Post on 07-Aug-2020
Supply Chain in Paradise
Presentation by: Mike Hildebrandt
Director of Supply ChainThe Queen’s Health Systems
May 11, 2016
The Queen’s Health Systems
The Queen’s Health Systems is a not-for-profit corporation established in 1985 to provide expanded health care capabilities to the people of Hawai‘i and the Pacific Basin. It is Hawai‘i’s oldest and preeminent family of health care-related companies, and has over 6,000 employees dedicated to a healthy Hawai’i.
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The Queen’s Health Systems*Punchbowl*West Oahu*Molokai*North Hawaii *Diagnostic Lab Services
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The Queen's Hospital, now called The Queen's Medical Center, was founded in 1859 by Queen Emma and King Kamehameha IV.
In King Kamehameha IV's initial speech to the legislature in 1854, the King voiced his desire to create a hospital for the people of Hawaiʻi. At that time, the continued existence of the Hawaiian race was seriously threatened by the influx of disease brought to the islands by foreign visitors. Queen Emma enthusiastically supported the dream of a hospital, and the two campaigned tirelessly to make it a reality. They personally went door-to-door soliciting the necessary funding. The royal couple exceeded their goal in just over a month, raising $13,530. In turn, the Legislature appropriated $6,000.
Through six generations, The Queen's Medical Center has become a major provider of health care to the people of our State and a part of the cultural fabric of Hawaiʻi.
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Brief History
Mission Statement
Mission Statement:To fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity
quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawaiʻi.
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The Queen’s Health Systems
Annual gross patient service revenue
$2.6 billion
Annual Supply Spend
$205 million
Annual Admissions
31,642
Annual Outpatient Visits
559,216
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Accreditation and Awards
The Queen's Medical Center takes pride in the patient quality awards that it's been honored with. Below are some of the accreditations and awards that Queen's has received:
Johns Hopkins PartnershipCertified Member of MD Anderson Cancer NetworkJoint Commission Accreditation AwardsJoint Commission Certified Primary Stroke CenterMagnet® RecognitionCommission on Cancer Approval with CommendationsBreast Center National AccreditationHarold P. Freeman Service AwardNCI Community Cancer Centers Program (NCCCP)The Guidelines Gold Plus Performance Achievement Award — StrokeGet With The Guidelines Gold Performance Achievement Award — CardiacBlue Distinction Center® for Spine Surgery and Cardiac CareUnitedHealth Premium® Cardiac Specialty Center
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THE CASE FOR CHANGE
The Queen's Health Systems (QHS) is dedicated to providing quality customer service. In the foot steps of our founders, we believe in our values C.A.R.E. - Compassion guides our actions; Aloha inspires us in all that we do; Respect and understanding are essential for the dignity of all; and, Excellence is our quest. These values shape our organization to strives for excellence and continuous improvement.
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CURRENT STATE
The current environment has major issues relating to age, supportability, number of interfaces, accuracy and speed of accessing data. Most importantly, this hinders support of future growth and initiatives.
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Case for Change
Finance
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.
Today
Decentralized Functions
Hospital Company Hospital
FIN
SCM
FIN
SCM
FIN
SCM
• Functions are performed locally at each entity
• Entities generally have their own structures, policies and procedures
5+different GL
Systems
Largest Systems Are
30+Years old
Highlymanual and Runs on a
Main-frame
Supply Chain
12+different Systems
LargestSystem
Installed in
‘99
3 Are past
end-of-life
Finance
Means to be one, to become one:
The vision is to become the Premier Healthcare Shared Services organization in Hawai'i, providing high quality, data-driven, responsive administrative services that support our health care delivery functions, our patients and our communities.
In order to achieve this, we will optimize QHS System-wide business support functions through the implementation of organizational structure changes, process improvements, and leveraging of an enterprise technology platform.
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BUSINESS TRANSFORMATION AS A STRATEGIC LEVER
Future growth:
How do we position QHS for future growth?
Need to address current system issues:
- Age, supportability, sustainability and growth
Implementation of the Finance and Supply Chain applications, known as the QHS Enterprise Resource Planning (ERP) Project.
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PROJECT OVERVIEW
• An Enterprise Resource Planning (ERP) system is typically comprised of software that enables finance and supply chain management and includes a common database, real-time processing, integrated workflow, seamless system interfaces, automation, and enforcement of business rules and practices. Our goal is to utilize the software as the lever to achieve business transformation.
• Transformation will encompass People, Technology and Process.
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Project Overview
Phase 1 Scope:
• General Ledger
• A/P & Expenses
• Assets
• Project Costing (Capital Projects)
• eSettlements
• Strategic Sourcing
• Purchasing
• eProcurement
• Inventory
• Mobile Inventory
• eSupplier Connect
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Project Overview
Phase 2 Scope:
• Grants
• A/R & Billing
• Real Estate Management
• Project Costing (enabling Grants)
• Treasury
• Contracts & Supplier Contracts
• Financial & Supply Chain Analytics Core
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Guiding Principles
• As we design this transformation project, we'll use the following principles to guide us:
- Facilitate standardization and consistent execution of business practices across the system
- Maximize the use of functionality of our chosen technology solutions
- Ensure efficient delivery of high levels of service quality
- Provides for the creation and maximizes the use of information and analysis to improve decision making
- Improve cash management
- Allow Queens to scale – to grow without adding proportional cost
- Maximize affiliates' management focus, time, and attention on the quality of care delivery
- Provides the flexibility to expand in scope and evolve toward a vision of system-wide shared services
- Be a catalyst for creating the culture to which we aspire – customer service oriented, with a working environment that is supportive and effective
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Ho'olōkahi Enterprise Administrative Systems
• Finance
• Supply Chain
• Human Capital Management
• Enterprise Learning Management & Enterprise Portal
SCMFIN
HCM
We are finalizing our deployment strategy for Ho`olokahi and as part of that effort have identified the staffing needed to provide ongoing support for the FIN/SCM applications and other major business and administrative applications (HCM/ELM/KRONOS) of QHS:
ELM
SUPPLY CHAIN VISION
We will provide responsible stewardship of QHS resources, products and services through integrated and innovative service delivery, value
analysis decision-making, and data-driven product/services/vendor management practices. Our goal is to provide service excellence and
continuous improvement for our QHS and affiliate customers and clinical partners, and ultimately our patients.
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Transformation 2020
Goal = $45,000,000 annualized cost savings
$22,500,000 in FY 2016 for the organization
$19,000,000 savings goal for Supply Chain
Five Year Net Cash Flow Benefit$89,800,000
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Ho'olōkahi FTE Changes Overview
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Centralization of inventory management and supplier management
Additional SUPPLY CHAINpositions in
• Demand & Inventory Management• Analytical Support• Supplier Management Efficiencies achieved through
automation and org redesign
Reduction in SUPPLY CHAINFTEs in
Buyer staffing positions
This is a long-term plan, that starts with Finance, Supply Chain, and then HR and Rev Cycle
Confidential Information
Launch ERP and Functional
Shared Services
2016Program Launch
2015
Within each function
Launch
Multi-Function Shared Services Operation
2020
Consolidated Shared
Operation Center
Its own function
Separate Entity
Separate, revenue-generating entity
Shared Services Offered to
Market in Hawai’i
2025
Functional Shared Services
Shared Delivery Operation
Profit Center
Premier Healthcare Shared Services in Hawai’i
The Journey to System Shared Services
HCM Fin SCM
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Centralized purchasing that will coordinate and standardize procurement activities across all entities
Requisition to check automation that will provide visibility and make the end-to-end procurement process easier for end-users
Online catalogues with better information, product photos and descriptions, pricing, and ratings by other employees.
Strategic Sourcing benefits, putting more purchases on contract
Increased contract compliance, decreased special spend and decreased noncontract buying
Cash acceleration from inventory management
ERP functionality that will easily identify and track vendor rebates
Automation and efficiency gains resulting in increased inventory turns
Use of handhelds and ERP to automate and increase efficiencies related to inventory fulfillment replenishment
Benefits to Supply Chain & Requisitioners
Key Elements of Shared Services
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1. Service Delivery Center is typically centralized and responsible for transactional requests, responding to low risk transactions, process / rule driven transactions, commonly asked questions, and escalating unresolved issues.
2. Centers of Excellence (CoEs) comprised of specialist resources with subject matter expertise responsible for performing policy, process ownership and knowledge management roles. Typically consolidated supporting a certain part of business or more broadly across the organization.
3. Decentralized functions are localized strategic business partners in a client-facing delivery/execution role; providing guidance to stakeholders and linking the field back to the centralized business unit.
Centers of Expertise
Decentralized Functions
Service Delivery Center Common
Governance
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In order to…
So that…
Standardized and consistently executed business process across
the system
System-wide adoption of our chosen technologies
The centralization and consolidation of finance
and supply chain as shared services
Improve efficiency and quality of
service
Improve cash management
Allow Queen’s to scale without adding
proportional cost
Provide information and analysis needed to improve decision
making
We can become the Premier Healthcare Shared Services organization in Hawai‘i providing high quality, data-driven, responsive administrative services that support our health care delivery functions, our patients and our communities.
Results We Expect
• Purchasing • eMarketplace• Master Data Maintenance
Service Delivery Center (Centralized)
• Consolidate Repair Requests/Information
• Performance • Management• Clinical Asset Maintenance
Asset Lifecycle
Purchasing
Transactional or rules-based services
• Inventory & Demand Management
• Operations Management
• Category Complexity & Risk Management
• Value Analysis Process• Contracts Management• RFP Management• Supplier Relationship /
Vendor Credentials Management Process
• Procurement Policies & Procedures
• Rebate Management
Center of Excellence (Centralized)
• Analytical Reporting/Metrics
Core Supply Chain Analytical Support
• Asset Management Process Management
Asset Management
Distribution & LogisticsCategory, Value Analysis, Contracts, and Supplier
Relationship Mgmt.
Policy and strategy oriented services
Decentralized Functions
Affiliate Representatives, Supply Chain Staff
• Receive Items• Inventory Management• Sterile Processing/Central
Services• Repairs Operations/ Clinical • Disaster Recovery• Waste Management
Critical on-site services
Confidential Information24
Supply Chain Management Operating Model
Supply Chain Management (SCM) Organizational Chart Summary
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As of 8/10/15
Organizational Chart: SCM Service Delivery Center
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As of 8/21/15
Title(FTE – Grade)
New Position
Positions subject to reduction-in-force
Title(FTE – Grade)
Organizational Chart: SCM Center of Excellence
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As of 7/20/15
Title(FTE – Grade)
New Position
Positions subject to reduction-in-force
Title(FTE – Grade)
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Organizational Chart: SCM Decentralized FunctionsAs of 8/18/15
Title(FTE – Grade)
New Position
Positions subject to reduction-in-force
Title(FTE – Grade)
Expected Benefits
There are significant savings, balance sheet, and other benefits that we can expect from this effort. We will consolidate transactions, build additional capability, and allow affiliate staff to focus on delivery.
Supply Chain
• Centralized purchasing
• Requisition to check automation
• Increased buying power and vendor rebates
• Improved inventory replenishment with handheld bar code scanners and automated inventory ordering processes
• Improved inventory turns
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Ho‘olōkahi*Goal: Build organizational capacity as an enterprise through a strong, integrated administrative system, and centralization and consolidation of Finance and Supply Chain as Shared Services
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Phase 1 Go Live: 7/1/2016
Phase 2 Go Live: 4/1/2017
*This section summarizes the estimated on-going operating impact of the Finance and Supply Chain target operating models and application support
Supply Chain
Key outcomes expected:
• Improved cash management
• Timely and accurate information and analysis to assist with decision making
• Scalability to support growth
• Strategic Supply Sourcing
• Efficiencies and improved service levels
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Benefits to Healthcare
Technology plays an important part in a health system’s ability to deliver high-quality care at an affordable price
ERP systems can assist departments to be more transparent, efficient and prompt at delivering their services which ultimately drives more accountable patient care and services
Healthcare is a quickly evolving field, so the more healthcare systems can be ahead of the curve, integrated and cost-effective, the better equipped healthcare providers are at handling the influx of new patients, changes in regulation and new technologies
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Solidify Presence on
O‘ahu
Establish Presence
on Big Isle
Build Clinical
Integration
Establish Payer
Relationships
Create Strategic Alliances
Integrated HC System
Build Org. Capacity
The Transformation
• Starting from a position of strength
• Significant near-term investment required for transformation
• Future with a sense of purpose: the Integrated Healthcare System
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1 2 3 4 5 6
Ho‘olōkahi Benefits
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EDI
System focus
Results
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Service Line
ANNUALIZED BENEFIT
(Implemented) FY2016
ANNUALIZED BENEFIT (Identified) FY2016
ANNUAL REALIZED BENEFIT
THROUGH 04/30/16*ANNUAL REALIZED
BENEFIT by 6/30/16*
Cardiac $382,148 $2,014,547 $637,307 $720,643
Nursing $262,615 $587,395 $658,913
Path/Imag/Lab $88,070 $211,140 $136,681 $161,119
Pharmacy $2,872,183 $1,216,038 $2,124,825 $2,603,523
Rebates $1,559,609 $1,559,609 $1,559,609
Supply Chain $315,192 $6,743,171 $171,887 $231,494
Surgical Services $1,062,539 $3,933,671 $1,982,266 $2,195,314
Grand Total $6,542,357 $14,118,567 $7,199,970 $8,130,616
* includes FY15 carryover savings = $2,414,903 as of 4/30/2016
The Queen’s Health Systems
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