Standardisation of risk screening processes in healthcare through business rules management

In 2012, an audit held by the Netherlands Institute for Accreditation in Healthcare (NIAZ) at the ‘Rivierenland’ hospital in The Netherlands, concluded that their processes were not sufficiently standardised. One of the suggested improvements was to develop and implement a hospital-wide method for analysing and standardising care processes. This paper focuses on the standardisation of the risk screening process, which is used to assess a number of patient risk factors prior to treatments or hospital admissions. By separating the decision logic of the risk screening processes into a set of business rules, the screening process was standardised to be identical for each risk factor. This allows for the decision logic and the process to be changed independently of each other. Additional business rules were introduced to serve as constraints, thereby limiting the number of performed screening processes depending on the age of the patient and the duration of the treatment or admission. Based on historical data from the year 2013, a retrospective analysis demonstrated potential time savings of around 1600 hours on a yearly basis thanks to the introduction of the new standardised process incorporating business rules. Similar standardisation methods may be useful to other hospitals facing increasingly stringent demands for quality, safety and efficiency.