Operational Excellence & Quality

Operational Excellence

Operational excellence is a philosophy of leadership, teamwork and problem solving, that results in continuous improvement throughout the organization by focusing on the needs of the patient, empowering employees, and streamlining existing activities in the process.

Operational excellence in a corporate culture, enhancing the way an organization provides patients with products and services. It requires a strong commitment and a culture of continuous improvement to solve current delivery problems such as cost and efficiency.

Continuous improvement applies not only to improving the quality of human resources, but also to improving processes and standards. Continuous Improvement starts by setting and correctly measuring the key process indicators (KPI), using the right documentation, controlling results, and defining preventive and corrective actions.

Implementing operational excellence and continuous improvement processes will lead to reduced waste and operational costs, shortened cycle time and reduced cost of the product/service.

Over the years, Tefen accompanied dozens of companies in implementing processes of continuous improvement and operational excellence with professional multidisciplinary teams and a shared commitment to improve business results.

Patient Care Operations Excellence

The clinical units of a hospital offer large opportunities for increased revenue if patient efficiency and increased capacity can be realized. Tefen helps clients reduce unnecessary costs and waste by leveraging the tools and techniques of Lean, Six Sigma, simulation and change management. The standardization of operating processes and the use of these tools and techniques, can enhance and improve performance, eliminate redundancies, and improve patient safety, satisfaction and admission process. 

Improve Patient Flow, Reduce Length of Stay, and Increase Capacity

Variability in patient flow often leads to issues with hospital capacity, bed availability and provider-to-patient ratios. We help redesign operational and process procedures to streamline patient flow between departments from admission to discharge.

These improvements result in faster turnarounds, better management of materials and better management of active discharge. These things lead to increased resource utilization and improved hospital wide patient flow and capacity. Furthermore, they contribute to improving the overall organizational performance and perception of patients.

Through the redistribution of workload and the elimination of peaks in patient occupancy, hospitals are able to increase patient volume without having to invest in new facilities. These changes improve access throughout the hospital and decrease processing time, wait time and patient lead times, allowing for patients to be treated effectively and in a timely manner.

Tefen also helps its clients focus on reducing the average length of stay (LOS) of patients when working on improving patient flow. Through reduced LOS, effective capacity can be increased, leading to additional scheduling opportunities and increased revenue.


In the obstetric ward of a hospital, safety of the mother and infant is the main consideration, and therefore, quality improvement is a main focus.

As quality of care is increased, process improvements lead to more efficient services. Further enhancements can then focus on increasing birth volume capacity, while continuing or improving the current level of care.

Tefen works with clients to increase birth volume, while improving performance and limiting new capital investment in facility renovation or construction.

In addition, improvements in materials management, provider practice patterns, room utilization and discharge management lead to reduced length of stay and reduced room turnaround time.

These solutions, coupled with improvements in procedure scheduling, staffing and facility sizing through forecasting, result in increased effective capacity. As a result, patient wait times are decreased and ultimately, patient satisfaction is increased.

Emergency Department

Hospitals are often challenged with emergency department admission wait times due to understaffing and inefficient patient flow and processing.

Tefen helps organizations realize quality improvements and cost reductions in the emergency department through assisting in the redesign and optimization of operational processes. These improvements lead to increased patient flow and effective capacity, resulting in easier patient access, as well as lower access costs.

Tefen also works with clients to improve patient information flow, resulting in an effective, efficient and accurate care administration. Ultimately, these changes can help streamline patient flow through the emergency department, resulting in shorter stays and increased admittance rates. Increasing the number of patients seen in one day enhances patient satisfaction, as well as increases revenue.

Perioperative Services

Surgical services in a hospital account for a large portion of its revenue. However, many health care systems are not fully utilizing their key assets’ space and time, and therefore are not performing to their potential.

Tefen works with hospitals to improve their scheduling process by using block scheduling and capacity planning, in order to reduce staff overtime and improve room and resource utilization. Tefen also helps organizations optimize room-turnover times, in order to minimize case delays. The effective flow of a patient can be improved through many process changes. Focusing on the OR, improvements can be made in patient preparation and information flow to minimize delays and support on-time starts. Through staff leveling, forecasting and improving access throughout the hospital, processing times, wait times and patient lead times can be decreased.

Materials management solutions can also be examined to reduce inventory holding costs, stock out event occurrences and time spent looking for materials. Tefen also works with organizations to increase accurate and on-time equipment delivery, resulting in quicker instrumentation turnaround time.

All of these solutions allow for patients to be treated effectively and in a timely manner, increasing the effective capacity of an operating room and resulting in increased revenue.


Radiology departments face many challenges that result in fewer patients being seen by physicians, lower patient satisfaction scores and overall financial return. Challenges such as on time starts, patient wait time, turn-around time, no shows/cancellations, backlog, cycle time, volume, wrong orders and unread exams, all affect the success of a radiology department.

The efficiency and effectiveness of hospital radiology services can be improved through the standardization of operating processes and procedures. Through work flow optimization, the department’s processes and overall flow can be streamlined to eliminate non-value added activities. These changes can help eliminate waste and reduce unnecessary costs, resulting in increased capacity and, therefore, revenue.

Tefen helps organizations improve their radiology services using several tools and approaches. Tefen also helps clients with evaluating their patient scheduling process to determine the most efficient and economically viable operating model. Tefen can also help with analyzing the impact and performance of patient transportation between the radiology department and other areas of the hospital.

Lastly, Tefen helps clients to complete staffing analysis and productivity measurement in order to align staffing patterns to historical patient demand while considering productivity performance measures.

Non-Clinical Operations Excellence

Improvements in an organization’s Laboratory Services, Pharmacy Department and Supply Chain can reduce unnecessary costs through streamlined processes. Using Lean, Six Sigma, simulation, and change management techniques, process enhancements are possible and will lead to more accurate and effective services.

Efficiency can be improved, resulting in reduced lab turnaround times and reduced pharmacy RX fill times, which in turn will lead to increased patient satisfaction and increased processing.

Laboratory Services

Many organizations struggle with inefficiencies in their clinical labs, resulting in decreased productivity and wasted time, both of which negatively impact the organization’s overall bottom line. When a lab is operating effectively, internal processes won't affect patients' responses to service, but once problems arise, patients will directly feel the negative effects.

Improving lab processing, reducing turn-around times, reducing variability and streamlining information flow can help increase efficiency. Variability in laboratory services leads to frequent errors resulting in rework and wasted time.

Tefen helps organizations streamline laboratory processes in order to reduce variability and improve accuracy. By identifying the root causes of variances, it is possible to determine which processes need to be standardized in order to eliminate process output variation. Through the standardization of data collection techniques, operating costs can be reduced and accuracy can be enhanced.

Information flow and efficiency can be improved through collaboration with institutional entities and research centers — such as the integration of the diagnosis and lab departments—as well as improvements in communication management and the delivery of test results.
Tefen also works with clients to leverage the tools and techniques of Lean, Six Sigma, simulation and change management to encourage laboratory transformation. These techniques result in the reduction of inefficiencies, coordination costs and waste throughout the laboratory; as well as significant improvements in patient care, due to increased accuracy and improved processing times, along with desirable cost savings.


Hospital pharmacies strive to improve workflow and reduce waste to achieve timely and quality service at low cost. Pharmacies can increase efficiency and effectiveness through process improvements, resulting in greater patient and physician satisfaction.

Tefen offers solutions to increase efficiency, such as improving communication between physicians and pharmacies and reducing idle time by utilizing down-time to perform preoperational activities.

Tefen also works with clients to determine optimal working shifts to address fluctuations in demands while maximizing patient units’ coverage. These solutions provide benefits to the operations of the pharmacy such as reducing the average fill time and limiting patient wait time.

Tefen helps hospitals realize cost reductions through examining drug purchases and pharmacy processes and procedures. Improvements in these areas can be achieved through better planning of the pharmacy’s supply chain, in order to optimize stock flows and Par levels, resulting in reduced stock-out turnaround times and satellite inventory, and as a result – to additional cost savings and reduced waste.

Organizational Excellence

Tefen helps clients improve organizational health through transformational changes and process redesign. Through process improvement, many opportunities that lower costs and increase productivity can be realized. Through labor management and effective management systems, Tefen helps organizations reduce redundant tasks and wasteful activities, resulting in increased efficiency.

Overall organizational health is enhanced through organizational design changes such as labor management and the establishment of a Project Management Office. These changes can result in improved patient flow, increased capacity, enhanced physician alignment and an adaptive foundation for future change.

We support our clients to identify current performance metrics and develop future state Key Performance Indicator dashboards. With Tefen, our clients develop management routines such as report-outs, reviews, huddles and visual controls such as notice boards and trackers, allowing day to day and month to month management and performance assessments.

Organizational Design Changes

Improving organizational design focuses on the enhanced integration of the assets of an organization: people, information and technology. Through transformational changes, strategic aims are reinforced, ensuring alignment of the corporate design and the organization’s actual functions.

Tefen helps clients improve their organizational design through the development of new working models and major operating processes. We also work with our clients to focus their organizational structure development and to establish a proactive system that forecasts potential failures and addresses them beforehand, in order to ensure lasting results.

Adaptive Foundation for Future Change

Effective change management is important to establish a foundation for ongoing change and continuous improvement. One challenge organizations face is achieving equilibrium where all levels of management and staff are willing to accept changes.

To support sustainable solutions, Tefen assesses the readiness of organizations to absorb change, anticipates resistance to change, and ensures that organizational infrastructure is capable of sustaining gains.

Tefen offers solutions through an analytical approach based on facts and data, with an emphasis on implementation and real transformation. Periodically auditing and reevaluating progress and solutions creates a continuously changing foundation, allowing for adaptive changes in the future. This foundation allows solutions to be easily transferable to other facilities, resulting in further continuous improvement.

Increase Efficiency and Productivity through Labor Management

All modern organizations face the challenge of utilizing their staff effectively and the healthcare industry is no different. Waiting, transportation, non-conformities and other non-value added activities reduce productivity in an organization immensely. Therefore improvements in staff management and utilization can be extremely beneficial in enhancing staff performance and the organization as a whole.

Tefen offers solutions to help increase efficiency and productivity of processes and staff. Offerings include aligning staff with demand, controlling workload volumes and optimizing single departments, resulting in a streamlined organization-wide process. Tefen also works with clients to help define the specific roles, tasks and working processes to minimize errors and rework and increase productivity.

In addition, Tefen helps clients create FTE rationalization programs and measurable performance guidelines in order to enhance the organization’s labor management techniques. Solutions include working towards the reduction of paid overtime and the decline of inefficiencies to increase employee satisfaction. Through labor management, Tefen also helps organizations reduce redundant tasks and wasteful activities.

Healthcare Quality

Over the last decade the focus on quality, whether during the provision of care or at the outcomes level, has increased. Tefen helps organizations increase the quality of their services through strategic thinking, while pursuing efficiency improvements and cost effective innovations.

Tefen’s methodology culminates in an organization realizing the benefits of a combined proactive and reactive approach to risk management. A reactive approach leads organizations to wait until an adverse event occurs and then react to this event with ‘local fixing acts,' while a proactive approach is achieved through the implementation of preventive actions before any adverse events have occurred.

Through the combination of these approaches, which has been determined to be the most practical and suitable implementation, patient safety risks are minimized and the overall quality of services enhanced, leading to enhanced service, greater patient satisfaction and reduced costs.

Patient safety involves reporting, analysis, and prevention of errors. The Healthcare Quality Consulting realm covers the degree to which programs, policies, services and research increase desired outcomes and conditions in a healthcare organization. Advancements in desired outcomes are challenging if the organizational environment does not support the processes.

In addition, the impact of the Patient Protection and Affordable Care Act on the industry intensifies the need to overcome the previously listed barriers. Tefen has worked to develop an innovative methodology which will help healthcare organizations adapt to these changes while continuing to achieve excellent Healthcare quality and patient safety.

Quality Maturity Assessment

Analyzing the current state of an organization helps to determine where improvement changes will be the most beneficial and prevents confusion and unfocused goals. In the Quality Maturity Assessment phase, Tefen helps clients use a maturity scale to evaluate a hospital’s current condition in order to focus future improvement initiatives. Through this approach, clients are able to increase the value and quality of their offerings through improvements in strategic and operational approaches throughout the entire system.

Quality Measures Management

When working to improve healthcare quality, it is important to have a system that allows for improvement measurement in order to determine progress. During the Quality Measures Management phase of quality improvement, Tefen helps organizations develop tools and processes for effective measures management and to routinely review measures in order to drive continuous improvement work.

The Institute of Medicine has defined 6 categories in Healthcare Quality Consulting: patient safety, safe care, timely care, effective care, equitable care and patient-centered care. These tools can be used as measurable parameters that can help an organization determine if it is improving its quality and patient safety.

Establish a Project Management Office (PMO)

A centralized and coordinated management of initiatives is extremely important in any organization if long term, positive results are to be achieved. It is crucial for ownership to be taken over all projects and this sense of accountability helps support the project leader’s prioritization and decision making process.

A Project Management Office (PMO) must work to balance the challenges of optimizing organizational efficiency, lower costs, as well as answer to the needs of the stakeholders. It is important for the PMO to oversee the proper management of all initiatives in the healthcare facility. The PMO must be able to manage quality projects, direct and guide project execution, promote collaboration and ensure that standardized, best practice processes are utilized on all projects.

Tefen helps in the establishment of a PMO to provide project governance, prevent wasteful duplication and train project leaders and team members on project execution.

In order to optimize the quality of care, hospitals are expected to adhere to a set of core care measures, developed by the Joint Commission. This set of measures is a standardized performance measurement system that has been proven to reduce the risk of complications, prevent recurrences and enhance the treatment of patients. Tefen helps organizations follow these measures in order to improve the quality of care.


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