tag:blogger.com,1999:blog-7108456.post3497981798966376848..comments2008-06-20T10:22:28.893-05:00Mark Grabanhttp://www.blogger.com/profile/07953086531083611251noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7108456.post-9043603367240998352008-06-20T10:22:00.000-05:002008-06-20T10:22:00.000-05:002008-06-20T10:22:00.000-05:00Actually. It's a shame that noone took the time to look at all the numbers. Collaborative doesn't save money. It costs more. <BR/><BR/>The entire study is based on an 11 bed unit. At this moment those involved in trying to advance collaborative care are realizing that it is non-sustainable. <BR/><BR/>While one doc rounds on the Collaborative care unit, another twiddles his thumbs waiting for his turn to be allowed in. There simply isn't enough pharmacy staff and nursing staff to handle more than one doc at a time. The result. ineffeciency. That number however isn't being included in this study.. it's being included in another LEAN event that's trying to figure out how docs can see more patients in shorter time!? HA! (pure Thedablunder)<BR/><BR/>What's more, the powers that be have finally realized (1 year after they were warned by dozens of docs) that the system can't work on a scale larger than 10 beds. The money it would take to hire enough pharmacy/nursing/support would cost more than iit would save. This reality finally sunk in last month when a top level manager said, "Gee, we are going to have to totally rethink the entire collaborative care process!"<BR/><BR/>Ya think?!<BR/><BR/>The model was doomed to begin with. Instead of relying on thoughts from docs, they took 1-2 docs, made them "champions" and gave them a list or unrealistic goals. Couple that with bowing down to the desires of nursing, pharmacy and everyone else who wanted to do more than the original job description and the result is a culture where everyone thinks they know best and morale is abysmal. 99% of docs in "Collaborative Care" hate it. What do you expect when you take docs and force them to change to a practice style they realize from the start is less effecient (and yes.. more expensive.. (see above)<BR/><BR/>The result. Failure.<BR/><BR/>Next time, listen to the ones who see 20 patients a day. <BR/><BR/>In a fantasy land it would be great if every class has 2 kids and every patient had a trio. The reality? It wont work system wide.<BR/><BR/>-Whistleblower.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7108456.post-51908900067857367792008-02-25T13:40:00.000-06:002008-02-25T13:40:00.000-06:002008-02-25T13:40:00.000-06:00Wow. This has the potential to advance Lean in healthcare to a whole new level. I wish Dr. Toussaint good luck with this venture.Dean Blisshttp://www.blogger.com/profile/18034549658270609406noreply@blogger.com