Productivity tips: Is 100% efficiency desirable?
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates, Dallas
(Editor’s note: This is the first of a two-part series on productivity. This month, we tell you what productivity really means and discuss why 100% productivity may not be a good idea. Next month, we offer you realistic goals and suggest some ways to achieve them.)
How much productivity is enough, and when is it too much or too little? This column is written to address respondents to the Same-Day Surgery Reader Survey who said that work loads and caseloads are two of their top challenges.
What really is productivity? Depending upon whom you ask, there are differences of opinions. I called 10 nurses in ambulatory surgery center (ASC) environments, and 10 nurses in not-for-profit hospital settings. The difference between the two groups was interesting. The ASC group thought that productivity meant to "do whatever it took to get the job done," provided that patient safety and quality of care were not compromised. This "whatever it took" included flip-flopping of rooms, starting cases early, sending staff home when the workday was complete, cross-training staff, weekly staff meetings, "keeping the docs happy," exceeding expectations, and constantly seeking new ways to stay increasingly profitable.
Most in the hospital sector commented that productivity requirements were passed down from the top, and as managers, they had to comply with them. This was true even when the requirements were unreasonable and counterproductive, such as 100% productivity. The top comments about productivity from the hospital sector managers were: staying within the budget, achieving 100% productivity (by the measurement of the "organization"), providing superior patient care, having a quality work environment ("provide a great place to work"), and receiving positive patient feedback.
All of these measures are noble and worthy, but one difference between the groups is the understanding that productivity is the ability to get the job done. The error of most hospital systems (I have been there) is to expect too much in the way of measuring productivity. The goal of being 100% productive can be devastating on the surgical department. The way most hospital management measures success is to take the available minutes the surgical department is open and look at the difference in the surgical minutes.
For example, if you have 100,000 minutes of available operating rooms available, but you only use 75,000 of them in surgical minutes, than you are only operating at 75% efficiency. If you crank up the volume, you can get to 100%. In fact, we have clients who have exceeded 125%. The fact is that once you go past 75%, problems and complaints start to occur. The cases drag out, and elective cases go into the evening as the ability to "flip-flop" rooms goes away. You now are a slave to your own environment.
So what is productivity? The ability to get the job done in a quality environment that meets the needs of the organization mission statement and that makes you proud to be associated with it. That’s the goal we should all want to achieve.
This is the first of a two-part series on productivity. This month, we tell you what productivity really means and discuss why 100% productivity may not be a good idea.
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