Below we have summarized some of the projects we have executed:
Working on continual improvementClose
‘From good to great’A large healthcare organization active in the area of housing, welfare and healthcare wanted to substantially invest in its services and market position. Yet being able to achieve the improvements it desired required highly effective planning due to changes in elder care and to the organization’s intended objectives. Our task was to provide guidance and ensure these objectives were met. Given that the organization’s financial management was already very good, the challenge to go from good to great was enormous.
Identifying potential for improvementFollowing an intensive period during which we identified specific areas for potential financial improvement, our team worked together with the managers to create improvement plans for several areas. Over the course of one year, these plans were then implemented. Alongside this financially-driven top-down approach, we also reinforced the future foundation and effectiveness of the organization by instructing employees in Lean and Kaizen principles and methodologies and then working together with them to apply these. As a result, employees now are able to apply these processes themselves or even devise new processes to continually improve the effectiveness and quality of the organization.
Not for everyoneSuch a bottom-up approach is only possible for clients that are prepared to work with us for the long haul. More importantly, increasing employees’ problem-solving abilities must be within the vision, direction and strategy of the organization.
‘Great to work with everyone from the cleaning person to the geriatrician’
From advice to results – can you do that?On this assignment, I stepped into the picture exactly when most consultants generally leave, when it comes to translating advice into actual results. In other words, it was time to put our money where our mouth was. Combining a top-down and bottom-up project at all levels within an organization is complex and requires many of Gupta Strategists’ core competencies – teamwork, analytical skills and critical thinking. I’m really proud of the results we achieved both at the strategic and operational levels. My work matters, every day.
Thijs de Kruif
Testing strategy for elder care providerClose
Growth in a time of contractionOn the eve of major spending cuts in elder care that implied a significant decrease in revenue for the average market player, one of our client organizations presented a strategic multi-year plan that forecast modest growth in the coming years. Several board members questioned whether or not this outlook was unduly optimistic and called on us to estimate the extent to which market changes would impact their revenue.
Scenario analysis of policy effectsWe designed a model that enabled us to calculate the effects of changing government and insurance company policy and of the changing competition climate on the revenue of the elder care institution for various scenarios. We did this for three areas of service: light elder care, heavy elder care and home care. Based on our analyses, the client was then able to adjust its multi-year strategy and identify challenges for its teams to begin tackling.
‘Nice to be able to add value in a short period of time’
Great experienceIt is great to see that in a relatively short period of time you can gain an array of insights that are recognizable to the board and can serve as a tool for improving the multi-year plan. That we then were able to present our findings to the team leaders during their strategy day and see them put everything to use was the icing on the cake.Kees Isendoorn
Ensuring clients always have access to the medication they needClose
Changes in the pharmacy worldIn recent years, a lot has changed in the pharmacy world. The Dutch Health Care Inspectorate (IGZ) has placed tighter controls on quality, and profit margins are being squeezed to the extent that some pharmacies are being forced to shut their doors. Such developments can have negative effects on patients who then must go out of their way to get to another pharmacy. Together with a large health insurance company we developed a model that makes it possible for everyone to always have access to the medication they need.
From a vision to an implementable planFor a healthy thirty-something living in the center of Amsterdam, a pharmacy closing has much less of an impact than for an older person living alone in a small town. Working closely with an insurance company, we created a model that offers solutions for every type of patient in every type of situation. We also worked in constant coordination with primary care physicians, pharmacists and patient organizations.
This model is already operational in several places to meet the needs of the insurer’s clients. The solutions vary from a transition service that arranges for patients to be able to give consent to allow a new pharmacy to view their medication file to, in the most extreme case, the establishment of a temporary pharmacy location. The latter is of course only necessary in the event that there is no other pharmacy nearby the one that closed.
‘Instructive to work on both strategy and implementation’
Varying workIn the initial phase of this project, we created a model – which is typical for strategy consulting. We then were involved in the actual implementation of the model – perhaps not typical strategy consulting, though certainly just as fascinating and instructive. In this phase we worked with many parties both within and outside the client organization to put the solutions we’d come up with into practice. Only then do you really get to know an organization.Roxanne Busschers
Determining the impact of relocating healthcare servicesClose
Keeping care localSurgical volume standards often exist for oncological surgeries, meaning that a hospital can only perform a given operation if it does so more than a certain number of times per year. As these standards become increasingly high, relocating healthcare services from one hospital to another can be critical to keeping these services available in the area. For a group of hospitals we analyzed the impact of such healthcare service shifts on important parameters such as revenue, fees, length of stay, etc. so that a well-thought-out decision could be made regarding where which service is best performed in terms of both quality and quantity.
Building a flexible simulation modelTo be able to provide outcomes for all of the various scenarios, it was crucial to build a flexible simulation model. The model we built made it possible to immediately see the outcomes of all possible relocation options for the important parameters specified. However, to ensure that such a model is actually able to add value, the outcomes must be reliable. The real added value we provided was thus by ensuring that both the board members and the surgeons recognized and trusted the numbers and, as a result, were able to use them to simplify complicated decisions.
Procurement strategy for long-term healthcareClose
Major changes on the wayThere are major changes on the way in long-term healthcare. Insurance companies and municipalities are becoming responsible for lighter care (such as home care) and, at the same time, significant spending cuts are having to be made. In such a situation a good procurement strategy is essential, and together with an insurance company that is what we developed.
Establishing an overview of the situationTogether with analysts from the health insurance company, the very first thing we did was to establish a clear picture of the current long-term healthcare situation. In doing so we were able to determine where the insurance company could cut spending and where it should be vigilant in maintaining the accessibility and quality of healthcare.
Translating the insights into a procurement planThe insights gained offered several angles from which to approach the procurement strategy. We worked out three different procurement models, which we then presented and discussed in workshops. We ultimately opted for a widely accepted procurement strategy, which will be implemented over the course of the coming years.
‘Nice challenge to implement political decisions’
Dynamic projectThe reforms in long-term healthcare affect large groups of vulnerable clients. No wonder that this subject has garnered a great deal of attention and is regularly in the news. It was very interesting to look beyond the news reports and, together with the insurance company, find a good way to implement the political decisions made. The fact that these decisions were being made while the project was still in full swing made it all the more dynamic.
Ensuring home care that is viable for the futureReady for the futureA mid-sized player in home care struggled with fluctuating financial results. Furthermore, the organization had insufficient equity to ensure its security for the future. Due to the organization’s poor financial situation, planned government spending cuts in home care posed a serious threat to its survival. The assignment was to help ensure a future for the organization.Close
Identifying potential for improvementTo identify where there was potential for performance improvement, we benchmarked the entire company. We compared various aspects of the organization with other institutions to see where the company’s performance was lagging and thus where there was potential for improvement. Using scenario analysis, we also estimated the effects of the planned government cuts on the organization. Based on these analyses, we formulated an action plan so that we could work with employees to institute change and prepare the organization for the future. In the coming years we will continue to support this organization in implementing these changes.
‘Very instructive to establish a clear picture of all the layers and processes in home care all at once’
Instructive challengeFor this project to succeed, an integral approach was needed. We had to coordinate all aspects of the company – the client administration, the finance department and of course the care itself. We made sure that all actions and changes fit together like pieces of a puzzle to ensure the project was a success. A great, instructive challenge.
Substantiating choices in care offeringsClose
Making revenue and cost understandableAmidst current discussions on healthcare concentration and distribution, a hospital wanted to make choices regarding the care it offered to ensure optimal financial health and sustainability for the future. To do this, it was necessary to know what sort of care the hospital excelled at and where it operated with healthy margins. For the latter, we worked with the hospital to develop a model that enabled us to understand both the costs and the revenue per individual patient. From the perspective of the patient, it then became possible to look at the hospital’s performance in all possible areas (diagnosis, specialization and department). These insights proved to be useful not only when it came to discussing care offerings but also when considering cost-saving programs and negotiating with insurance companies.
To measure is to knowDuring this project we worked closely with GIDS, a spin-off of Gupta Strategists. GIDS specializes in knowledge-intensive business intelligence solutions in the healthcare sector and has developed a web application to make hospital performance understandable in a way that is quick and intuitive. The financial model developed for this project was built into the GIDS web application, which means that in the coming years the hospital will be able to measure the effects of care offering choices on all fronts based on up-to-date data.
‘My medical knowledge and the close collaboration with the hospital ensured results were widely accepted’
Personal successDuring this project I focused primarily on developing the model for assigning costs to individual patients. By working closely together with a team from the hospital, we were able to make optimal use of available medical and financial data. Thanks to my medical knowledge and experience, we were well-positioned to create a model that reflected the complexity of reality. As a result, the model was well received by the financial and policy departments and by the medical specialists – a personal success.Niels Hagenaars
Strategy for better healthcare qualitySince the establishment of the new healthcare system in 2006, the question still remains: how can insurance companies (and their purchasing departments) guarantee high quality care at the best price for their insured? Gupta supported an insurance company in developing a strategy to improve healthcare quality.Close
Pinpointing success factorsThe government, patient organizations, insurance companies and specialists have worked hard to create standards by which to measure healthcare quality for patients with specific illnesses. Specialist medical associations have also formulated minimum quality requirements for certain procedures. Despite this, doctors and patients still only have insight into the outcomes of delivered care for less than 10% of conditions. Therefore, in this project, the resounding question was: what are the success factors for improving healthcare outcomes?
‘Faced with a mountain of facts, I was able to quickly draw relevant conclusions’
Translating strategy into action‘The challenge in this project was to analyze a mountain of facts, including examples from abroad, in a very short period of time. By doing so we were able to decide on a strategy. My task was to draw relevant conclusions and advise the insurance company. I also coached employees on how to translate the strategy into concrete action plans. All in all a considerable job, but also a very interesting one.’
Lissy van de Laar
Better pharmaceutical care from pharmaciesFor a pharmacy chain we developed a complete program for improving pharmaceutical care. Our role consisted primarily of structuring, quantifying and steering the team. We worked closely with a client team, part of which was outside of the organization to ensure better results.Close
From an idea to a productWe began by taking stock of the ways in which pharmaceutical care could be improved and made less expensive. For example, by prescribing less expensive medications and preventing medication errors. All options were assessed based on their feasibility and impact. Next, we chose three options that improved both quality and effectiveness. These three were developed into a concrete product that was ready to be tested in practice. Together with the client, we developed an ICT tool to support interventions in medication. A useful operational process that didn’t waste time with trivial details.
Successful pilotThe pilot was a useful way to make adjustments to content, process and organization based on actual experience. Following the successful pilot, the project was scaled up to a large number of pharmacies. The success of the project lies in its focus on obtainable products, developed by a multi-disciplinary team where pharmacists have the lead regarding medical content
‘Great to contribute to an actual improvement in patients’ health.’
Typical strategy consulting‘A sharp bird’s-eye view was essential during the second part of this project. Throughout the implementation, I functioned as a strong link between the pharmacists, ICT technicians and commercial staff. In other words, I made sure that everyone was always on the same page, that deadlines were met and that there was sufficient support for the new concept. You can imagine how motivating it was when, afterwards, pharmacists told me that this project had contributed to an actual improvement in their patients’ health.’Jurre de Bruin
Making smarter purchasesAn average of 30% of hospital costs consist of procurement costs. This percentage is steadily increasing. During this project, we aided a small hospital in reducing procurement costs, considering that our analysis showed that these costs were around 20% higher than for similar hospitals. This resulted in the formulation of the goal to reduce the procurement costs with 20% in the coming years, 10% of which within the duration of our project. It was an extensive challenge to reduce these procurement costs, in which both analytical puzzles and operational implementation proved to be of the utmost importance.
Where is the money going?The first phase of the project consisted of mapping all procurement costs of the hospital. To obtain a clear overview all costs divided into several categories (distributors, hospital departments, type of product, etc.) we had to combine a multitude of different data sources. This overview enabled the hospital to identify the categories on which the most costs can be reduced.Close
Getting to work! The second phase of the project posed a whole different array of challenges. We would – as representatives of the hospital- engage in negotiations with distributors ourselves, to evaluate existing and new contracts. We established purchasing groups in which we, together with doctors, nurses and managers, would screen all possibilities to economise. This could be by reducing prices, but also by using less or choosing a cheaper product. Therefore, we conversed with users such as doctors and nurses, to evaluate whether it would be possible to transfer to different products (i.e. different brand catheters) or to use less of the same product (i.e. use less printer paper). Together with the hospital we managed to meet this ambitious goal to reduce costs.
It is great to make a noticeable substantial amount of process in a couple of months.
From data and meetings to cost reductions.During the first phase of this project, I mainly focussed on drawing up a record of expenses. Quite the puzzle, that required me to consult several data sources that proved to be largely inaccessible. When I succeeded in using these sources to gain new insights for the hospital, my confidence grew. That confidence helped me to conduct conversations with both people from within the hospital and distributors. It gave me a sense of accomplishment to help the hospital realise a substantial, measurable reduction of procurement costs with 10-15%.Koen Merkus
The future of suppliesSupplies are used a lot within the healthcare industry, both by professionals and patients. Examples are bandages, but also blood glucose meters for diabetics. Together with the distributor of medical supplies, we investigated the possibilities to develop services to complement these products.Close
More than regratingTraditionally, a supplies distributor is a party that buys products from a manufacturer to subsequently sell them again. Usually their customers are hospitals or other care providers, or they sell directly to the patient. The patient is not interested in the product itself, but the result of use: healing, returning home from the hospital, or managing a chronic illness. What can a supplier do to aid the patient in meeting this goal as quickly as possible with a satisfactory result? A supplier can offer complementary services together with the product, such as offering insight in the development of the disease with an app, giving personal tips about the use of the product, or offering specific expertise in addition to that of the doctor or nurse. This allows the supplier to add a large amount of value than solely selling the product.
Exploration and elaborationTogether with a team consisting of supply distributors, we have assessed the possibilities to offer supplementary services. In this project, the patient was put at the centre: what are their needs? The sky was the limit while compiling the longlist of possibilities; we didn’t let practical objections or technical obstacles limit us. Consequently, we developed a method to systematically evaluate different options, for example based on impact and feasibility. Subsequently, we further developed a concrete business plan with a sound justification for several of these options. The next step was to, together with teams with profound knowledge of the specific product, implement a number of these plans.
Nice to translate an abstract concept to a concrete plan
From idea to implementationDuring this project, it was nice to take the step from an idea on non-existing services to implementation in practice. How do you translate a concept to a concrete plan, that is also financially attainable? One of the challenges was to merge different perspectives: wishes of patients and care takers, technical feasibility, funding from the health insurance companies and supplier’s internal processes.Lisa Vogelpoel
Achieving a future-proof mental health care for children and youthSupplying mental healthcare for children and youth has been the responsibility of local authorities ever since the Youth Act was introduced in 2015. This is coupled with retrenchments and an emphasis on accessible basic care. Organisations offering more specialized mental healthcare to children and youth are forced to restructure both commercially and content-wise. We supported on of these care providers in heading in such a new, future-proof direction.
Transforming while maintaining qualityTogether with a workgroup of practitioners and operational managers, we tried to answer the question on how care provision could be transformed without compromising its quality. We developed a model that enabled us to map out numbers, costs and gains for each client group. Subsequently, we made an inventory of all opportunities for improvement and economy for each individual client group. Lastly, we carefully considered the possibility of implementing the changes in each client group. The extensive knowledge on healthcare and expertise supplied by the work group was essential in this aspect.
Concrete plan of approachThis process resulted in several tangible plans that correspond with the desire of local authorities and clients to clearly distinguish between basic and specialised care, reduce inpatient care, and reduce waiting lists. In a plan of approach, we defined the needed actions, prerequisites, and possible risks. This enabled our client to engage in a dialogue with local authorities at an early stage, offering sophisticated care based on content and quality. Close
The collaboration with managers and practitioners had an energising effect
Intensive collaborationThis project called for an intensive collaboration with a workgroup consisting of both practitioners (psychiatrists, psychologists, group leaders) and operational managers. During our weekly meetings, we combined our project-based and analytical approach with their substantive knowledge and practical experience. A combination that turned out to be effective and energising!Marloes Hagemans