Why Initiatives to Reduce Variation Fall Short–And What #Cardiovascular Service Line Leaders Can Do About It
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- On January 22, 2020
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The healthcare industry is awash in variation-reduction initiatives. A simple Google search for “decrease variation in healthcare” returns over 51 million results, many case studies on how a single process change resulted in some improvement in patient outcomes and decreased costs during a given period of time. However, as anyone familiar with Nassim Nicholas Taleb’s seminal 2007 book, “The Black Swan: The Impact of the Highly Improbable” knows, it is what you don’t know that is far more relevant than what you do know. We would ask: what is the overall return rate for all of the resources spent trying to eliminate variation? For those initiatives that do manage to eliminate or reduce clinical care variation, how long are those clinical and financial gains sustained? Research to answer those questions suggests, well, an opportunity for research. We do know, however, that Harvard Business Review reports that, “Studies consistently report that about three-quarters of change efforts flop—either they fail to deliver the anticipated benefits or they are abandoned entirely”. Given that healthcare costs are projected to reach 20% of US GDP by 2025, and the average American family spends more of their income on hospitals than they do on taxes, it’s time we begin to question these resource-intensive “variation reduction” programs, and find a new approach to achieving the real goal, which is reducing costs while simultaneously improving care quality.
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. Follow us on LinkedIn or Twitter to keep up with the series.