Theory of Constraints Handbook - James Cox Iii [619]
The Internet has also given the public access to healthcare performance data. Through measurement and benchmarking, many areas of medicine today are open to scrutiny by their consumers. Choice, even in some socialized healthcare systems, is fast becoming a perceived right of the healthcare consumer around the world. In some countries, health-care is considered to be a basic human right that carries with it statutory legal rights for the individual.
With good physicians and a high proportion of facilities experiencing increases in demand and with some poorly performing services struggling to attract patients, it is an imperative of healthcare providers to keep improving both now and in the future.
Therefore, the global goal of healthcare is to be able to treat more patients, better, sooner, now and in the future.
What to Change
Where to Start: Government or Facility?
There are many opinions on how healthcare should be funded and who should be responsible for its delivery.
Socialized healthcare has much to commend it as well as to condemn it. The exact same thing can be said of privatized medicine. The only census that can be reasonably reached about the best mechanism for managing the funding and management of healthcare is that there is currently no one best way and each of the methods used thus far appear to fail any given measure of “value for money.”
Tackling the problems facing healthcare at the governmental level of any country is a long, laborious procedure that all too often results in unsatisfactory compromises.1 Very few people or organizations work within a sphere of influence large enough to be able to have a meaningful impact on a national or legislative level on the delivery of healthcare. If we, as individuals or organizations, strive to change healthcare from the very top down, through the representatives of our respective governments, we will have a mammoth task on our hands with very little chance of success.
However, those of us working within or consulting with healthcare facilities do have a chance of making a difference. Therefore, we need to recognize the limitations of our sphere of influence and be prepared to work within it.
Unlike industry, healthcare is an industry sector that is, for the most part, prepared to share best practices and ideas and processes for improvement because it recognizes the need, even between competing facilities, to contribute to the common goal of trying to treat more patients, better, sooner, now and in the future. This openness supports the numerous journals and publications covering medical advances and the management of healthcare. Healthcare openly admits its need to improve and it is prepared to consider and share ideas and processes that will help it to improve. However, there are far too many instances when the “silver bullet” for one system or facility is adopted by another facility without fully understanding why it was able to be so successful in the first place. Because of the driving need of healthcare managers and administrators to improve the performance of their facilities, many of them have fallen prey to consultancies and methodologies that:
Do not address their core problem and therefore fail to achieve the operational improvements achieved in other facilities.
Fail to yield an effective return on investment.
Are strangely familiar to longer serving staff who claim to have “seen it all before.”
Fail to take into consideration the concerns and reservations of the people who are expected to implement the changes.
However, these experiences have failed to quell the intuition of the industry that there must be a better way to manage these systems and produce better results.
That intuition provides the imperative for facilities and systems to continue to seek out, adapt, and adopt new improvement methodologies.
As with all purchases, the caveat needs to be “buyers beware,” unless the facility or system is able to prove to itself that it knows what its core problem is, the underlying reason that most