Trade-offs are a fact of life. Evaluating trade-offs can help set priorities, for example by making us confront options and select the ones that really matter. But in other cases, the long-term effect of trade-offs can lead to outcomes that we would prefer to avoid.
In healthcare, trade-offs between costs and mission are daunting. Technology has emerged as a way to help dampen the pain of the trade-offs, especially with respect to patient outcomes. It is seen everywhere, from the OR and ER to records and building services. The results are impressive and encourage us to embrace technology.
But in one area, operations are still 100% manual. Environmental services collects waste or recycling from containers in public areas the same way it did 100, 500, and 1,000 years ago. A person checks a can, removes a bag, often 25% or less full, puts in a new bag, and wheels the empty bag and other bags around the facility until a cycle is complete. Often they do this many times a day. The consequences of not doing this--litter, pests and worse--demand it.
They do a terrific job: hospitals are clean and and they deserve credit for their work. But they’re locked into an operational framework with zero automation and zero information technology support. This forces them to employ manual processes and diverts resources from other activities. To make sure they don’t face overflows and litter, pests, or unsightly messes, countless hours are spent on the unrewarding routine of preventively collecting waste from old-fashioned receptacles in cafeterias, courtyards, and parking structures. These are hours that environmental services would prefer to spend on things that would align them with the mission of patient-centrism and showcase their operational excellence. And that would give them the recognition they deserve.
The reason for this persistent operational framework is simple. Environmental services can’t afford to let trash get out of hand. To keep up with it, resources are diverted to preventive collections. They can’t know when each of the 50 - 100 or more trash cans characteristic of a medical center is full, so they collect from every single one of them long before it can get full.
Imagine how this could be different. For example if every trash can could handle five times as much waste and tell you when it’s full, you could end up collecting as much as 80% less. And use the recovered time and resources for other things.
That’s what Bigbelly does. Its software and hardware system compacts waste, increasing capacity between 300% and 500%, and alerts you when collection is required. Software analytics, managed from a unified dashboard, permit just-in-time collection, freeing resources for other hospital activities. Costs are recovered, service improves, and outcomes are better. Upgrades are seen in budgets, job satisfaction, employee and visitor engagement, green performance, and HCAHPS. The lock on manual operations is opened and environmental services can employ technology like nearly all operations of the medical center have.
Trade-offs may be a fact-of-life. But they are not destiny. Stay tuned for more case studies on how Bigbelly has helped the healthcare industry leverage technology and just-in-time techniques for environmental services.