Where is money wasted in healthcare?

Pediatric Critical Care Columnist · Jul 1, 2009

How about not having exclusive doctors/surgeons lounges? How much does that cost? By the way have you seen them...I used to clean one as a volunteer. High end coffee machine with the little single serving coffee pods (Keurig I think), subscriptions to at least 11 professional journals (just for the lounge) -- that is some serious dosh right there every month.

We have a Keurig coffee machine in our unit staff room. Our physician team got it for us for Nurses' Week last year. BUT... we have to pay for the coffee twice. First when our social committee buys the pods and then again when we want to drink it.

Put a lock on the fridges that get emptied by visitors on a daily basis.

Our unit nutrition centre doesn't contain anything that visitors would even think about eating. Except maybe the Kozy Shack chocolate pudding, but there's only ever 2 of them in there.

Ruby Vee, BSN · Jul 2, 2009

what would be the cutoff age for aggressively trying to save a life rather than letting nature take its course? have we not seen miracle patients come back from what we thought were impossible odds?
they're called "miracles" because they happen so rarely.

the "cutoff age" would seem to be fluid. if someone is an active 90, still teaching classes in investing twice a week, gardening every day, walking 6 miles every morning that's one thing. but a 90 year old spending all day (and all night) in the recliner every day watching "jerry springer" and knitting, they may not recover as easily or regain as much function as the active 90 year old. and someone who's been in and out of hospitals muliple times in the past year . . . maybe palliative care is a good option.

SoundofMusic · Jul 2, 2009

Seems to me, that if many of these ideas were actually implented, that we might not necessarily even NEED government run healthcare.

Cut out the waste, reduce the costs, and there you have it.

But here we're going to introduce a socialist scheme, and believe me, the middle class is NOT going to prosper from this. It will be a lot of money in the hands of a few, like all these other socialist countries.

I think Americans are really not thinking too straight. We've got all this constant propoganda being put out on health care, when the solutions lie right beneath our noses.

Honestly, why or why does OUR floor need 8 managers types for a staff of 40 or less? My husband led companies with more people in the military all on his own!

I can see 1-2 bosses, but we've got so many "managers" who provide no nursing care. Yet, we're told every other day that we've got to cut down on numbers of RN's and ancillary staff to save money!

Middle management is protecting itself. The CEO's are protecting themselves. Someone needs to speak up, because as socialist healthcare continues, it will only get worse. Worse for RN's and ultimately way worse for the patients.

heron, ASN, RN · Jul 2, 2009

I was lying in the bed this morning thinking about this very same thing. (for what reason i dont know but this is what i was thinking of, lol).
what i was thinking was how if a patient is discharged from LTC, their unit dose packed regular meds go back to the pharmacy. yet the narcotics, which are NOT unit dose and are packaged in little plastic boxes, have to be destroyed. why not just package the suckers in unit dose so they can be sent back and credited so there is little waste??

I think it's a DEA/state boards of pharmacy rule ... facilities have no control over it. Sometimes, in my hospice unit, there's enough medication waiting to be destroyed to pay off my house!

ChristyRN2009 · Jul 2, 2009

Paper. Lots and lots of paper. I would LOVE to know what our facility spends on paper alone in a day. Just for staffing education, it gets posted several places around our unit, put in our mailboxes, discussed in meetings and handed out in the same meetings. We might get 3 copies of the same education topic and they are usually color paper. That's just one example. I pray for the trees every time I go to work.

seablitz.llc · Jul 2, 2009

All of the responses are good observations and can be compiled into a good article or a book. However, most are found in many healthcare literature. As a system, the providers, the recipients, and all involved in the production of health contributes to waste and misutilization of healthcare services. Knowledge of sources of waste in healthcare is a good start to think about the solutions. One nurse or healthcare provider or healthcare recipient at a time. Hopefully we will have a "green consciousness" type of solutions. Quantum solutions may not come easily because of the political complexities of our government.

StNeotser, ASN, RN · Jul 2, 2009

Seems to me, that if many of these ideas were actually implented, that we might not necessarily even NEED government run healthcare.
Cut out the waste, reduce the costs, and there you have it.
I can see 1-2 bosses, but we've got so many "managers" who provide no nursing care. Yet, we're told every other day that we've got to cut down on numbers of RN's and ancillary staff to save money!
Middle management is protecting itself. The CEO's are protecting themselves. Someone needs to speak up, because as socialist healthcare continues, it will only get worse. Worse for RN's and ultimately way worse for the patients.

This is another huge waste. When I worked for a big corporate place we had more people clacking around the halls wondering why this target and that target wasn't being met and why call lights were not being answered. They outnumbered the staff on my hall, not to mention interrupting me every five seconds for something. The obvious answer was that if they were all to don a pair of scrubs and help out and leave us alone with their nitpicking, there wouldn't be any problems meeting such targets and no call light would go unanswered in their targeted time.

nerdtonurse?, BSN, RN · Jul 2, 2009

Take the cost of the 3am "I've had sniffles and a sore throat for an hour, I need morphine for it" ER trip out of their monthly check (think medicaid charge back). If it's truly an emergency, great, pay for it. If it's stupid, it comes out of your check. I think we'd see a pretty sharp decline in the drunks and drug seekers showing up that last weekend of the month when they got a check for 14 cents.

southernbeegirl, BSN, RN · Jul 2, 2009

I think it's a DEA/state boards of pharmacy rule ... facilities have no control over it. Sometimes, in my hospice unit, there's enough medication waiting to be destroyed to pay off my house!

yes, i understand it's a legal process. but it should be changed!!!

how do we go about advocating for THAT?

southernbeegirl, BSN, RN · Jul 2, 2009

Take the cost of the 3am "I've had sniffles and a sore throat for an hour, I need morphine for it" ER trip out of their monthly check (think medicaid charge back). If it's truly an emergency, great, pay for it. If it's stupid, it comes out of your check. I think we'd see a pretty sharp decline in the drunks and drug seekers showing up that last weekend of the month when they got a check for 14 cents.

if i go to the ER and it's not an emergency, i have to pay a $100 copay. why shouldnt medicaid pts have to do the same? it might cut out them abusing the ER.

Elvish, BSN, DNP, RN, NP · Jul 2, 2009

My facility does circumcisions on newborns that a) is not considered medically necessary to begin with; and b) Medicaid does not pay for. Do you think people pay up front for this? No.

Considering what our hospital charges for a circ, multiply it by 365 (1 for each day).....equals nearly $250k (not a typo). That is one heck of a lot of money for a tiny little piece of skin that's really not an anomaly to begin with!!!

GeauxNursing · Jul 3, 2009

we get small (150? 250ml?) bags of Na citrate for ONE patient who is allergic to heparin. We lock her CVC with it. the bag is single-use. Really expensive, I hear. That's a waste.