Considering Cost and Quality
Chief Operating Officer
St. Mary's Medical Center
Grand Junction, CO
We try to focus very carefully on our cost-containment initiatives, always being careful to balance them with any downstream effects they might have. But in many cases, reducing costs can actually improve quality; by removing added steps in a complex process, you may remove some of the reasons why errors were made in the first place. I think that, in most cases, reducing costs will not automatically impact quality.
We have multiple cost-saving initiatives in our hospital. Perhaps most important is our comprehensive throughput initiative. We've been closely examining all the steps in the value stream from the point that the patient accesses us and removing non-value-added steps. We also are utilizing a dashboard of key process indicators we monitor to identify where we have the most opportunity to save money or improve our process.
The greatest barrier around sustainable cost reduction is the assumption many people tend to make: that if costs are driven down, quality will automatically be reduced. So, a challenge for us is trying to educate and bring along people in control of a lot of those costs that, no, we're not trying to make changes that are going to impact quality or safety in the negative—here's why we don't think it will, and then make our case for why these changes will actually improve quality and safety.