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- On January 24, 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 two posts in the series, discussing why initiatives to reduce cardiovascular care variation fall short, and the uniqueness of each patient, catch up using the link.
Variation Initiatives End. Performance is a Way of Life
The story is repeated in leading journals, at conferences, and in vendor case studies: “We wanted to reduce [negative process outcome/cost]. We assembled a team, and built analytics to prove that this was a problem. The team relayed what to do to the physicians and nurses. Through dates xxx to yyy, we reduced the problem. The end.” While it’s okay for books and movies to end that way, we believe that physicians know that patient care is lifelong, not a timeboxed episode. Further, shouldn’t it be a doctor-patient decision as to how, and what, care should be delivered? Sure, infection rates may have decreased overall, but were unnecessary costs heaped on already cash-strapped patients? Were patients kept in the hospital longer? What happened to the sickest patients? How do you know it wasn’t just a string of patients who had lower risk for complications? While you may be able to answer some of these questions after the fact, that is a retrospective approach. Physicians care about what is happening right now, and what is best for this specific patient. And, what about those cases where variation produces an exponentially more positive outcome? Should those be eliminated? We believe that focusing on variation is a short-sighted approach. For all of the resources allocated and bits and bytes dedicated to variation elimination, the real goal is about enabling physicians to deliver the best care to every patient.
Follow us on LinkedIn or Twitter to keep up with the series. Tomorrow we explore the impacts of variation elimination projects, not only on physicians, but the expensive resources these projects consume from the hospital system.