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Game-changer in how hospitals work

UEMS, which services six out of the eight hospitals here, is intent on improving productivity.
Friday, November 20, 2015 - 05:50
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Mr Chan is taking his productivity message to government agencies and restructured hospitals in the hope that they will relook their contract requirements.

HAVING tackled the housekeeping in his own organisation and improved the productivity of workers at UE Managed Solutions (UEMS), chief executive Chan Cheow Hong is now taking the productivity message back to the top of the food chain - government agencies and restructured hospitals - in the hope that they will relook their own contract requirements to further spur productivity downstream.

UEMS, which was established in 1988, provides a range of services including facility engineering services, environmental services (such as housekeeping, portering and linen and laundry management, particularly for hospitals) and property management services. But healthcare remains a segment close to its heart, in part because of its roots - then parent company United Engineers bought the licensee from Service Master USA which focuses on hospital support services - but also because healthcare facilities form the bulk of its business. UEMS is, for instance, the second- largest player in Singapore's healthcare scene and it services six out of the eight hospitals here; it is also the market leader in Taiwan and in the private hospital sector in Malaysia.

"Everyone thinks this is an easy business, and everybody wants to open a company. There are almost 2,000 cleaning companies in Singapore compared with three years ago, when there were 1,400 or 1,500," says Mr Chan, who rejoined UEMS in 2011 and went about re-engineering the way the company did its business, firmly aware that the business model would not be sustainable if it simply relied on cheap labour.

One of the game-changers implemented was the creation of the firm's in-house UETrack System which tracks workers' locations and assigns jobs via the app.

When ward nurses, for instance, put up a request for a porter to move a patient to a specific area within the hospital, the system assigns the task to the relevant porter (based on his skillset).

Upon arriving at the location, the porter scans a QR code which will indicate his response time, and after sending the patient to the relevant area, he scans another QR code to indicate that the job is done. The system will then assign him to another job in the vicinity.

Says Mr Chan: "In the past, they would walk from the central office to the location - unproductive time - do the job, and then walk back - unproductive time again. We find that the workers do a lot more jobs now because they are less tired. In between jobs, they walk about 50 per cent less, compared to the past."

ADAPTATIONS

The system goes beyond these productivity improvements. With data that's been gleaned over the years, UEMS is looking to leverage data analytics to further improve its productivity by pre-empting orders.

"We know that in hospitals, certain departments will make a request for a porter at different times; we have all this information in our database. So we are now designing that part - to be able to predict an order before the order comes . . . (This means) we can send a notification to a porter and he can start walking there. So when you put in your order, he's so near you, he can meet the key performance indicator (KPI)."

Says Mr Chan: "We see huge potential in this area. And this is something that's very important in our business - we move about 3,000 patients a day, on an average of eight to 15 minutes, with 80-90 per cent efficiency."

Having developed the system in-house also means that the company is able to quickly adapt the system to the needs of its clients.

"(With a) third-party programme, a lot depends on what you tell them to do. Even then, there is a gap between what you want and what they do. And after they write the software, it becomes a standard software.

"Our experience working with different customers is that their protocols vary . . . Over the years, the nurses have been trained in that hospital (and) that's the way they do things. If you try and push them to do something else, they'll say, 'No, I don't want to use your system'. So if we understand what they want, we can customise the software."

When the company tried to port over the UETrack system to Taiwan, for instance, it met a lot of resistance as the staff preferred to pick up a phone and dial for the service rather than key the data into a computer. UEMS was able to redesign the front end to suit them. Its solution? A simple touch-screen interface which allowed hospital staff, through a few clicks, to pick the services they require.

The company also went down the route of mechanisation in an effort to improve productivity. It employs, for instance, a compact multi-purpose system to tackle toilet cleaning. The machine, which has a spray jet and wet vacuum, allows the cleaner to deep clean and sanitise the toilet without touching it.

But improving productivity goes beyond simply buying machinery.

"The machine is so expensive, we couldn't continue to do things the way we used to (because) the machine would be idle 95 per cent of the time," says Mr Chan. The job re-design comprised setting up toilet cleaning teams which would be equipped with the specialised machine. This freed up the housekeepers who were then given other areas of work.

This has resulted in visible dollar savings - previously, the labour cost to manually clean a male toilet, for instance, was S$3.88 per toilet; the figure is now S$1.99 per toilet.

Not surprisingly, training and upskilling play a big part of UEMS' productivity improvements. Its in-house training programmes, which span technical skills training to soft skills, dovetail with the progression plan the company offers to all workers.

"If you look at the workforce, we have the lowest grade of workers in our company. But you need to train and upskill them, motivate them. In the past, for example, if we used 20 people to do a job, we now use 18. If I look at our labour productivity over the last few years, from 2012 to 2013 there was an increase of 7 per cent. And from 2013 to 2014, it was an increase of 11 per cent . . . Going forward, I think we can do above 5 per cent every year. There's still a lot of room for improvement. Even for the lowest grade of worker, you can upgrade them."

But even as UEMS pursues such productivity measures, Mr Chan notes that margins will always be slim if clients don't rethink the way they procure services.

"Most procurement contracts for our services - whether for porters or housekeepers - are still headcount-based. When they specify the number of workers they need, you have to provide that number of workers or they will penalise you for the shortfall. So what is your motivation to increase productivity?"

Instead, procurement contracts should be performance-based, says Mr Chan. This means trusting the service provider to decide the optimum number of staff to put on the job which can ultimately result in savings for the service provider and the customer.

"We have been in the business for so long, we can say, to clean this room, it will take 25 minutes. We have unitised every piece of work and broken it down. For example, in a hospital, in a day we need to do 10,000 jobs. We can work out how much resources we need to channel. Then we can save some labour cost, pass some of that to the workers, and pass some back to the customer and, of course, we earn a little bit more."

UPHILL BATTLE

This shift in thinking about the way procurement contracts are set up is gaining traction in Taiwan, where the hospitals are more budget-conscious. But educating customers to rethink their procurement style in Singapore continues to be an uphill battle.

"With the government pushing for labour productivity, it has to get its own agencies to set an example. They have to give out contracts that move away from headcount. Or, you can still have headcount but give incentives to companies that can improve services using fewer resources but can prove to them the work is done just as well or better."