BUSINESS PROCESS MANAGEMENT CASES Digital Innovation and Business

BUSINESS PROCESS MANAGEMENT CASES Digital Innovation and Business Transformation in Practice EDITORS: Jan vom Brocke Jan Mendling

PEOPLE-CENTRIC, ICTENABLED PROCESS INNOVATIONS VIA COMMUNITY, PUBLIC AND PRIVATE SECTOR PARTNERSHIP, AND E -LEADERSHIP: THE CASE OF THE DOMPE EHOSPITAL IN SRI LANKA Dr. Wasana Bandara Rehan Syed Bandula Ranathunga Dr. K. B. Sampath

INTRODUCTION

The Dompe e. Hospital in Sri Lanka • Health sector reforms are a challenge ! – especially technology-supported process improvements in developing nations, This case on the Dompe e. Hospital in Sri Lanka is a unique success story of a peoplecentric ICT-enabled BPM effort that overcame many challenges through steady championship fueled by a multi-sectorial support network (local community, government agencies, private sector and institutes of higher education).

SITUATION FACED

At the start: A weak Regional Hospital • The story is of a regional hospital with a weak reputation in Sri Lanka – It had mundane and manual processes – Physical set up was chaotic – Poor patient record systems

Key (differentiating) ingredients • The project was driven by a desire to make a difference • Had the following Key ‘forces’: – the championship of a doctor who had (then recently) been transferred to work in the role of medical-officer-in-charge • Became the glue that brought all the other “assets” and enablers together and brought the digital revolution to the hospital. – Strong Partnerships with • Other public sector agencies • The community; able professionals in the community, the private business sector (large and small) • Academia. Cases like this bring a paradigm shift to public sector management in developing nations by pointing to new management models that bring together a public-private-

ACTION TAKEN

Main transformations done • Changes in the physical environmental • Patient-centric ICT-enabled processes for delivery of medical services • m-Channeling

‘People factors’ – supporting the change “People are at the heart of processes. ” (Jeston & Nelis, 2010, p. 5) • Staff ICT training • Better workplace organization method (like 5 S) • Outbound training for staff at all levels: to build a team spirit and a sense of urgency • Celebrating milestones and success • Educating the patient (user) community of the changes that were coming • Strong Championship

Recognition of resident community leaders Team-building across multiple staff levels Celebrating success annually with all staff Making a group pledge to commit to positive change

RESULTS ACHIEVED

Physical space improvements • The physical space improvements enabled patients to access the services they needed easily and effectively. – Eased congestion and created space for the staff to perform their duties effectively and efficiently. – Better Patient experience: • waiting time was reduced • Patient feedback that “Dompe Hospital is a better place now” The hospital became a pleasant place to visit instead of a chaotic one, with the inward rush reduced and people knowing where to go and what to do. See video clip demonstrating the changes in the environment that have resulted from the reform efforts: https: //www. youtube. com/watch? v=-Yquj. XDf. HHQ

Implementation of the digitized health management information system (HHIMS V 1. 3) • The system-supported process improvements have benefitted multiple stakeholders in multiple ways – The electronic queue management system made management of patients’ waiting time more efficient, and generation of daily reports improved OPD staff’s productivity. – Doctors have real-time access to patients’ medical history and demographic details, the availability of drugs in the stores, and lab reports. – The efficiency and productivity of nursing staff have improved as a result of them having easy access to treatment instructions from doctors. Access to the patient treatment information has helped the nursing staff improve their ward planning and scheduling activities. – The pharmacy staff has access to legible prescriptions and automation of the required quantities of prescribed drugs for patients. The automation of stock counts and inventory processes has significantly reduced the staff workload. – Appropriately labelled lab samples that are now delivered to the lab technicians have improved the accuracy of the lab analysis reports and reduced human error. – Administrative staff can easily monitor operational performance and make effective decisions by analyzing the required statistical data. – The ultimate beneficiaries are the patients, whose healthcare services have improved as a result of the improvements in the processes and culture of Dompe Hospital.

m-Channeling system • Eliminated time-wasted by patients - Walk-in OPD patients get service within an average of forty minutes, as opposed to ~2 hours previously. - Patients who use m- Channeling are served in a 15 -30 minutes from arrival to exit. • Reduced congestion in the hospital premises.

At Present: An (inter)-national exemplar of ICT-enabled hospital processes • Dompe e-Hospital has become a landmark success story in Sri Lanka’s ICT-enabled government process-transformation efforts. – The initiative received a national productivity award from the Sri Lankan Presidential Secretariat, and – an e-Swabhimani award, in recognition of its ICT-enabled transformations

LESSONS LEARNED

Main insights… The Importance and Power of the ‘PEOPLE’ factor in BPM initiatives People = human capital - This case study demonstrates: - How wide that ecosystem of human capital can be. - Mechanisms of tapping into these social networks. - The project is also evidence of the essential role of a champion, particularly an e-leader in the case of ICTdriven process change. The e-leader does not have to be a top-level executive; in the Dompe case, the champion was a humble middle manager with IT expertise and a passion for having a meaningful impact. He maximized the technology’s affordance to optimize and streamline the processes. The case demonstrates that an e-leader must have strong interpersonal skills to be able bind everything and everyone together.

Taking lessons learnt here, things you may wish to consider in your own BPM efforts… • What are the physical and virtual social networks in the targeted BPM context that can play a role in creating impactful, innovative, and sustained process-improvement initiatives, and how can they be tapped? • When resource constraints exist, can other options (e. g. , open-source systems, grant schemes, people’s talents and skills beyond their normal job roles, collaboration with local institutions) be used creatively? • What change management efforts are in place to continue, succeed, and sustain the outcomes? • How can a project champion identify and orchestrate the use of available resources?