A Study On Hospital Business Process Management Model Based On Patient Value Chain

Since 700 BC, the development of Chinese hospital has experienced a fairly long course, and played an important role in society evolution. With the sky-rocket speed of economic development, people have an increasing demand in health and health care services. Meanwhile, for the reason of lacking in investment and inaccuracy in health plan, people complaint that "difficult in accessibility, weak in affordability" when they are seeking for healthcare services. The development of hospital faces new challenges.Objective:Hospital development has experienced three phases, i.e., ancient hospital, neoteric hospital and modern hospital. There are both challenges and opportunities for nowadays hospital's development. Reviewing on the evolvement of hospital management patterns in our country indicates that there's a further need for management innovation, so that, efficiency can be improved and cost can be reduced, medical protection can be more fair, and the situation of "difficult in accessibility, weak in affordability" can be mitigated. The objective of this study is to management pattern which can be aligned with the increasingly changing environment, so that excellent patient value (PV) could be made, competitive advantages could be developed.Methods:This study theoretically based on customer value theory, value chain theory, strategic management theory. By the methodology of theoretical deduction, this study has construct a hospital business process management model (HBPMM) based on patient value chain (PVC).This pattern includes: patient value and patient value chain, hospital business process management framework, basic methodology, and performance measurement framework. At the end of this dissertation, a case is discussed to illustrate the practical tactics and effect of the usage of this pattern in hospital management.Results:In this dissertation, the PV is defined as within a patient's involvement in medical service consume, in the selective rang that the patient has, a patient's recognition which is achieved by comprehensively trade-off judgment between medical service and ancillary service's contribution to his goal and the cost he has to pay. According to this definition, the PV can be divided into two dimensions: scenarioness and hierachicalness. The dimension of scenarioness refers to that the patient's recognitions and assessments on medical services depend on a certain consuming scenario. The dimension of hierachicalness refers to the different values provided by medical service have various importantness in patient's recognition. When those two dimensions are positioned on the vertical and horizontal axis, a patient value matrix is formed. A PV matrix is used to analyze the elements of patient value. In medical service chain, the elements of PV may vary from one link to another. On every link, a patient will make trade-offs between the perceived benefits and perceived sacrifices, which results in patient perceived value and patient value chain. Patient value chain (PVC) is a holistic view on patient perceived value result from trade and relational process in medical service. Thus a PVC includes trade value and relational value, is a continuous volume of patient value created by the patient's medical service chain involvement. The PVC and PV matrix can form a patient value cube. The patient value cube together with patient value chain analysis can provide a more exhaustive analysis to patient value elements.The framework of hospital business process management model is divided into two hierarchical components: conceptual framework; operating framework.The conceptual framework is theory-oriented. In the framework, the HBPM is a continuous circle of management activities. The circle begins with patient value chain analysis, then optimizes and reconstructs the value chain of hospital, and follows with process improvement. Process improvement integrates the ideas of both BPR and TQM, in other words, combines the incremental improvement and breakthrough improvement. On this case, better patient values can be created, which leads to higher competitive advantage.Operating framework is practice-oriented. The framework has flowcharted the basic procedure of HPMM. First, a patient value chain analysis is carried out, according to the results, hospital value chain is optimized and reconstructed, and a set of targets is identified for business process management. Second, existing process is improved or redesigned. Third, patient value measurement and hospital performance measurement are implemented. The results are used in developing new management circle.As a complete management model, the two frameworks need a certain methodology support. Therefore, a basic methodological system included methods, rules and procedures is developed. The methods comprise a series of techniques in supporting HBPMM, such as PV matrix, PVC analysis, PVC-HVC fit matrix, process modeling based on IDEF0, process evaluation, process management, patient services experience description based on IDEF3, patient value measurement and hospital performance management. There are 10 rules for HBPMM's implementation, i.e., senior management must lead the BPM, improvement must be driven by strategy; add value for patient; focus on process instead of function; system thinking; Carefully prepare and learn as you go; Metrics matter; care for the human dimensions; continuously improve; communication. The implementation procedures include breakthrough improvement and incremental improvement. The former decomposed in to a triple-phrase, going as design, simulation and implementation. The latter is comprised by four stages, i.e, critical process identification; process analysis; process improvement; and implementation. The study constructs a process measurement framework to support HBPMM, based on the methodology of Balanced Score Card. In this framework, the measurement should involves: strategy planning; critical business process, stakeholder's need, senior management participation, personal participation, conceptual framework and measures. Furthermore, a conceptual framework of performance measurement is developed, which includes five dimensions: financial performance, process performance, patient satisfaction, employee satisfaction, and community satisfaction.At the end of this dissertation, a case of the implementation of the HBPMM is discussed in aim to illustrate the tactic and effect. The analysis results indicate that there are many flexible tactics in practice and with a result in better effect.Conclusions:By the analysis of patient value and hospital value, patient value chain and hospital value chain, two conclusions are developed. The one is that patient value is the core of hospital value; the other is that there is an interracial dependency relationship between patient value chain and hospital value chain. To have outstanding ability to create patient value, the hospital needs to, on one hand, optimize and re-construct basic value chain, on the other, integrate the industry value chain. Both of those two aspects require improvements or innovations on hospital process. Therefore, there is also an interracial dependency relationship between patient value chain and hospital business process management. Naturally, there is a tendency to integrate those two components, which contributes to the framework of hospital business process management model. the HBPM is a continuous circle of management activities. The case study indicates that there are many flexible tactics in practice and with a result in better effect.