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Atul Gawande's 80% Healthcare Solution

Joe Cantlupe, for HealthLeaders Media, September 20, 2012

Was my son in a facility that should be run more like the Cheesecake Factory?

Indeed, Gawande's article has prompted much debate. Some say it points to exactly what healthcare needs to do in order to revamp fix itself by developing standards and more effective protocols. Others maintain the comparison is purely bunk, because the food service and healthcare industries don't mix.

One of the most interesting commentaries was from Steve Denning of Forbes,who noted that the notion that the Cheesecake Factory model or any other model is the best prospect for change in healthcare is to "fail to realize that the U.S. healthcare is a collection of different problems that will require different solutions, not a single model."

James Merlino, MD, the Cleveland Clinic's chief patient experience officer and vice president of the hospital's digestive disease institute, doesn't completely buy the whole Cheesecake Factory idea, either. But he supports most of it.

Healthcare in general "needs to be figuring out how we can reproduce things we do consistently, reliably, [and] in a precise manner that is cost effective," Merlino adds. "No question, it's the future, and 80% of the (Gawande) analogy is correct."

Then there's that 20% that the Cheesecake Factory model can't deliver, and that's the human element, Merlino says. "You can't take somebody out of fellowship into positions at Cleveland Clinic and expect the infrastructure to carry them," he adds.

A personal experience

I thought of those different models and the delicate balance of healthcare delivery, while we spent a day and night over the weekend in our son's hospital room.

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2 comments on "Atul Gawande's 80% Healthcare Solution"


sdaniels (9/21/2012 at 9:01 AM)
Only when the hospital can rid itself of its archaic dual governance structure and adopt a top down quality culture, can it truly hope to emulate the quality and consistently of the Cheesecake Factory. With Boards and execs who are loathe to confront the "accommodating culture" that pervades most of the healthcare industry, there is little hope of successfully confronting the fragmentation and problems so artfully described in Brownlee's "Overtreated" and Markary's recent "Unaccountable."

Adrian Byrne (9/21/2012 at 8:43 AM)
Joe has correctly noted, Atul's commentary on the Cheescake Factory solution is 80% correct. In the words of my friend Dr. Ed Henegar we must plan for the normal and manage the exceptions. No amount of systems or standardization will cure all. Anyone in hospitals who has worked with Sodexho or other outsourcing companies will know the product and service is only as good as the on site manager. Meanwhile, there is still a lot Healthcare can learn from other industries.