What is the evidence of how hospitals capture financial benefits of process improvement and does it impact hospital financial performance?: A systematic review

Abstract Title What is the evidence of how hospitals capture financial benefits of process improvement and does it impact hospital financial performance?: A systematic review Background Hospitals managers around the world are looking for ways to address the continual growth in expenditure by reducing the level of waste in the healthcare delivery system and improving the value of care provided to patients. Process improvement methods are being applied to increase high value care, reduce low value care and remove waste from care processes. The purpose of this study is to establish whether hospitals can measure and capture the financial benefits of process improvement (PI) through reducing process and clinical care waste and improving the value of care. Methods A systematic review was undertaken that followed the PRISMA process and employed qualitative research methods. Results Only six papers that reported a reduction in care process waste or improvement of the value of care using an evidence based PI approach and included financial benefits analysis were identified through the systematic review. In these papers, a positive financial impact was measured for the PI initiatives but none of the studies reported how the financial benefits were captured or applied to the enterprise level. Three of the studies suggested that sophisticated cost accounting systems were required to enable this. Conclusion The study demonstrates the paucity of literature in the field of PI and financial benefits measurement in healthcare. Where financial benefits are documented, they vary in terms of cost inclusions and the ‘level’ at which the costs were measured. Further research on best practice financial measurement methods is needed to enable other hospitals to measure and capture financial benefits arising from their PI programs.