The successful reorganization and integration of two major hospitals in Shiga Prefecture

-Vision & Strategic Planning-
Saiseikai Shiga Hospital (Shiga Prefecture, 393 beds)

Saiseikai Shiga Hospital

Backgrounds and Objectives

In December 2016, Moriyama Municipal Hospital approached Saiseikai Shiga Hospital to be integrated into the Saiseikai group in light of its prolonged financial difficulties. Both hospitals, situated within 5km of each other, function in the same healthcare region (as determined by the Ministry of Health, Labor and Welfare based on population density by geographical areas), with Moriyama Municipal Hospital being a key provider of long term and rehabilitative care, and Saiseikai Shiga Hospital as an acute care hospital with a primary focus on emergency medicine and oncology.

During the same period, Saiseikai Shiga Hospital was experiencing challenges in managing post-discharge care and coordination with neighboring facilities in the region. Moriyama Municipal Hospital’s wish was to relinquish all rights of management to the Saiseikai group, in other words, providing Saiseikai Shiga Hospital with a golden opportunity to facilitate the smooth discharge and transfer of its post-acute patients whilst enabling the survival and capitalizing on the strengths of Moriyama Municipal Hospital.

With different parent organizations and primary functions, GHC’s help was enlisted to facilitate a smooth integration.


Employing our trademark benchmarking analysis approach, GHC supported Saiseikai Shiga Hospital through a consulting stint that lasted close to 2 years. With the overall goal of integrating the functions of the two hospitals, while drawing upon our expertise in Integrated Delivery Systems (IDS) from past engagements in the US, GHC worked closely with the Director of Saiseika Shiga Hospital, Dr. Tsuneharu Miki, to closely examine operational, clinical, organizational and supply chain aspects including but not limited to the following:

– Reviewing procurement sources and usage practices of medical supplies
– Streamlining internal procedures for patient flow management within the hospital and referrals to other hospitals in the region
– Clinical integration between Saiseikai Shiga Hospital and Moriyama Municipal Hospital in terms of standardized treatment pathways and uniformed quality of treatment for each clinical specialty
– Reorganizing hospital departments to tailor to the needs of patients in the region


Under the leadership of Saiseikai Shiga Hospital’s Director Dr. Tsuneharu Miki, the new Saiseikai Moriyama Municipal Hospital (since April 2018) found itself back in the black in monthly earnings within 3 months, with a new Patient Flow Management Center and enhanced ER functions, and a revenue hike of approximately 8.5m JPY (approximately 80,000 USD) in a year.

The referral rate between these two hospitals also increased, allowing for better long-term management of patients of all levels of severity in Shiga Prefecture. The integration of these two hospitals enabled a win-win situation for both hospitals, and a smooth delivery across the continuum of care for patients in the region.