BackgroundThe housekeeping management team was passive in allocating sta� to cope with �uctuated �ll rate among wards. • Patient experience towards housekeeping services was 65% positive • Housekeeping satisfaction was 60%

A study from The U.S. Centers for Disease Control and Prevention reported that contaminat ed surfaces made up to over 10 percent of the total healthcare-associated infection (HAI) in 2009(1). As a result, improving competencies of hospital housekeeping team is critical.

Purpose of the project: Apply Time-Driven Activity Based Costing and Lean concepts to analyze on waste and manage housekeeping costs more e�ciently among wards

Step 3: Analyze using Time-Driven Activity-Based Costing

1. Savings in headcount and housekeeping consumables

2. Patient experience has improved from 65% to 93% positive

3. Housekeeping staff satisfaction has increased from 60% to 86% positive

The application of Time-Driven Activity-Based Costing in housekeeping department has not only provided more visible cost picture for housekeeping efficiency, but also: • Facilitate similar projects for better efficiency in nursing and doctor management • Help reduce risk of HAIs by proper surface contamination control • Help further assess the role of environmental cleanliness to patient safety

Activity

Result

Conclusion

Time-Driven Activity-Based CostingFor more efficient staffing and cost saving in housekeeping service

Nguyen Tien Phat, Nguyen Nhut Bao, Nguyen The Huy, Vuong Kim Hang, Nguyen Ngoc Thao

Step 2: Directly observe and time activities within the streamlined process

Step 1: Engage the housekeeping team to perform Value Stream Mapping to eliminate non value-added activities

(1) Scott, RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Bene�ts of Prevention. Atlanta: Centers for Disease Control and Prevention, 2009.

IM: Internal Medicine Department; SUR: Surgical DepartmentOB&GYN: Obstetrics & Gynecology Department; PED: Pediatrics Department

Unit: VND Total cost (4 months)

With previous costing system from 01 Jan to 30 Apr 2019 (1) 1,284,248,479

With TDABC from 01 Jan to 30 Apr 2019 (2) 1,072,682,598

Total saving (1) – (2) 211,565,881

a. Saving on Wages for sta� 164,486,030

b. Saving on Consumables 47,079,851

History Jan – Apr 2019

TDABC Jan – Apr 2019

Total cost (VND)

N. sta� (4 mths)

Time required

(mins)

Unit cost

(VND)

Total cost (VND)

N. sta� (4 mths)

Di�.

IM 338,174,577 31.0 224,503.5 1,151.5

1,151.5

258,511,304 23.5 -7.5 SUR 289,246,177 26.0 162,055.3 1,151.5 186,603,511 17.0 -9.0 OB&GYN 352,049,626 32.0 342,858.9 394,795,199 35.9 3.9 PED 304,778,100 28.0 202,150.8 1,151.5 232,772,584 21.2 -6.8 (1)1,284,248,480 117.0 (2)1,072,682,598 97.6 -19.4 Saving (1) – (2)

211,565,882