More with less

[marc demers]

Given our current national economic climate, the longer arc of healthcare in the United States, and the trends that have been so profoundly beneficial in manufacturing and other industries, shouldn't we in healthcare focus ourselves relentlessly on accomplishing more with fewer resources? Isn't the very definition of quality a better outcome at a lesser cost?

[Ascent Healthcare Solutions]

Marc-You've brought up a very valid point. Hospitals that haven't yet done so should reevaluate their sustainable resources and business practices to find ways to cut costs without cutting patient care. As a company that reprocesses and remanufactures medical devices, we have seen a significant increase in the number of hospitals and physicians selecting FDA-cleared reprocessed and remanufactured devices. We've noticed a trend that more and more hospitals are adopting a program that incorporates the use of such devices and, as a result, can reallocate more resources toward improving patient care. Hospitals have also been impressed by how these programs support their green initiatives.

So, to your question, while hospitals have been experimenting with solutions that are about lesser costs, I know of very few initiatives that successfully combine better quality and less cost. Using reprocessed or remanufactured devices achieves this magical solution because equal-quality devices are used while resources are being freed to invest in more nurses or better equipment. For example, we have smaller, local hospitals that have literally hired four or five new nurses last year from the budget dollars they saved using reprocessed devices.

What are some other "resource sustainability" tactics that hospitals are using in this poor economic climate?

[marc demers]

At my hospital we have developed an application which makes hospital discharge happen in a more highly efficient manner, with automation replacing healthcare worker (primarily nurse) activity. We have driven our discharges an average of four hours earlier in the day and decreased the amount of work. This benefit represents about a $10 million savings per annum for the system, and nurses are free to spend more time with patients. Improved outcome at lesser cost = higher quality.

[Mike Anderson]

I think your point is one of the more critical for health care and hospitals. Seems to me that many in health care are locked into that "we've always done it this way" mentality or the "but more resources must make it safer and higher quality" thinking.

MY eyes have been opened in the last few months as our hospital has worked with a consultant (Chip Caldwell and Associates). This group first noted that its philosophy is that 30% of health care is non-value added waste. Then, we applied some basic lean and six sigma principles to identify and eliminate waste. The core idea is do just that - provide higher quality care with less resources and a lower cost.