tag:blogger.com,1999:blog-32053362.post3059337483142263562..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: "But they are different." Not!Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-32053362.post-21469965301814379472011-06-11T22:32:18.870-04:002011-06-11T22:32:18.870-04:00Dear Paul,
I am a doctor working in Sao Paulo, Br...Dear Paul,<br /><br />I am a doctor working in Sao Paulo, Brazil, as a medical director from TotalCor Hospital, a 100 bed's hospital, especialized in cardiology. I'd like to say that I really like your comments every day and they have been a inspirational source for me day by day. You know that problems in the health system are also prevalent throughout the world. But we are seeing every day more people interested in making it safer and trasnparent results. This remains a source of inspiration. Cheers,<br /><br /> Valter FurlanFurlanhttps://www.blogger.com/profile/17952645754436390475noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-3670979788867804012011-06-10T15:46:47.431-04:002011-06-10T15:46:47.431-04:00From Facebook:
Great article Paul. As former ASQ ...From Facebook:<br /><br />Great article Paul. As former ASQ member, I truly believe that quality and profit do complement each other. However, I realized that this practice is not as widely used in the healthcare industry, as much as in the manufacturing sector.Nathannoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-27651643987441667302011-06-10T14:10:42.553-04:002011-06-10T14:10:42.553-04:00The assertion they make seems fairly ignorant. I&#...The assertion they make seems fairly ignorant. I'm pretty sure that the area that IH serves has large Hispanic and Native American populations in addition to the white Mormon majority.Annahttp://www.redbamboomedispa.comnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-58369482712046390462011-06-10T10:50:17.348-04:002011-06-10T10:50:17.348-04:00I sure wish I knew more about IHC as I've live...I sure wish I knew more about IHC as I've lived in Utah while going to school for a number of years now (boy NYC is humid...I miss the dry). <br /><br />A good friend of mine shared an anecdote with me after shadowing an IHC supply chain manager. This IHC manager said that when he first started with IHC, he did not take a salary--instead he proposed to receive compensation based on a relatively small percentage of the savings he intended to create by streamlining ("lean-ing") the supply chain. <br /><br />This fellow apparently made well into seven figures that year. <br /><br />Now some may scoff a bit, but think of the efficiency and cost savings he created within the organization that could then be devoted to other things, like research, job creation, and most importantly, improved patient care via a number of channels. My take—the gentleman earned his keep. <br /><br />He did say that they switched him to normal salary the following year. <br /><br />If there is innovation of that caliber going on there, my thoughts align with Paul's--it's got to be worth taking note of.Marcus hardynoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-45134934062570703922011-06-10T10:46:58.695-04:002011-06-10T10:46:58.695-04:00It reminds me of all the similar arguments about h...It reminds me of all the similar arguments about how the Japanese were different, and had unique cultural skill making automobiles.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-25314054904289419482011-06-10T09:49:42.584-04:002011-06-10T09:49:42.584-04:00I have to agree with Paul; it is the process impro...I have to agree with Paul; it is the process improvement which is the important thing, and the outcomes follow on as a natural consequence. However, I believe that implementation of this process improvement requires incredible commitment and tenacity on the part of leadership. I have been witness to numerous failed attempts at such at my former hospital system, and it was those 2 leaderhip qualities above which were missing. You just can't give up the first time when the staff and docs try to blow you off. Witness Gary Kaplan's experience at Virginia Mason.<br />Botom line, this CAN be done, but as of yet there is little will to do the hard work. What will it take? Patients who demand it. Or, someone famous will have to die from a blatant medical error before anyone starts paying attention - your and my relatives aren't enough.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37415352230302987282011-06-10T08:39:14.211-04:002011-06-10T08:39:14.211-04:00Barry,
The obesity rate is lower than the nationa...Barry,<br /><br />The obesity rate is lower than the national average but not lower than a lot of other states. See here: http://www.cdc.gov/obesity/data/trends.html. Utah - 23.5%; MA - 21.4%; VT 22.8%; Oregon 23%; CT - 20.6%. <br /><br />True enough on media age.<br /><br />But the point is that most of what IH did has nothing to do with those demographics. It was pure and simple process improvement.<br /><br />Having worked on similar things in my former hospital, I can assure you that it is not magic, and it is not patient mix dependent. It is a matter of administrative and clinical leaders choosing to do it -- and boards of trustees supporting and/or insisting on it.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-25170475838780925122011-06-10T08:18:02.527-04:002011-06-10T08:18:02.527-04:00Paul –
I don’t doubt that Intermountain Health ha...Paul –<br /><br />I don’t doubt that Intermountain Health has done a lot of great work in process improvement. Presumably, widespread use of interoperable electronic records is necessary to help with all the needed measurement and evaluation of results.<br /><br />However, I think it is also relevant to note that Utah has the youngest state population in the country based on median age. Also, due in part to the comparatively healthy Mormon lifestyle, the state’s obesity rate is well below the national average. Moreover, I wonder if patient expectations are any different when it comes to demanding marginally useful tests, especially imaging, and very expensive but probably futile end of life care,<br /><br />It would be interesting to see if the IH approach could be replicated elsewhere, especially in large cities or more rural areas with above average poverty rates, even with the critical cultural buy-in from physicians. Perhaps IH should consider establishing satellite clinics in other geographies like Mayo has done though even Mayo has not been able to completely replicate the culture at the main facility in MN at its satellite locations.Barry Carolnoreply@blogger.com