The Eternal Triangle: Balancing Cost, Access and Quality

Dr. Emanual A. Friedman, writing in Physician Executive more than twenty years ago, called the delicate balance that healthcare providers must achieve between cost, access and quality the “eternal triangle.” He argued that the variation among these concerns is that each, in turn, receives the most attention from policymakers, payers and the public over time.

Which is most important to today’s hospital? Arguably, all three are more critical than ever. However, soaring healthcare costs, labor shortages and the high burnout rate among physicians are impacting the ongoing pursuit of this already elusive equilibrium. 

And it’s only going to get worse.

How to Improve Healthcare Costs, Labor Shortages, and Burnout

Fortunately, there is a way to better balance the triangle. Leading hospitals throughout the United States are accomplishing this, and we at IN Compass Health have been privileged to help many of them in doing so.

For the purpose of this discussion, “cost” is the cost the hospital incurs to deliver care to its patients. “Access” is the ability to see patients in a timely manner. “Quality” is the quantifiable measure of clinical outcomes relative to the national average.

How to Lower Costs At Your Hospital

To lower costs—or at the very least keep them in check—hospitals must make their human resources a priority. Creating an environment in which employees can’t wait to jump ship only ensures that the high cost of traveling nurses, locum physicians and recruitment professionals will be required. Talk to your people to gauge their satisfaction. Implement flexible shift schedules when needed. Pay them competitive salaries. Always keep the lines of communication with them open.

How to Reduce Wait Time in the Emergency Room

To reduce ER waiting times and increase overall capacity, create a “culture of throughput.” Move patients out of the ED in a timely manner and reduce overall LOS. Complete about 25% of discharge orders by noon. You can read more about this by reading our previous blog on this very topic.

Hospital Quality Improvement

To improve quality, unleash the leadership potential of your physicians. Achieve better communication between ED and hospitalist physicians with nursing staff and hospital leadership. Analyze current quality metrics and solicit opinions from all staff about how to improve them. Then, give your people the tools and authority to make this happen.

How IN Compass Health Can Help Your Hospital

Of course, there is much more detail to all of this than we can share in a blog post. But even the pursuit of these goals and minor improvements along the way will make a real and positive difference to each point of the eternal triangle. Fully achieving the right balance takes time… and there is no better time to start than the beginning of a new year.

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