Better, Faster, Cheaper

Every healthcare organization would love to do the same three things: deliver better quality, care for more patients, and reduce costs. It’s the Holy Trinity of health system goals. It’s also a bit of a trap.

Lean transformation promises to accomplish all three, and initially it delivers some results. There’s waste in every system, and cutting it out can help with quality, efficiency and cost at the same time. But Lean has its limits. After a while, there’s no more fat to cut away--it’s all flesh and bone. And we need to remember that system redesign isn’t a free ride. Sometimes the most impactful system changes require substantial investments in personnel, equipment, and even facilities. 

More often than not, there’s a trade-off. You can have two thirds of the Holy Trinity, but then you usually have to back off on the last third. Which two thirds you choose depends on what you want to accomplish.

I know health systems that are optimized to see a lot of patients at low cost. Guess what? Their providers are all burnt out and/or their quality of care sucks. Then there are the boutique private practices that have minimal staff, but pretty good care. They see about a patient an hour.

The point is, if you want to take care of a lot of people and do it really well, it’s going to cost you. You have to recruit and retain good people, and train them, and give them the resources to succeed. Anyone who tries to tell you otherwise is either insincere or out of touch with reality.