Standardization: Makes life Easier and Cheaper perhaps in Healthcare?

The Cheesecake Factory and Healthcare do not seem like an obvious association, in fact they seem like they should never coexist in any type of healthcare comparison. But when author and surgeon Atul Gawande went to dine there with his children he was struck by the Cheesecake Factory’s efficiency, diversification of menu and enormity. Almost immediately he started thinking about how hospitals and healthcare could learn how to run large and diverse hospitals more efficiently if they looked into how the Cheesecake Factory run their successful company. Dr. Gawande looked into all facets of the Cheesecake factory structure. How the food is planned, prepared, made and sent out; all done on a large scale. It was this large scale that caught the attention of Dr. Gawande because at the size of the company they were able to have increased goods, services, variety and quality while decreasing the costs. Dr. Gawande discovered that size was key because of their buying power. A trend Dr. Gawande was seeing in hospitals around the nation, a new type of hospital: a large scale food chain like hospital. Hospitals that were large scale and had a production line type goal to minimize differences in care and standardize the way procedures were completed. The following excerpt from Atul Gawande’s The New Yorker ‘Big Med’ displays how some physicians in healthcare are attempting to standardize procedures where there had previously been no protocol of standardization.  Dr. Gawande met with Dr. John Wright who had caught the vision of standardizing knee replacement surgery.

“Customization should be five per cent, not ninety-five per cent, of what we do,” he told me. A few years ago, he gathered a group of people from every specialty involved—surgery, anesthesia, nursing, physical therapy—to formulate a single default way of doing knee replacements. They examined every detail, arguing their way through their past experiences and whatever evidence they could find. Essentially, they did what Luz (A 'Cheesecake Factory' Manager) considered the obvious thing to do: they studied what the best people were doing, figured out how to standardize it, and then tried to get everyone to follow suit.”

Dr. Gawande himself felt the benefits of this standardization of care when his mother went in to receive a total knee replacement. Her recovery was quick and less painful than her past knee procedures: a standardized procedure that cost the hospital and Dr. Gawande’s mother less money.

Standardization of care can sound callus and impersonal in a field that is filled with working with many different types of people from many different situations. But if standardization can help minimize mistakes and decrease medical costs, and improve the quality of care, it should be looked at more seriously and with more fervor than perhaps expanding expensive technology that only reaches a small percentage and perhaps does little for patient outcome and success.

I have been a fan of Dr. Atul Gawande from the day I read his first book and this article continues to ask the right questions and cause the medical world to look at their system. I encourage others to read his article and get involved in the medical discussion that affects every American. I have expanded my knowledge on healthcare and interest in making it more efficient for all it serves by enrolling in Baylor University’s Healthcare Ph.D.

The New Yorker ‘Big Med’ by Atul Gawande: http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande?currentPage=1