How a smart hospital used a simple approach to solve a big problem

Technology has a lot to offer health care. However, its development and implementation can often be slow and complicated. We do not need to be waiting idly for advanced technology to arrive – there is plenty that can be done now to achieve improved work flows and health outcomes.

As Professor Zenios from the Stanford Graduate School of Business states “it is important to acknowledge that well-targeted, low-technology approaches can make a huge difference”. He provides a good example;

Narayana Hrudayalaya Cardiac Hospital in developing Bangalore, India hada rate of hospital-acquired pressure ulcers of6%. Instead of spending money on high technology solutions such as pressure redistributing mattress, the hospital simply worked to improved paper documentation, communication and staff attention to patient skin care, reducing the rate to 0%.

The key to achieving this was identifying the root cause, raising awareness, increasing transparency and personal accountability, education, constructive feedback and improved communication. These key principles to achieving sustained solutions and managing change are just as applicable when technology is employed, because technology is only part of the solution.

We can learn from this in supporting perioperative processes. For example, anesthesiologists face increasing pressure to demonstrate the value of the care they provide, whether locally or nationally through public reporting and payor requirements. Rather than feel overwhelmed by performance measurement, we can identify gaps and opportunities in performance measurement to add value – not merely justify expenditure.

A recent article by Hyder et al highlighted the poor correlation between some measures of performance, and demonstration of value. This is of particular concern in perioperative care, where the different phases are usually siloed, such that inputs (e.g. preop assessment) in one area that affect outputs (e.g. postop outcomes) are not usually correlated.

Perioperative Solutions is working with software vendors to enable indicators that capture the perioperative process and thereby reflect whole of patient care. Please let us know your areas of concern, to incorporate in our development process.

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