Reducing 30 day re-admissions by leveraging patient remote monitoring solution
The issue
- Colorectal surgery (related to cancer) accounted for 27% of the total case mix for a large healthcare system
- Colorectal surgery department noticed a steady increase in the number of patients returning back to the Emergency Room (ER) for non-urgent issues over a 24-month period
- 30-day readmission rates were significantly above the national average
- Based on an initial internal assessment, the hospital management and colorectal surgery department hypothesized an issue with the patient discharge process
- Established a cross-functional team to perform a root-cause analysis of the entire patient journey and flow
- Mapped the entire patient journey and flow and identified a number of improvement opportunities
What we did
- Designed a pilot study to test a new discharge process enabled by technology
- Enrolled 97 patients, focusing on younger more tech savvy profile who were open to self-managing recovery during post-operative phase
- Identified root-causes of readmissions into ER (over 78% non-emergency which could have been avoided if patients were better educated and informed during the discharge process)
- Redesigned the discharge programme with a greater focus on patient self-management enabled by smart technology
- Sent patients electronic reminders to help keep them on-track with recovery milestones
- Established post-discharge daily check-ins to track stoma output, incision photos, pain levels, bowel function, etc.
- Implemented algorithms to flag patient issues and automatically provide feedback to patients on how to self-manage or how and where to find relevant support
- Developed intelligent notifications to automatically notify clinical team members if patient at risk
- Designed and implemented a dashboard with real-time reports and analytics to help the care team understand a patient’s post-operative concerns, trajectory of recovery and ways to improve patient experience
The results
- Delivered a 72% reduction in 30-day re-admissions
- Avoided 7 ER visits which were resolved through triage via telephone consultation or outpatient clinic
- Improved patient satisfaction scores by 24% (compared to baseline pre-launch)
- Based on the success of the programme, supported client to identify other surgical programmes to roll-out similar solution
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Leveraging procurement to increase profitability of orthopaedic services
The issue
- Many suppliers (18+) resulting in reduced spend leverage
- Prosthesis selection based on supplier systems familiarity not generic technical spec
- Large cost variances for similar hip and knee systems from supplier to supplier
- Large amount of “additional” costs associated with instrumentation and loan kits
- Huge variety in ‘same’ type of hip and knee systems (7+ systems for each)
- Too many system variations (75+) resulting in staff needing to be trained on many systems/brands
- Varying published data to support clinical outcomes of implants resulting in low predictability of patent outcomes
- Huge cost-per-procedure variance impacting profitability at Orthopaedic Consultant and Hospital level
- Need to increase profitability
What we did
- Increased spend with fewer, more capable suppliers
- Established patient profiles. Use patient profiles to guide system selection
Linked into project to Care Pathways - Established minimum acceptance of prosthesis outcomes (leveraging ODEP ratings for both hips and knees)
- Established dedicated training for Orthopaedic Consultants and clinical staff
- Renegotiated with partner suppliers based on redistributed business (volumes)
- Established traffic light reporting for Ortho hip and knee (cost and compliance to agreement)
- Established a clinical advisory group to evaluate innovation and agree protocols to be followed by all Orthopaedic Consultants across the Group
The results
- Delivered 22% in annualised savings through volume leverage and brand/system standardisation
- Reduced clinical risk by only allowing 10 or 10* ODEP rated products and eliminating Orthopaedic work at low volume sites
- Increased profitability substantially which allowed the BD teams to improve NHS and PMI contract win rates
- Reduced supplier power (demonstrated appetite and willingness to shift balance of power)
- Improved patient satisfaction and outcomes by channeling more work to Orthopaedic Consultants with higher PROMs scores
- Reduced subjectivity by ensuring system selection based on patient profile
- Standardised length of stays for given procedure and patient profile
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Evaluating structural entity options for a new arm of government transport body
The issue
- Embryonic consulting business established one year ago by a local government body responsible for transport, to monetise and deploy in-house specialist experience
- Consulting business deeply embedded in one of the organisation’s existing holding companies
- Business had not yet established the appropriate frameworks for managing revenue, project delivery, Intellectual Property and assets
- The client wanted to review the optimal entity structure for its Consulting business in order to better drive commerciality
- Strong desire to set up the Consulting business using an entity structure that fostered commerciality and leveraged in-house resources in the most optimal way
- Clear focus on building a profitable revenue funnel, self-financed growth, better IP and asset monetization, capitalisation on tax benefits, simplified and robust governance and transparent risk management
- Aim to start competing for, or partnering with big organisations to, deliver Advisory, IP and Operations & Maintenance contracts
What we did
- Conducted an exhaustive benchmarking exercise to provide the client with insights into how other service utility organisations have established successful Consulting businesses
- Defined a robust set of design principles and considerations for reference throughout the operating model design exercise
- Identified and shortlisted a set of structural options following a complete option evaluation in terms of feasibility and suitability
- Conducted end-to-end scenario testing, using carefully selected in-flight example bids, across the shortlisted structural options
- Refined the final structural model based on outputs of the scenario testing, for proposing to the client’s Finance Committee.
The results
- A benchmarking report, providing a crystallised view of the comparator landscape, including assessment of comparator suitability, and a summary of key insights and recommendations
- A report outlining the full assessment of entity options against a set of robust criteria and the rationale for down-selection
- A recommended structural model, clearly outlining three distinct entity options catering to the distinct requirements of each activity stream
- A high-level timeline illustrating implementation options and a trajectory of maturity
- A concise, crisp report containing key messaging for the Client to socialise to key stakeholders in order to secure Board approval
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Unlocking over £20m in increased gross margin at a major health insurer
The issue
- Shrinking customer base
- 13 legacy books and numerous policy variants causing customer and staff confusion
- Operationally complex to manage – high cost to serve
- Existing proposition and pricing created trigger points for customer exit
- Customers not segmented by value
- No differentiated renewal or save strategies
- Not pricing for risk or maximised value retention
- Poor customer journey: passed from function to function, advisors not empowered
What we did
Designed & executed a pricing, product and service migration of all policyholders to one new modular product
- Developed new proposition which drove retention of high value customers and higher return from lower value customers
- Built in upgrade/downgrade ‘right-size’ choices to mitigate competitor switching
- Created pricing engine enabling all business to move to NCD-based policies and set renewal premiums to optimise gross margin
- Cut expected IT lead time to launch from 12 to 3 months
- Changed customer communications and management processes to de-risk customer disruption & loss
- Engaged Legal and regulator on ‘automatic renewal’ plans throughout
- Piloted the transition on 2 highest lapse-risk books to ensure error-free process and no adverse increase in lapse rates
The results
- Exceeded the £20Mpa gross margin improvement target
- Reduced customer loss by 25%
- Improved operating cost ratio from 30% to 16% with greatly improved IT flexibility
- Excellent customer and FSA feedback
- Successfully rolled out from personal to SME & Group schemes
What our clients say
“As a result of Curzon’s support a strategic and digital leap has been made in how we manage the entire asset lifecycle to transform our Developer Service experience. This is a programme and a product that sets a new benchmark within the industry.”
Jason Tucker
Director of Alliances & Integrated Supply Chain, Anglian Water
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Performance turnaround at global construction product manufacturing group
The issue
- A European headquartered global construction product manufacturing & distribution group with a C. and S. American Division located across 14 countries
- The Division was consistently the worst performing business unit in the Group
- Interventions from Europe had failed to address the issues and turn performance around
- Performance was poor with an EBITDA generation significantly lower than the Group average
- Underperformance was a consequence of a multitude of issues: poor sales disciplines, inefficient production, lack of adequate cost management and ineffective leadership
- Previous attempts to turn the business around with other consultancies had failed
- The challenge was not only to quickly improve performance, but to set up the business for sustainable profitable growth
What we did
- With our Alliance Partner for C. and S. America, Curzon established a programme team to implement a comprehensive change effort
- A focus on commercial performance including pricing management and product mix optimised the market opportunities and stopped margin give-away
- Introduction of lean practices in manufacturing and distribution facilities improved productivity and started to tackle excess inventories
- Organisational changes were made to reduce management overheads and to streamline support functions
- Initiatives were piloted in country businesses and the learning was transferred to other business units through a centrally managed process to coordinate and accelerate the impact
The results
- Within one year the division rose from the worst to the best performer in the Group
- The combination of programme and other initiatives were delivering measurable bottom-line savings with a headline profitability run-rate that had tripled
- Change was happening on a broad base and over 1000 staff across multiple countries were involved improving the business
- Capability development and introduction of new tools, disciplines and ways of working had provided a solid platform to sustain the results
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Company-wide performance improvement at UK water utility
The issue
- Ineffective incentive structure resulting in organisational silos & sub-optimal performance (in-house and contractors)
- Limited long-term planning and investment as result of weak and inaccurate in-house Asset Knowledge
- Legacy support services from merged smaller companies resulted in fragmented internal processes
- Lack of job prioritisation and adequate planning leading to poor productivity & rework
What we did
- Development and introduction of single performance management framework and incentive system to drive efficiency and customer focused culture
- Implementation of an Asset Capability Centre focused on three capability areas: Physical Asset Management, Stewardship & Delivery; revalidated proposed Capex and ran adaptive approaches on costs
- Implemented regulatory compliant Shared Services with revised governance, improved service levels and cost efficiencies
- Redesign and implementation of new job initiation, planning and scheduling processes
The results
- 20m annualised improvement in Totex
- Annualised Capex avoidance of c£18m throughout the regulatory period
- Annualised Opex reduction of c.£3m
- 25% reduction in shared service cost base
- 20% productivity increase in Field work, 30% increase in RFT and 10% reduction in Customer Complaints
£20m
annualised improvement in Totex
£18m
annualised Capex reduction
c£3m
annualised Opex reduction
25%
reduction in shared service cost base
20%
productivity increase in Field work
10%
reduction in customer complaints
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Change management optimisation at a UK retail bank
The issue
- Unprecedented customer growth & branch expansion coupled with focus on improving service delivery and customer satisfaction placed pressure on our client to deliver greater and more complex change
- A need to improve the architecture and governance of business process change
- To ensure change management is ready and optimised for successful delivery of current and downstream change demand
- Rapid growth brought complexity & uncertainty
- There was a need for tightly defined governance mechanisms supported by a standardised way to adhere to change
What we did
- Designed framework for a multilevel business change process architecture to facilitate effective governance
- Translated the framework into a new change management model with new working practices & Balanced Scorecard
- Consistent communication and deployment in line with organisation’s need
The results
- Building blocks in place for bank to deliver its growth strategy securely
- Reduced change backlog
- Change management framework to drive sustainable change and maximise results implemented across bank operations
- Agreed metrics/KPIs at selected organizational levels including baselines and targets
What our clients say
“As a result of Curzon’s support a strategic and digital leap has been made in how we manage the entire asset lifecycle to transform our Developer Service experience. This is a programme and a product that sets a new benchmark within the industry.”
Jason Tucker
Director of Alliances & Integrated Supply Chain, Anglian Water
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Improving customer satisfaction at a leading retail and commercial bank
The issue
- Continuing declines in NPS and CRI scores across retail and commercial customer bases
- Board’s ambition was to achieve market-leading customer recommendation levels
- Ongoing customer service challenges driving up customer dissatisfaction ― but unclear as to true extent and causes
- Big gaps between customer expectations and delivery
- True extent of customer dissatisfaction not identified or addressed, and NPS surveying not used to mine for triggers. 40% of customers thought they had complained vs 4.5% recorded
- Reality was 45% of customers who’d formally complained were dissatisfied with complaint resolution, making them far more likely to churn (62%)
What we did
Designed & executed a pricing, product and service migration of all policyholders to one new modular product
- Worked across retail and commercial banking operations to understand and map impacts of service failures and complaints response on NPS and CRI scores
- Identified biggest linkages between types of service failure, quality/ timeliness of complaint resolution, and the creation of Detractors
- Surfaced major under-reporting of complaints and inaction where known detractors continued to be detractors
- Developed set of targeted remedial actions to apply at point of service failure or complaints to prevent creation of detractors or convert them into neutral/advocates, minimising risk of eventual lapse
- Defined how to cost-effectively and proactively pinpoints and stop service failures occurring
- Designed operational changes in four customer management areas across Retail & Commercial Banking to reduce service failure and complaints volumes and costs
The results
- Recommendations agreed by both divisions
- Transition plans delivered
- ExCos in implementation
- Reported improved NPS & satisfaction rate scores
- On-target run-rate cost reduction benefits
What our clients say
“As a result of Curzon’s support a strategic and digital leap has been made in how we manage the entire asset lifecycle to transform our Developer Service experience. This is a programme and a product that sets a new benchmark within the industry.”
Jason Tucker
Director of Alliances & Integrated Supply Chain, Anglian Water
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Increased operating profit at glass manufacturer
The issue
- Our client, a manufacturing site for automotive glass had struggled to break-even through four years of plummeting demand
- The site’s future was in doubt unless it could quickly demonstrate growth in efficiency and competitiveness
- Cultural resistance to change
- Strain on production teams
What we did
- Operational analysis identifying where, why & how greater efficiencies were achievable
- Designing & managing transformation pilot, measuring effectiveness
- Prioritised roll-out, training & robust project governance
- Worked with management to embed leadership skills & capabilities
The results
- Our work delivered benefits exceeding €10m annualised operating profit & €20m working capital reduction
- We helped our client become a Group-wide exemplar of best operating practices and re-establish its position as a market leading producer
- The transfer of crucial capabilities to the local team has enabled sustainable change
- San Salvo is now a credible, long term engine of growth
- Our work was awarded “Highly Commended” at the MCA Awards for Change Management in the Private Sector
What our clients say
“As a result of Curzon’s support a strategic and digital leap has been made in how we manage the entire asset lifecycle to transform our Developer Service experience. This is a programme and a product that sets a new benchmark within the industry.”
Jason Tucker
Director of Alliances & Integrated Supply Chain, Anglian Water
An award-winning team
CONTACT US TO FIND OUT HOW WE CAN HELP
Delivering a step change in operational performance
The issue
- Four factories on one site producing 60% of the company’s European demand for the Automotive market
- Utilisation and performance had been in steady decline for four years and with very poor customer delivery and service performance this was seen to be a failing site
- Local custom and practice was inhibiting opportunities to improve productivity
- Curzon was engaged to help the Site Director achieve control and turn performance around
- The site was achieving less than 60% OEE on its premium integrated lines
- High inventories but of the wrong products due to lack of control of demand and production priorities
- No performance management system in place to drive improvement
- Disconnected Planning and Production functions causing late delivery and high costs
- Limited management capability and lack of proactive supervision
What we did
- Create an overall approach to transform the performance of the site involving all of the management team
- Implement a cross-functional planning process and tools e.g. production wheels to establish a clear view of demand, delivery priorities and factory capability to deliver
- Implement Lean capabilities on the shop floor e.g. SMED techniques, SIC and Kaizen to improve productivity and develop a sense of ownership
- Selective capital investment in facilities (underway)
- Implement visual performance management and supporting proactive supervisory/management processes
- Build the capability of the local team to ensure sustainability
The results
- Achieved in excess of 25% reduction in inventories and a significant uplift in on time delivery to distribution centres
- Improved OEE on key integrated lines by over 20%, increasing capacity and enabling transfer of work from less productive sites
- Built the capability of the client team to be able to complete the programme rollout successfully themselves and to sustain the initial improvements
- Created a blueprint that can be rolled-out to other sites globally
What our clients say
“As a result of Curzon’s support a strategic and digital leap has been made in how we manage the entire asset lifecycle to transform our Developer Service experience. This is a programme and a product that sets a new benchmark within the industry.”
Jason Tucker
Director of Alliances & Integrated Supply Chain, Anglian Water
An award-winning team