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SPANNING THREE DECADES OF VALUE MANAGEMENT LEADERSHIP

May 14, 2003

Knowing How We Do Things Around Here Is A Critical Factor In Making Savings Happen.

Robert T. Yokl - President - The HCP Group, Ltd.

“A Study of Your Culture (Ethnography) Will Surface Hundreds Of Savings Opportunities For Your Healthcare Organization That Have Been Hidden From Your View For Decades Or Even Generations.”

Every healthcare organization and every group in a healthcare organization has a defined culture which exhibits behaviors, values, rules, expectations and practices that have been handed down over decades and even generations to diverse healthcare workers.  This is the reason why some healthcare organizations and groups of healthcare workers (operating room, laboratory, emergency room, nursing, etc.) are conservative, prudent, unadventurous, data driven and slow to act, while others are innovative, risk takers, adventuresome, intuitive and fast to act.

This is the same cultural reason why some hospitals utilize three IV administration sets, while others use 16.  It is also is why courtesy x-rays are given to all physicians that are listed on a patient’s chart at one hospital, while at another hospital physicians must request an x-ray to obtain one.  The culture at one hospital would have nurses throw out recyclable products, while at another hospital nurses never throw recyclables away. Why one hospital can change its brand of sutures without any problems -- overnight, while at another hospital just talking about such a change starts a war.

The Study of Cultures: People, Places, Time and Things

As value practitioners (or Ethnographers) it’s our job to define a particular group’s culture by asking the questions, “What’s going on here?” How does this work?” “How and why do people do what they do?” in order to characterize, “The way we do things around here.”  We then observe by shadowing people or groups of people, what they are really doing, as opposed to what they are telling us they are doing, to insure that our observations are accurate and reliable.  Answering these questions requires a willingness to suspend premature judgment until all of the pieces to the puzzle have been pieced together. When premature judgment is suspended and replaced by “Field Work” HCP’s clients have uncovered:

·        $128,000 savings in contrast media that was specifically formulated by the manufacturer for pediatric patients, but was used for all patients at the hospital.

·        $91,542.00 savings in a “General Requisition” form because the nursing group never realized that the form had changed its function over 20 years from “Test Reporting” to “Test Request”, therefore, didn’t need all of the features that were previously required for the “Test Reporting” form.

·        $500,000 savings due to the fact that the nursing group was returning 50% of the hospital’s linens sent to their floors daily for the reason that the linen, in their opinion, was unfit for their patients use.

These are just three of the hundreds of examples I could cite on how value practitioners have uncovered HUGE savings opportunities by becoming “Ethnographers” at their own healthcare organization.  I’m sure you could quote some too at your healthcare organization, but didn’t realize that it’s all about CULTURE!

Multiple Research Methods – Grounded In Data

To truly understand a healthcare group’s cultural behaviors, values, rules, expectations and practices, value practitioner’s work must be grounded in data.  The data elements that you must research include people, places, time and things: How many, how much, how often a product, service or technology is utilized and who, what, when, where, how and why it is used. By looking, listening, asking, watching and evaluating the data you have collected, you will finally understand what is going on.

The critical factor in your research is to use multiple methods, which should include interviews, observations, surveys, focus groups, data mining and quantitative analysis to truly understand a group’s culture.  But the most important technique that you can utilize is to “observe the culture in action”.  This means, value practitioners need to observe people and things first-hand.  Spindler and Spindler, noted Ethnographers, tell us that “Ethnographers work … (in the field is to obtain knowledge about people or groups) which can be gained in no other way than just “hanging around” and “picking things up” from a naturalistic setting.”  By doing so hundreds of thousands of dollars in savings opportunities will surface at your healthcare organization that have been hidden from your view for decades or even generations.

 Copyright © 2003 The HCP Group, Ltd.

Robert T. Yokl, President, The HCP Group, Ltd., has over 35 years of experience as a consultant and manager in the field of Supply/Value Chain Management and is one of the country's leading healthcare experts in value analysis, value engineering and materials management. He is the developer and program leader of the award winning Certified Value Analysis Practitioner Training Program™. Mr. Yokl is also the developer of the healthcare industry's leading ValueNetCentral™ Value Analysis Software. Over the past two decades he has trained thousands of healthcare managers in his patented Strategic Value Analysis™ and Team-Based Project Management™ processes and has assisted scores of organizations in developing their own value management programs. He has published six books, videos and audios on supply/value chain management. His latest book being, “ Strategic Value Analysis™: The #1 Smart Strategy for Taking Cost Out of a Healthcare Organizations’ Supply/Value Chain”.