Fumbles, Touchdowns and Lessons for Health Care

It was New Year’s Day, 1929. Nearly 10 months before the infamous stock market crash. On a warm sunny day in Pasadena, Georgia Tech played the University of California in the Rose Bowl.  More

Complex Environments Require Complexity Leadership

Our industry is under considerable pressure to improve processes and practices that will result in lower costs, better patient outcomes, and exceptional patient experience. In virtually every article discussing improvement strategies there is one factor that is always noted as critical for success: leadership. More

Interventions for Accelerating Improvements in the Ambulatory Space

Providing the right care in the right setting has long been advocated to improve health care quality, patient experience and cost. Often that setting is the ambulatory environment with a strong foundation of primary care and collaboration with specialty care. More

Can We Talk? What Health Care Can Learn From Broadway

I have no musical talent whatsoever. I could not, as they say, carry a tune in a bucket. But I thoroughly enjoy Broadway productions, in particular the old Rodgers and Hammerstein classics. One of my favorite show tunes is “Some Enchanted Evening” from South Pacific, in which Emile de Becque, a mysterious French plantation owner, contemplates meeting someone who will change his life. Another song from the same musical, “Happy Talk,” has none of the life-changing... More

Windmills and a Conquistador: 40 Years of Health Care Policy

In 1605, Miguel de Cervantes gave us Don Quixote, one of the most enduring characters in literary history. A hopeless romantic intent on proving that chivalry was alive and well, Quixote set off on his unsteady steed, Rocinante, in the hopes of defending the honor of Dulcinea, who appears to have existed only in his imagination. Accompanied by his portly squire, Sancho Panza, Cervantes’ protagonist conjures a world in his mind that is largely unanchored. More

How the Migration of Orthopedic Procedures to ASCs is Impacting Hospitals

The confluence of market and regulatory forces in the orthopedic surgery space has created the perfect “migration storm” with extensive implications for acute care providers. The shift of these procedures to outpatient (OP) status and the migration of total joint replacement to ambulatory surgery centers (ASCs) have accelerated with CMS’s latest proposals — removing total hip replacement from the inpatient (IP)-only list and adding total knee replacement to the ASC-... More

BPCI Advanced: The Race Is On for Episode Selection

As we gear up for a busy autumn, CMS’ recent release of claims data related to the Bundled Payments for Care Improvement Advanced (BPCI Advanced) program has increased anxiety among providers across the country. Those participating in, or considering entering into the program for Model Year 3 face the daunting task of culling three years of claims data and target-pricing sheets encompassing both peer and risk adjustment factors in search of opportunities to reduce Medicare spend for... More

Pirates, Physics and the Perils of Intuition

A physicist from Oxford found himself the prisoner of a group of swarthy pirates who had commandeered the professor’s schooner. Desperate for an escape, the physicist hatched a plan. He struck an intellectual bargain: if the pirate correctly solved a riddle of the physicist’s making, the academic would walk the plank. If the pirate answered incorrectly, the prisoner would be set free. More

Empowering the Workforce Using Visual Management

Imagine an organization where ... The most precious resource is maximized to its fullest capacity. The leader’s role is to coach, teach and mentor that most precious resource to achieve results that were thought impossible. The precious resource is excited to come to work and is trained and empowered to make decisions. Now imagine this scenario expanded to all of your precious resources – your staff. You have the proverbial army of problem solvers. Thousands of employees... More

How Does Your Hospital Move ED Patients to Inpatient Nursing Units?

I have worked with many hospitals concerning patient throughput – it’s one of those issues that every hospital struggles with. A common barrier of efficient patient throughput is moving ED-admitted patients safely and quickly to inpatient nursing units. There are likely many barriers to this process and a process improvement event or A3 problem-solving team should be utilized to identify all the issues and direct the improvement team to action. More