Henry Ford invented the assembly line and efficient mass production, but until recently efficiency hardly characterized the inner workings of the automotive pioneer's namesake hospital in Detroit.
Case in point: If a television in a patient room at 668-bed Henry Ford Hospital was broken, the course to getting it fixed or replaced was long and tumultuous, often requiring a series of phone calls that easily could lead to a dead end if the right person couldn't be located at the right time. Ditto for linen delivery, equipment repairs or many of the other countless, mundane tasks required for the smooth running of a major hospital.
Ford managers referred to it as the "silo" arrangement: a bureaucracy where information tended to flow up or down, but rarely laterally. In such an environment, an air-conditioning unit leaking into a ceiling would require individual calls to fix both the ceiling and the unit.
"Many times it would take six, seven or eight phone calls and sometimes multiple visits to a particular (department) to get to the right person," recalls Mike Whelan, Henry Ford's vice president of integrated support services. And even then, there was no guarantee something would get done right away.
"There was no real-time tracking in terms of how long it took to assign and perform a task," says Tom Mahony, manager of the hospital's express services division.
A decision was made in late 1998 to centralize the handling of in-house service calls. Along with the revamp, which was handled with the help of Sodexho Marriott, it was decided that the level of dedication given to the tasks should parallel the level of care given to patients.
"We didn't do this out of a need to fix a broken system," Whelan notes. "The critical calls, the emergency calls, were being taken care of. We have very good people in terms of responding to an emergency situation and making sure patient care is sustained. But the issue for us was more of the chronic delay that gets built in, because this is a very large place and processes are easily overwhelmed."
Changes were rolled out in March 1999 and were completed by July. A centralized call center was installed in a 300-square-foot section of the hospital basement. Fifteen employees who usually handled service phone calls staffed the center, armed with new computer software designed to better delegate and track service calls. A triage system was established to sort deferrable tasks from more important service requests to ensure that regular maintenance didn't suffer as spot maintenance was performed.
The 35 maintenance employees, who were accustomed to performing two or three tasks each, were retrained to do as many as 45 tasks each.
Hospital officials also were determined to make sure the level of internal service matched the care given to the patients. "Many of the departments were able to change the independent way they think and enabled us to make the changes," says Valerie Clark, director of integrated support services.
Results were obvious. Delivery times of medical equipment to patient rooms dropped to less than an hour from an average of nearly 21/2 hours. Light bulbs that often took hours to replace are now being changed in fewer than 25 minutes.
The cost of implementing the changes was minimal (no exact figure was available), but Henry Ford realized a net gain of $205,000 per year through the reduction of nine full-time positions. "The improvement was such that we had a bunch of people asking if we had turned on the lights in the basement or repainted," Mahony says.
The proportion of the caregiver staff satisfied with in-house services jumped to 80% from about 60% in the first year of the program, according to in-house surveys.