Organizational Development

Personnel costs account for 55 to 70 percent of a hospital’s total costs. Recent decisions by the Federal Ministry of Health regarding nursing staff structures present many hospital operators with significant staffing and, consequently, performance challenges. The fact that personnel costs in primary care have been rising faster than the associated revenue for years must be offset by hospitals through increased performance and more efficient staff deployment in areas where there are no rigid requirements.

Antegrad assists with:

1. Establishing personnel and qualification concepts for primary care for the present and—aligned with the corporate and medical development strategy—for the future. These future concepts are supported by Antegrad with business plans to objectively and economically demonstrate opportunities, timelines, and risks, as well as options for action should reality and planning diverge over time.
2. Developing efficient operational organization concepts and calculating specific employee profiles and volumes for tasks in secondary and tertiary sectors.
3. Benchmarking as a basis for make-or-buy decisions.
4. Designing high-performance organizational structures, developing transformation and development plans, and setting up profit and loss accounts for these areas (supporting every make-or-buy decision with its own business calculation model and controlling tool).
5. Operational implementation of personnel development and changes.

While the primary sector focuses on market niches, marketable service portfolios, regionally coordinated service distribution, cooperation, and targeted competition, the secondary and tertiary sectors focus more on efficiency and optimal support of primary services in terms of organization, service range, and costs.

Operational Organization Concepts for the Primary Sector:
Market analyses, competitive analyses, and epidemiological and demographic developments determine the framework for every medical department. The detailed development of a specific service portfolio for each department is vital for survival and is therefore a core task of corporate management.

Antegrad supports management in:
– Creating transparency regarding the market and the opportunities and risks of the existing service portfolio
– Coordinating a future concept for each department and jointly developing a development plan for services, training, and personnel structure
– Managing the implementation process and analyzing progress and deviations
– Identifying opportunities for cooperation and cross-sector care concepts
– Their implementation and financing

Operational Organization Concepts in the Secondary Sector:
The following situation often exists:
– The secondary sector allocates its costs. Service providers in the primary sector are dissatisfied because they feel they are being charged costs that are too high.
– The secondary sector faces no “real” pressure to perform due to cost allocation.
– Efficiency (number of examinations/time unit, etc.) is low compared to the “market,” and waiting times are too long.
– Tensions exist between secondary service providers and primary providers.

Antegrad helps coordinate the entire service process with the primary processes. Only an optimization of the entire process (from ordering requirements to the written availability of the test result) enables a leap in improvement instead of mutual finger-pointing. Antegrad analyzes specific problems and provides solution scenarios. We develop implementation planning and also implement the concepts.

Operational Organization Concepts in the Tertiary Sector:
In the tertiary sector, we very often find:
– Organization by service type (instead of process/team)
– Historically grown structures in organization and workflow
– Low transparency
– Little technical expertise at the executive management level

This leads to:
– Low performance efficiency
– Low reputation of tertiary service providers within the organization (facility management, IT, etc.)
– A “gap” between medical and non-medical staff
– Significantly high operating costs for construction, technology, IT, administration, etc.—combined with objectively low performance, extremely long project durations, and subjectively perceived low competence

Antegrad helps define tasks for the tertiary sector very precisely and standardizes the processes for requesting services. We support you in developing and implementing modern service concepts (e.g., decentralized food supply or digital supply chains). Antegrad’s approach is always to coordinate closely with the client. We recommend an expert view for the “new organization.” This distinguishes us from consultants who develop organization and performance “bottom-up” with service providers according to their own ideas. Antegrad draws on its many years of operational experience in various industries to transfer efficient approaches to the hospital environment.

Whether we like it or not, as a hospital, we are in competition with private practitioners and other hospitals. A hospital is a business, and at the end of the year, the hospital owner expects the hospital to make a profit. If this is not the case in the long term, the “usual fundamental entrepreneurial questions” regarding the maintenance of operations and services arise.

Even if this approach provides plenty of room for macroeconomic and ethical discussion, it remains the framework for every hospital management today and in the coming years.

Consequently, management should be able to track the house’s costs and services accurately and reliably. They should know which services generate revenue and which do not, which area has an excessive or appropriate cost structure, and should control where development funds flow.

This transparency of financial systems is a prerequisite for any entrepreneurial management. However, the question arises whether the financial system is set up in such a way that this requirement can be met. Or is it the case that no chief physician takes the confrontation with figures seriously because the figures are simply incorrect or cannot be transparently and clearly assigned?

Antegrad develops the appropriate financial and management system together with its clients. Derived from the organizational structure, we recommend simple financial structures and clear rules for cost and revenue distribution—and implement them.

Does a hospital have to manage and carry out its construction projects itself?

Can we expect the employees of a hospital construction department to perform this professionally?

Do we have to determine every laboratory value needed for patients in the in-house laboratory?

Does the hospital need its own workshops and, if so, what exactly should they do and what not, and who draws the line?

Does it need its own kitchen, and must the cleaning service be performed with its own staff?

These questions are answered in some way in all facilities—but the boundaries between in-house production and outsourcing are often not consciously drawn. They have evolved, and it is unclear whether the existing division between make or buy leads to good results and is efficient, fast, appropriate, and cost-effective.

Antegrad questions this in depth and provides management with a very nuanced answer—combined with an objective, temporal, and monetary potential analysis. Antegrad examines existing competencies and options in all functions and recommends the ideal make-or-buy interface. We create the transformation plan and take over project management during the transformation and development phase and for key projects (including construction). Antegrad makes the tertiary sector transparent and its services marketable and comparable in the market. We can lead the departments for the duration of the transformation, deliver the transformation, and develop talent that can continue to evolve the organization after Antegrad’s departure.