Saturday, October 17, 2009

KM, Healthcare & CSUN KM

The most recent issue of Time Magazine (Monday Oct 26, 2009) has an article relevant to KM titled “A healthy way to pay doctors.” It's also relevant to CSUN's Master's in KM program.

http://www.time.com/time/magazine/article/0,9171,1930501,00.html

The article talks about how doctors get paid (by the treatment, by the day, health outcomes….) but also how sharing and institutionalizing good practices (although they don’t call them that) can significantly reduce costs, improve outcomes for patients…and keep doctors happy.

What struck me about this article was its relevance to KM. The article talks about how Geisinger Medical Group in Pennsylvania has significantly reduced costs, improved patient health outcomes, and attracted and retained top quality doctors through the use of some fairly straight forward KM practices. An example of what they have done is in surgery.

The first thing he (the head of surgery at Geisinger) and his team did was take 20 general steps all surgeons follow throughout a bypass episode and try to sharpen them in a way that would remove as much chance and variability as possible, going so far as to spell out the specific drugs and dosages doctors would use. The result was an expanded 40-step list that some surgeons balked at initially, deriding what they called “cookbook medicine.” Once doctors began following the expanded checklist, however, they grew to like it. After the first 200 operations — a total of 8,000 steps — there had been just four steps not followed precisely, for a 99.95% compliance rate. A total of 320 bypasses have now been performed under the new rules. “There are fewer complications. Patients are going home sooner. There’s less post-op bleeding and less intubation in the operating room,” says Casale. What’s more, the reduced complication rate has cut the per-patient cost by about $2,000.

The article goes on to talk about how Geisinger Doctors have done similar things for hip-replacements, bariatric and cataract surgeries and kidney treatment. And the very positive results from both a cost perspective and a health outcome perspective.

So why is this relevant to KM and to CSUN's KM program?

The processes that are being used to develop better practices in the hospital are classic KM. They include assessing the current processes and looking at current outcomes. They then ask the question...how can we do it better...and how can we standardize the process to improve overall outcomes? They then look at metrics and analyze outcomes to ensure what they have put in place is making a difference.

While these are well known KM techniques and processes, it is amazing how few people know how to effectively apply them. A staff will try and implement something like this...or they will bring in a consultant -- who often will say -- implement this technology and it will solve all of your problems.

But for those steeped in KM...you know that this won't be solved by technology alone. You know culture and change management will be a big part of a successful solution. You know that putting in processes that fit with the organizations culture is key to success. And you know that technology can be a big part of the solution...if done well. Finally you know that one size does not fit all. KM solutions that are appropriate for this type of issue may be completely inappropriate for more complex or complicated problems.

In CSUN's KM program we are introducing our students to the types of problems outlined in this article. And we are helping them learn what it takes for successful implementations that make a difference to the bottom line for the enterprise and to all of their stakeholders. We are also working with them to make sure they understand various KM frameworks and use cases that will help them analyze the types of KM solutions that will be most appropriate and effective.

For more information on CSUN's Master's in KM program check out our website at http://tsengcollege.csun.edu/kmdl/ and attend one of our upcoming online introductory sessions. The time and registration information for these sessions is on the website.

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