Case Analysis

Question #5
IHC has effective systems for creating protocols, implementing them in clinical settings, monitoring protocols’ performances/outcomes, and rewarding clinicians for using protocols. Please discuss how these contribute and advance organizational learning and organizational competitiveness; e.g., in terms of service quality improvement and cost savings.

IHC’s development and use of protocols has been instrumental in their rise to the top of the health care market. Through the process of creating and improving them they have found ways that both help provide better quality of service and at the same time help with their own competitiveness when it comes to cost.

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IHC has done many things that have led to this. By developing a team of members that implement protocols and at the same time giving them incentives such as reimbursing them for the time that they spent working on the protocols and providing staff support for them, they could give an honest and effective effort to find protocols that would really work. They also had specialist physicians that had salaried time to work on the protocols. Having these groups working on the development and implementation of the protocols led to several key things. After identifying three sources of ideas for developing and updating protocols they ended up finding things that they may be doing well already compared to other health providers, but could still improve upon in order to be more efficient. The development teams looked “for statistically significant patterns of variance in process and outcome, with the view that they presented opportunities to improve the protocols (pg. 9).”
The process of consistently looking for better and new protocols has also led to discoveries of weaknesses in already existing ones. One such example was when they found that they were violating the key principles of data management: “To obtain accurate data, collect data once, and collect it at its point of origin.” They estimated that 15% of their largest expense, salary for operational staff, was entering data for billing and financial tracking systems. By making this discovery they were able to look for more effective means of gathering data and not waste so much time and money on it.

A change in attitude with regards to finances has helped IHC with its approach as well. Bill Nelson, President of IHC, changed the attitude from being nearly all financially oriented to being 1/3 medical outcome goals, 1/3 service outcome, and 1/3 cost outcome. This change in attitude helped the administrators look more at the clinical side of things. This change in attitude, along with a concentration on getting the physicians to buy into the importance and value of the protocols helped significantly. Once the physicians found that the protocols were more convenient (pg. 12) and that the protocols actually helped them increase their own productivity (pg. 13) then they became more than willing to use them and encourage others to use them as well (pg. 15).


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