Preventing Unintended Consequences from Change

Every Business is in a Race for Improvement

Hospitals, like all businesses, are in a race to become much more efficient, accomplishing more with the same, or even fewer resources. Stagnant or declining hospital revenue increases motivation to eliminate activities that bring little value, or even undermine quality outcomes, delivery and service.

We face is some ways “the perfect storm” — a movie about a fishing trawler caught in a perfectly coordinated fury of nature that led after a brave fight to the sinking of the boat and the loss of the crew. The perfect storm of 2009 for healthcare is a recession so deep that it is causing consumers to reduce their seeking healthcare services, a national economic reform that is so large that virtually no one can see the whole picture, and the near certainty of some form of universal access that will in one swoop double the potential number of patients coming into a supply system that is geared for much lower numbers.

Few businesses have the complexity that hospitals must deal with on a day-to-day basis. That means simply there is no magic bullet that is going to cure hospitals as fast as the government and other payers want things fixed.

Conflicting Signals

In fact, one part of government is pushing for cost reduction while another is pushing for higher levels of certification that call for increasing some areas of cost. Yet another is pushing for universal access to the system, a noble and essential pursuit of humanity, but it is being done without concern for the supply of care … today’s medical practitioners and facilities are not equipped for massive new numbers of patients.

While some may want less spent on healthcare, this movement toward universal access demands additional providers and facilities, combined with new ways of working effectively and efficiently. There may be attempts by government to push cost by containing payments to providers, and that will almost certainly lead to unintended consequences like the brightest of future college students seeking careers outside healthcare.

Such is the box we all find ourselves in with an impending struggle between government, physicians, hospital leaders and consumers of healthcare.

Admittedly, there are ways in which hospitals can move forward in both efficiency and effectiveness. That, after all, is precisely the task that the people at Compass Clinical Consulting have dedicated themselves.

We all need to make sure that unintended consequences of reform do not tear down what is still – with all its room for improvement – the best healthcare system in the world.

We know from experience that you cannot boil the ocean. The first thing is to begin listening. Our ears must be tuned to hear problems and discontinuities, especially those that seem counterproductive to producing a better hospital. No two hospitals are alike. Practically speaking, even no two DRGs are exactly alike. So when you ferret out the distinctive qualities that make you a good hospital and those that can be improved to make you a better hospital, you have begun the process of prioritizing action.

The time for such productivity improvements is now. If we wait for the perfect storm to swallow us, it will be too late to make the changes needed.

Filed Under: Featured Articles • Hospital Leadership

Tags: hospital compensation, Medical School, Medicare, Physician compensation, Physician Shortage