Hospitals often approach quality the wrong way. Instead of analyzing quality, hospitals should analyze processes and functions, outline desired outputs and build a cost effective way to consistently achieve those outcomes. Using a productivity-focused model will enable "quality" to be a natural outcome.

Related topics

• Improving Healthcare Cost
• Performance Improvement

...that quality and productivity are companions, not trade-offs?

...that earlier this year an Australian medical journal published results of a clinical trial in which there was a 50 percent drop in adverse events and a 36.9 percent reduction in the post-operative hospital mortality rate at a medical center that had begun using such a Rapid Response Team?

...that with the reporting results of patient outcomes by hospitals through public databases, and theoretically, payers being able to research the same results, effective clinical management of pneumonia patients has moved front and center in the minds of clinicians and administrators?

...that preparing your staff for JCAHO, through repeated tracers and other educational methods, is the surest way to put your best foot forward?

...that while a high-risk case management model may focus on persons with a high risk of becoming seriously ill due to a combination of medical, social and functional problems, a Disease Management Case Management model addresses standard, evidence-based needs related to a specific diagnosis?

...that the government released a report suggesting that JCAHO was not doing their job to assure patient safety?

...that Setting up a committee tied to nursing and research is a great way to achieving Magnet status as well as research initiatives together?

Quality and productivity are companions, not trade-offs. Quality outcomes can be enhanced only if managers manage to both quality and productivity. But hospitals seem to be missing out on both dramatic increases in productivity currently experienced by other industry sectors, and positive changes in patient outcomes. Without increases in productivity hospitals will continue to increase charges, further perpetuating rapid increases in healthcare costs. Without increases in quality outcomes, hospitals are placing a portion of their revenue at risk.

Hospital systems in the United States face two significant problems – decreasing productivity and neutral changes in quality outcomes. Starting in 1997, the Budget Reconciliation Act began reducing scheduled Medicare reimbursements to hospitals. Suddenly, responsibility for healthcare expenses began shifting to acute care hospitals, where management still finds itself grappling with the need to develop strategies to reduce hospital costs and improve the quality of patient care.

In 2006, the ability to maintain a competitive cost position will be further compounded as hospitals will have a portion of their reimbursements at risk, that is, based on hospital performance as measured by quality outcomes. Mixing decreased reimbursement with quality outcomes makes the pressure to increase quality an important initiative. However, it also places a concomitant squeeze on the financial resources of a hospital since it seems that the few solutions to delivering a higher quality of care require a significant investment in information systems and additional labor. Implementing any of the potential solutions to providing a higher quality of care, such as Computerized Physician Order Entry (CPOE), without considering how these components are integrated, or how other currently available resources will be impacted, will result in further decreases in productivity and ultimately a higher cost position for hospitals. (continued...)