Continuous improvement is about removing the things that get in the way of your work. The headaches, the things that slow you down, that's what continuous improvement is all about.
If your family has health insurance and an insured loved one is in need of a medical procedure, does the cost of that procedure matter to you? If you are a healthcare provider and there are two treatment options available that are likely to produce similar outcomes, how much does the price of each option affect the one you choose? When it comes to health and/or lifesaving interventions, what role should cost play? Given concerns over maximizing the effectiveness of healthcare dollars and government debates about healthcare reform, healthcare quality is now being graded not only on clinical outcomes, but also on the cost efficiencies with which those outcomes are achieved.
Dr. Jan Tillisch, professor of clinical medicine and executive vice chair, Department of Medicine at UCLA, notes, "These efficiency concerns are not new to the people who have done health service research, but they are increasing in the public debate. People are talking a lot more about compared effectiveness research. In the federal government's economic stimulus package, more than $1 billion was allocated for compared effectiveness research." Dr. Michael Steinberg, chair of Radiation Oncology at UCLA, adds, "We live in a country where the demand for healthcare and technology is very high. You've seen the graphs; the percentage of U.S. gross national product allocated to healthcare is twice that of Europeans and Canadians. Our cost per capita is twice as much. Citizens in other countries have a much lower demand for technologically driven care. Some of these cost differentials are system-based, and some are cultural." From Dr. Steinberg's perspective, professionals in the U.S. healthcare system have not done a very good job of sitting down and explaining the trade-offs to patients. Specifically, Dr. Steinberg clarifies, "I'm not talking about money necessarily, but about having conversations like, 'Will this technology actually work?' We have some phenomenal devices. There is a robotic device for doing surgery on prostate cancer—the Da Vinci robot—and it tells a great story. It costs more than $2,000,000. You can magnify the surgical field three times larger. In a place where a human hand can throw about six or seven sutures, it can throw ten. When you go back and look at the outcomes, however, findings suggest that the results that the robot produces may not be substantially better than those from other surgeries. Now more than ever, quality has to come with questions like, will it work and is it worth the cost?" Increasingly, in all business endeavors, the issue of quality comes with the question, "At what cost?" Companies that deliver efficient quality wrapped in a maximized experience will enjoy a competitive advantage.