Hospital Set to Rethink, Retool Business Ways By Steve Libowitz Administration looks to re-engineering as way to remain competitive The Johns Hopkins Hospital formally launched last week a process that will rethink and reorganize the way it does business for the foreseeable future. The "re-engineering" of every aspect of the hospital's operations over the next three to five years is designed to cut costs, improve quality of patient care and minimize any potential loss of jobs. "This is the hardest job we will ever do as an organization," said James A. Block, president and CEO of the Johns Hopkins Hospital and Health System. " But it is one on which our mission and our 7,000-person workforce depend." Dr. Block acknowledged that re-engineering is often perceived by the public as being synonomous with staff cutbacks, but he stressed that Hopkins' goal is to avoid or reduce to a minimum any loss of jobs. He cited the Department of Orthopedic Surgery's re-engineering effort, which began in early 1993, and projects savings of $5.5 million over the next five years without staff layoffs. The re-engineering effort will be led by a steering committee headed by Gennaro J. Vasile, executive vice president and chief operating officer, with representation from senior management, hospital physicians, nurses and house staff. "There will be literally hundreds of employees involved in the design team," said Diane M. Iorfida, senior vice president for human resources and organizational effectiveness. "We are committed to cross-training and retraining to maximize the contributions and potential of every employee. This is not a zero-sum game in which one person's gain will be another's loss." Iorfida noted that the Wilmer Eye Institute, which re-engineered its emergency care unit, same-day surgery and inpatient surgery units into one unit, reduced costs by more than 20 percent since July 1992. Although some positions in the renamed Wilmer Nursing and Trauma Center were lost to attrition, she said, no layoffs were necessary. "Like academic medical centers everywhere, we face the task of staying competitive in an aggressive local marketplace while carrying built-in costs related to education, biomedical research and indigent care that other hospitals don't have," Dr. Vasile said. "We are determined to continue to provide the highest quality and the best possible value for patients and insurers alike." Quality health care and cost-effective delivery are also the primary concern to the School of Medicine's faculty practice of more than 800 physicians who provide the community with all aspects of health care. "In general, if re-engineering is managed properly and is successful in cutting costs without shifting them around, that's good for the School of Medicine," said the school's dean, Michael E. Johns. "By reducing costs and making the operation of the hospital more efficient, we will be able to establish a fee structure that will be competitive with anyone in the area and therefore better offer Hopkins quality care. "But we have more than a business interest in this process," he said. "It is the faculty practice that subsidizes the school's research and education mission. So, we look forward to working in collaboration with the hospital to get the job done." Re-engineering will become an enduring feature of hospital administration at Johns Hopkins, Iorfida said. "We want to manage by constantly reinventing and refining ourselves. We will be improving all the time."
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