The use of the Lean Method

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Higher death rates at Community hospital may be cause for alarm. People often do not want to see negative statistics that may infer lower quality care. However, does higher death rates mean lower quality care or can it be something else? Something like this may be brought up because the logical conclusion would be that low quality care brought on by potential problems within the hospital such as understaffed departments or lower quality medical tools, could lead to the higher mortality rates. Still, it may be randomly attributed, and these higher rates of death could be from chance rather than quality of care.
Looking into the past, a 1990 article shows how higher rates of death may indeed be random variation along with potential area-specific chronic diseases. “Although death rates in targeted hospitals were 5.0 to 10.9 higher, 56% to 82% of the excess could result from purely random variation. Differences in quality of the process of care could not explain remaining statistically significant differences in mortality” (Park, 1990, p. 484). Therefore, if some of these deaths may be attributed to random variation, what then should determine quality of care? The article provides some past knowledge on this subject. Nevertheless, new research may either support or refute it.
For example, a 2016 article on patient ratings, quality of care, and mortality demonstrated that nurses with varied skills led to better health outcomes, lower mortality, and improved patient ratings. When nurses demonstrated limited skill, the negative markers increased, attributing to erosion of safety and quality of hospital care, even contributing to hospital nurse shortages (Aiken et al., 2016). While the higher death rates are not necessarily a marker for poor quality care, increased mortalities can exist within hospitals with signs of lower quality care, especially pertaining to lower skilled nurses.
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Senior health policy makers can and should remove the free market pricing model. Drugs and medical services within the United States can be marked up to the point where insurances and out-of-pocket patients pay thousands of dollars for something potentially worth 1-10% of the determined value. For example, anti-cancer drugs can be very expensive. Companies like Bristol-Myers Squibb would set the price of their Yervoy course of therapy at $120,000 (Howard, Bach, Berndt, & Conti, 2015).
The government has done little to protect patients and hospitals from these inflated prices. In fact, government-mandated price discounts could have contributed to the annual 10% increase of launch prices (Howard, Bach, Berndt, & Conti, 2015). What may have been meant to help the situation could have hurt it do to lack of price regulation overall. Issues like this could be resolved if the United States government maintains control over pricing in all levels through changes in health policy.
Regarding healthcare professionals, they can operate efficiently through understanding effective ways of managing resources and staff. For example, the Lean approach to healthcare. In recent years, Lean has been a popular method to adopt in healthcare (D’Andreamatteo, Ianni, Lega, & Sargiacomo, 2015). What is Lean? Lean is a means to augment productivity D’Andreamatteo, Ianni, Lega, & Sargiacomo, 2015). The first departments in hospitals to adopt Lean were surgery and emergency. The themes within Lean are removing barriers, determining challenges, and identifying success factors (D’Andreamatteo, Ianni, Lega, & Sargiacomo, 2015).
These themes highlight what needs to be done regarding assessment and research. Evidence-based practice yields better results than when it is not applied. Such is the Lean method. One identifies what works and why, and then applies it as a standard practice within the healthcare setting.
References
Aiken, L. H., Sloane, D., Griffiths, P., Rafferty, A. M., Bruyneel, L., McHugh, M., … Sermeus, W. (2016). Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety, 26(7), 559-568. doi:10.1136/bmjqs-2016-005567
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, 119(9), 1197-1209. doi:10.1016/j.healthpol.2015.02.002
Howard, D., Bach, P., Berndt, E., & Conti, R. (2015). Pricing in the Market for Anticancer Drugs. Journal of Economic Perspectives, 29(1). doi:10.3386/w20867
Park, R. E. (1990). Explaining Variations in Hospital Death Rates Randomness, Severity of Illness, Quality of Care. JAMA, 264(4), 484. doi:10.1001/jama.1990.03450040080035