Strategy & Realignment

The orthopedic outpatient clinic of a regional Swiss hospital center found itself in a critical situation following a major personnel shake-up: inconsistent processes, a lack of standards, and increasing workloads led to declining performance. The aim of the project was to stabilize operations in the short term while at the same time aligning structures in such a way that the outpatient orthopedics department could operate more efficiently and economically in the long term.

In a multi-stage process, clear process and role logics, digital standards, and a new outpatient clinic structure were developed. This not only eliminated previous bottlenecks, but also created a sustainable operating model that enables a performance increase of around 20% and lays the foundation for sustainable growth.

Background: Staff changes reduce capacity

The hospital center operates several locations and treats over 10,000 inpatients and over 120,000 outpatients annually. With its specialized sub-departments, the orthopedics division is a key pillar of the medical services offered.

Until 2023, the orthopedic outpatient clinic was run by an experienced team. Due to retirements, resignations, and internal changes, the available capacity was significantly reduced, while at the same time several new employees had to be trained.

This situation meant that existing structural weaknesses became more apparent and increasingly noticeable in day-to-day operations: the processes that had developed over many years proved to be only partially viable under the changed staffing conditions.

Challenge: Integrating new employees into inconsistent processes

• Training new employees: New team members were introduced to processes that were sometimes informal and inconsistent, which led to uncertainty and additional work.
• Insufficient use of digital tools: Digital applications were available, but were used inconsistently and often not in accordance with their functionality – partly due to a lack of training and clear guidelines.
• Lack of process standards: Different approaches, especially in medical work processes, made coordination difficult and led to duplication of work and friction losses.
• Declining patient numbers: As individual physicians extended their consultation hours, fewer patients could be treated per unit of time, putting further pressure on the economic utilization of the outpatient clinic.

Solution: Joint development of clear structures and processes

The outpatient clinic was reorganized in a multi-stage, participatory process:

1. Analysis and prioritization
   Key weaknesses and areas requiring action were identified through structured interviews with medical and administrative staff and a comprehensive analysis of the initial situation.
2. Development of a target process
   In two interdisciplinary workshops, a sustainable target process was developed along the patient pathway. This formed the basis for new workplace and task logics for medical practice assistants, the introduction of “unit logic” to increase the efficiency of medical consultations, and the targeted, standardized use of digital applications for physicians and medical practice assistants.
3. Validation and finalization
   The developed concept was tested on site and validated directly during consultations. As part of the pilot run, the new processes were run through with the employees and further developed in close consultation. For example, an additional counter was set up for the MPAs for the “unit logic” in order to provide a fixed workplace with a screen.
4. Preparation for implementation
   Specific target figures were defined for sustainable implementation, which individual physicians will be expected to achieve in their consultations in the future. These targets were established as the basis for future controlling. In addition, training sessions were organized with software solution experts to optimally prepare employees for the use of digital applications and the implementation of new processes.

Result: Higher performance and sustainable stability

1. More efficient processes: The new, standardized processes and the uniform use of digital tools reduce the workload and free up more time for patient care. In addition, digital patient files were introduced for all physicians, almost completely replacing paper records.
2. Increased performance: Structured scheduling and optimized consultation procedures have made it possible to increase the number of appointments by approximately 20%.
3. Economic effect: The concept enables a noticeable increase in efficiency and improves the utilization of existing resources. In addition, the introduction of a fixed quota for new patients has also increased the number of operations and thus the number of inpatient discharges by approximately 10%.
4. Sustainable team development: Clear responsibilities, targeted training, and coordinated resource planning strengthen teamwork and ensure long-term performance.