A report posted on the Institute of Medicine website this month may give some cost-embattled healthcare executives just what they need, even if it's not something they're all ready for just yet. It's a 10-point "CEO Checklist for High-Value HealthCare," a list of tips on how to keep their organizations alive, written by an all-star cast of leading hospital chiefs.
"We can't afford the healthcare that we're delivering today," says Brent James, MD, executive director of the Intermountain Institute for Care Delivery Research in Ogden, UT. "If you're not adapting right now," James says, "you will die."
He is among 11 well-known executives who believe that at its core, the healthcare delivery system must be radically transformed to improve quality and reduce cost. And there are a lot of healthcare CEOs, he says, who really don't understand that yet. Or if they do, they're bewildered about how and where to begin.
In addition to James of Intermountain, efficiency/quality tips are shared by big-name leaders: George Halvorson of Kaiser Permanente; Gary Kaplan, MD, of Virginia Mason; Gary Gottlieb, MD, of Partners HealthCare System; Patricia Gabow, MD, of Denver Health; Michael Fisher of Cincinnati Children's Hospital Medical Center; Delos Cosgrove, MD, of the Cleveland Clinic; Robert Petzel, MD, of the Department of Veterans Affairs; John Toussaint, MD, of ThedaCare Center for Healthcare Value; Glenn Steele, MD, of Geisinger Health System; and Jonathan Perlin, MD, of HCA, Inc.
Not a silver bullet
"We weren't trying to give them the magic bean formula, you know, just do this and everything will be fine, a silver bullet," James says. "It's just that this transition is happening with increasing rapidity across the industry, so we wanted to help people be more successful in their transitions, and not step into the same holes that we stepped into in the past."
The report says that extensive waste within the healthcare system, estimated at $750 billion or 30% of national healthcare expenditures, "do not improve health."
A chart in the report, however, shows that Geisinger, achieved a 67% decrease in elective mortality of patients undergoing coronary artery bypass grafts, while Kaiser cut HIV mortality in half and HCA saved 200 people who would have died from central line bloodstream infections, simply by delivering care better and smarter.