The Joint Commission’s recently published study on how no industry consensus exists on what a “high-performing” healthcare delivery system means induces laborious thoughts of a Christopher Nolan film.
Standards and standard definitions remain incognito.
Evaluating, adopting and implementing potential solutions to this leaves many with insomnia.
Regulating, governing and discerning bodies remain incorrigibly incommunicado.
It should leave us with some sense of indignation.
Is there an exception? Only in your MMIS or ERP Supply Chain module field codes.
We really need an inception.
The Joint Commission’s review of a decade’s worth of literature (2005-2015 to be precise) found no consistent definition of the “high-performing” nebulous and non-descript epaulet when applied to such dimensions as cost, quality, access, equity and patient experience and safety or any combination.
No evidence apparently shielded it from variability.
The Joint Commission deserves accolades for shining a black light on this white sheet of branding, marketing and promotional hubris — even if many of us suspected unbridled hyperbole with a Dwayne Johnson eyebrow raise.
What’s the first step in those 12-step programs? Admit you have a problem.
But “high-performing” as a jingoistic appellation isn’t the only fuzzy ingredient in our fizzy water.
In an industry that prides itself in pursuing the need for standards, the players could strive to accept and adopt standard definitions and parameters in a variety of areas.
To wit: Here are a few that have haunted readers of Healthcare Purchasing News for at least four decades (had to work in a shameless plug for HPN’s 40th anniversary this year).
- Annual purchasing volume (APV) of group purchasing organizations (GPOs)
- Descriptions and descriptive categories of product attributes for more efficient comparison (branding differentiators can be customer service)
- Validated instructions for use (IFU) for effective sterile processing of devices
- CPT and ICD-10 codes that allow very little or virtually no level of human interpretation rooted in subjectivity (thwarting the “gaming of the system” to maximize reimbursement)
- Key performance indicators
- Functional job descriptions for Supply Chain professionals — even the ones hovering around vaporous strategic objectives
- Causal factors of a variety of hospital-acquired infections with reasonably detailed traceability factors
- Total cost of ownership
- Value-based purchasing — centered on the application of insurance
- Value analysis and management via evidence-based planning and outcomes
Back in the Clintonian healthcare reforming 1990s, doctors bristled at the notion of clinical pathways as “cookbook medicine” because it left virtually no room for variability and the individuality of the patient. Noted. You should find little motivation to dismantle the logic behind the need for standard definitions for financial management and operations. Call it “cookbook management and operations” if you want, but that measure should lead to effectiveness and hopefully efficiency down the road, which should trump complaints long-term.
Which ones have we missed? Let me know at [email protected].
Rick Dana Barlow | Senior Editor
Rick Dana Barlow is Senior Editor for Healthcare Purchasing News, an Endeavor Business Media publication. He can be reached at [email protected].
