Posted by: knightbird | December 30, 2011

Savings in Health Care

I am not sure I always make it clear in my writing and presentations that when I talk about quality and productivity improvements in health care using Lean Thinking I am referring to the whole enterprise. I read a lot about excellent programs, and in reviewing an article about integration of behavioral health screening for depression in a Midwest health system they revealed having a total of 33,000 employees. 675 are physicians. Do the math. There is 48 staff per physician, which constitutes 2.05% of total staffing. Physicians are the primary value-adding employees. If, as I maintain, we can improve productivity gains of 30%, 9,900 employees overstaff the system. This is a simple way of looking at the numbers, but I believe it conveys the thought. If we look at the entire system of health care, we are overstaffed substantially. We have income to throw after problems instead of fixing them. Consultants, crutch positions, quality control and overstaffing for the service provided are all problems. They are exacerbated when more money flows into inefficient operations.

Our larger Alaska Native health systems are now showing much larger surpluses than they have in the past few years. They are seeing more patients and revenue is increasing. I also see an increase in consulting, crutch positions, quality control and overstaffing for the volume of need. If we are to bring health care costs down in the U.S. we need a heavy dose of enterprise wide lean healthcare.

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