Rearranging Deck Chairs? too little...
It will be near impossible to show a positive result of any isolated change in our current healthcare system. Like "an ice cube in hell," no significant effect should be expected. A revolution is necessary at every level. Currently, values are so deranged that "rearranging deck chairs on the Titanic" will not fool anyone. What I find both bizarre and troubling is that the hospital workers on the front lines are all aware of the problems though the "leaders" live in the moment. Foresight coupled with a large upfront investment is needed to produce real change.
I truly believe a HCP-patient centered system would not only be better for HCPs and patients but CEOs and CFOs as well. Good doctors doing the right thing is not only desirable on a karmic level, but, I think, will be the key to long term financial success. Medicine is firmly mediocre at this point (being very generous). Whether the model is hospitalist centered, physician-extender centered (a derogatory term), or based on multiple small "teams", patient care and HCP satisfaction will continue to decline without improving safety and the money will dry up.
Let's do the RIGHT things:
Reward effort and skill
Refuse to accept mediocrity
Hire people based on value added rather how many RVUs are available and what is the most "efficient" way to fill them.
Budget not for the year but for success. The graph may not look pretty at the first evaluation point but building safer, patient- and provider-friendly hospitals and staffing them with the brightest, most knowledgeable, and compassionate workers will pay huge dividends.
The leaders need to be present - not just when a regulatory agent or a VIP shows up.
Ask the nurses what will make the hospital better.
Competition and individuality are good things - providers are not interchangeable.
Celebrate good work with more effort than ensuring dress codes and filing PSIs.
I can go on (I promise) but, of course, this is but one link in the chain. Physician education, post-discharge facilities, etc. also need a complete overhaul!
We are not doing fine!