You Can Challenge the Status Quo in Your Health Care Organization

In my work with health care organizations, it’s common to find inefficient, costly processes exist everywhere, simply because no one has ever taken the time to question the status quo.

Charleston Area Medical Center (CAMC) Health System in West Virginia shares a great case study in the Feb. 1, 2016 issue of the American Journal of Health System Pharmacy about how they greatly reduced drug costs by using Lean and Six Sigma tools to improve their batching i.v. medications process.

The four-hospital system centralized its pharmacy compounding system in 2007 to increase efficiency. To “batch” i.v. medications, the staff would prepare a certain number of sterile i.v. products a day in certain amounts, then deliver them to the nursing units for administration to patients.

While staff perceived that centralization was a vast improvement, they found with a little data collection that the medication-use process for i.v. compound making remained less than ideal. The i.v. bags filled and sent to the nursing stations in the morning often were not needed in the afternoon. A lot of waste in the process was undetected.

When asked why the i.v. medication carts were only filled once a day, staff replied that it was simply “the way we’ve always done it.” There was no metrics or reasoning behind it that anyone could remember.

After reviewing medication orders and administration times and zeroing in on when waste occurred, the pharmacy staff switched from fill the carts once a day to filling them five times a day.

Intuitively, you might think that filling the carts more often would be more costly. In fact, the process change saved them $134,000 annually, exceeding a target of a 50% reduction.

These are just a few of the ways that CAMC Health System and its pharmacy team challenged “the way we’ve always done it.” It seems very fitting that their refreshing approach earned them the coveted 2015 Malcolm Baldrige National Quality Award for health care – another rigorous system for improving an organization’s processes.re are four tips to help you challenge the status quo at your organization:

1. Invite different perspectives. As a leader, encourage different perspectives to examine the a long-standing process – particularly those that are closest to the work.
2. Ask questions. Lots of them. When a staff member brings up an issue with the current status quo, use this as an opportunity to be curious and ask questions. Why has it always been done that way, and what would he/she do differently?
3. Embrace the “d” word. “D” as in data. Gather some data and see what it shows you.
4. Be willing to experiment. Try a solution on for size. But just like CAMC, be open to making a change if it doesn’t work.