Introduction

A leading hospital in the city engaged our firm to review their accounting processes and recommend improvements. Initial discussions with the management and a preliminary review of their books revealed a deeper issue: the hospital’s business processes were outdated and lacked adequate systems and standard operating procedures (SOPs). To address this, we structured our engagement into three distinct phases.

Phase 1: Comprehensive Study of Operations

Our objective was to understand the hospital’s operational framework and pinpoint inefficiencies in the revenue and process flows. Key activities included:

1. Departmental Analysis:
   • Revenue Flow: Mapped revenue streams from inpatient, outpatient, laboratory services, and pharmacy operations.
   • Procurement and Stock: Studied the purchase department, goods inward movement, and stock handling protocols.
   • Cash and Accounting Processes: Reviewed cash handling mechanisms and accounting systems to ensure compliance and accuracy.
2. Operational Observations:
   • Noted critical patient flow patterns, identifying peak hours and service bottlenecks.
   • Assessed existing control systems and their alignment with operational needs.

Phase 2: Development of Tailored SOPs and Control Systems

With insights from Phase 1, we proceeded to design internal controls and operational systems customized to the hospital’s needs:

1. Customized SOPs:
   • Created department-specific SOPs that balanced accountability and operational fluidity.
   • Focused on minimizing disruption during high patient flow periods.
2. Internal Controls:
   • Designed controls to enhance process oversight without compromising patient care quality.
   • Integrated data-driven analytics for monitoring compliance and efficiency.
3. Patient-Centric Adjustments:
   • Aligned controls with peak operation hours to maintain service standards during busy periods.
   • Prioritized ease of adoption by department users to reduce resistance to new procedures.

Phase 3: Implementation and Handholding

Execution of the designed systems and processes required a collaborative and phased approach:

1. Training and Sensitization:
   • Conducted workshops with department heads and staff to explain the new controls and their benefits.
   • Addressed concerns to ease the transition to updated processes.
2. Monitoring and Feedback:
   • Established monitoring checkpoints to evaluate adherence to the new systems.
   • Collected feedback to fine-tune the SOPs for practical application.
3. Sustainability of Changes:
   • Ensured that the systems were embedded into the hospital’s culture through continuous engagement.
   • Conducted follow-up reviews to confirm that processes remained effective and relevant.

Outcomes

The engagement significantly improved the hospital’s operational efficiency and financial control:

• Reduced errors in accounting and cash handling.
• Streamlined procurement and inventory management.
• Enhanced compliance with regulatory standards.

Long-Term Engagement

Impressed with the results, the hospital’s management requested us to continue as retainers. We now oversee their internal control function, ensuring sustained improvements and alignment with evolving industry standards.

This phased approach exemplifies how a structured, collaborative strategy can resolve deep-rooted operational issues while ensuring minimal disruption to critical services.