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Small hospital changes can make big healthcare impact

August 21st, 2014

by Scott Kashman

In April 2011, President Obama discussed his plan to curb the growth of healthcare costs.

The framework called for $340 billion in cuts over 10 years and $480 billion by 2023 (including the proposals already included in the president's budget). Over the subsequent decade, the president's proposal will save more than $1 trillion by further bending the cost curve, doubling the savings from the Affordable Care Act. That plan called for increasing the amount of uninsured by 50 million people.

Throughout my career, one thing remained constant: Our evolving and transforming healthcare industry. We could get ourselves really frustrated if we chase every headline. So the question is, what can you do to influence your organization's destiny?


Several years ago I met with our leadership team. We discussed how we could leverage the knowledge we have within and across health systems. We would continue to improve our quality and safety efforts, enhance our patient experiences and reduce costs.

We discussed how mine for ideas formally and informally. Certainly, formal ways need to exist to measure, manage and advance efforts. In my current organization we use Lean as our management system, and the framework of an optimal healing environment, as guiding principles.

That challenge still remains: How can we informally and formally get those ideas from people closest to our patients? We use huddle boards, staff meetings and rounding which help. What do you do in your organization?

I enjoyed learning from some high school students who used to meet as a group to brainstorm ideas. They would reflect on the following:

  • I hate it when ...
  • I wish I could ...

Then, they prioritize based on the goals of their project and the estimated resources needed. Sounds simple yet it is something we could do even better in healthcare--the mindset of continuously improving with a smarter use of our resources.

So, should the future of healthcare concern us? Of course. Our industry is very challenging, but I'm optimistic because it's in our hands to make the necessary changes needed within the resources provided.

As the students asked:

  • I hate it when...
  • I wish I could...

Based on the answers to those questions, what's one change you and your organization could make starting next week that would add value to your patients and further the organization's mission?

Let's continue to work together and learn from each other so we identify even the little things that we could change that will make a big cumulative impact in years out.

Scott Kashman serves as the chief administrative officer of Cape Coral Hospital, part of the Lee Memorial Health System in southwest Florida.


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