If it was easy, anyone could do it! How many times have you reminded yourself of that, as you are trying to solve a complex issue with a piece of equipment, or trying to find a better process for managing a challenging situation? There are some circumstances where finding “something better” requires taking a few steps back and looking at everything from a different perspective. It seems we are often resistant to changing our old ways of thinking and doing, even if others show us opportunities for improvement in whatever it is that we do. Maybe it goes back to the standard line about not fixing things that aren’t broken? That leads to a hard question. If something is working, but it could work better by changing a few things, is it actually broken after all? Now let’s look at that in the context of Healthcare Technology Management.
The demand for cost reduction, without any compromise to the quality and the quantity of service provided, continues to be at the top of the list of challenges for healthcare organizations. From what I am seeing, the Affordable Care Act has not made healthcare affordable for anyone. The costs for delivering healthcare to the public are going up, while the revenues for the healthcare providers are decreasing. That means every healthcare organization is constantly looking for cost reduction opportunities, especially if there is anything they have not already tried recently. Healthcare organizations seem to follow a periodic cycle of looking at outsourcing their HTM program, or if outsourced already, then looking at bringing it back “in-house.” The idea of any one solution being right for all organizations, or for a single organization for all time, is long gone. I have been in my current role for about seven years, and in that time we have evaluated other service options, restructured, and modified our scope of service at least seven times. It is a constant process, as we look for ways to improve our program and still save money for the hospitals. During these seven years, a few effective process improvement ideas have originated in our own department, allowing us to continue to demonstrate our value within the organization.
Many other times, there have been “suggestions” presented to us from administration or via outside business consultants. There have been some consistent results from these outside proposals: a drain on resources and energy, and at least a temporary lack of engagement from the members of my team. It has all seemed very counterproductive, especially when any of those external proposals would have driven our costs up by millions of dollars each year.
As Pat Lynch has consistently tried to communicate, the best way to keep running your program the way you want to run it is to have excellent documentation of what you do, how you do it, and how much it saves your organization. If you do that, it puts you in an excellent position to make decisions driven by data and logic, instead of making decisions driven by emotion or by whim. That has traditionally worked well, only this time I seem to be facing a new challenge.
What are we supposed to do if the data and logic tell us that it may be time to rethink our service delivery strategies? It is one of those situations where we don’t think we are broken, but what if we could get even better?
That is exactly the issue we are facing, and there certainly is no easy answer. We are experiencing yet another round of new hospital administrators who are not yet familiar with what we do here. They decided we should look at what they did where they were before. I don’t believe it hurts to look at options, but I also know enough about this industry to not just accept the propaganda from any of the service companies (or equipment vendors claiming to be service companies). The administrative team identified the organizations they had worked with in the past. Just to have a valid comparison, I asked for a proposal from another organization. We defined the rules they would all be expected to play by, and decided what information to give them to start with. Of course there were the predicted attempts from certain organizations to do end-runs directly to the presidents when they did not like our rules. Those were blocked, at least initially, and the proposals came to us to evaluate, not to the presidents and the finance team. Most of them were what I expected, the fluff and stuff with a bottom line that excluded everything unpleasant to manage, and still would cost several million dollars more per year for our organization. One proposal, however, was very comprehensive and similar to our current program, with some added opportunities to help manage costs in the future. I am not sure we could do the same on our own. That forced me to do a deep inner evaluation of my beliefs regarding service delivery, customer relationships, employee development and long-term cost-containment.
I came back to a very basic realization. I enjoy this profession tremendously because I believe we are passionate not only about technology, but about building relationships, working together to help others, driving costs down for our organizations, and having some fun while we are learning and improving. The next phase for my team, to achieve that next improvement in our service delivery strategy, may require resources that we don’t currently have access to.
Within the hospitals, we have seen the transition of senior leaders, and have worked to educate each new group of them, only to go through the same thing again when they all change two years later. We have written business plans to add positions, only to have them eliminated when the next consultants come in. What if we have the opportunity to partner with an organization that understands our core function, has developed processes to drive more costs out of service delivery, and demonstrates a sense of commitment to our employees and our customers? Is it possible to enhance our program, even if we are already performing well above average?
If you have heard that we are being taken over, eliminated, or outsourced, that may all very well be true in the end. As of the time I am writing this article, though, we are seriously looking at ways to resource our service delivery model. If the goal is still to deliver excellent service at a competitive and sustainable cost ratio, then it is worth having a really open mind and taking a serious look at any legitimate business proposal that can help us. My rediscovered realization is very simple. It is imperative to have the right people doing the right work for the right reasons. The customers and the employees need to feel valued. The source of the compensation is not as important as the fact that recognition and appreciation are bestowed when and where deserved, and that individuals receive the intrinsic benefit of contributing to a worthwhile objective.
You may know the outcome of our process before this article gets printed. Whatever that outcome is, we know that what we do is not easy, and that not just anyone can do it. The proposals from most of the other companies validated that for us, again. We remain fully committed to continuous improvement, though, so we cannot just stop where we are. We need to be open to looking at new arrangements for achieving better outcomes, even if that means wearing shirts with the name of a different organization on them.
Watch for a group of us at MD Expo in Orlando, and maybe we will know our future direction by then!