Hospitals

"There are two things we need to do in medicine," a hospital administrator told Guy Boulton of the Milwaukee Journal Sentinel recently. "We need to learn to see waste. And we need to see risk."

The paper wrote a thoughtful two-part series (here and here) recently documenting how ThedaCare, a four-hospital chain in Wisconsin, has used those two guiding principals not just to save money but to improve patient care. They've re-examined everything from washing sheets to heart surgery. They've saved money—and improved outcomes for patients. They've shortened waits for appointments for CT scans. And they've eliminated hundreds of forms.

One example: an uncomplicated heart bypass surgery, including the doctors' fees, cost $30,400 at a ThedaCare hospital. At some other southeastern Wisconsin hospitals, insurers pay more than double that.

A lot of the improvements can be seen in the general medicine unit at ThedaCare's Appleton Medical Center, where they've introduced a model called "Collaborative Care." The unit serves patients with infections, pneumonia, heart failure, and similar problems. The improvements have cut the amount of time patients typically stay in the hospital by 20 percent.

Yesterday I posted on this year's "100 Top Hospitals: National Benchmarks for Success" list, released this week by Thomson Healthcare. I promised I would post today about how to get from here to there.

I bet you lost sleep with anticipation!

Again, I want to quote Steven Pearlstein's column last year on this issue, specifically the story of how Winchester Medical Center in Virginia responded to its "somewhat disappointing" report a few years ago:

Winchester Medical Center set a goal of making the Top 100 list by 2008. It hired a consultant, altered its executive compensation to put a bigger emphasis on quality and organized teams in every department to implement small changes in procedures that translate into big improvements in its quality score.

After nurses took extra time to take fuller medical histories, and body hair was clipped rather than shaved before surgery, and the timing was changed on when antibiotics were administered, for example, surgical infection rates fell by 75 percent.