- 06 January, 2009 11:13 AM EST
- Making Progress in Healthcare: Visible Process = Predictable Results
A warranty from your healthcare provider? Not only has Geisinger Health System moved to a flat fee for their coronary artery bypass surgery, but they offer a 90 day warranty. If a complication arises within 90 days, they will cover the cost.
How did they make this quantum leap? By turning healthcare on its ear! According to its CEO they shouldn't get paid if they don't do it right and have adopted a pay for performance strategy. Seems to be a concept that is gaining popularity these days.
By looking at this specific surgery, it identified 40 steps that must be performed. Much like a checklist, these steps guide the process - they are for conscious consideration, not rote following. What they found with the original process was that different surgeons had their own variations, with variable results - most of the time because they missed one or more of the 40 steps. While the patient group is still small - only 181 patients in this study - the results have been significant: a 45% decrease in readmission rates.
I often think about the tension between structured and unstructured processes and the connection between work that can be standardized and that which is knowledge work. It seems that Geisinger is on to something here by creating an overall framework that guides the surgery with the 40 steps, but obviously doesn't get into excruciating detail and enables surgeons to perform their "art." And it's working!
This seems a good example of using BPM to manage at the strategic level and produce big results - all things that Dr. Geary Rummler envisioned - BPM as a strategic management discipline. I believe that if you look at your organization, there are many opportunities to apply the strategy Geisinger has adopted. In these tough economic times, customers will be loyal to the companies that can promise to get things right. If this can be done for something as complicated as surgery, the sky is the limit for your organization. What better time to deploy BPM?
(Article in Fast Company: "The Cure," October 2008)
