The Need for Productivity Transformation
Medicine has long resisted the productivity revolutions that transformed other industries. But the explosive growth of provider systems like Medstar, Stewart, and Kaiser Permente aim to change this mindset. An article by Dr. Atul Gawande, a surgeon at Brigham & Women’s and professor at the Harvard School of Public Health, recently published in The New Yorker magazine offers some inspiration for change from an unlikely source: The Cheesecake Factory.
Below is an excerpt from the article:
The place (the Cheesecake Factory) is huge, but it’s invariably packed, and you can see why. The typical entrée is under fifteen dollars. The décor is fancy, in an accessible, Disney-cruise-ship sort of way….The waiters are efficient and friendly….They try to make you feel as if it were a special night out. As for the food….it was delicious.
The chain serves more than eighty million people per year. I pictured semi-frozen bags of beet salad shipped from Mexico, buckets of precooked pasta and production-line hummus, fish from a box. And yet nothing smacked of mass production. My beets were crisp and fresh, the hummus creamy, the salmon like butter in my mouth…The whole table was happy.
I wondered how they pulled it off. I asked one of the Cheesecake Factory line cooks how much of the food was premade. He told me that everything’s pretty much made from scratch—except the cheesecake, which actually is from a cheesecake factory, in Calabasas, California.
I’d come from the hospital that day. In medicine, too, we are trying to deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality. Unlike the Cheesecake Factory, we haven’t figured out how. Our costs are soaring, the service is typically mediocre, and the quality is unreliable. Every clinician has his or her own way of doing things, and the rates of failure and complication (not to mention the costs) for a given service routinely vary by a factor of two or three, even within the same hospital.
Healthcare Must Learn From Other Industries
Gawande goes on to draw insightful observations of how The Cheesecake Factory operates with great efficiency, consistency, and quality of service and how hospitals can learn from this casual dining chain of 160 restaurants. His message is clear, healthcare needs to learn from the good work being done in other industries to lower costs, improve service, and increase customer (or patient in the case of hospitals) satisfaction in the face of increased competition.
Toyota achieved these advantages over its competition in large part thanks to LEAN manufacturing – An operational ethos which is now being embraced more openly in healthcare. Southwest Airlines has done the same through standardization of planes to improve on-time departures and arrivals, a critical component of customer satisfaction as well as the airlines cost profile and profitability.
Clinical Workflow Optimization Should Be Part of the Solution
Optimium Health could not agree more with Dr. Gawande’s message. That is why we have tailored business process management (BPM), or more simply put, workflow technology to the clinical setting. BPM has been widely used in banking, manufacturing, and many other service industries for decades. Yet, until now, in healthcare use of BPM is relatively uncharted territory.