How do you solve care management problems at your hospital?
I think that's a fair question. I was talking with a nurse from reputable a STEMI receiving center just a few days ago, and he told me "our times are amazing!" In my role, anytime I hear that it makes me ask lots of questions. I want to learn what the leading hospitals are doing to solve the problems that we all face.
How are you doing it? What's the secret? "Oh it's simple, we staff a midlevel in the hospital, and they shepherd the process." If you could hear what's going on in my head, you would hear the sound of brakes screeching.
“You staff a midlevel??”
Some of you might be wondering, what's wrong with that? I'm glad you asked.
If you haven't noticed, hospitals are struggling as of late. Every nurse and doctor seems strapped to the max, unable to take on one more thing, and then BAM! Another issue arises and who are we supposed to assign to solving and managing it? The days of throwing people at the problem need to be a thing of the past. It's just too expensive, and the overall value to the hospital diminishes when we patch a process with more people. Focus instead on fixing the process first, and save all the bling that you're wasting on additional staff.
Another answer I've heard from a couple of the major medical centers is "We staff a cardiologist and Cath Lab 24/7." Really?? What do you do with your unicorns? If we were living in a fairy tale, it wouldn't be a bad solution. In fact, there are a few lucky teaching hospitals who can do this, but it's not practical for us common folk. When I see especially stellar times from hospitals, I often wonder how much money they are wasting to get them. I admire their commitment, but at the end of the day, they have to keep their doors open, or what good is any of it?
Here is a very simple formula that all clinical staff needs to commit to memory: Value equals quality over cost over time, or V (Value) = Q (Quality)/C (Cost)/T(Time). This equation is what value-based care is all about. We need to find ways to work smarter and not harder. Hiring more bodies to solve our problems (sometimes) brings good quality, and (hopefully) decreases the time needed to solve the problem, but also certainly drives that cost factor through the roof, leaving us with a poor value score.
So where should hospitals turn to fix their processes and reduce workloads? Technology. Interestingly, technology is the one thing that hospitals seem to be the most afraid of, yet it also offers so many solutions to improve how effectively hospitals and their staff work, and at a very high value. It's time, finally, to catch healthcare up to modernity.