There is a constant tension in healthcare between the economic/ financial imperatives and the clinical demands. Not unreasonably, based on healthcare inflation around the world over the last 40 years, there is a belief that more (which for many people, clinicians and patients) healthcare is better healthcare. Those of us interested in quality believe that this is not always the case. However the quality people I believe have been remiss in not addressing the evidence base for what they do, or the economic benefits of improving quality. Followers of Deming believe unequivocally that improving quality drives down cost. Brent James firmly believes that improving quality in Intermountain has not only improved care but dramatically driven down costs. Hence the importance of this paper just published and free to access.
The authors aim was to systematically review comparative economic analyses of patient safety improvements in the acute care setting and they explored 15 patient safety conditions and six associated improvement strategies. They concluded that pharmacist-led medication reconciliation, the Keystone ICU intervention for central line-associated bloodstream infections, chlorhexidine for vascular catheter site care, and standard surgical sponge counts were economically attractive strategies for improving patient safety.
Great stuff, a lot more needed.
The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man. GB Shaw
Showing posts with label cost reduction. Show all posts
Showing posts with label cost reduction. Show all posts
Friday, May 18, 2012
Monday, March 28, 2011
Does improving quality save money?
The instinctive answer is, "yes, of course." If only it were that easy. I am more and more coming around to the view that to change a complex system like healthcare will require radical restructuring, which will only happen in the Western World when we realise we can no longer afford to deliver our current service. It wont be easy, it wont be pleasant.
Levette has sent me a paper which suggests that improved quality and lower costs may not go hand in hand. Bottom line;
"The evidence suggests that there are ways of saving money at the same time as improving quality. But doing so on a large scale requires changes in how services are financed, and increasing the capability of ordinary services to make changes. Approaches that look effective in theory rarely seem to have the same impact when implemented in practice and on a large scale. In this respect, the challenges of achieving real finan- cial savings by improving quality and reducing waste are no different from any other attempt to change a complex system."
Levette has sent me a paper which suggests that improved quality and lower costs may not go hand in hand. Bottom line;
"The evidence suggests that there are ways of saving money at the same time as improving quality. But doing so on a large scale requires changes in how services are financed, and increasing the capability of ordinary services to make changes. Approaches that look effective in theory rarely seem to have the same impact when implemented in practice and on a large scale. In this respect, the challenges of achieving real finan- cial savings by improving quality and reducing waste are no different from any other attempt to change a complex system."
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