5 minute read 4 Sep 2017
woman jogging on concrete steps

How Performance Optimization can improve health care

By Gary Howe

EY Global Solution Leader, Health Performance Optimization

Accomplished health leader. Passionate about the pursuit of excellence in health services provision. Recognized innovator. Frustrated sportsman. Work in progress.

5 minute read 4 Sep 2017
Related topics Health

A customized approach to Performance Optimization in health care can improve quality of care, curb inefficiencies and cut costs.

Current research suggests that the health care industry has a productivity level of approximately 43%. In a landscape where the demand for care is rapidly increasing, where budgets are continually strained and where regulations are becoming more uncertain and complex, this statistic is neither sustainable nor acceptable.

Performance Optimization (PO) is a collaborative methodology that addresses modern-day challenges in health care by improving care, accountability, resource management and transparency. It is customized to the needs of individual organizations to create a positive impact on the overall margin of the hospital.

Performance Optimization: solving four key challenges

While the specific challenges that individual health care organizations face vary from hospital to hospital, problems can be grouped into four major categories:

  1. Access: Providing comprehensive access for patients and their families in an environment of fiscal constraint and increasing demand poses major problems for health care organizations.
  2. Quality: The ability to maintain quality care is a growing challenge based on three main factors: increasing complexity and subspecialization of health care, increasing regulatory oversight and growing patient expectations for more personalized care.
  3. Value: It is becoming harder and harder to demonstrate value in terms of patient outcomes and investments in an era of competing government priorities.
  4. Margins: Working to improve margins across all pathways in the shadow of supply side cost pressures is an ongoing and escalating challenge.

Five key components of our Performance Optimization methodology

1. Eliminating variation

EY’s experience shows that the elimination of variation is one of the key enablers of transformation and change — but not if the focus is just on operational variation. To truly achieve change, and to reduce the potential for harm, we address and eliminate variation in clinical practice by:

  • Improving clinical and care pathways and, when relevant, examining the pathway across the whole system
  • Changing the culture and the behaviors that do not fit with clinical consensus and leading practice

Our collaboration with the Johns Hopkins Armstrong Institute for Patient Safety and Quality enables us to bring deep insight into clinical transformation to help eliminate avoidable patient harm.

As a result, EY has helped numerous organizations reduce variation at the function, pathway, specialty and individual clinician level. For example, we are currently working with a leading children’s hospital to integrate three existing pediatric hospitals into a single entity to provide leading-class clinical care.

2. Developing digital approaches

Around the globe, the highest-performing health care organizations demonstrate the ability to embrace innovations in digital health solutions. To truly drive efficiency and sustainable improvements, health care organizations must seamlessly connect across the entire patient pathway, regardless of organizational boundaries. In this way, they can enable patients and their health care providers to engage more dynamically with each other.

Embracing these technologies not only creates operational efficiencies but also challenges the existing models of care delivery, opening up the potential for new and innovative ways of working.

3. Leveraging analytics and simulation

Key to any behavior or transformational change is the ability to demonstrate where the potential for improvement lies. In this era of big data, any successful approach must be driven by the power of real-time data analytics, enabling decision-making to be both evidence-based and transparent.

In addition, the use of data analytics in the field of performance improvement allows changes in practice to be measured rigorously and consistently, enabling “like for like” comparisons across functions, locations and even whole health economies.

EY brings to the table a suite of analytical methods and tools to identify and provide quick turnarounds; for example: performance improvement dashboards with a proven track record in scores of health care organizations; and simulations accessible for both technical and nontechnical staff that pinpoint the key drivers of good and poor performance.

4. Adapting turnaround strategies

Our experience around the globe has shown that organizations with ambitions to be world-class can benefit from the techniques that, to date, have been used for the purposes of turnaround. The concept of “grip and control” concludes that leading practice must involve implementing a series of basic control measures that protect the organization from unnecessary financial inefficiencies.

We have developed a specific module of work designed to rapidly improve grip and control in health care organizations. It contains a range of controls that have been successfully implemented elsewhere; the controls are tailored to the needs of the specific organization and can be put into place immediately.

In the past year, we have successfully completed numerous turnaround engagements without compromising patient safety or performance standards.

5. Practicing “relentless execution”

The Performance Optimization framework has been designed to drive methodologies that provide both tactical and strategic improvements over a structured period of time. We also recognize that implementing any improvement program requires extreme organizational focus. Underpinning our approach is the principle of “relentless execution,” our single-minded focus that gives our clients additional support and capacity to help them succeed.

What exactly do we mean by “relentless execution,” and why is it so often cited by clients as a key component to the success of PO for their organization? It means the EY Performance Optimization teams:

  • Harness and adapt leading practices from around the globe to help our clients optimize the quality of care while reducing costs and inefficiencies
  • Work with our clients to achieve unprecedented levels of care for their patients
  • Acknowledge that success is defined exclusively by the achievement of our stated objectives
  • Continually monitor results to maintain sustainable outcomes
Solutions don’t have to be complicated; they just have to work. PO at its core is about execution and healing. That’s why it is relevant to any health care facility in any environment.
Gary Howe

The success of the EY approach to Performance Optimization lies in a number of key differentiators. We employ both proven and innovative methodologies to address the particular needs of each health care organization. Our teams include seasoned medical professionals who understand both the clinical and administrative sides of health care organizations. We stay with our clients until the agreed-upon goals are achieved. We have more than 10 years of experience in applying and fine-tuning Performance Optimization and have measurable success with both thriving and struggling health care organizations.

As health care administrators look for successful strategies to meet the challenges of an aging population, increased regulation, decreased budgets and a variety of other troubling uncertainties, it is clear that Performance Optimization can play a critical role in not just weathering the difficulties, but in improving outcomes.


Based on our extensive experience in the health care sector, we know that hospitals, like the patients they serve, have differing degrees of wellness. Wherever your hospital falls on the “wellness” spectrum, PO can prove to be a valuable ally.

About this article

By Gary Howe

EY Global Solution Leader, Health Performance Optimization

Accomplished health leader. Passionate about the pursuit of excellence in health services provision. Recognized innovator. Frustrated sportsman. Work in progress.

Related topics Health