by Nick Jacobs

Last week it was my privilege to spend a few hours with an entrepreneur who compiled every quality indicator published by all 20 organizations that list themselves as having a mission that is directed toward "healthcare quality." I can't remember if there were 20 or 30,000 of them, but it was a boatload.

The entrepreneur then had a software expert create grids and graphs and quantitative tables in relational databases that would compile all of the related indicators, cross reference them, and pull them together into the appropriate job descriptions. This system was constructed to enable employers to objectively quantify these job descriptions and thus to evaluate the employees in a more appropriate, efficient, and comprehensive manner.

All of this would lead to higher quality care, reduce costs normally created from employee turnover, and lead to a better workplace and better patient care.

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After my meeting with the aforementioned entrepreneur, I explained that we too had cut costs, produced higher quality, and moved organizations forward exponentially, but that we had done that without using any of the quantitative grids listed above. We did it by being nice, but firm. We did it by creating a culture of caring. The two of us are currently meeting to determine how these two similar left- and right-brained ideas can be merged.

Regardless of that outcome, it is clear that the way to reduce costs in any healthcare facility is to show the employees, patients, and staff that you really, sincerely do care about them and about their world. It's not enough to give these issues lip service; you must create a culture that does not tolerate bullies, that does not embrace anything crude, rude, or insensitive, and that rewards and reinforces appropriate behaviors and attitudes.

A major solution to our healthcare cost issues could stem from this culture. If your employees are respected, they will not throw away or disrespect resources; they will not disrespect rules, guidelines, or opportunities to make patients better or happier. All of these things will result in lower employee turnover, lower readmission rates, lower infection rates, lower lengths of stay, lower lawsuit rates, lower restraint rates and lower costs.

It's NOT rocket science or brain surgery. It is, however, not easy. It requires a complete top-to-bottom culture change. If you want to know more, don't hesitate to ask.