Ozcan: Chapter 9 Productivity Lecture 2

2y ago
18 Views
3 Downloads
340.81 KB
19 Pages
Last View : 2m ago
Last Download : 2m ago
Upload by : Bria Koontz
Transcription

Ozcan: Chapter 9 ProductivityLecture 2ISE 468 ETM 568Dr. Joan Burtner

Outline Productivity ImprovementTrends in Healthcare Productivity: Consequences of MedicareProspective Payment System (PPS)Productivity Definitions and Measurements Productivity Benchmarking Multifactor ProductivityCommonly Used Productivity Ratios: Hours per Patient Day or VisitAdjustment for Inputs Skill-Mix Adjustment to Worked Hours Cost of LaborAdjustments for Output Measures :Service/Case-Mix AdjustmentsProductivity Measures Using Direct Care HoursProductivity – Quality RelationshipProductivity DilemmasMultiple Dimensions of Productivity:Data Envelopment Analysis(DEA)ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 2

Productivity Definitions andMeasurements 1 (Review) Productivity is one measure of the effective use ofresources within an organization, industry, ornation. The classical productivity definition measuresoutputs relative to the inputs needed to producethem. That is, productivity is defined as thenumber of output units per unit of input.OutputProductivity InputISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 3

Productivity Definitions andMeasurements 2 (Review) Sometimes, an inverse calculation is used that measuresinputs per unit of output. Care must be taken to interpret thisinverse calculation appropriately; the greater the number ofunits of input per unit of output, the lower the productivity. For example, traditionally productivity in hospital nursingunits has been measured by hours per patient day (HPPD).That requires an inversion of the typical calculations:meaning total hours are divided by total patient days.Total HoursHPPD Patient DaysISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 4

Example 9.1(Review)Nurses in Unit A worked collectively a total of 25 hours totreat a patient who stayed 5 days, and nurses in Unit Bworked a total of 16 hours to treat a patient who stayed 4days. Calculate which of the two similar hospital nursingunits is more productive.Total Hours 25HPPD A 5Patient Days 5HPPD B Total Hours 16 4Patient Days 4Since the HPPD productivity ratio is expressed as inputover output, lower is better.Unit B productivity is better than Unit A.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 5

Multi-factor ProductivityLooking only at labor productivity may not yield anaccurate picture.Newer productivity measures tend to include not onlylabor inputs, but the other operating costs for theproduct or service as well.Service Item * PriceMultifactor Productivity Labor Material OverheadISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 6

Example 9.2 StatementA specialty laboratory performs lab tests for the areahospitals. During its first two years of operation thefollowing measurements were gathered:MeasurementYear 1Price per test ( )50Annual tests10,000Total labor costs( ) 150,000Material costs ( )8,000Overhead ( )12,000Year 25010,700158,0008,40012,200Determine and compare the multifactor productivity for historicalbenchmarking.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 7

Example 9.2 SolutionMultifactor ProductivityYear 1 Multifactor ProductivityYear 210,000 * 50 2.9150,000 8,000 12,00010,700 * 50 3.0158,000 8,400 12,200Since the multi-factor productivity ratio is expressed asoutput over input, higher is better.Year 2 productivity is better than Year 1.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 8

Commonly Used Productivity RatiosHours WorkedHours per Patient Day Patient DaysHours WorkedHours per Patient Visit Patient VisitsinpatientoutpatientSince these productivity ratios are expressed as inputover output, lower is better.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 9

Example 9.3Annual statistical data for two nursing units in Memorial Hospitalare as follows:MeasurementsUnit AUnit BAnnual Patient Days14,00010,000Annual Hours Worked210,000180,000Calculate and compare hours per patient day for two units of thishospital.Solution:Hours per Patient DayUnit A 180,000210,000 18 15 Hours per Patient DayUnit B 10,00014,000Since the HPPD productivity ratio is expressed as input overoutput, lower is better. Unit A productivity is better than Unit B.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 10

Example 9.4Performsbetter Associates – a two-site group practice, requires productivitymonitoring. The following initial data are provided for both sites of thepractice:MeasurementsAnnual VisitsAnnual Paid lculate and compare the hours per patient visit (HPPV) for the suburban andthe downtown locations of this practice.Solution:Hours per Patient Visit Suburb 115,000 .85135,000Hours per Patient Visit Downtown 112,000 1.15 hours or 69 minutes.97,000hours or 51 minutes.Conclusion: Suburb productivity is better than Downtownproductivity.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 11

.Adjustments for InputsSkill-Mix Adjustment weighs the hours of personnel ofdifferent skill levels by their economic valuation.One approach is to calculate weights based on the averagewage or salary of each skill class. To do that, a given skillclass wage/salary would be divided into the top class skillsalary.Let’s assume RNs, LPNs and Nurses Aides are earning 35.00, 28.00, and 17.50 an hour, respectively.One hour of a nurse aide’s time is economically equivalentto 0.5 hours of a RN's time ( 17.50/ 35); and one hour of aLPN's time is equal to 0.8 hours of a RN's time ( 28/ 35).ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 12

Calculations: Adjustments for InputsAdjusted Hours w * XiiAdjusted Hours 1.0*(RN hours) 0.8*(LPN hours) 0.5*(Aide hours)Adjusted HoursAdjusted Hours per Patient Day Patients DaysISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 13

Adjustments for Inputs.Similarly, in outpatient settings, if one hour of a nursepractitioner's (NP) time is economically equivalent to 0.6 hoursof a specialist's (SP) time, and if one hour of a generalpractitioner’s (GP) time is equal to 0.85 hours of a specialist’stime, adjusted hours would be calculated as:Adjusted Hours 1.0 (SP hours) 0.85 (GP hours) 0.6 (NP hours)Adjusted HoursAdjusted Hours per Visit Patient VisitsISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 14

Adjustments for Inputs: Example 9.5Example 9.5: Using data from Example 9.3, andeconomic equivalencies of 0.5 Aide RN, 0.8 LPN RN,calculate the adjusted hours per patient day for Unit Aand Unit B.Unit A at Memorial Hospital employs 100% RNs.The current skill mix distribution of Unit B is 45% RNs,30% LPNs, and 25% nursing aides (NAs).Compare unadjusted and adjusted productivity scores.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 15

Adjustments for Inputs Example 9.5 SolutionStandardized Cost of Labor.Solution: The first step is to calculate adjusted hours for each unit.For Unit A, since it employs 100% RNs, adjusted hours non-adjusted hours.For Unit B:Adjusted Hours (Unit B) 1.0 (180,000*.45) 0.80 (180,000*.30) 0.50 (180,000*.25).Adjusted Hours (Unit B) 1.0 (81,000) 0.80 (54,000) 0.50 (45,000).Adjusted Hours (Unit B) 146,700.In this way, using the economic equivalencies of the skill-mix, the number of hours isstandardized as 146,700 instead of 180,000.210,000 15.0 hours.14,000146,700 14.7 hours.10,000Adjusted Hours per Patient DayUnit A Adjusted Hours per Patient DayUnit BUsing adjusted hours, Unit A, which appeared productive accordingto the first measure (see example 9.3), no longer appears as productive.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 16

Adjustments for Inputs.Standardized Cost of Labor. Total labor cost comprises the paymentsto various professionals at varying skills. To account for differences insalary structure across hospitals or group practices, cost calculationscan be standardized using a standard salary per hour for each of theskill levelsLabor Cost ci * X iLabor Cost RN wages (RN hours) LPN wages (LPN hours) NA wages (Aide hours).Labor Cost Patient Day Labor Cost per Visit ISE 468 ETM 568 Dr. BurtnerLabor Cost of CarePatient DaysLabor Cost of CarePatient VisitsOzcan Chapter 9 Productivity Lecture 2Slide 17

Adjustments for InputsExample 9.6:Performsbetter Associates in Example 9.4 pays 110, 85,and 45 per hour, respectively, to its SPs, GPs and NPs inboth locations.Currently, the suburban location staff comprises 50% SPs,30% GPs, and 20% NPs.The downtown location, on the other hand, comprises 30%SPs, 50% GPs, and 20% NPs.Calculate and compare the labor cost of care, and labor costper visit for both locations.ISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 18

Adjustments for Inputs: 9.6 SolutionBased on Annual Visits and Annual Paid Hours listed in Example 9.4First, calculate “Labor Cost of Care” for each location.Labor Cost SP wages (SP hours) GP wages (GP hours) NP wages (NP hours),Labor CostSuburban 110 (115,000*0.50) 85 (115,000*0.30) 45 (115,000*0.20).Labor CostSuburban 110 (57,500) 85 (34,500) 45 (23,000).Labor CostSuburban 10,292,500.Labor CostDowntown 110 (112,000*.30) 85 (112,000*0.50) 45 (112,000*0.20).Labor CostDowntown 110 (33,600) 85 (56,000) 45 (22,400).Labor CostDowntown 9,464,000.10,292,500Labor Cost per Visit Suburban 76.24135,0009,464,000Labor Cost per Visit Downtown 97.5797,000Lower volume at Downtown location, Higher labor cost per visitISE 468 ETM 568 Dr. BurtnerOzcan Chapter 9 Productivity Lecture 2Slide 19

ISE 468 ETM 568 Dr. Burtner SlideOzcan Chapter 9 Productivity Lecture 2 3 Productivity Definitions and Measurements 1 (Review) Productivity is one measure of the effective use of resources within an organization, industry, or nation. The classical productivity definition measures outputs relative to the inputs needed to produce them.

Related Documents:

Introduction of Chemical Reaction Engineering Introduction about Chemical Engineering 0:31:15 0:31:09. Lecture 14 Lecture 15 Lecture 16 Lecture 17 Lecture 18 Lecture 19 Lecture 20 Lecture 21 Lecture 22 Lecture 23 Lecture 24 Lecture 25 Lecture 26 Lecture 27 Lecture 28 Lecture

Part One: Heir of Ash Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 Chapter 19 Chapter 20 Chapter 21 Chapter 22 Chapter 23 Chapter 24 Chapter 25 Chapter 26 Chapter 27 Chapter 28 Chapter 29 Chapter 30 .

TO KILL A MOCKINGBIRD. Contents Dedication Epigraph Part One Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Part Two Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18. Chapter 19 Chapter 20 Chapter 21 Chapter 22 Chapter 23 Chapter 24 Chapter 25 Chapter 26

Productivity ahf Applet Headline Factory document Productivity as Applix spreadsheet file . aep ArcExplorer project file Productivity mxd ArcGIS map document file Productivity alg ARCSOLO activity log Productivity avl ArcView File Productivity dbg ArcView File Productivity apr ArcView File . Productivity phb ClustaW tree file Productivity .

DEDICATION PART ONE Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 PART TWO Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 Chapter 19 Chapter 20 Chapter 21 Chapter 22 Chapter 23 .

Lecture 1: A Beginner's Guide Lecture 2: Introduction to Programming Lecture 3: Introduction to C, structure of C programming Lecture 4: Elements of C Lecture 5: Variables, Statements, Expressions Lecture 6: Input-Output in C Lecture 7: Formatted Input-Output Lecture 8: Operators Lecture 9: Operators continued

Lecture 1: Introduction and Orientation. Lecture 2: Overview of Electronic Materials . Lecture 3: Free electron Fermi gas . Lecture 4: Energy bands . Lecture 5: Carrier Concentration in Semiconductors . Lecture 6: Shallow dopants and Deep -level traps . Lecture 7: Silicon Materials . Lecture 8: Oxidation. Lecture

The American Revolution had both long-term origins and short-term causes. In this section, we will look broadly at some of the long-term political, intellectual, cultural, and economic developments in the eigh-teenth century that set the context for the crisis of the 1760s and 1770s. Between the Glorious Revolution of 1688 and the middle of the eigh- teenth century, Britain had largely failed .