"There's nothing more elegant than that simple statement, although we've now put in place through his leadership different ways of blocking ordering of tests in our system."
"I don't think the public understands the sea changes that are happening with hospitalists," he says. "I'm a big advocate of standardization where it makes sense."
In Seligman's self-described "little community hospital," he has two adult medical hospitalist groups, a pediatric hospitalist group, and neurological and surgical hospitalists.
"Most important, they're experts in using our IT," he says. "That is the vehicle for so much of the standardization of process."
He says the hospitalists focus on order sets, and as part of a four-hospital system whose physicians have agreed on clinical standards, "we're able to say, as a network, that this is the way that the physicians have agreed to treat this particular problem. We're not depriving a physician of the right to deviate from that, but we're establishing a standard and most of these orders are being written by a small group of people who work for the hospitals. That has changed dramatically the amount of variability in practice."
The beauty of the process, says Seligman, is that not only does it drive out waste, it also drives out unexplainable variability over time, a key metric in clinical quality.
Neither of these CEOs would claim that they are close to a finished product in making this transformation, but they're implementing real change to the way they do business. If you're looking for somewhere to start, you could certainly do worse than focusing on variability and waste in the utilization chain.