Integrated service management in healthcare – improving patient care and the bottom line

IT has revolutionised the healthcare sector, offering more sophisticated diagnostic machines and procedures as well as more efficient ways of processing admissions and patient information.

July 31, 2013

By Edward Carbutt, Executive Director at Marval South Africa

Information Technology (IT) has revolutionised the healthcare sector, offering more sophisticated diagnostic machines and procedures as well as more efficient ways of processing admissions and patient information, along with the ability to better manage all of the additional tasks that go along with operating a healthcare facility. However, reliance on IT is also a challenge for healthcare providers, as storing and handling the vast volumes of data generated is a complex process, and many of these functions are managed by undersized IT departments that operate on shoestring budgets.

While IT Service Management (ITSM) is often seen solely as a tool to provide better IT services, the reality is that IT in fact underpins practically every function of a healthcare service, from laundry and finance through to patient care. Integrated service management across a healthcare organisation therefore will not only ensure that IT services are provisioned more effectively, but that continual improvement across all services can be attained, improving patient care while increasing efficiencies for maximum profitability.

The world today is driven by data, and in the healthcare sector one of the most critical aspects is the management of patient information. Patient information is typically highly confidential, and therefore needs to be managed in a secure fashion to ensure that it is not compromised. High levels of availability are critical as well, as if a healthcare provider experiences downtime that renders them unable to access patient information the repercussions could be life threatening. ITSM and the adoption of industry best practices and standards such as ITIL and ISO/IEC20000 are intrinsically linked to the overall performance of any organisation that depends on IT, and given the importance of patient information, the healthcare sector is no exception. These standards enable hospitals and other healthcare facilities to deliver effective IT services, which will in turn assist with improving patient care.

However, ITSM can be extended and integrated throughout healthcare organisations, into areas that are not typically seen as the domain of the IT department, helping to leverage greater value from solutions and ensure more effective operations across the board. Facilities management is one area where ITSM can be of enormous benefit, and the laundry room of a hospital is the perfect example.

While laundry is not often seen as a primary function of a hospital, it is nevertheless a critical one, since the ability to provide clean sheets, towels and hospital gowns is imperative. Using ITSM tools and processes, laundry equipment can be added to the system as configuration items, so that scheduled maintenance can be easily recorded and followed up. Any incidents can also be recorded and reported to the correct party for resolution, and third party providers can be easily managed to ensure the laundry room functions optimally at all times. ITSM ensures that best practice processes are followed, and that problems are identified for faster resolution, ensuring continual service improvement.

Clinical equipment such as heart rate monitors, life support equipment and theatre equipment can be managed in a similar way, to ensure that it is correctly maintained and that any issues are corrected timeously. Support and service requests can also be incorporated into ITSM tools for improved efficiency. As an example, using ITSM tools, a nurse can request for a porter to move a bed from one ward to another. The request will be recorded by the system and delivered to the porters as a service task for action. The porter will then complete the service request, and log its completion. This ensures that the time taken to service the request is recorded, and it can easily be compared to the Service Level Agreement (SLA) in place for this specific task. This then aids performance reviews, providing accurate measurements of performance along with the proof and evidence needed for continual improvement of service delivery.

This concept can be applied to ambulances, other hospital vehicles, facilities, generators and any other equipment that needs to be managed. Service requests in any area are logged into the system and forwarded to the correct personnel for action, who are then tasked with resolving the service request and must log completion in the system once the task is done. All services are maintained in a configuration database so that the impact of any changes and problems can clearly be identified. Processes and structures are clear, making them easier to follow and enhancing service reliability.

The traditional view of service management across industries in South Africa is to view different departments and functions as silos, in isolation. In a hospital environment, where all functions are highly dependent on each other to ensure patient health, this can be detrimental. The key to service management is to look at the healthcare organisation as a whole, to identify where changes and improvements need to be made. Without the full picture across the organisation, this is impossible to achieve with any degree of effectiveness. The end goal of service management is to ensure continual service improvement. ITSM as well as industry standards and best practices put in place the mechanisms needed to achieve this, by continually identifying problems that need to be rectified, improving effectiveness and limiting risk. Having standardised, recorded processes and performance management in place will not only help to improve efficiency across all areas, it will ensure that patients receive the best possible service, and that services are continually being improved upon.

While extending ITSM outside of IT is a new concept, an integrated approach to service management across organisations delivers many benefits to the healthcare sector, including increased service reliability. By looking at people, process and technology across healthcare organisations, these enterprises can be turned into proactive service environments that are process and service oriented rather than task and activity oriented.

Patient care is the ultimate priority, and all tasks underpin this, supported by IT. As a result, integrated service management is a vital tool in ensuring improved patient care along with an enhanced bottom line.