Tom Peters, in a May, 2008 HFMA interview with the organization’s CEO, Richard L. Clarke, opens the door for a future of healthcare excellence using the key of simplicity.
Leveraging his background as one of the foremost authors on the application of leadership principles to stagnant industries, Peters calls for “a revolution of simplicity that gets us focused back on delivering health care and realizing that a lot of our operational problems …can be fixed with some straightforward solutions.”
Among the solutions floated by Peters, patient safety and quality rise to the top. He envisions incentives that promote family practice rather than the currently dominant super-surgeons, with telemedicine and technology keeping the aging Baby Boomer population out of the hospital.
Peters calls the medical error rate of 100,000-200,000 annual deaths “a disgrace”, but rather than pitching a simple-yet-global approach that would largely mitigate these numbers, he instead asks financial leaders of all health systems and hospitals to shift their roles to studying and experimenting with small solutions to the issues.
He implores these leaders to ask “What am I going to do in my hospital to make the world a better place?”
Clarke asks how they are to do this while mired in a broken payment system. Peters tells him to get over it, that the payment system will continue to frustrate, and that by focusing their time on making the hospital better, real progress can be made in the form of small experiments to improve quality of care.
Peters suggests micro experiments so that an organization can latch onto initiatives that are proven to work first at a local level, and abandon those efforts that didn’t make the cut. Financial experts need to become experts in the 5 or 6 issues most impacting quality delivery and patient-centric care at their hospitals.
To Peters, there is an enormous opportunity to build leadership right within the ranks of CFO’s throughout the health system, something generally regarded as missing in healthcare reform. This responds to Clarke’s demands for ROI associated with quality initiatives. Peters suggests that while there are lots of examples how improvements in quality resulted in short-term, lower bottom line results – flaws in the fundamental incentive schemes – making quality and patient safety/success part of the long term vision of every healthcare organization places the accountability of healthcare reform squarely on the shoulders of every ambassador of efficiency.
He shares two examples of health organizations that have
made sustainable commitments to patient safety and quality with dynamic
monetary success:
Griffin Hospital, which now commands dominant market share; the Veterans Administration hospitals which has invested small sums into quality improvement experiments.
What are your views about Tom Peters’ Revolution in Simplicity for Healthcare Reform? Do you believe he hits the mark for how true leadership among the financial stewards will reward health systems with a more sustainable future of better health delivery and profits, or is there something missing in Peters’ argument? How would you suggest health systems surmount their individual ambitions while taking care of America’s need to fix a broken system, plagued with death and errors?
------Michael
Many American health systems are significantly underinvested in quality management Infrastructure, Process, and Organization. To achieve breakthrough improvements in quality, patient safety, and resource utilization hospitals and physicians must work together to develop a "world class" quality management foundation that includes:
Strategy: including a clear linkage of quality and patient safety to the organizational strategy and a Board-driven imperative to achieve quality goals.
Infrastructure: incorporating effective quality management technology, EMR and physician order entry, evidence based care development tools and methodologies, and quality performance metrics and monitoring technology that enables "real time" information.
Process: including concurrent intervention, the ability to identify key quality performance "gaps," and performance improvement tools and methodologies to effectively eliminate quality issues.
Organization: providing sufficient number and quality of human resources to deliver quality planning and management leadership, adequate informatics management, effective evidence based care and physician order set development, performance improvement activity, and accredition planning to stay "survey ready every day."
Culture: where a passion for quality and patient safety is embedded throughout the delivery system and leaders are incented to achieve aggressive quality improvement goals.
My firm has assisted a number of progressive health systems to achieve such a foundation, and to develop truly World Class Quality.
Posted by: Scott Hodson | August 14, 2008 at 01:06 PM