Hospitals and specialty centers are juggling with rising costs and lower revenue. But the true Healthcare Value comes from a combination of optimized costs and improved healthcare.

Increasing Value implies working in multiple areas simultaneously, which requires a “Big Picture” view of the integrated structure. Leveraging innovative ideas with a bias towards tangible results can rapidly improve the overall performance of the Care Center. Moving simultaneously on operational excellence and innovative changes balances the usually conflicting directions.

An integrated approach is necessary to harness profitability while maintaining or improving the care outcomes and the patient experience.

The need for a new approach

The Healthcare sector is in the midst of a fundamental, disruptive transformation. Every day new articles, announcements and mergers add to the already volatile industry. Keeping up with the changes is difficult, but necessary as those changes can alter the course of a practice or trigger a major overhaul of a network.      

Many providers have remained somehow reactive, waiting until a change has firmed up before engaging into the new path. This position is easy to understand, as the increase of the costs of providing care has been meeting a dramatic reduction in both the reimbursement of acts and the coverage by networks. Any additional funding, even with a solid business case, might be delayed or ignored as hospitals, clinics and practitioners’ offices cannot afford the investment any longer.

A pro-active approach means finding a way to minimize the cash burden of investments into improvements projects and solutions. Such balanced approach requires a big-picture view of the efforts, balancing the four forces building the long term Healthcare Value:

• Patient experience
• Operational excellence and costs optimization
• Clinical excellence & innovation
• Information management and infrastructure maturity

Each of these forces bear on the creation of a long lasting balance between the quality of the clinical outcomes and the profitability of the provision of care.

Improvement programs that would only focus on one or two of those forces might achieve short term benefits, but at the expense of a less sustainable success. The left-behind elements can only grow over time and undermine the benefits accrued earlier.

The need for a Long Term Plan

Building a long term plan is a major undertaking, which will require all functions, teams and departments of a clinical facility to work together and in many cases, collaborate actively on mutually beneficial solutions. The Program driving such changes need to be chartered with achieving sustainable value, enabling it to embrace future and inevitable changes to the healthcare landscape.

It can sound somewhat easier to decide on a silver-bullet toolkit or model, insourced or outsourced, on the premises that the solution is already defined and based on field practices. The reality is that pre-defined solution usually focus on one or two of the forces only, which are the historical expertise of their authors. A sustainable solution would always require both buy-in and active participation of the entire healthcare organization. The most critical phase in a transformation is the actual deployment of the change and its adoption on the field. The involvement of all parties up front, including front line, administration and specialties is the best guaranty of a successful adoption.

Eventually, all four dimensions of the improved healthcare value complement each other in an intricate waving. Superior patient care means both patient experience and quality of the outcome, which is anchored by clinical excellence and optimal sharing of information, with expedited workflows. The optimal provider’s experience relies on all forces simultaneously at work, deliberately.

Innovation in Healthcare

How to improve the performance and value of care while getting equipment running at full capacity and better manage patients?

Clinical workflows are often siloed, missing out the potential collaboration with other practices. Patients fail to understand why delays, paperwork, mistakes and undecipherable costs can happen in what seems an integrated center.

Crossover Optimization

Cross-over optimization brings simultaneous improvement at once; the integrated deployment of the improvements helps skip phased implementations that often lose steam before they are completed.

Launching cross-departmental improvements implies cross-over innovation as well, exploring how a fresh idea can positively impact other steps of a workflow or improve the outcomes of other sub-processes. Linking up the imaging systems to the laboratory results and early diagnostic in a 360 degree view of the patient can improve the treatment and accelerate the final diagnostic or improve the accuracy of surgery.

Practitioners know well the potential areas of improvement in their own field, but as shown in a study by Dr. Laskowski and Dr. Dudley of the Brigham and Women’s Physician Organization published by Harvard Business Review (October 2015), clinicians usually consider the cost equation as an afterthought.

Registration teams and nurses know well how their own workflows and interface with the patients could be optimized, but have in general a limited view of other departments’ constraints and improvement drivers.

Bringing all the actors together might be a complex and ineffective approach, but proceeding with “seeded” ideas for improvement and expanding the boundaries of the scope to include all related disciplines can foster the collaboration on a practical, tangible level.

Another example could be the readmission ratio. Discharging patients from intensive care too early causes high rates of readmissions with possibly severe conditions. Moving them to an acute-care or rehabilitation unit or facility can help, but can also create transfer issues and still high rates of re-admission. New mandates from regulators and Managed Care Organizations suspending payment in Intensive Care after a deadline could increase tension between clinicians and administrators. Enrolling them into a joint effort provides a solution where both drivers are considered equally, increasing the chances that the solution is optimal for both.

The need for a Business Case

Hospitals and Clinics or Doctors’ offices are often struggling financially and cannot easily afford a flurry of new ideas with unproven returns. Adopting an innovation process based on a typical R&D portfolio blends in the clinical, operational and financial value of an ideas into a standardized business case. The Brigham Care Redesign Incubator and Startup Program modeled their approach on a VC-like funding of ideas. Not all organizations can go this far, but funding the ideas based on a business case, and holding the sponsor and the program lead accountable for both the successful execution and the returns creates a positive tension between results and financials.

Encouraging cross-functional and cross-departmental teams to present integrated cases helps spreading the innovative momentum across the organization. Crossover teams often have a better chance defining a solution with a positive financial balance than a department acting alone.

Innovation can be a great differentiator, inspiring and making both customers and employees feel good about the company and the brand.   Employees and leaders are likely the best assets: why don’t we give them a chance to bring their best value to the table?