Use of Health Management Consultants Draws Fire

  1. 4
    [color=gray]by kari lydersen
    [color=gray]published: august 19, 2011

    when its chief operating officer, tony tedeschi, handed over his responsibilities at the troubled cook county health and hospitals system last month to carol schneider, the two had something in common besides serving in that job: both work for private consulting firms that have played a major role in [color=#004276]the sprawling system’s highly controversial restructuring. …

    …ms. schneider, whose contract runs through december, works for the washington group ltd., a consulting company that provides administrative help to the system. pricewaterhousecoopers has a three-year, $50 million contract calling for it to save the system $300 million or bring in the equivalent in new revenue. cook county’s use of consultants is similar to that of many municipal agencies elsewhere that have turned to outsiders for advice. …

    …in addition to advice on staffing and internal processes, consultants have helped guide efforts to secure more money and to interpret regulatory policies. consultants also contributed to the plan to close oak forest hospital and reduce inpatient services at provident hospital.

    the county decided to close oak forest based in part on the advice of navigant consulting, which in a 2009 report found that cook county’s hospitals were overstaffed compared to those of other health systems. navigant’s assessment also formed the basis for the layoff of 1,350 people systemwide in the last two years.
    doctors, nurses and union leaders argued that navigant’s calculations were flawed. …

    …doctors and administrators also said the company had recommended procedures that add bureaucratic cost while undermining employee morale.

    the head of the national nurses organizing committee union, leslie curtis, said pricewaterhouse’s relentless focus on cost cutting undermined the company’s ability to grapple with the more important issue of bringing better organization to what she called a chaotic system.

    “sometimes people need to have a fresh eye,” ms. curtis said. “but if your fresh eye is all based on money, then i don’t think that’s a fresh eye; it’s a blind eye.”

    a nonunion supervisor, who would speak only on the condition that her name not be used for fear of retaliation, said the constant presence of consultants — and a lack of clear results — was undermining staff morale.

    http://www.nytimes.com/2011/08/19/us/19cnchealth.html
    lindarn, SummitRN, TroyPhD, and 1 other like this.
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  4. 13 Comments so far...

  5. 8
    Instead of using private consultants who do not have healthcare backgrounds, wouldn't it be more prudent to use a highly experienced RN with a MBA degree who has previously functioned as a chief nursing officer? Perhaps they could use a very experienced physician who has functioned as a medical director in the past?

    Couldn't they use anyone better than private consultants with no hospital experience?
    Jarnaes, VivaLasViejas, lindarn, and 5 others like this.
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    I too am puzzled by the use of outside consultants with little or no health care experience. Heck, I'm puzzled by the use of any expensive outside consultant.

    Isn't that what administrators and upper level managers are paid for...to do long range planning, buddgeting, goal setting, etc.? If the high level employees of the system are not capable of forging a plan themselves, in conjunction with their legal advisors, why are they still employed? I know with certainty that if I, as a staff nurse, were not able to do my job with minimal support from my co-workers and manager, I would be out the door!

    Hubby used to work for a Fortune 100 company that hired a new team of consultants about every 2 years to come in and advise, re-vamp, reorganize, etc. Without fail, they would let a bunch of people go, only to re-hire for those positions 2 years later when the latest and greatest consultants came along. It's no wonder no one seems to last long at that company, and no wonder that they seem to have made little, if any progress in the last 15 years.
    Jarnaes, VivaLasViejas, lindarn, and 4 others like this.
  7. 6
    Quote from TheCommuter
    Instead of using private consultants who do not have healthcare backgrounds, wouldn't it be more prudent to use a highly experienced RN with a MBA degree who has previously functioned as a chief nursing officer? Perhaps they could use a very experienced physician who has functioned as a medical director in the past?

    Couldn't they use anyone better than private consultants with no hospital experience?
    Why would they do that- someone in "the know" would not cut as much, therefore making the ceo's profit less. I'm sure they hire these "consultants" to clean house SO the ceo can have more profit- after all, the consultant made it look good on paper!

    The Corporations of this country are PURE EVIL!!!!
    laborer, Jarnaes, lindarn, and 3 others like this.
  8. 6
    Quote from jrwest
    Why would they do that- someone in "the know" would not cut as much, therefore making the ceo's profit less. I'm sure they hire these "consultants" to clean house SO the ceo can have more profit- after all, the consultant made it look good on paper!

    The Corporations of this country are PURE EVIL!!!!
    Your point is good and very salient. Thank you for opening my eyes.

    However, I was looking at the situation through the lens of someone who wants to see the organization truly improve. I was not thinking about the extra dollars lining the CEO's pockets, although this is the possible ulterior motive of the CEO. Hence, they're using outside consultants with no healthcare credentials to ensure this outcome.
    IowaKaren, laborer, Jarnaes, and 3 others like this.
  9. 13
    But without outside consultants, we wouldn't have fabulous ideas pervading the hospital like Disneyfying it or "Giving customers the pickle."
    HouTx, IowaKaren, barbyann, and 10 others like this.
  10. 12
    hiring outside consultants is a routine thing at my hospital. we have 3 ceo's at my place of work..we refer to them as the "3 stooges". of course they make hard command decisions like informing staff where we cant or can park, changing the times the cafateria is open and what kind of tv's to place in the waiting rooms...pretty impressive huhh. but for any decision that might actually take them out of there comfort zone they'll gladly shell out 50-100k to have someone else come in and lead them by their little darling hands. i honestly think its done as a safety net for the ceo's..meaning if the idea is a bust and the hospital loses money, they can just lay the blame on the consultant and divert the blame off them. purley face saving tactic. thats is how its done here in mississippi..
    NurseShelly, Katie5, IowaKaren, and 9 others like this.
  11. 8
    Going with the thought of the CEO's hiring business consultants to continue to protect their own multimillion dollar salaries, It's time someone with clout in healthcare, maybe someone who has a position in the Federal Dept of Health and Human Services, with a pure healthcare backround not one tainted by the business world to stand up and get rid of these CEO's, their business consultants and all their little generals of profit(the financial CZARS and their entourage, the Boards of Dictators and Mistrustee's) out of our country's healthcare system's once and for all. They are are going to have to get rid of all these CEO's and replace them with healthcare professionals with their advanced degrees in medicine or nursing who know and is focused on the "workflow" of patient care and has a committment to it's accountability and responsibilty, not personal profit at the expense of vulnerable populations. These CEO's are to driven by their own personal profiteering to be effective anymore in this future of healthcare reform and cost effectiveness. They have proven over and over again they are out of touch with the contmporary direction of reform and are totally incompetent at their jobs for which they are paid very handsomely. They have defiantly refused to cut their own salaries in the best intrest of safe patient care and turned a blind eye to thier role(and a very big one at that as their are the one's driving health care) in contributing to to patient neglect,injury, and malicious malpractice by the mis appropriation of hospital( and ultimately federal and state) funds. These CEO's are no better than racketeers and have escaped just prosecution by pointing the finger at the doctors and nurses who are on the front lines of this fiasco trying to doggie paddle.

    Cut the business consultant contract- $50million saved right there. Cut the CEO's salaries to $300,000-$400,000- another $2-4 million saved. Cut down the top level management positions- millions more saved. Give the CEO and all their top level management the same healthcare plan that everones else gets- housekeeping, lab, nursing. Cut all the performance bonuses of the CEO and his/her top administration- it's time they started doing their job for the pure thrill of it like we have to. Give the CEO and top management directions to Walmart with their new found income bracket- like we have had to. Cancel their memberships to the healthclub, shutdown the executive washroom and turn it into an onsite day care- job creation! Discontinue all the power lunches in the neighborhood trendy fancy restaurants- they now become "bring your own and learns". Selloff the company jet- have their spouse make their plane reservations on commercial jets.(pat down time! buddy) No more corporate loop hole tax cuts- put their names on a big list to the IRS- manual face to face audits every year.
    Last edit by kcmylorn on Aug 21, '11
  12. 3
    “Sometimes people need to have a fresh eye,” Ms. Curtis said. “But if your fresh eye is all based on money, then I don’t think that’s a fresh eye; it’s a blind eye.”

    No kidding!
    IowaKaren, herring_RN, and Jarnaes like this.
  13. 4
    Quote from wooh
    But without outside consultants, we wouldn't have fabulous ideas pervading the hospital like Disneyfying it or "Giving customers the pickle."
    I know for sure I haven't given any patients, or their families, any pickle. I haven't given ANY form of customer a pickle since I was 16 and worked in fast food. The phrase makes me think pickle is a substitute for "finger" which I would heartily give people if I could get away with it.
    NurseShelly, jrwest, Jarnaes, and 1 other like this.


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