In today's economy, hospital executives are realizing that the variables they can control are quickly being dwarfed by the size of the problems they cannot control. This is a good time for executives to revisit clinical protocols as a way to position their hospitals in the face of a chaotic marketplace.
Clinical protocols are also a way to engage physicians who are more aware of their role in hospital operations than they were a decade ago. By taking the first steps to establish a clinical protocol committee, hospital leaders can bring physicians into the process of developing, updating, and improving clinical effectiveness. By bringing together stakeholders in this way, hospitals are better able to control their costs while also finding innovative ways to deliver quality patient care.
To understand the impact that clinical protocols can have in today's hospitals, it is important to understand the following:
Before delving into the reasons for updating protocols, take a minute to review some of the troubling trends that are emerging. The data clearly show that hospitals are facing many simultaneous negative pressures—unprecedented in our time—and they are being forced to look at innovative ways to control costs while maintaining quality care. Some of the most critical trends that are simultaneously facing hospitals, physicians, and patients today include:
As a result of these and other pressures, many hospitals are attempting to reduce their cost profiles in both the short term and the long term. In addition to the other difficult cost-cutting measures that hospital executives are undertaking, they should also revisit clinical protocol committees. Such committees can ensure effective patient treatment and position the hospital to take advantage of changing forms of reimbursement while benefitting the operational health of a hospital. Given the size of the chaos that hospitals and the country as a whole currently face, there may be less resistance to the concept.
Physician pushback eroding
Historically, physicians pushed back against protocols and resisted being told "how to practice medicine." Physicians usually voiced some common concerns: their training was likely better than those who are designing the protocols, their patients were sicker than the norm, or standardized protocols limited innovation. The lack of protocols, however, can have far-reaching consequences. For example, one 700-bed hospital chose to stay away from protocols and case management because of pushback from physicians. Upon review of the quality of this hospital's outcomes, it was poorly rated by national agencies, patients' length of stays were excessive due to delays in receiving routine tests, and services were dramatically overutilized. This represents a tremendous waste of resources and an increase in costs that could otherwise be avoided.