Sunday, May 20, 2007

Live and Learn

The decade of the 1960’s was an exciting time to be working in health care, one of the main beneficiaries of the pent-up wealth and energies being released during the post-World War II period. Expansion was going on everywhere and there was great receptivity to ideas and innovations.

Concern about cost was being expressed even then and a common justification for many new approaches was that they would improve efficiency.

I was an administrator at the time, feeling the pressure to find the resources to implement these supposedly better ways of doing things while being responsible for operating within a finite budget. That experience ultimately led me to observe that whatever we did to improve efficiency seemed always to cost more money.

That and other experiences also led me to the more general conclusion that in health care, if it was better it cost more.

I believed that until the early 1990’s, when I was first exposed to the concepts of the renowned quality guru, W. Edwards Deming. Deming taught that the continuous process improvement needed to improve quality would also reduce cost by eliminating rework, cutting waste, and generally improving efficiency.

Apparently he was right. The magazine Modern Healthcare annually publishes a list of what it calls the 100 Top Hospitals. The group is compiled in cooperation with Solucient, an Evanston, IL-based healthcare information company. This year’s selection was published on May 7. Its sub-heading read “The organizations on the 100 Top Hospitals list give higher quality care at a lower cost, while paying their staffs better.” The publication went on to identify the evidence on which that conclusion was based.

So it seems that the quest for quality improvement is supportive of efforts to control cost, not in conflict with them. That may be counterintuitive, but apparently it is true.

I guess one is never too old to learn something new.

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