hewitt, during the past five years “employees’ share of health care costs—including employee contributions and out-of-pocket costs— will have increased more than 52 percent, from $3,389 in 2010 to $5,151 in 2015.” In addition, patient collections for ASCs cost as much as five times more than obtaining payments from payers. Creating a detailed process map outlining the various steps for collecting patient payments up front allows ASC decision makers to reduce


delayed patient collections, lower expenses related to working aged patient receivables and strategically deploy the latest software tools, such as payment portals and auto dialers, during the revenue cycle process. Patient collections, however, are just one opportunity. When implemented properly, process improvement tools like Lean and Six Sigma can produce dramatic operational improvements in countless business office processes performed in ASCs each day. By bringing more predictability to these important operational areas, ASC leaders can focus on staying competitive, growing their business and delivering the best quality care to their patients.


Lewis Custer is senior vice president of operations at National Medical Billing Services in St. Louis, Missouri, www.nationalascbilling.com.


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