|
Quote of the month
First they ignore you, then they laugh at you,
then they fight you,
then you win.
MOHANDAS GANDHI
|
|
NEWS ITEM
U.S. spends half its budget on elderly.
Programs and services that target senior citizens accounted for nearly half of what the federal government spent in 2005, according to a new report from the U.S. Census Bureau.
Social Security, Medicare and Medicaid spending comprised almost $1.1 trillion of the $2.3 trillion budget in 2005 - an 8% increase over 2004. The Consolidated Federal Funds Report for Fiscal Year 2005 presents data on most domestic spending by the federal government for state and county areas of the United States, including the District of Columbia and U.S. outlying areas.
Federal spending per person was highest in Alaska, Virginia, Maryland, New Mexico and North Dakota, according to the report.
|
|
MORE QUOTES...
I went into a restaurant one night and ordered lobster, and the waiter brought me one with a claw missing. I called him over and told him about it. He told me that in the back there's a tank they keep the lobsters in and while they're in there, they fight and sometimes one loses a claw. I told him "then bring me a winner."
Al McGuire
Don't worry about your heart. It will last as long as you live.
W.C. Fields
"I'm all in favor of keeping dangerous weapons out of the hands of fools. Let's start with typewriters."
Frank Lloyd Wright |
|
October Survey Comments
The principle improvements have been in the advances in technology, medicine, etc. Patient relations has either stayed the same or gotten worse.
My mom is in the hospital now and if I wasn't there every day I shudder to think how her care would be.
The financial side of healthcare is difficult. I've been told that because I had successful heart valve surgery at age 56, I am not insurable privately again.
Healthcare is better only in some areas, flu shots for example, but 48 mil uninsured - horrible.
It's no worse, at least for middle class professionals.
Technology is better but access to primary care is worse. Hospitals do not understand the geriatric population.
There have been many advances especially in non invasive technology and pharmaceuticals. Not much progress in wellness which is mostly unreimbursed.
People may be living longer, but they are not healthier. The USA has the fattest people. Prescription drugs are ruining peoples' lives due to misuse.
Healthcare really is better than 15 years ago. We are able to do so much more, cure more things. But, the healthcare delivery system is the same or worse.
I believe we are doing some things better as far as care. My expertise is in the area of long term care. I know we are providing more acute care.
A few years ago, after learning that the company my daughter worked for was using Six Sigma, I asked her what she thought about it. She became really excited, turned on her laptop and showed me these "really neat" equations and files filled with data, then bragged about their quality improvement and cost reduction success stories. As an aerospace engineer she is accustomed to working with numbers and equations. After teaching financial management to health administration students and watching their eyes glaze over when they see numbers, I've decided that one of our biggest problems in improving quality is that healthcare people shy away from numbers and don't get excited about reviewing data. We can't solve our problems with guesswork; we've got to do the math.
| |
Greetings!
In October's Newsletter I asked a number of people with healthcare backgrounds what their views were on quality in healthcare - had it improved over the past 15 or more years? I have to admit that my own view is that we haven't made much progress.
I have been fortunate to have met with two quality improvement gurus, Dr. Deming and Dr. Juran, and in the 1980's and early 1990's I believed that we were about to participate in a golden age of healthcare quality. Now, looking back, I see many, many opportunities lost and few that were capitalized on. Yes, there has been progress in technology, research and pharmaceuticals but very little improvement in how a patient moves through the acute care or long term care system. Has customer safety or customer service improved? Are payment systems any easier to navigate? What about infection rates, unnecessary deaths and in institution negative events? Now ask yourself: are physicians any happier with their lot in life? Can they spend more time with patients? Has their paperwork burden been reduced? Do nurses see their lot in life as improved? Is the nursing shortage a thing of the past? Is nursing as a profession any more respected and are nurses treated as partners in care delivery? Think about employers and other payers. Have they seen positive change? Adjusted for inflation have insurance and healthcare costs declined? Of course the answer is a loud no!
On my most negative day I think that healthcare has had all of the pain associated with massive change with no results to show for it. On my most positive day I realize that my blood pressure is normal because of a tablet I take daily and that many people are walking around alive because of an EMS system that seems to work.
I'm trying to figure out what it will take politically to bring all of the diverse parities, who have only looked out for their own interests for the past 50 years, to the table to make difficult decisions. Politicians, insurance companies, providers, employers and consumers must develop a real, workable, cost efficient, safe, effective healthcare system and they can't take another 50 years to do it.
I do know that quality can't be seen as the project of the month. It needs long term nurturing. It also needs managers who realize that, if they keep thinking that they can't go to firefighter training because they are too busy holding the hose, they will never see improvement. It needs senior executives who don't confuse quality improvement with cost cutting. For too long quality initiatives have used cost savings as the only incentive for change with none of the savings reinvested in employees or additional quality improvement.
Finally, healthcare boards of directors must come to understand their role and they must support and insist on quality improvement in their organizations. Healthcare as a whole must define quality. Is it life expectancy, survival rates, access - what? Society requires agreed upon definitions.
What do you think? Email me.
Ken Bast
KenBast@MgtConsultinginHealthcare.com |
|
Taking a "Big Picture" view, comparing healthcare in the United States now to 15 years ago, is it:
1) Much Worse: 6%
2) Worse: 17%
3) The Same: 17%
4) Better: 54%
5) Much Better: 6% |
Questions that might cause pain
What questions cause your organization's leadership to become uncomfortable, to squirm, maybe even to feel pain?
Here are some samples - how would your organization respond?
Do you know which processes are most important to your customers? Does this information come from your customer or from management's assumptions about what the customer wants?
Do you know which process errors cost your organization the most money to correct?
How fast does news, both good and bad, travel up and down your organization? Is news acted upon? Is it "safe" to bring bad news to the attention of leadership?
Does your organization have a process for tracking change in the environment that might adversely affect your business or create opportunities to explore?
Does your organization know what its turnover rate is by position, by shift, by department, etc.? Do you know the real cost of that turnover?
How "political" versus factual is your organization? Does it make a difference who came up with an idea or complaint?
Email any of your organization's pain inducing questions to Ken Bast.
.
| |
|
|
|
Management Consulting in Healthcare
is:
A small, focused consulting firm that...
Believes hands on, down in the trenches operational experience combined with consulting expertise is vital in obtaining real, lasting results for clients.
Has experience in acute care, long term care, health systems, CCRCs, medical schools and other healthcare organizations.
| |
|
