“It’s the tenor and method of asking questions,” says
Keswani. “If I ask, ‘Did you get your work done today?’ that’s
a yes or no question; but if I ask, ‘Is there anything you need
from me to help support you?’ that’s a totally different tenor
and tone. You’re hard on the process, and respectful of
the people.” What does this kind of respectful approach
mean for solving hard problems? In one case, it’s reduced
a patient’s wait time for a prescription refill from 72 hours
to 12 hours, and reduced the system’s cost of processing a
prescription from approximately $10 to $5.
Another example is reducing supply expense in the operating room.
The supply chain, surgery, and sterile
processing departments redesigned
their procedures to reduce fragmented
communication and workflows that
were causing equipment, supply, and
instrumentation losses. Now, turnover time between surgeries is down to
28 minutes from 35 minutes.
“The real value of the front line—
where the work is being done—is at
sites,” says Keswani. “And it’s great to
hear and see physicians go and ask what
is working well, what’s not. They are
building a culture of humility, which is
‘I’m not the doctor with all the answers.’
That’s hard to do as a physician.”
Scripps is seeing lower costs while
improving quality by focusing on
reducing variations in care and pro-
cesses. For example, in Scripps’ prima-
ry clinics, care teams are standardizing
exam rooms at 14 sites.
“If I wanted to see an extra patient
and I borrow my colleague’s room
because she has her half day off, I may
not be able to find anything because
it’s not in a place I am accustomed
to, or it’s not stocked properly,” says
Siu Ming Geary, MD, vice president
of primary care at Scripps Clinic. She
sees patients part-time and coman-ages operations.
“Variation can lead to inefficiencies
and waste,” she says. “We recognize
that when doctors see patients, they
typically have all the standard neces-
sary equipment, but sometimes doc-
tors do procedures and have certain
types of equipment that may not be
found in a standard room. So we allow
physicians to have a dedicated space or
room they use most frequently. “
Stocking all the exam rooms with standard equipment and
supplies can reduce cost and time spent looking for simple
items needed for a patient exam. For example, when a physician
has to interrupt an exam to get a tongue depressor, or can’t find
a thermometer, it wastes time and reduces the patient’s satisfac-
tion with the visit. Geary also says it doesn’t make sense to over-
stock because that generates waste when certain items expire.
“If we can go from room to room blindfolded and open
a drawer and find what we need, that makes us much more
effective,” she says.
of physician leadership
in patient-centered care, now serving
hospitals in the perioperative setting.
CEP America announces our new anesthesia
practice line. To learn more about the value
anesthesia provides to an integrated physician
group, visit go.cep.com/anesthesiology.