Five Ways to Improve Hospital Labor Productivity

In 2017, U.S. health care spending increased 3.9 percent to $3.5 trillion — close to 18 percent of the nation’s gross domestic product. But more isn’t always good; this growth has broad negative impacts on federal, state and local budgets, as well as on employers and individuals.

One solution: transform health care delivery into an engineered system, learning lessons from high-tech industries such as aerospace. Opportunities for improved value and productivity will grow, and delivery systems will be able to provide care that patients deserve, providers desire and payers demand.

Alan Ravitz, chief engineer for the National Health Mission Area at the Johns Hopkins Applied Physics Laboratory, along with collaborators Adam Sapirstein, associate professor at the Johns Hopkins School of Medicine, and Peter Pronovost, chief clinical transformation officer at University Hospitals Cleveland, shared this and other ideas in “Improving Hospital Productivity as a Means to Reducing Costs,” a new post appearing in Health Affairs.

The team identified five key areas of high-impact interventions that can improve hospital labor productivity:

• Manage the last 10 feet of the supply chain to address the high downstream costs of safety risks, nursing efficiencies and dissatisfaction;
• Convert the human double-check of medications to electronic methods, to reduce clinician error and effort;
• Eliminate false alarms by engaging a systems integrator to integrate alarms and processes;
• Minimize the documentation burden by working with regulators and partnering with clinicians with technology companies; and
• Develop an electronic system for submitting and processing claims and a common data platform for all insurers.

The Johns Hopkins health care team hosted leaders from several technology and management consulting companies to discuss the use of systems engineering in health care, explore opportunities to improve productivity in the industry, and identify high-impact interventions that can improve hospital labor productivity.

The team focused on the lack of systems engineering in health care compared to other industries, and contrasted health care technology procurement with how a major airline acquires a jet. For example, airlines do not order components and assemble the aircraft; they contract with a systems integrator. Health care systems, on the other hand, design their own hospitals with myriad suppliers, leading to inefficiencies and technology-integration barriers.

“As care has become more complex, new equipment, capabilities and requirements have simply been added without a system integration plan,” the authors note. “Aviation and other industries have demonstrated that purposely designed and integrated systems can significantly reduce materials and labor costs while increasing efficiency and safety.”

APL’s National Health Mission Area seeks to understand the complex technical and operational capabilities needed to fundamentally transform health and the delivery of care. The Laboratory’s deep understanding of systems engineering and analytical expertise allow it to develop and deliver scalable, sustainable and resilient solutions to a broad range of challenges. Learn more about the National Health Mission Area.