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Alexandra Hospital
Design Business Case Study
August 2009
CONTENTS
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Alexandra Hospital
Design Business Case Study
August 2009
Most people will typically associate the term design with its conventional
definition where the physical appearance and attributes (including how it will be
made) of a product or building are developed. However, not many will directly
relate design to more abstract products such as experience. Specifically,
experience design is the creation and delivery of experiences that are original,
unique, memorable and transformative, using spaces, objects, people and
channels as tools.1 It is driven by consideration of the moments of engagement,
or touchpoints, between people and brands, and the ideas, emotions, and
memories that these moments create.
Alexandra Hospital
Design Business Case Study
August 2009
According to Liak Teng Lit, Chief Executive Officer of the hospital, their
intentions were not simply automating existing operations, but to redesign those
conventional and mundane tasks that collectively comprise hospital services,
facilities maintenance, and administration. The effort and resources expensed in
redesigning the patients experience prove to be worthwhile as apparent in the
results of the latest Patient Satisfaction Survey released by the Ministry of
Health (MOH) in 2008. Through this survey, it is evident that AH continues to
remain as the hospital with the highest level of overall patient satisfaction
amongst all the restructured hospitals in Singapore. In fact, the hospital has
attained this excellent achievement for the past five consecutive years.
2.
AH was officially opened in September 1971. In its early years, it was one of the
top hospitals in Singapore, with about 15% share of all public hospital
admissions in 1980. However, sustaining this level of patient volume soon
Alexandra Hospital
Design Business Case Study
August 2009
One of the first steps taken by AH early in its transformation exercise was to
understand what matters most to its patients. Specifically, the AH team
conducted focus group discussions with various stakeholders, particularly its
patients, to better understand their expectations from a hospital. Findings from
the various focus groups showed that a good hospital should deliver the
following:
Alexandra Hospital
Design Business Case Study
August 2009
Using these findings as key guiding principles, the hospital then embarked on
its journey to re-design the different functions and operations of the hospital. In
supporting this process, AH has also incorporated the use of relevant
management tools and philosophy, and adapting from best practices various
industries.
3.
The dental clinic at AH used to receive complaints from callers who dialled to
make appointments. They were annoyed that the line was frequently engaged
and when they finally got through, they were directed to leave a voice message
to a mailbox which was usually full. This is one of the classic examples
commonly found in the healthcare facilities due to high patient volume and the
lack in process efficiency. At such instances, patients become frustrated with
the services offered and frown upon a second visit.
Alexandra Hospital
Design Business Case Study
August 2009
inpatient care and pharmacy, systems and processes must be developed with a
holistic and integrated approach so that there is minimal inconvenience to the
patient. In other words, the designing of the hospital system was unlikely to
succeed if each of these systems and processes were developed independently.
First begin with the needs of a patient in mind- Mr. Liak Teng Lit
Alexandra Hospital
Design Business Case Study
August 2009
Unlike the Toyota car manufacturing factory, where automation can be easily
applied, the application of technology to healthcare confronts a large array of
difficulties to quantify and draw links between human task and kiosk-based
information appliances. As such, AH faced a trickier task of redesigning
traditional labour-intensive, hands-on jobs around the new technology to
minimise work time and not staffing levels.
Alexandra Hospital
Design Business Case Study
August 2009
In this regard, in order to better appreciate how the various principles in the TPS
can be applied, the hospitals senior management visited the Toyota plant and
its workshops in Japan, physically looking at the nuts and bolts of its operations
to learn how they can apply similar principles back in the hospital.
Alexandra Hospital
Design Business Case Study
August 2009
Alexandra Hospital
Design Business Case Study
August 2009
Six Sigma @ AH
In March 2001, AH embarked on the Six Sigma Project with the objective to
provide patient-centred quality healthcare that is accessible and seamless,
comprehensive, appropriate and cost-effective.
The Six Sigma is a business management strategy tool which seeks to improve
the quality of process outputs by identifying and removing the causes of defects
(errors) and variation in business processes. In general, it involves a process
mapping procedure, comprising the following five steps:
Measure key aspects of the current processes and collect relevant data.
Improve or optimise the processes based on the findings from the data
analysis.
Control to ensure that any deviations from target are corrected before they
result in defects. Set up control mechanisms to continuously monitor the
processes.
Specifically, using the Six Sigma, AH managed to improve its key processes in
terms of boosting efficiency, reducing defects and costs, and enhancing
patients satisfaction. In this regard, project teams were formed to examine the
various areas that require systems improvement, one of which was the patient
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Alexandra Hospital
Design Business Case Study
August 2009
4.
AHs approach brings two interesting and innovative elements into the
conventional implementation mix: a drive to break down tasks and re-engineer
them more efficiently, and a desire to manage for success at the individual level,
with a comprehensive understanding of individual responsibilities and how they
impact on other staff in the healthcare service chain. The experience of AH has
indeed successfully demonstrated how design can be incorporated to benefit
organisations, particularly service providers.
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Alexandra Hospital
Design Business Case Study
August 2009
In this regard, for Singapores healthcare industry to stay in the forefront, one of
the key differentiators is for the local healthcare institutions to design and
develop their operations around its patients. The healthcare providers need to
first establish a clear understanding of their customers needs, and to keep an
open mind to learn and unlearn. They also need to constantly adapt from best
practices, and to engage every level of the organisation to seek continuous
improvements to its systems and processes, using technology to enhance their
performances where possible.
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Alexandra Hospital
Design Business Case Study
August 2009
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