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Increasing value in plagiocephaly care: a time-driven activity-based costing pilot study.

Gino Inverso1, Michael D Lappi, Susan J Flath-Sporn

  • 1From the *Department of Plastic and Oral Surgery, Boston Children's Hospital; †Harvard School of Dental Medicine; and ‡Harvard Medical School; and §Harvard School of Public Health, Boston, MA.

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Summary
This summary is machine-generated.

Time-driven activity-based costing improved healthcare value by reducing patient visit times by 19.9% for plagiocephaly cases. This process optimization increased clinic revenue and demonstrated a novel metric for continuous improvement.

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Area of Science:

  • Healthcare Management
  • Process Improvement
  • Cost Accounting

Background:

  • Healthcare process management is often poorly understood, leading to inaccurate patient care cost assessments.
  • Time-driven activity-based costing (TDABC) was employed to analyze the diagnosis of plagiocephaly, a high-volume, low-complexity condition.
  • The study aimed to enhance value within a clinical setting through process evaluation.

Purpose of the Study:

  • To apply Time-Driven Activity-Based Costing (TDABC) to a specific clinical process.
  • To identify inefficiencies and areas for improvement in patient care delivery.
  • To quantify the impact of process modifications on patient visit time and cost of care.

Main Methods:

  • A cohort of 59 plagiocephaly patients was studied across two phases.
  • Phase 1 involved process mapping of 23 activities performed by 5 clinicians and administrative staff.
  • Phase 2 implemented workflow modifications based on Phase 1 analysis to assess impact on visit time and costs.

Main Results:

  • Patient visit time decreased by 19.9% (13 minutes, 25 seconds).
  • Per-patient cost increased by 7.7% ($8.22) due to physician process time changes.
  • Workflow improvements generated an estimated $7904 in additional annual revenue by enabling 2 extra appointments daily, yielding a value ratio of 1.113.

Conclusions:

  • Time-driven activity-based costing is a novel and effective tool for healthcare process improvement.
  • The value equation, combined with TDABC, provides a quantifiable metric for continuous quality improvement initiatives.
  • This pilot study demonstrates successful application in a clinical environment for optimizing patient care value.