Efficiency signifies a peak level of performance that uses the least amount of inputs to achieve the highest amount of output. Efficiency requires reducing the number of unnecessary resources used to produce a given output including personal time and energy. It is a measurable concept that can be determined using the ratio of useful output to total input. It minimizes the waste of resources such as physical materials, energy, and time while accomplishing the desired output.

The notion of health sector efficiency – and related issues such as cost–effectiveness and value for money – are some of the most discussed dimensions of health care performance. These concepts seek to capture the extent to which the inputs to the health system, in the form of expenditure and other resources, are used to secure valued health system goals. In many other sectors of the economy, consumer preferences help to ensure that the most valued outputs are produced at market prices. However, there are numerous, well-rehearsed market failures in the health sector that mean that traditional market mechanisms cannot work, allowing poor quality or inappropriate care to persist at high prices if no policy action is taken. Most commentators would therefore agree that the pursuit of efficiency should be a central objective of policymakers and managers, and to that end better instruments for measuring and understanding efficiency are urgently needed.

Inefficient use of health system resources poses serious concerns, for a number of reasons:

It may deny health gain to patients who have received treatment because they do not receive the best possible care available within the health system’s resource limits;
by consuming excess resources, inefficient treatment may deny treatment to other patients who could have benefited from treatment if the resources had been better used;
Inefficient use of resources in the health sector may sacrifice loss of consumption opportunities elsewhere in the economy, such as education or nutrition;
Wasting resources on inefficient care may reduce society’s willingness to contribute to the funding of health services, thereby harming social solidarity, health system performance and social welfare.

To most people, efficiency simply suggests the idea of getting the most out of something, for example making as much use of a hospital X-ray machine as possible (allowing it to stand idle much of the time would be wasteful or inefficient); however, efficiency can also refer to the situation of using least inputs for a given level of output, such as keeping hospital length of stay down to a level that still ensures safe and appropriate discharge. Beyond these two pathways for improving the way in which inputs to health care are optimized (so-called ‘technical efficiency’), there is also the broader notion of ‘allocative efficiency’, which brings in the question of how well the outcomes of health care provision are distributed among the population. Accordingly, questions of allocative efficiency in the health sector tend to revolve around what might represent the mix of services or interventions that maximizes health improvements, both within disease entities (such as prevention versus treatment strategies for HIV/AIDS) and across them (i.e. how the health of a population can be most improved with existing resources). This concept of value for money can be appropriately addressed via the application of cost effectiveness analysis (CEA), which pulls together into a single ratio the health inputs (summarized in monetary terms) and the health outcomes (expressed in natural units such as lives saved or combined into a summary measure such as disability-adjusted life years averted). In this section, we consider both technical and allocative (in)efficiency, with a view to identifying probable sources of current waste that can be readily addressed through remedial action.

Four Ways for efficient health care:

Efficiency of Process incorporates the planning and operational practices that significantly reduce or eliminate the negative impact on clinical service continuity in healthcare facilities. The analysis of infrastructure data and its contribution to decision making will result in better understanding of cause and effect scenarios affecting the environment of care. When measured against tangible criteria such as cost and quality, appropriately weighted against the potential severity of impact from infrastructure failure to patient care and patient experience, the process and its outcomes become enablers to change management initiatives, people efficiency and productivity gains. This level of complexity, and the number of variables involved in determining the right process and reaction under certain conditions, can no longer be contained without the aid of technology.

Efficient people can make the most important difference to cost and quality of healthcare facility management service delivery. The challenge to deliver better service quality at lower cost is driving the need to adopt innovative ways in communication and people interaction with technology. Analysing and collaboratively managing patterns of infrastructure behaviour creates visibility for potential issues and strengthens engagement with all stakeholder groups in the organisation. It turns a potentially daunting experience into a positive, proactive risk mitigation approach, allowing for wide recognition, shared commitment and support in required resolution. This information can also be used to continuously tune building systems to facilitate the seamless interaction between services, enabling their logical connectivity and response to uniquely complex and critical environment’s inputs.

Efficiency of technology and end-users’ adoption are key success factors. The challenge remains to balance cost and complexity in implementation of intelligent solutions with a measurable performance output and ROI by choosing the appropriate technology to deliver the right process with an optimal utilization level.

Building services in healthcare facilities are managed through electronic systems which cover monitoring, controlling or simply handling alerts and notification of operating status. An intelligent integrated building management solution provides the healthcare facility operator with valuable insight on building performance, status of critical infrastructure and the likelihood of impact on clinical service delivery. Applications and systems attached to building services accumulate a significant amount of data which can be analyzed and transformed into information, hence becoming an important decision making support tool in managing the infrastructure and service continuity in the healthcare facility.

Efficiency of solutions implementation implies the decision to implement the right solution in the right place, at the right time, for the right outcome. An efficient implementation will support all other key considerations discussed thus far, providing demonstrable ways to meet business objectives, offering ease-of-use for all stakeholders and providing an environment that supports people-centric processes with near-term ROI.

Balancing the risk of downtime from infrastructure failures, raising cost of maintenance for ageing plant and equipment, resources and budget constraints with an increased demand for performance and efficiency, the healthcare facility management profession is facing also the challenges from service criticality, considering that asset failure can potentially have direct or indirect impact on patient care outcomes.

An efficient solution for healthcare building infrastructure should offer a holistic approach to information management, an intuitive design with proven technical capabilities, flexible & adaptable features matching the dynamic health service environment and ensure visibility of information to aid decision making. Only the sum of all of these aspects will result in measurable value for the healthcare organization.

Thus, as well as its instrumental value, tackling inefficiency has an important accountability value: to reassure payers that their money is being spent wisely, and to reassure patients, caregivers and the general population that their claims on the health system are being treated fairly and consistently. Also, health care funders including governments, insurance organizations and households are interested in knowing which systems, providers and treatments contribute the largest health gains in relation to the level of resources they consume. Efficiency becomes particularly important in the light of financial pressures and concerns over long-term financial sustainability experienced in many health systems, as decision-makers seek to demonstrate and ensure that health care resources are put to good use. When used appropriately, efficiency indicators can be important tools to help decision-makers determine whether resources are allocated optimally, and to pinpoint which parts of the health system are not performing as well as they should be.