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Beyond the Conference Room Solution

January 11, 2013

It Just Doesn't Have to be This Way

An article in this week's Wall Street Journal reported that healthcare costs are again on the rise. 

Data published Monday showed "that the amount spent to treat individuals, as opposed to spending on administration and insurance premiums, began to rise in 2011, signaling that cuts in health spending hadn't become permanent.  I find this outrageous because radically reducing healthcare cost - without compromising service levels - is nowhere as hard as our leaders would have us believe.

Last week I had my annual physical exam.  As my physician was examining my hearing, she nicked my inner ear causing a drop of blood.  To prevent an infection, she prescribed antibiotic ear drops and recommended I apply a drop twice a day for two days - 4 drops in total.

I went to pick up my prescription and after waiting 45 minutes in line at the pharmacy, picked up my drops and my bill for $166, or $41.50 PER DROP!  I (not so) politely declined the drops and made a beeline back to my physician asking her why she felt my ears required this most costly elixir.  Her response: I had no idea.  Had I known that your insurance carrier did not cover that particular medication, I would have certainly prescribed a suitable substitute.  But how many people would not have questioned their physician and simply paid for the medicine they were told they needed.  And why were these drops so expensive in the first place?  And why didn't she know before prescribing them?

There was clearly no transparency among the physician, the pharmacy and the insurance company. If they were all focused on the patient and their need for cost-effective appropriate medicine.  Rather, they exist in silos with little regard for the overall patient experience.

A number of years ago, I worked with Mississippi Baptist Medical Center who asked us to help them transform their key process to dramatically reduce their cost position while improving patient satisfaction. We formed several teams consisting of nurses, physicians, administration and staff to unlock Medical Center experts.  We liberated the latent knowledge trapped within our team of experts to formulate our recommendations.

The team's improvements included:
• Improving waiting time in the ER
• Transforming patient transportation
• Eliminating the use of inaccurate and obsolete codes on outpatient records
• Preventing falls
• Reducing medical training facility wait time
• Decreasing the number of employees not receiving proper occupational health screenings
• Reducing medication errors and reporting
• Reducing the credentialing cycle time for physicians.

At the conclusion of the project, the overall cost structure had been radically reduced, morbidity and mortality increased, and patient service scores improved.  The work was documented in Peter Boland's book:  Redesigning Healthcare Delivery: A Practical Guide to Reengineering, Restructuring, & Renewal.

And it didn't take decades; the work was completed and implemented in months.  True, the U.S. healthcare system is a larger, more complex version of MBMC however the same principles that enabled us to help them transform are directly applicable to our health system.  We now need Washington to stop arguing, hand wringing and postulating and just roll up their sleeves and GET TO WORK.   But first, they must believe that it can be done.

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"When I have fully decided that a result is worth getting I go ahead of it and make trial after trial until it comes." - Thomas A. Edison

Let’s start with an explanation of the title, Beyond The Conference Room Solution. In all of my workshops and in many of my lectures, I refer to the phrase, The Conference Room Solution as a far too common approach used by organizations use to solve many of their most challenging issues.

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