From the EditorRobFromberg_2012_r1 

Robert Fromberg, Editor-in-Chief

My sons have been rehearsing with their rock bands for upcoming gigs. Listening to their steady improvement has spurred some observations about what factors have created the exciting progress I am overhearing.

Motivation. To buckle down and rehearse, the kids need both immediate motivation ("If you rehearse, I'll take your turn walking the dog"), short-term motivation ("Wow, that sounds good"), and long-term motivation ("We'd better not embarrass ourselves at the gig").

Preparation. Before the rehearsal, each band member needs to practice on his own. In the case of my younger son, who is getting a new group of musicians together to play original material, he needed to give each person sheet music and a recorded piece to practice from, so no one would come to the first rehearsal unprepared.

Repetition. Having had one fairly good run-through, some of the kids say "Sounds good; we're all done." But eventually they buckle down to the business of repetition and refinement, repetition and refinement.

Exhilaration. What really drives the boys (and is fun for me, overhearing them) is the magic of bringing together disparate parts into a new and exciting whole.

The same factors are at work in any improvement initiative. In this issue of hfm, Jeni Williams' article "Finding Your Sweet Spots for Cost Reduction" highlights the work of teams at Bellin Health, Avera, and Partners HealthCare. Williams is the author of last year's HFMA Best Article Award-winning article about hospital business strategy, and this is another great one. As Williams tracks the work of these healthcare professionals, she notes many of the same factors driving their progress as I noted with my kids.

Motivation. The experts Williams interviewed emphasized the motivational benefit of starting small and achieving significant wins. Economics are another motivator. For example, a 2003 drop in volume motivated Bellin Health to focus on driving out waste and inefficiency. And everyone Williams interviewed was motivated by the desire to provide better care for their communities.

Preparation. The organizations all made sure they had data and a plan. For example, Partners HealthCare, targeted specific high-volume clinical processes for redesign, and gave each team data on associated costs, which allowed the team to focus on areas of highest expense.

Repetition. At Partners, the clinical areas being targeted for expense reduction had already been the target of quality-improvement efforts focused on inpatient settings. That work provided a solid foundation for the expense-reduction teams.

Exhilaration. Regarding the considerable progress her organization made in just over a year, Partners' Elizabeth Mort says, "We're working incredibly hard, and it's exhilarating...." Bellin's Dietsche says, "We've posted tremendous results in terms of reducing cost and improving quality, and our utilization is lower than what is seen nationally. And we're receiving national recognition for our efforts."

Those are sweet sounds, indeed.

Publication Date: Thursday, March 01, 2012

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