Zen and the art of hospital maintenance

Based on the analyses of the annual reports of hospitals we present our 2008 study of Dutch hospital performance “Zen and the Art of Hospital Maintenance”. Hospitals are complex organizations and are undergoing significant changes. These changes bring several risks. One of the new analyses we report in this study is an Early Warning System. The Early Warning helps identify at risk hospitals based on current, concrete risks.

The Zen and Maintenance aspects of care are two key concepts we emphasize in this report. Care is always about Zen: the complete feeling and heeling aspect of our health. But to continue to provide this superior care hospitals need to be tuned in like good mechanics on the running of their operations. Volume, price, revenue, costs, case-mix, profits, debt, equity are all key metrics. Hospital management needs to continuously hear, see, smell, taste and touch this complex care machinery. It needs to be in tune with this engine. Anticipate early signals of malfunctioning. Have the competences and the tool kit at hand to make the necessary adjustments on the fly. And should the malfunctioning be major not hesitate to call in the cavalry. To help hospitals and other stakeholders keep a feel for the functioning of the hospital sector we publish our annual report. The five key conclusions of this report which cover 2008 are:

  1. Revenues continue to increase well above economic growth, costs increased just a notch faster
  2. Productivity of hospitals declined again in 2008
  3. Labor cost, both salary of own personnel and number of externally hire personnel, saw sharp increase
  4. Tumbling profits were propped up by bungling transition
  5. Early Warning System is reported to identify hospitals at risk both due to low operational cash flow and large debt in changed cost of capital regulation regime
Download the full report 'Zen and the Art of Hospital Maintenance' (in Dutch) here » Download the executive summary of 'Zen and the Art of Hospital Maintenance' (in Dutch) here »