Business process re-engineering
Business process re-engineering
Summary of the case study
The article “Business process re-engineering in healthcare management: a case study” by Massimo Bertolini, M. Bevilacqua, F.E. Ciarapica and G. Giacchetta is driven by the purpose of carrying out a business process re-engineering (BPR) in a given surgical ward to improve the efficiency of operations in the unit. The authors argue that health care, just like any other industry has become very complex regarding operations. This has therefore made the management in many institutions to come up with clear strategies for managing this form of complexity. Despite the efforts made, there is the difficulty of fusing coordination and specialization. This especially applies in the healthcare industry, which requires high levels of specialization .
The article goes on to point out that there has been a variation in the number of traditional tools to foster the two aspects of coordination and specialization. Some of the most common ones that the article briefly explains are total quality management and business process re-engineering (BPR). The authors note that a review of the outcome of the traditional approaches in making services efficient in hospitals, shows that they have yielded mixed results. Several reasons are given for the failure of the traditional approaches to improving efficiency in business processes. First is the resistance of doctors in these hospitals, who are often not ready to accept change. Another reason is that administrators in hospitals often adopt short-term visions that are not very helpful to the institutions .
In this study, the authors plan to simulate some of the most common models applied in institutions similar to the hospital. These simulations would target the two aspects of the waiting list and procedures for electing people to enter the surgical units. The study, therefore, sought to come up with different ways of modifying the critical aspects of the ward management practices, in an effort to come up with possible solutions that would lead to improved client outcomes. The authors then focus on the historical development of the concept of business process re-engineering. They suggest that historically, BPR has been applied in an effort to improve the efficiency in different industries. With time, the competition within players in the same industries necessitated the use of BPR to ensure that institutions stood out amongst competitors. They subdivide the development of BPR into two periods; pre and post 1996. Before 1996, the BPR approach was exclusively applied to improve the efficiency of business processes, while after 1996, the BPR approach was used to provide a platform for integrating the new aspects of the internet age to the operations of businesses. The BPR approach sought to effectively integrate IT infrastructure with traditional structures to take advantage of new electronic and web based business. This period saw the introduction of the concept of the EPC, which is a business process modelling technique, which has the elements of function, events and logical connectors.
The case study, in this case, focussed on the Neurosurgery Ward of Parma Hospital. The authors came up with a what –if study, which was arrived at through the division of subprocesses which were then analyzed and simulated into various scenarios. The idea was to observe the outcomes when specific aspects of the processes within the ward were modified. The simulation process was complex and involved the analysis of the current state of the hospital processes. The goal, here, was to come up with information on aspects such as the occurrence of delays, possible bottlenecks, resources required in sub-processes and the time required for completion of processes. The Delphi methodology was used during the study, where the researchers got the input of a panel of experts in trying to get a clearer picture of the possible problems that face the ordinary surgical wards. After this exercise, the study settled down on several bottlenecks .
Some of the identified bottlenecks include lack of enough operation sessions, delaying of operations sessions due to the time required to prepare rooms for the operations and wastage of time due to the long process of authorizing the use of surgical equipment. Others included limited availability of beds in intensive care that prevented the conducting of more operations, the unpredictability of surgical operations and the aspect of the unpredictability of emergencies. The next stage of the study was to come up with what-if scenarios. This was realized by the modification of different parameters that had considerable influence on the surgical operations conducted in the ward. The what-if scenarios were created based on the bottlenecks that had been previously established .
Here, the researchers focussed on four different aspects. The first one touched on the operations rooms, where special ones were set for emergencies to ensure that emergencies do not influence the processes in the surgical ward. The other aspect was the beds, where an effort was made to always have one available bed during any operation. The third aspect touched on beds in the intensive care unit, where one was to be constantly availed. The other factor touched on the number of operations carried out. The proposed situation to have more operations done required more resources, both human and financial. The study, therefore, involved the simulation of the different scenarios to establish the impact that these changes would have on the hospital service provision process. Through these exercises, the researchers were able to establish the changes that could be made on the hospital’s operation to lead to more efficient practices in the surgical ward.
For any business, it is important to have a clear conceptualization of the process that is required for the institution to come up with products or services . The EPC’s, therefore, appear to be an invaluable tool that enables an institution to analyze its processes with the end goal of process re-engineering. By using EPCs, companies and other institutions are able to effectively model, analyze and produce new designs for their business processes. The EPC’s, due to its simplified breakdown allows an institution get a finer grasp of the dynamics of the business processes within an organization. The EPCs first allow for a clearer understanding of the functions, which are the building blocks of the processes that institutions engage in . In addition, the EPCs lead to further understanding of events. In the business process, there are occurrences that occur before and after the implementation of a function. This is clearly seen in the EPCs. The other important aspect of the EPCs is the logical connectors which link activities in a business process to events. Understanding this relationship is important in getting a better conceptualization of the business process .
EPC charts are very important in understanding the relationship between inputs and outputs. In any business, the end goal of all processes is coming up with a product that meets the needs and the specifications of the customers. Two important factors come into play when coming up with the product; inputs and outputs. The two have a unique relationship, whereby when one of them is negatively compromised; the other automatically gets the same form of compromise. Through the EPC charts, businesses are able to keep a close eye on the operations and relationships that these two important aspects of production have . This is achieved through the hierarchical representation of how different inputs and outputs are involved in business processes. In the case of the surgical room, for instance, some of the inputs included the surgical recommendation, examination by the anesthetist and hospitalization and eventual operation. These outcomes directed whether a patient was actually admitted into the surgical units and whether they were operated on .
Another importance of having EPC charts is getting a clear conceptualization of controls that are in play during different business processes. As pointed out earlier, conventional business processes are made up of different actors who are responsible for the occurrence of different events which are connected by logical connectors. Through the EPC charts, management is able to first know the kind of control that each of the actors in the business process has. In the case study on the surgical wards, for instance, there were different actors such as the doctors, nurses and anesthetists. Each of the actors exerted certain types of controls on the whole process of handling patients. The doctors examined the patients to establish whether they would gain entry into the surgical wards. The nurses prepared the ward and necessary equipment required for operations and, therefore, exerted some form of control over the process. Anesthetists, on the other hand, had control over the examination of patients, which determined whether they were ultimately operated on . With the EPC charts, management is able to get a clear picture of where different controls of the business process lie. This makes the efforts to improve on the overall efficiency of the business process easier.
The EPC charts also offer the opportunity for management to fully analyze specific components of the business process. The building blocks of the chart are functions, events and logical connectors. These can also be viewed as key aspects in the business process. Through the charts, management can conduct an intensive, individualized, analysis of each of the three aspects . In the case study on the surgical wards, for example, extensive analysis of the component of the function is made possible through the EPC chart. When the function of operating on a patient is considered, the chart establishes that the doctors carry out this function. The chart shows that other actors such as the nurses and anesthetists provide support for the function. In addition, the chart points out at administrative players that have to be informed on various aspects such as on the equipment required for operations .
EPC chart for a cloth company
One of my friends used to work in a company that produce custom made clothing or uniforms for institutions, industries or companies. The process of serving the customer first involved the receiving of the order where a customer specified the kind of clothing that they wanted. The company only dealt with cotton made garments, and the implication was that the client’s order was cancelled once they requested for garments made of other materials such as nylon. In addition, the order was cancelled if the customer did not agree with the kind of fee charged per garment. This is an area that needs modification, since, more explanation can be offered on the procedures used for the cancellation of the customer orders. It is an addition that would help management change its approach to test whether better business outcomes can be achieved.
Once the order made by a client was approved, a process of cross-checking whether the product was readily available. If the required garment was readily available, it was directly shipped to the address provided by the client. Some modification is applicable here, where the actors involved in the verification and analysis of the customer’s order is made. In addition, t5here are many other functions that are not covered in this chart. Aspects such as the processing of payments and the individuals involved is an important aspect of any business. These, therefore, are aspects that can be included in the chart .
When it comes to the modification of the chart in the garment company, the management can explore the idea of diversification when it comes to the numbers of the materials used to produce garments. In the present state, orders are turned away once particular materials are requested for. Another aspect of the business process that can be modified is one that touches on increasing the number of call centers that answer clients’ orders . For this to be effective, it will be worth to examine whether rejecting the non-ready items that further increase the time to finalize the order leads to better outcomes. Management can, therefore, explore the idea of only dealing with readily available items that do not require sourcing from third parties.
Another area of possible modification is about the time required to gauge the authenticity of customer orders. In this kind of business, it is important to verify whether the orders are genuine before commencing customizing practices. When the process is too long, however, the efficiency of the process is compromised.
Bottlenecks in the business process above
The first bottleneck is the fact that there is no limit to the number of orders that can be taken. The implication here is that many orders can be taken without the consideration of the ability of the company to deliver on the said orders. There needs to be an established limit to the number of orders accepted in a day, to ensure that the delivery of the product is not compromised. Another option here would be offering a pre-statement of the capacity of production of the company. This will enable the clients to be aware of the periods required for orders to be actualized.
The other bottleneck is the reliance on third parties for delivery of products. When orders are received, there is the option of requested items being readily available or requiring manufacturing and outsourcing from the third party. The reliance on third parties has the potential of compromising the business process since the outside party may lack the capability of producing the required quality of orders made by clients. In addition, the third parties may take more time in delivering the items, meaning that the delivery to the customer is delayed. All this portrays the business as inefficient in its operations.
Lack of enough items to cover the orders made by different customers is another bottleneck that the company faces. When orders on items readily available are made, there is the possibility of the company accepting too many orders which exceed the number of items the company readily has. The implication, therefore, is that the customers will be unable to get their desired items at the appointed time since it would require production that was unplanned for. When an incorrect assumption that the company has enough items to cover orders is made, there may be an accumulation of unfinished orders. Over time, therefore, the whole process of delivery will be compromised.
Customer verification is another bottleneck in this company’s business process. The process of verifying whether the orders made by clients are genuine, has the potential of taking long. The implication here is that the time used to process the order for one customer may close the way for acceptance of new orders. Generally, therefore, the number of orders processed by a company may be very limited, meaning that the business process will not be as productive as required.
Payment, which comes very late on in the business process is a source of another bottleneck. The company deals with custom made garments, meaning that once the plain material has been branded and logos applied, it takes a long process to undo the customization. When a customer makes an order, customization of their product begins right away. If they do not finalize their payment, further production of the order is stopped and possibly reversed. This, therefore, slows down the whole business process, meaning that the finalization of orders for other customers who duly pay is compromised. Another bottleneck is the unpredictability of the technology and equipment used in the production process. After the orders of the customers have been successfully taken, there is the possibility of system failure where the details of the given orders vanish. The implication is that it will be necessary for clients to re-do the order, an aspect that would lead to wastage of time and resources. In addition, all this results in negative outcomes of the business in general.
Conclusion and recommendations
The EPC charts are important in the conceptualization of the business process in every business. It is recommended that management takes a keen focus on the validity of process chains. Having EPC chains that are erroneous can result in negative outcomes for any business, resulting in less productivity and the false need for improving the capacity of an institution .
In conclusion, the case study on the surgical ward at Parma Hospital provides an effective model for showing how business process re-engineering can be effectively realized. Attaining efficiency in business processes is imperative in the modern day competitive environment. Through drawing of EPC charts, business processes can be effectively analyzed, resulting in improved efficiency in business processes.
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