The Public-Private The Public-Private Debate Best Practices & Debate Best Practices & Future Directions Future Directions Paul Faguy Integrated Vice President St. Joseph’s Healthcare Hamilton Hamilton Health Sciences
Jun 15, 2015
The Public-Private Debate Best The Public-Private Debate Best Practices & Future DirectionsPractices & Future Directions
Paul Faguy Integrated Vice PresidentSt. Joseph’s Healthcare HamiltonHamilton Health Sciences
“There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things.”
Niccolo Machiavelli
Points for Discussion
• Role of the private sector
• A working perspective to consider
• Lessons learned
Role of the Private Sector
• Take the transactional work
• Add value
• Enable focus
• Collaborate
• Innovate
Transactional to Strategic
Transactional activity is defined by the importance of what is done or accomplished or delivered, not how.
Strategic actions are activities that define the very nature of the enterprise.
Any enterprise that wishes to succeed must constantly shift its intellectual energies from the transactional to the strategic.
What is transactional for one organization, is strategic for another!
“A secret in life is to
keep things simple,
but not too simple.”
Albert Einstein
Challenges for Healthcare
• Traditional view
• Digging the same hole deeper
• Benchmarking
• Lack of funding
• The “private” dilemma
• Unanswerable demand
Measuring the Value of Alternate Sourcing
1. Keeping the lights on for less
2. Increasing innovation
3. Transferring & optimizing risk
SMARTSOURCING, Koulopoulos and Roloff
Keeping the lights on for less
Using scale and process efficiency to reduce the cost of non-discretionary process spending.
Creating more innovation for the given dollar
Discretionary process spending in healthcare usually occurs because of crisis or occurs last! Proper core focus provides greater access to scarce resources to increase the value of the discretionary spending.
Transferring & Optimizing Risk
Moving risk to the partner best equipped to absorb it. Scale, or past investment, makes one partner better able to absorb certain risks. Shifting risk to that partner can create value for both.
““The significant problems The significant problems we face we face
cannot be solved atcannot be solved atthe same level of thinking the same level of thinking
we were at when we we were at when we created them.”created them.”
Albert Einstein
First decide what is core and
then determine opportunity
and priority.
A Working Perspective
Our core competency is
the patient care process
and relationship.
12 Areas of Consideration
• Nursing relief• Security• ER physician
coverage• Clinical
housekeeping• Core housekeeping• Transportation
• Human resource
business processes• Grounds keeping• Parking• Materials
management• Retail food• Laundry and linen
Patient care core
Nursing relief YSecurity YEmergency physicians YClinical housekeeping YCore housekeeping NTransportation NHR BPO NGrounds keeping NParking NMaterials management NRetail food NInpatient nutrition YLaundry and linen N
Lights on
Transfer of risk
Innovation Economies of scope
Core housekeeping
H L L M
Transportation H H M H
HR BPO L H H H
Grounds keeping H H M H
Parking H H H H
Materials management
M M H H
Retail food H M M H
Laundry and Linen
H H M H
High Impact Medium Impact Low Impact
“Strategy without tactics is the
slowest route to victory.
Tactics without strategy is
the noise before defeat.”
Sun Tzu
Lessons Learned
• Changing versus change• Business process transformational
change• Legal Issues• Opportunity or Strategy• Wherewithal• Managing the “new” service
relationship