The Challenge and the opportunity
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Transcript of The Challenge and the opportunity
8/12/2019 The Challenge and the opportunity
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
3
The Challenge
• U.S. healthcare costs >$2 billion/year• Healthcare inflation >CPI for many years
• Continuing issues of safety and errors• Lack of use of evidence-based medicine• Patient dissatisfaction
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Institute of Medicine —Crossing theQuality Chasm
Goals of a New System
• Safe• Effective• Patient-centered• Timely• Efficient• Equitable
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Steps to Close the Chasm• Care based on continuous healing
relationships• Customization based on patient needs and
values• The patient as the source of control• Shared knowledge and the free flow of
information• Evidence-based decision making
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Steps to Close the Chasm (cont’d)
• Safety as a system property• The need for transparency• Anticipation of needs• Continuous decrease in waste
• Cooperation among clinicians
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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The Opportunity
• Evidence-based medicine – Could reduce healthcare costs by 28 percent – Over 400 care guidelines currently available
• Knowledge-based management – The new engineering/healthcare partnership – Widespread adoption of electronic health records
• A more active role for the consumer – Consumer-directed healthcare savings accounts – The Internet and self-care
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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System Stability and Change(Peter Senge —The Fifth Discipline)
• The structure of a system is the primarymechanism to produce an outcome
• No system is ever completely stable• Each system’s performance is modified and
controlled by feedback• Feedback is ―any reciprocal flow of influence • Feedback can be one of two types: reinforcing or
balancing• A confounding problem of feedback is delay
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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System with Reinforcing and
Balancing Feedback
Salaries
+
+
+
Employeemotivation
Financialperformance,profit
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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System with Reinforcing andBalancing Feedback (cont’d)
Add orreducestaff
Actualstaffinglevel
−
−
Compare actual toneeded staff on thebasis of patientdemand
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Chemotherapy as an Example of Linkage of Partsof the Healthcare System
New paymentmethod forchemotherapyis created
Chemotherapy
treatmentneedsto be moreefficient to meetpayment levels
Changesare madein careprocessandsupportsystems tomaintainqualitywhilereducingcosts
Payers wantto reducecosts forchemotherapy
Environment Organization Clinical Microsystem —Patient
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Framework for Effective OperationsManagement in Healthcare
Setting Goalsand StrategyExecution
PerformanceImprovementTools,Techniques,
and Programs
FundamentalHealthcareOperationsChallenges
HighPerformance
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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Vincent Valley Hospital (cont’d) • Two major competitor hospitals• Surgeons from all three hospitals recently joined
together to set up an independent ambulatorysurgery center
• Three major health plans provide most of theprivate payment to VVH• Plans, along with the state Medicaid system,
have recently begun a pay-for-performance
system• VVH has a strong balance sheet and a profitmargin of approximately 2 percent but feelsfinancially challenged
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Healthcare Operations Management© 2008 Health Administration Press. All rights reserved.
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End of Chapter 1