From the EditorRobFromberg_2012_r1 

Robert Fromberg, Editor-in-Chief

Every Sunday evening, having finished the week's laundry, I cannot feel the satisfaction of a job well done. That's because after I've put away every piece of clothing, I am still staring at a pile of unmatched children's socks.

Sometimes the pile is large, sometimes only one or two socks, but it's always there. Sometimes the socks don't look familiar, or are types I haven't seen in years. And although we seem to have an abundance of socks, our kids still can be spotted stealing them from our drawers.

Individual socks are not the only things that go missing in our house. Remote controls, guitar cords, scissors, and working pens also seem to be everywhere until we need one.

This state of affairs crossed my mind when reading an article in this month's issue of hfm, "Out of Control: Little-Used Clinical Assets Are Draining Healthcare Budgets" by Ruslan Horblyuk et al. The authors show that nurses spend an average of 21 minutes per shift searching for lost equipment, although average utilization of mobile clinical devices is only 42 percent, suggesting an oversupply. The article goes on to demonstrate a 62 percent increase in the number of clinical devices per bed over the past 15 years, accompanied by a 90 percent increase in the service and maintenance costs per bed.

This sense of being out of control can also be found in the article "11 Critical Questions to Ask When Buying a Physician Practice" by William F. Jessee. The article outlines a series of signs that indicate a dysfunctional relationship between a hospital and an acquired physician practice, including lack of agreement on how to measure financial performance and a sharp decline in the practice's margin.

Both of these articles present sound advice for seizing control. Regarding clinical devices, Horblyuk and colleagues suggest focusing on one high-volume or high-cost group of devices, conducting a physical inventory, redesigning the workflow, and developing a replacement strategy.

Jessee casts his eye on the future and offers critical questions to ask before any practice acquisition-questions designed to ensure that the practice aligns with the hospital's strategic plan and is financially sound, among other issues.

The challenges in these two articles represent a multitude of risks faced by healthcare organizations today, from a changing payment system to regulatory compliance to market competition. And the solutions the authors propose represent a wise approach to coping with all these risks: careful assessment, sound strategy, clear processes, and continuous monitoring and evaluation.

Unfortunately, I suspect that no matter how many of these techniques I employ, on Sunday evening I will still be staring at a pile of mismatched socks. 

Publication Date: Monday, July 02, 2012

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