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dagaz success
   - Inpatient billing was delayed up to 75 days upon discharge, resulting in 19 Million dollars outstanding.  Improper billing, coding, transcription, and collection fees resulted in millions of dollars uncollected.
Project Work   - Focus on the patient chart from discharge to final collected bill uncovered poor documentation by MD’s, lost charge capture by nurses, inefficient use of coding staff, and billing software not current.
Final Result     - Patients are now billed within 55 days (goal is 40 days), uncollected fees per month equal 6 Million dollars, new procedures and policies ensure that fees are captured correctly and submitted within 3 days.  Work-around loops were eliminated, chart flow through the Medical Records Department is streamlined and employee satisfaction has improved.

success dagaz
Background    - Construction of two additional surgical suites had been budgeted at a cost of 2-2.5 Million Dollars due to inadequate surgery time according to the Surgery staff.
Project Work   - Dagaz Inc. calculated the actual use of the operating suites between 65-68%.  A goal of 88% utilization of the surgical suites was established and achieved within four months of the initial assessment.  Departmental contributions included: Surgeons deciding to block surgical time based on historical use not seniority; Nurses improving turn-around-time of surgical suites between procedures to maximize availability; Office staff submitting cancellation of blocked time at least 72 hours in advance.
Final result      - Surgical capacity was increased without additional construction. Additional surgery revenue was realized as well.

Background  - Increasing patient volume has contributed to waiting room delays of 4 hours, treatment cycle times of 6 hours, and admission delays up to 12 hours. 10 Million Dollars was allocated to build a larger Emergency Department.
Project Work
 - Bottlenecks during MD shift change; lack of bedside registration; delays in radiology and laboratory services; and patient admissions being “pushed” to the floor not “pulled”, were identified as root causes for the long delays and patient dissatisfaction.
Final result
   - By improving workflow, removing bottlenecks, and investing minimal capital investment, the department is prepared to accommodate 20-30% increase in volume within 1.5 years. Patient satisfaction has risen from the 10th percentile to the 50th percentile. With improved efficiencies we were able to employ “creativity before capital”.

bed capacity
Background  - Bed occupancy at 95% has led to Nursing staff shortages, reliance on Agency Nurses with additional costs, poor management of floor supplies, delayed admission times from the Emergency Room, and other “downstream” issues.
Project Work
- Evaluating patient flow led to improved admission and discharge processes. Eliminating non-value added Nursing functions, increased employee satisfaction; increased time dedicated to treating patients, and increased productivity from the Nursing Staff.
  - Nursing productivity increased, cost savings resulted due to less dependence on Agency Nurses, Nursing satisfaction rates increased, communication between departments led to less “critical shortage of beds” overall.

success dagaz
Background    - An overall increase in patient census with frequent “critical shortage of beds”, and inefficient workflow patterns suggested that significant capital investment in the form of new construction would be necessary.  Millions of dollars for construction, interruption in routine delivery of care, and patient inconvenience were significant hurdles facing the new construction project.
Project Work  - Identifying root causes which led to bed shortage, poor workflow, and an inefficient process was completed.  Our data, employing Lean and Six Sigma tools, and collaborating with Hospital architects and construction engineers resulted in a design that minimized unnecessary space, and reducing construction costs.
Results   - Capital investment for construction costs was significantly less than initially expected.  Staff were excited their input within the Process Excellence program translated to highly efficient and functional workplace.

dagaz material 
Background    - Expansion of the Hospital and newly added services led to inventory and supply chain issues.  Material shortages led to overnight transportation costs, inefficient delivery of supplies to nursing floors, increased distribution costs, and increased inventory costs.
Project Work   -
Value stream mapping of the supply chain revealed inconsistent ordering policies within the hospital, inaccurate inventory of supplies, and no process to monitor whether supplies ordered were used.
Results    -
Capital investment to construct additional storage space was deferred at present.  Minor investment to the loading area, new policies for supply orders, and new strategies for delivery of materiel to peripheral centers were initial projects determined from the value stream map.  These suggestions resulted in Materiel Management ability to maintain the correct inventory for the Hospital as it grows into the future.