A Scrum Master and a PMP walk into a bar – they both work in healthcare (rimshot)
Six Sigma and Project Management Professional (PMP) Certifications are nice but many times are not necessary in healthcare. It is sad but true. If you have been in Health IT for a while, you have seen fat projects and complete unnecessary waste in project spend from an implementation standpoint. You have seen methodologies get half-way adopted and then not have the staff funding to support necessary work. What gives?
How is it that you have executives say something is important and pay for training/licenses but then not support the staff when they tell you 10 people must be hired. It calls to mind the quote thrown around on LinkedIn constantly which addresses people who say that they can’t afford to hire good people, but that in fact, they can’t afford not to hire them.
So what makes healthcare project management and operations so special? What makes us say the best practices running rampant in other industries aren’t applied here?
So glad you asked.
Let’s step back for a minute and give the caveat required of any consulting firm putting information out there like this — there are absolutely the healthcare companies, payers, and providers who excellently manage and execute projects efficiency.
However, we are suggesting that we have seen far more healthcare operations teams not have a need to perform with operational efficiency excellence that other industries require. The need does not exist because people will continue to get sick.
Unlike fast-food where the consumer decides that it takes too long at the window of one restaurant and goes to the other restaurant right away. Drive-through line time is such an important driving factor for the consumer. Yet the same person cannot just decide not to get sick and not need care.
When someone must go to the hospital, we would like to believe that they will go to the hospital that has the best cost/value, but if it is an emergency – the person is typically going to the hospital closest to them. Therefore the hospital is not really forced to have efficiency excellence.
HITRUST is required for many vendors working with payers, yet the same vendor is still required to fill out 400-600 question Standardized Information Gathering (SIG) questionnaires when the HITRUST certification could be enough.
Okay so some redundancy for data security. We like it and can live with it but let’s take a step deeper and look at vendor management for the government vs the commercial payers, we as vendors know where the waste exists and much of it lies in keeping the wrong people in the wrong seats.
We have seen nurses perform intern work and there is not a six sigma pressure to better manage the resource. It is either the technology is bad or the person is fulltime and would be sitting around not doing anything so having a nurse work with image rotation rather than only reviewing images seems like a good idea. It beats us as we constantly analyze components of projects that could be better leveraged down.
The issue is the stakeholder that essentially pays for the nurse to do the work is so far from their payment (be it taxpayers, self pay insurance companies, or employees who pay into insurance) – the payment model is not like shopping on Amazon where you click one seller vs another based on days to deliver, rating, and/or price. No instead, the patient/member goes to the doctor when necessary and then all of the revenue pieces behind this simple transaction get overwhelmingly fat and costly.
Is all lost for healthcare? We certainly hope not. We are inspired by those who still strive for the Baldridge Award and wake up every day with a renewed hope to foster leadership, strategy, measurement, analysis and operations. We know that these organizations and people achieve results and our only hope is that they receive the funding and support from their boards, stakeholders and executive management.