What does a patient registration cost? Process observation as a method for determining administrative process costs - A field report
Knowledge database Organisation Structures & processes Data management & digitalisation System selection & implementation Workload & well-being Patient-centred approach D.4: Method kit for quantifying the process potential of digital health toolsHow much effort is actually involved in administrative patient registration - and how does this effort change when digital solutions such as heyPatient are used? This question was at the centre of the pilot studies carried out as part of the D.4 sub-project.
Problem description, research question and relevance
Hospital processes cause not only clinical but also administrative costs. Patient registration in particular - as the first step in the care process - is a central but often underestimated component.
It not only influences organisational efficiency, but also the patient experience and downstream processes. Digital solutions such as heyPatient promise relief here, for example in the context of digital preparation - but how measurable are their actual benefits? Our central question was therefore: How does the process effort of patient registration change when digital modules from heyPatient are used - and how can these effects be systematically recorded using the "process observation" method from the method kit?
Methods and procedures in the project
As part of a pilot study, the process observation method was applied in two acute-care hospitals in Switzerland. The aim was to test the practicality of the method and to obtain initial quantitative information about the time and effort involved in patient registration. For example, in a pilot hospital by comparing the processing of patient registrations without use vs. use with the heyPatient solution.
The process observation was used to record real processes, times and media breaks in order to be able to draw conclusions about the process costs. A selected part of the heyPatient portfolio was taken into account - in particular those modules that enable digital registration and information transfer prior to admission (digital preparation module).
The methodology followed the guidelines from the methodological toolkit:
- Definition of the process area to be compared (patient registration)
- Development of observation sheets to record work steps, duration, participants, systems and interruptions
- Carrying out the observations on site in the patient administration area of the pilot hospital
- Separate documentation of registration processing with and without heyPatient use
- Analysing and comparing the data collected with regard to time expenditure, staff involvement and potential cost differences
The successful implementation of process monitoring requires foresighted and careful planning. A key success factor here is the early involvement of employees. As early as the preparatory phase of the pilot study, the teams in the respective departments were informed transparently about the objective, procedure and scope of the observations and actively involved in the planning. Clear communication of the purpose of the observation is particularly important: Process observation does not serve to evaluate or monitor individual performance, but rather pursues the goal of recording processes in a structured manner - particularly with regard to time sequences, interfaces and potential optimisation potential. The focus is on the process, not on the person carrying out the work.
Results and findings
After carrying out the process observations, the time measurements for processing patient registrations with and without the heyPatient solution were analysed and compared.
The results showed differences between the observed variants:
- When using heyPatient, several steps of data collection were omitted, as information was already transmitted digitally in advance
- The processing time per registration was shorter on average (time saving of at least 16% per processed patient registration)
- Using the heyPatient solution improves the quality of the data and ensures completeness. This saves time in subsequent processes.
- By using the heyPatient solution, cost savings can be achieved thanks to process optimisation, both in the processing of patient registrations and in downstream activities.
The observations thus allowed a systematic quantification of the administrative effort using an instrument from the D.4 method kit and thus a basis for the evaluation of digital healthcare solutions at process level.
Recommendations for practice
Our experience shows: The process observation method is suitable for making the impact of digital tools such as heyPatient measurable in the administrative area. Our recommendations:
- Use the method specifically forbefore-and-after comparisons or with-without comparisons when introducing digital solutions
- If possible, combine observation with qualitative feedback from the team (e.g. through interviews or focus groups)
- Allowssufficient time for the preparation and training of observers and analyses data anonymously
- Ideally, measure the work steps at the same time on the same days to ensure comparability and make sure that the observers are the same people for several measurements
- Utilises the findings not only for evaluation, but also for change management and process adaptation
In our pilot study, structured process observation not only provided realistic insights into the registration process - it also showed in particular how digital solutions such as heyPatient have a concrete impact on administrative work. The method from the D.4 method kit therefore not only provides access to process cost analyses, but also a valuable tool for evaluating and managing digital healthcare interventions. The method kit has proven to be a practical tool that can be used flexibly, even in the context of pilot studies in real hospital settings.