Where is money wasted in healthcare? - page 5
Some time ago, I took a week-long class in a process called "Six Sigma", which began in industry and has now migrated over to health care. Officially, it is known as a "process improvement" effort,... Read More
Jul 2, '09Paper. 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.
Jul 2, '09All 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.
Jul 2, '09Quote from SoundofMusicThis 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 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.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.
Jul 2, '09Take 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.
Jul 2, '09Quote from heronyes, i understand it's a legal process. but it should be changed!!!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!
how do we go about advocating for THAT?
Jul 2, '09Quote from nerdtonurse?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.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.
Jul 2, '09My 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!!!
Jul 2, '09we 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.
Jul 3, '09Thank you to all those who have posted for your thoughtful responses. It's the wastefullness that really gets to me. And the thoughts posted about the lavish furnishings seen in many facilities, a few nice pictures are okay, but some of these places just really go over the top. When did hospitals have to start competing with luxury hotels?
The whole end-of-life scenario is a dicey one, at best. Surely that debate needs it's own thread. I wonder how much the family's perception of death and beliefs about death affect the decisions that are made when faced with catastrophic conditions. But that's another thread for another time.
Jul 3, '09Here's an example of ridiculous waste that happened to me just last night. I admitted a neonate from the CV-OR right after my shift started. It had been a long procedure and the kid was sick-ish. He had a significant hyperglycemia and so I started an insulin infusion. Because of his age and size, that meant hourly glucose monitoring. I went and got our glucometer and discovered that the responsible party had not uploaded the information to our main lab's database as required by policy, and it had not had any QC done in months. It wouldn't let me do anything with it. (I could have done the QC but not the uploading.) So instead of doing hourly bedside chem-strips I had to do hourly ABGs all night. Don't think that didn't waste a few hundred bucks in supplies, to say nothing of all the extra time and needing to have the RT involved.
Jul 8, '09I am a new nurse, but I am now working in an ER and I totally agree with the abuse of ER services for everyday problems. My first day in the ED we had 2 people with tooth aches and a couple of ear aches! Having worked as a CNA I also agree with the palliative care comments. I encourage everyone I know to have a living will and make decisions about that kind of thing in advance so their children and family aren't left with the guilt of deciding to opt of ICU and extraordinary treatments.
I also think we waste a lot of money in small things...I don't know how other healthcare systems do it, but where I work if someone comes in for surgery, KNOWING they're going to stay overnight in the hospital, we still provide them with everything they need for grooming. And if a patient does happen to bring their own things, most of the time the CNA's have already brought a basin full of stuff into the room and left it there - so it can't go back into supply. That is also a problem with nursing staff and their supplies. I can't tell you how many extra bottles of sterile saline or Kerlex (sp?) and 4X4's are left and thrown out in a room because the nurse didn't see what was there before she went in to do a dressing change. Or laundry costs - we had a patient leave after several weeks in the hospital and when housekeeping went to clean the room, they found 3 linen bags worth of clean laundry stored in the cabinets because it was brought in and never used and the patient stored it. Not only was it a pain for the housekeeper, but what a waste in laundry costs.
Jul 8, '09When I was an agency nurse, I worked in the NICU of a large children's hospital. Half the electrical outlets were broken and most of the charger cords were frayed just to name a few problems. This hospital benefitted from the Children's Miracle Network, but the staff nurses told me that any money they received went for cosmetic improvements to the building, like new statues for the outside. It's disgusting.
Jul 8, '09Because majority of nurses here was worked and lived JUST in US, well is hard to belive how the helath care function and in other countries.
Trying to apply in US the healthcare model from another countries will not work at one point, because their model was adapted for their own needs and US is US!
The problem here in US are insurance companies beetwen patients and providers, is the huge mistake ever.
As soon you have the second part involved in healthcare "ring of fire", they are second part who make money for NOTHING, always the cost will be high and much more you will NEVER know who is a REALLY good provider and who not, because all will be the same. Because of insuarnce companies we developed here in US a lot ot 10000 employes who suck a lot of money also, 10000 services also sucking money, insurance companies here is what a italien movie named "La piovra". You could not doing nothing againt it!
In a really free healthcare, the providers are free to setup the fees and patients free to go or not to providers. IF YOU hospital doctor, facility if you are REALLY good, people will come and will pay as much as you ask for it, if not ....you could enroll your self and your hospital facility on comunitar programs and you will be paid from social funds, and you will be the one like many others.
I know insurrance companies work for them self but not just only for them self, loooooool, is a big huge mistake. America is country for investitors for bussiness... but as good as you know ...I know also that...the best bussines is the bussines with.....insurance companies, lol
In my past I worked for a insurance company over the ocean, I had friends working there still...you really don't want to know how the thinks work from the insiede out, .... .
But still , I know how is to be in "for all the same" health care", at one point will be a mistake... but when money are involved.... you know always need to keep the balance beetwen money and helathcare...damn it I learnt good my US lessons, lol.
I belive in US stakeholders and I am sure that whatever they will decide they will balance both visions, and they will not let Zuzi and many others to live again what she lived one time ago... "for all the same, but for us a little different" is a a so tricky vision, ONLY you you lived it, you know it!
Health care money are wasted by insurance companies!
Nurses who come in nursing for money and just for money they need to go there, they will like it!