Thursday, 21 February 2013

Cuts won't save healthcare – staff will

Cuts won't save healthcare – staff will: Reducing staff numbers will damage performance. Healthcare providers must find ways to utilise workers in a smarter, more efficient way.

Increased human longevity is one of the greatest advances in civilisation. Over the past 60 years, global life expectancy has risen from 47 to 67. By 2047, there will be more people aged over 60, than under 15 on the planet.
Such growth poses huge challenges for our health and care systems. In practical terms it means there will be more pressure on front-line staff to deliver more, in less time, with fewer resources.
And the consequences of this change will be profound. With growing numbers of patients requiring care, and fewer people working in the profession, questions must be asked about how care will be delivered. The constraints caused by changes to the supply and demand of healthcare mean that the patient-doctor relationship is changing.
Insufficient attention has been paid to these changes and, left unchecked, the impact will be felt in a distinct way. Strained resources have the potential to damage staff morale and motivation, leading to care standards dropping.
Perhaps this shouldn't come as a surprise given that most people perform better when they are motivated, but the financial crisis has significantly reduced the amount of room for manoeuvre. A focus on finances has meant less time spent maintaining staff morale, and those who argue that 'costs walk on two legs' are gaining traction. But this is a short-term and damaging perspective – it's much better to think that 'value walks on two legs'.
If we are to resolve our impending workforce problems, we need to take a longer-term, strategic, view about how to increase workforce productivity instead of salami-slicing staff, their goodwill and patient care. Improving payment systems, purchasing procedures and governance remain important, but better health outcomes for patients will only be achieved if hospitals focus on their staff.
They need to pay attention to the way clinicians are able to interact with patients and improve the time they can spend on patient care. They must look at the methods being put in place to deliver care, so that the needs and voice of the patient is heard loudest.
For the past 60 years, technical, therapeutic and professional advances have revolutionised many approaches to healthcare, but at the same time the underlying business and care models have remained largely unaltered. Unlike most other industries, healthcare has proved to be stubborn when faced with radical change and ultimately it's the patient who suffers.
KPMG's analysis of organisations across the world show that providers must follow five approaches together, to improve patient healthcare:
• Incorporating a focus on creating better care for patients into their organisational culture.
• Empowering professionals by giving them the freedom to take responsibility for delivery of care.
• Redesigning tasks and processes so that patient need comes above staff convenience.
• Actively managing staff performance using outcome measures to promote a safe culture, such as measuring infection control instead of adherence to hand hygiene policy.
• Challenging traditional approaches to staff management by improving recruitment, induction, reward and appraisal programmes.
Adopting these five approaches works. For instance, Circle Health experienced a 22% improvement in productivity in 12 months in Nottingham, and a 'return to surgery' rate four times lower than the national average.
Hiring more people is not feasible in the current climate, but firing them is not the way to reduce costs and increase performance, either. Instead, healthcare providers must find ways to utilise the current workforce in a smarter, more efficient way.
Changing the habits of the past 60 years is a starting point because doing so will buy enough time for the more fundamental changes, redesign initiatives and innovations that the healthcare industry is just beginning to explore.
Andrew Hine is head of public healthcare at KPMG Guardian Professional.

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