Because of that, we formed a multidisciplinary team to find a way to
lower the cost of care while improving quality and outcomes.
Less Van Gogh, more Henry Ford
That's when we started looking at a care model that takes a little less
from Van Gogh and a little more from Henry Ford. While most health-
care organizations use a "solution shop" model to treat patients based
on an individual provider's decisions, a "focused factory" approach
relies on standard care pathways to treat a specific condition, special-
ty or procedure, ultimately improving efficiency and reducing unwar-
ranted variation.
The focused factory idea originally came from the Harvard Business
School, when economists discovered that U.S. companies offering a
narrow selection of products or services were more competitive with
their international counterparts. The same idea is applicable whether
you're a hospital or a company making widgets — if you focus on pro-
ducing a limited number of high-quality products or services, your
costs decrease, your internal service lines don't compete for
resources and your overall workflow improves.
In surgery, here's how it works: The facility creates a pathway that
dictates each major step in a patient's care for a specific specialty or
procedure. All patients that meet a certain set of criteria — which can
include factors like BMI, surgical complexity and comorbidities — are
treated using this pathway. These defined treatment protocols control
the important aspects of the patient's perioperative experience,
including case scheduling, pre-op instructions, medications, surgical
tools, anesthesia, post-op ambulation, diet, discharge and more. If a
patient continues to meet the criteria, it triggers a domino effect
where each staffer or physician defaults to the next step of treatment
as defined in the pathway.
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