10 broad calls to action
The checklist's 10 items are extremely broad. The top item calls for "visible and determined leadership by the CEO and Board." The second item urges "a culture of continuous improvement, commitment to ongoing real-time learning." And number three calls for "IT best practices – automated, reliable information to and from the point of care."
The others are:
4. Evidence protocols: effective, efficient, and consistent care
5. Resource utilization: optimized use of personnel, physical space, and other resources
6. Integrated care: right care, right setting, right providers, right teamwork
7. Shared decision-making: patient/clinician collaboration on care plans
8. Targeted services: tailored community and clinic interventions for resource intensive patients
9. Embedded safeguards: supports and prompts to reduce injury and infection
10. Internal transparency: visible progress in performance, outcomes, and costs
Waste and cost-shrinking strategies
But the report also gives 32 specific examples of strategies hospitals have employed to reduce waste and spending, that over time, improved quality and appropriateness of care. And yes, they reduced cost, too.
At Intermountain Healthcare, when an obstetrician refers a pregnant woman for an elective induction, she must meet nine criteria before the procedure is allowed to proceed.
If she doesn't, and there's no medical necessity for the induction, she will be sent home. That practice has reduced the elective induction rate from 28% in 2001 to less than 2% today, saving the Ogden, UT healthcare system $50 million a year.