Clinicians, hospital admin: Leave these 3 biases at the door
The following is a guest post from Pat Cormier, managing director at strategy execution and change management consultancy Kotter.
The healthcare system is fraught with challenges — ranging from disruptive technologies and reimbursement complexity to price and cost obstacles, as well as pressure from the government, insurers and businesses.
There is often a “sky is falling” mentality to cost-cutting initiatives, though reality doesn’t always support this perspective. With pressures mounting and the industry growing in complexity, hospital administration is always putting on pressure to cut costs and increase efficiency.
Clinicians and hospital admin can certainly tackle these issues together to find new ways to reduce expenses while better serving patients. Effective collaboration mandates breaking down existing biases and building a culture of trust — one that is centered on enhancing patient care. This will be contingent upon leaving preconceived notions at the door and fostering an environment that is open and collaborative—not confrontational, so teammates aren’t seen as enemies.
To create this culture, hospital administration and clinicians must break down three biases that act as roadblocks to moving together in the same direction.
BIAS 1: High quality equals high cost
High quality care doesn’t have to translate into steeper costs. Cost and quality of care aren’t mutually exclusive and don’t need to be competing priorities.
There is a notable difference between per capita spend on healthcare, in relation to GDP, in the U.S., as compared to numerous other wealthy nations with world-class healthcare systems. There are also numerous examples of hospitals able to achieve better care outcomes at lower price points — even within the same region.
Physicians might perceive that hospital administration only care about the margins — but this is not always the case. Discharging patients to a hotel to shorten the duration of hospital stay, for example, can reduce costs and free up hospital beds, while also reducing patients’ risk of infection, enhancing mobility and leading to a better and quicker recovery.
Bias 2: The tension between hospital administration & clinicians is detrimental to success
The polarity between hospital administration and clinicians can foster a healthy dialogue that inspires the ideation of more creative solutions to enhance patient care, drive down costs and improve efficiency.
Despite their differences, clinicians and hospital administration must view each other as a team and create an atmosphere that welcomes new ideas and respects each party’s needs and priorities. This will help the group move toward a common objective.
For example, a client looking to reduce operating room supply costs created a diverse team of surgeons, administrators and support staff from across the system to find opportunities to consolidate and reduce complexity and unnecessary duplication. Physician pushback was anticipated, given strong personal preference and reluctance to change what isn’t broken from a patient outcome perspective. However, the team discovered the costs were unknown to most, if not all, surgeons. When presented with the cost differences for many items and how much this would eliminate the need for nurses to train on multiple, yet similar, items for individual surgeons, they too could not justify the need in many instances.
Not only will an open and welcoming culture inspire the group to find new ways to enhance the patient experience, but it will also lead clinicians and hospital administration to better identify avenues to cut costs and improve efficiency. Hospital administration will then be empowered to make more strategic investments that benefit doctors and patients — freeing up capital to invest in new operating rooms, surgical technologies and more.
Cutting costs is also in patients’ best interest, as they want medical bills to be as low as possible, while not diminishing the quality of care.
Bias 3: All change is bad change
Change can be challenging — especially for organizations at the top of their field. New ways of working and thinking can create feelings of unease and vulnerability, both from clinicians and hospital administration. But vulnerability can be beneficial, it keeps you hungry, keeps you learning and, most importantly, keeps you asking, “How can we better serve patients?”
Just as they welcome new cures or medical innovations, clinicians must apply the same appetite they have for embracing change in medicine to the systems side of the equation.
A large academic medical center was looking to restructure its very profitable radiology department due to external competition from local independent imaging centers. While quality was unmatched, pricing pressure and convenience of location to the patient were becoming driving factors. By working together across the system, they were able to identify untapped capacity and economies through new ways of working collectively.
Much of healthcare remains siloed — department chairs often have complete autonomy. Clinicians and hospital administration must take a more holistic approach, consistently asking themselves questions like, “Are we really at capacity, or are we not maximizing our efficiency?”
Mayo Clinic is one example of a hospital that has recognized working in isolation is a sure way to stay stagnant and fall short in seizing opportunities to grow. At Mayo, nearly one in five surgeries involve multiple teams. They even use the tag line, “It’s nobody’s case — it’s Mayo’s case.”
Breaking down silos and identifying new ways to collaborate will help find gaps to close, opportunities to seize and areas to improve. The key is to strike the right balance between the push to enhance quality and pull to cut costs.
While there’s no silver bullet to navigating the complexities of the rapidly evolving healthcare environment, one thing is for sure: many minds are better than a few. By breaking down deeply-ingrained biases that hinder effective collaboration, clinicians and hospital admin will clear the pathway to more creative solutions to enhance patient care, cut costs and keep that competitive edge needed to stay ahead.