Helping Patients Find Their Way in the New Era of Efficiency

Now that the operating principle is to do more with less, efficiency efforts need to be designed and implemented in a mindful way


After decades of living beyond our means, we have finally entered the Efficiency Era, and -- whether it's health care, the Federal budget deficit, corporate balance sheets, or factory supply chains -- the operating mantra of the moment is "do more with less."

Unfortunately, too many people view efficiency through a narrow lens, simply equating it with belt-tightening, cutbacks, cost reductions, and layoffs.

But trimming, slashing, or hacking in the name of austerity doesn't lead to efficient efficiency. And the knife, scalpel, axe, or chainsaw rarely achieve much of anything -- except pain -- if deployed in a thoughtless vacuum.

Indeed, for efficiency efforts to truly take hold and make a difference in an organization, institution, or nation, they have to be designed, developed, and implemented in a broad and exceedingly mindful way that makes work, management, or stewardship simpler, easier, leaner, more productive, more constructive, and more rewarding.

And, whether they unfold in the public or private sector, efficiency initiatives must be created and rolled out transparently, with people very much at the epicenter of the conversation; uncommon sensitivity must be displayed toward the employees, customers, and citizens who will be directly affected by streamlining in order to successfully reap the benefits that result from solid and substantive efficiency programs and policies.

That said, while I firmly believe that humanizing efficiency must put people first, it must not dilute the work ethic or drive for quality in any form or fashion. The best efficiencies remove excess without reinforcing entitlement.

Efficiencies can't be instituted in government, in business, or in our health care system if an entitlement mentality is in place, but they also can't be implemented without a tremendous amount of hard work, laser-like focus, and sincere and constructive engagement from all involved participants.

There are lessons here for all of us. To achieve much-needed efficiencies, people need to come to the table personally committed to compromise. Making efficiency a reality means making tough -- but necessary -- choices. And this often requires putting self-interest aside in the name of the common good. Everybody needs to chip in and contribute when thoughtful efficiencies that make sense are well within reach.

In Washington, D.C., that's putting country over party; in a company, it's putting the success of the overall business over one department or another; and in a hospital, it's putting patient care over the individual needs of insurers, for example.

Attaining pure compromises -- or pure efficiencies, for that matter -- are pure ideals, of course. Still, there's no question in my mind that the struggle to deliver efficiency is well worth it. And I believe there are three key areas where 21st century efficiencies can make a huge difference in our lives:

  • Waste: Designing new processes, programs, and policies so that business and government can operate more effectively, without getting bogged down by what's unnecessary and what gets in the way.
  • People Support: Making sure that people feel good about efficient change initiatives, and that they're committed, as well as inspired, by these efforts.
  • Navigation: Helping citizens and customers (or, in health care, patients) find their way in a newly efficient and significantly transformed environment. Right now, navigation is a top priority; but, over time, as efficiency becomes an institutionalized norm -- or way of business and government life -- it will be less needed.

The humanization of efficiency is the next chapter -- the chapter for 2011 and 2012 -- in a long-running story that began a generation ago.

The bottom-line, small-is-better saga began in Washington and on Wall Street during the early 1980s. It started with cutting fat and downsizing; then it turned into rightsizing; moved on to squeezing savings and increasing shareholder value; gained intellectual momentum with re-engineering and re-invention; went further with productivity gains and process improvement; and finally ended up with bending the 21st century cost curve.

We are now at a delicate yet demonstrative moment in this efficiency epic; and there is a growing awareness in almost every quarter that the fundamental needs of people matter as much as the absolute need to smooth and simplify processes while reining in spending and bridling excess.

Humanizing efficiency also resonates today because of the ongoing and vociferous debates over corporate profitability and responsibility, health care reform, and government spending.

In each of these critical national arguments, the human -- as well as financial -- costs of efficiency are slowly (but finally) being brought forward; and the all-important impact on people now stands front and center at a time of increasing economic uncertainty.

Image: dean bartoncelj/Shutterstock.

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Patrick Hagan joined Seattle Children’s Hospital in Seattle in May 1996 and currently serves as its president and chief operating officer. Previously, Pat held leadership positions at hospitals in Ohio, Arizona, and Michigan. More

Patrick Hagan joined Seattle Children’s Hospital in Seattle in May 1996 and currently serves as its president and chief operating officer. Prior to joining Seattle Children’s, Pat held leadership positions at hospitals in Ohio, Arizona, and Michigan. Pat helped to develop and has led Seattle Children’s Continuous Performance Improvement (CPI) strategy for over 10 years. CPI has been instrumental in Children’s success in improving its performance in service quality, clinical access, patient safety, staff engagement, and financial results. He has presented at national meetings on building successful physician/hospital relationships, continuous performance improvement, and the importance of staff and physician engagement. Pat is co-author of Leading the Lean Healthcare Journey, published in 2010.

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