You must learn to break through barriers and overcome opposition!
In each issue of HVAM we will provide our readers with the one basic proven and time-tested tenet of value analysis to assist you to refine, enhance, and advance your value analysis processes. If you have any questions on this lesson, please contact us at bobpres@StrategicVA.com.
One of the sayings around our office is, “If value analysis was easy, anyone could do it.” The truth is that value analysis isn’t easy, especially when your customers erect roadblocks and try to stop you from doing your VA job. The secret to success in value analysis is not stopping your value analysis process because of excuses, manipulation or down right Machiavellian tactics that can throw you off course. You must be unstoppable!
Tens of thousands of dollars (sometimes millions) are lost each year at hospitals, systems, and IDN’s when their value analysis process is stopped because of barriers and opposition put in the path of value analysis practitioners by their customers. This isn’t a new phenomena. Larry Miles, the father of value analysis, talks about this frequently occurring while he was a value analysis engineer at General Electric in the 1940s. His famous quote was, “You can’t do value analysis if you’re going to let everything stop you.” Larry further stated, “There is a stopper that causes everything to stay the way it is, for better or for worse. But once you break through that, then very often your hands are on 50 percent or 60 or 70 percent of the cost. I mean that much of a reduction. So your main job (as a value analysis practitioner) is now to expect these stoppers, look for them, and be a little excited when you see them because now it’s out in the open.” What Miles is talking about here is that there are big savings hidden behind these barriers and walls that your customers are putting up to keep you from finding their secrets.
We can relate to what Miles is saying since we have seen this aberrant behavior on every value analysis consulting assignment we have undertaken over the last 20 years. Value analysis practitioners stop their value analysis process at the first signs of resistance. It can happen when a customer makes a statement like, “The Joint Commission has mandated it,” or, “We need this extra port for infection control purposes.” Yet, when you investigate these claims 90% of them are unfounded or just plain wrong.
Just A Starting Point
One of Miles’s philosophies was, “When you come up with a stopper, you’re just starting. That’s when value analysis starts.” That’s why you need to verify all of the claims made by your customers. One of the first things I learned in my long consulting career is that I couldn’t take customer claims, statements, or statistics at face value. I had to vet them!
For instance, when we tell clinicians their utilization is up on oxisensors, I.V. catheters, stents, etc., we are frequently told that this is happening because their census is up. We have learned that this is one of the default answers often heard from clinicians to confuse and cloud this issue. We then tell them that all of our utilization metrics are case adjusted for volume, thereby smoothing out their census’ increases or decreases for any given period of time. This usually gives these individuals a reality check and then they are ready to talk about why their utilization is beyond acceptable limits. The moral to this story is to never accept any customer’s excuse, claim or explanation that doesn't make sense to you unless it is proven!
Don’t Lose Money
Naturally, there are value analysis studies that don’t achieve savings, quality or safety improvements, but these are rare occurrences. Based on our own experience, we have documented savings, on average, of 26% on every value analysis study we or our clients have conducted over the last six years. The reason for this ultra-high savings yield is that we insist the value analysis practitioners we coach have a specific “indisputable” reason for stopping a value analysis study.
I can remember that we were certain a client of ours was using a disposable patient bathing system that was costing them three times the lifecycle cost (not price) as other hospitals with the same operating characteristics. Only to discover, after we visited their patient floors, that this hospital had no showers in their patient rooms, only shared showers. So, most patients couldn’t take a shower, necessitating their high use of disposable bathing systems. This is what we are talking about when we say you need specific “indisputable” reason for stopping a value analysis study. Otherwise, I can guarantee that you are losing money (26% on average) if you stop your value analysis studies prematurely.
Don’t Skip Tough Studies
There is a tendency to skip tough value analysis studies, especially physician preference items. Yet, this is where the big savings reside at your hospital, system or IDN. You might say that tough VA studies denote virgin territory since no one has looked at these categories of purchase for years — maybe never. Generally, what keeps us from attacking these tough VA studies is the fear of upsetting someone.
In reality, most physicians respond favorably to good data. So, if you can build a solid case for change with their own data you are halfway home to the completion of your VA study. If you still find resistance to your data presentation, then as Miles says, “You can generally find somebody who is on the same side of the fence as you. Find him (or her) and let (them) help you with (your VA study).” A good place to start is with your medical director. He or she can usually suggest an ally that can remove roadblocks and barriers that have been put in your way.
In short, value analysis is a game of inches. You most likely won’t succeed on your first, second or even third effort. Yet, you must not stop your value analysis study for any reason unless you find a specific “indisputable” reason to do so. Along the way, you must learn to break through barriers and overcome opposition because there is gold at the end of your journey just waiting for you to mine and extract.
On-Site, Fully Customized 1, 2 or 3 Day Advanced Value Analysis Training Program Can Help Your VA Team(s) Increase Savings by 300% or More
“This (training) program offers a different perspective on value analysis than the GPO based programs. It can offer a recipe – complete with tools for the development or revitalization of a (VA) program.” Betsy Miller, Value Analysis Manager, Shands Healthcare
E-mail bobpres@StrategicVA.com for On-Site fees