Posted by: knightbird | July 22, 2011

“Goals at the theoretical limit”

Yesterday in my Restoration to Health blog, I recommended my readers listen to Mark Graban’s podcast with former Treasury Secretary and Alcoa President/CEO Paul O’Neill. Mr. O’Neill introduced lean thinking at Alcoa, the Treasury Department and the Pittsburg Regional Health Initiative. His pedigree in lean is impressive, but even more impressive is his strategic thinking concepts. One that struck me in his interview was the statement he made and which I used as the title for this blog. While talking about the lack of leadership among executives in our country, Mr. O’Neill argued that there is no reason we should discount our ability to achieve results that near perfection. In his experience, there is no reason we should not target zero injuries as a goal—just as they did at Alcoa. And in terms of reducing Central Line Infections (CLI), he believes that there is no reason they cannot be eliminated.

As I have been thinking about our Native healthcare in the Chugach region and the state of Alaska, I was reluctant to surface the goals I believe we can achieve. Mr. O’Neill’s interview makes me appreciate my decision to do so. What I have stated is contained in 5 initiatives: (1) through the adoption of lean thinking in the Alaska Tribal Health System, we can achieve a goal of freeing up 10% of the resources we use; (2) The adoption of lean thinking can also achieve performance improvements of at least 30% overall; (3) by adopting lean design principles for any new construction, we can achieve substantial savings—although I am not able to quantify those savings; (4) by integrating behavioral health services into our primary care system, we can start to reduce the burden of chronic disease on our healthcare system by 50% in 25 years; and (5) by integrating a biopsychosocial analytical approach to healthcare, we can reduce the average primary care patient visit total by from 35% to 45% annually.

The end result of my analysis and the goals I believe are achievable is that we will be able to reduce the size of our healthcare system by 40% to 50% in cost and size. We reduce our demand for medical personnel, space and equipment. I haven’t even started to account for the reduction in pharmaceutical spending, which is substantial.

Ultimately, my goal is to increase the overall happiness of Alaska Native people. Seeking goals at the theoretical limit is a great concept. I hope some of our leadership in Alaska can see the wisdom of setting the goals I am advocating.

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