A bad decision can cost a hospital millions

Things can go wrong without the right equipment in place

I recently read an article that attempted to explain the cost overrun experienced by a hospital during the launch of its new EMR. The article was clear about what caused the excess, but did not communicate why the decision that created the cause was made.

In many hospitals, emotions can be intense fueled by attitudes of resistance to change. The pressures and stress associated with getting started can be a challenge to manage; however, allowing those forces to affect decision making can have lasting adverse financial effects. When all the planning, budgeting, constraints, and common sense that need to be applied are thrown aside, you can almost always expect the worst. It may seem like appeal is the right thing to do to relieve stress, but it may not be the best thing to do. Sticking to plan and staying within budget should always be the driving factor behind decisions, even when the pressure is great.

It’s unfortunate, but some decisions are based on problems that may not exist at all, but are only perceived based on excessive negativity. Having an experienced team that can help make fact-based decisions is vital.

Negotiation skills pay off!

When doing logistics, treat it like your money

Getting one of the best hotels in town to give you the lowest rate with great concessions is great. In this arrangement, the hotel managed flight itineraries and provided transportation to and from the airport. They provided a large conference room for orientation and then surprised us at the contract with a complimentary welcome reception for 120 guests with hearty hors d’oeuvres. Provided two fifty-six seat deluxe buses and several shuttles to transport consultants to and from the training center. They also agreed to use their shuttles to take consultants working within two miles of the hotel to and from work each day. Everything mentioned above was in the room price of $105.09 with tax. Note that this removed a large burden from the consulting firm and the savings were passed on to the hospital.

When a hospital hires a consulting firm, that consulting firm must do its best to save money, not spend it. Creating a positive cost variance (CV) indicates that the consulting firm is indeed on your team. Negotiating for the best price is good, but getting the most value for the lowest price is better.

The consultants saved the day!

Good consultants can mean the difference between success and failure

I sat in an auditorium with over three hundred consultants when the speaker invited the lead implementation project manager to the podium. “Dr. So-and-so has overseen the implementation of EMR in over nineteen hospitals, please give him a round of applause.” Wow, nineteen projects, that’s impressive. However, it turned out to be a challenging project in many areas, but mainly with significant workflow issues.

Although it is unclear why this is happening, it is clear that the leadership was out of touch. Looking for someone with excellent qualifications can be attractive to any hospital, but having someone with the insight that can eliminate problems before they exist is priceless. I’m not sure why this project manager didn’t know this.

Fortunately for everyone, the consultants came with the necessary experience and knowledge to handle these types of problems. Jumping into action and building on past experiences, they began the process of educating staff and leadership on what works. This startup would never have survived without the tremendous efforts of the consultant.