Rapidly increasing levels of uninsured patients. Unsustainable costs. Demand for services outstripping capacity. Welcome to 2008--a "Perfect Storm" in healthcare is about to hit. At no other time in the history of the U.S. healthcare system have we reached this point--one where all of the fundamentals of our system will be stressed to the breaking point. In the very short term, hospital administrators will be asked to start examining their processes in light of these pressures and will be looking for innovative approaches to providing service. Here are a few of the most significant issues for the coming year:
EDs today suffer from significant serial processing, whereby patients wait in beds while tests are performed. This serial processing, coupled with major variation in patient care processes, results in significant waste in care time, bed capacity, and clinician time. With uninsured patients hitting the EDs, most institutions lack non-urgent, "Fast Track" capabilities to quickly process these patients to unclog the patient funnel. It is a public imperative that hospital EDs implement best practices in order to utilize specialized treatment centers for non-urgent patients, while improving the flow of urgent and emergent patients through parallel processing.
As operational experts have learned in manufacturing firms, the proper application of these techniques can have profound impacts on the efficiency and effectiveness of all clinical and ancillary services. Hospitals in 2008 will begin to seriously leverage these principles to transform their cultures while adopting high-performing processes.
Hospitals will be expected to be more transparent and accountable for their expenses. Issues including Performance Improvement and No Pay for Poor Performance will begin to become part of the lexicon in hospitals. Hospitals that seize the initiative to improve quality and performance levels will be the early adopters in 2008, as these forces hit the mainstream of the industry by year's end.
First, alternatives to the current tort system will become part of the dialogue for industry change in 2008. Reducing the impacts of defensive medicine and establishing mechanisms like Health Courts will allow practitioners to actively pursue best practices and standard protocols for birth methods. This second initiative will begin to be more prevalent, whereby institutions and physicians will be held accountable for performing within a clinically accepted benchmark for all services, using their training and experience coupled with best practices instead of performing unnecessary procedures.
Hope or Despair?
So, why should anyone be optimistic with all these pressures? The answer is contained in the nature of the major stakeholders: dedication. Physicians, nurses, technicians, administrators, and executives share the same passion for healing, patient care, and excellence. It is this dedication that will enable the industry to change from the inside out. Anything short of this could threaten the system, resulting in legislative moves to adopt socialistic medicine. The major players have the will and desire to make serious changes. Now the hard work of implementing these capabilities will prove successful in 2008.
Tefen USA, a subsidiary of international management consulting firm Tefen, works with hospitals and health organizations to make sustainable improvements in the areas of business strategy, operations excellence, project management and organizational development by applying LEAN, Six-Sigma, and related operations strategies to improve the cost, quality, and access performance of healthcare organizations.