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- On January 23, 2020
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This week, we take a look at the problem with trying to eliminate, or reduce, variation, and some thoughts about what physicians can do to educate others about why this approach is limiting. If you missed the first post in the series, discussing why initiatives to reduce cardiovascular care variation fall short, and what service line leaders can do about it, catch up using the link.
Here’s a look at the problem with trying to eliminate, or reduce, variation, and some thoughts about what leaders with medical backgrounds can do to educate others about why this approach is limiting.
Variation Initiatives Don’t Consider Patient Uniqueness
Every individual who has cared for patients knows that every patient is unique. Whether a doctor, nurse, APP, or allied professional, at some point, the patient’s care will deviate, in some way, from ‘the plan’. Those clinical experts in leadership positions can (and do) run variation reduction programs that account for this, but they fundamentally recognize that return on variation-limiting programs will be bounded. While this is understandable, given that variation reduction is given prominent place in most strategy operationalization programs, a fundamental bias in problem structuring exists. Patient uniqueness is a feature, not a bug.
Physician leaders must ask again, “What problem are we trying to solve?” The problem isn’t variation. Even focusing on cost and quality is bounded: price can’t be reduced past, well, cost, and the quality of the outcome is unique to the patient’s health goals. What if we frame the problem correctly: how do I bring all of the best possible practices to every one of my patients? Unlike variation, the solution set for that problem is unbounded: as long as medical knowledge continues to develop, and people in healthcare continue to innovate, it will always be possible to improve. Additionally, solving that problem inherently delivers the outcomes that we are truly seeking: lower costs and higher quality, not cookie-cutter, systematized care delivery. We encourage physicians to ask themselves and their organization what problem they are solving.
Follow us on LinkedIn or Twitter to keep up with the series. Tomorrow we explore introducing the concept that variation elimination initiatives are time boxed, whereas total quality becomes a way of life.