So much for stewardship
By John Whittlesey
We have a facility – that will remain nameless – which has gone through a major physical transformation over the past three years. It recently built a brand-new, state-of-the-art tertiary facility to replace its older facility, but essentially keeping the same services intact. Now prior to the move, they certainly didn’t have what I would consider to be a cost-effective model of delivering healthcare.
So, when they were planning and building this facility, I advised one of the key planner-implementers of the project to take advantage of this singular opportunity to redesign the staff’s processes, productivity, utilization patterns, clinical protocols, etc. This could allow the facility, in effect, to “reset” its cost position in a new environment. He assured me the managers were working those things into the plans. I crossed my fingers and hoped for the best.
So we’ve just finished the facility’s 2009 clinical benchmark, and I was curious to see what major changes occurred. I went back to the 2007 report to see what its cited excess was at the old facility, and compared it to the first full data set under the new facility (FY 2009). Interestingly enough, the excess was 5 percent greater in the new facility than before, its cost/case was nearly the same, and most of the same DRGs were cited for similar variation.
So, to my eye nothing really changed, except they have a new, pretty facility. Is that really good stewardship of healthcare resources?
John Whittlesey is principal at HMC
