Action Plan

There is an old German observation that individuals who are healthy have many wishes but individuals with illness have only one wish. Almost without exception, individuals and not-for-profit institutions in the healthcare industry strive to grant the wish of health and control of suffering to the patient. This corporation will remind and refocus individuals and institutions on that goal.

Best care guidelines are an essential element to insure that all healthcare providers are "reading from the same page" in their endeavors to deliver healthcare. These guidelines are generally well known throughout the healthcare industry. As such, they offer a convenient jump-off point for reengineering endeavors. It will be necessary to focus on the definition of time domain and cost domain implied by these guidelines. To measure efficiency and cost across the United States, the definitions will need to be uniform.

Unfortunately for the majority of hospitals, the cost of healthcare delivery is impossible to define. The concept of true cost of production is just now emerging. Historically until the late 1970's and early 1980's, cost was not a consideration. The focus was on charges which were crudely based on generating a reasonable return to physicians, hospitals and other contractors. It was only with the explosive growth of healthcare costs as related to gross domestic product that the question of true cost was raised. Most hospital systems are now trying to track cost by various inventory controls but the efforts are only partially successful. Third party payors tend to define cost in terms of what they pay to hospital systems and physicians for various services. It is the goal of the corporation to reduce costs for any given client by 10-25%. However it is recognized that measurement of this goal will be extremely difficult until hospitals are able to define cost.

 As each best care guideline is implemented for its clients, MRC will focus on the plan utilizing three pillars for a foundation. These pillars of medical ethics, clinical efficacy and academic honesty must be balanced from the beginning. Attention will then be directed to reducing redundancy within the plan and eliminating barriers to care. At the same time, the definition of maximum hospital benefit will be answered. This will take a consensus and almost certainly represent a shifting definition. It is recognized that scheduled periodic reviews of this definition are essential.

For any given illness, MRC will help its clients to identify rate limiting steps for resolution of the problem. MRC will also identify elements of the plan where additional resources will amplify the return of energy. A central theme in this endeavor will be eliminating redundancy and moving to push information systems for key elements.

At the time of presentation, the discharge planning for the patient needs to begin. It is easy to forget the patient would rather be someplace else than in the doctor’s office or the Emergency Room. At the same time, effort is being expended to resolve the healthcare problem, the discharge planning must go forward.