Right now, many hospital systems put an inordinate amount of pressure on hospitals. Patients are staying for long periods of time because they have nowhere else to go, doctors are required to perform minor procedures that nurses are trained to perform and many governments don't want to admit that there are other options for those that can afford it. In Canada, approximately 7,500 people are living in hospitals (living is defined as having been there longer than 100 days) because they have nowhere else to go. That costs the system approximately $7.5m every day!!! Does that sound like an efficient system? We need a system where these people have a place to go where they get better care that is more cost effective. The hospital is the most expensive place they can be.

We need to develop local clinics and providers who can take much of this pressure off of hospitals. Hospitals should be a place where people go for emergencies and specific kinds of specialty care, not a catchall where patients stay because they have nowhere else to go. Develop local communities and homecare facilities to support those that need a place to go and be cared for, provide for better home care and give people options when it is time for them to be discharged from hospitals.

Like most businesses, much is lost in the transition from one system process to another. However, in most businesses this leads to lost money and profits. In healthcare, this leads to lost money and lost patients. There are lives at stake here so let's make a better effort to fix the problem.

Right now, patients are in the middle of a system where not much is integrated. Their records need to be shared by hospitals, specialists, local clinics, care centres and many other healthcare providers. But currently, patients are pretty much responsible for their own records, or least knowing about their health. Every time you see a specialist or a new doctor, you must go through the same discussion about past medical history and treatments. What happens if I am in a critical situation and am unable to tell anyone my previous history? Technology is advanced enough to have our medical records follow us wherever we go, so we need to create a system where incentives are given to make the patient experience seamless and more integrated. Start locally, then move to regionally and then internationally. Imagine a world where a universal health card stores all of my health records and information and it can be accessed virtually. The technology is there (think bank debit cards), so why not healthcare records? Because people are trying to tackle the system all at once instead of breaking into manageable chunks.

In our healthcare systems, we need to do a better job of creating processes that are proactive and engage patients and front line caregivers better to anticipate need. This doesn't mean patient and employee satisfaction surveys, although this is a good start. This means creating a process by which employee feedback can be gathered, analyzed and implemented. Create an employee feedback program and encourage staff to put forth ideas on how to improve the performance of the organization. Those ideas must be captured and reviewed, with the best ideas implemented. Success for a program like this will only happen if employees feel that their ideas will get a fair shake and that they see other ideas coming from employees being implemented. As for patients, employees need to be more aware of the ideas patients and their families may have. Talk to patients about their experience...what they liked, what they didn't like, whether or not they felt comfortable, if they had a positive experience that they would tell people about. All of these things can help gain a better understanding of what patients really need and some simple ideas to improve the performance and speed of the organization. If you treat patients like customers and recognize that they are a wealth of valuable information, then you are one step closer to improving your organizational effectiveness.

I have many clients in the healthcare sector and have worked in it for years...there need to be some serious changes in the current model in order to keep it sustainable. Costs are going through the roof, it is hard to attract outside talent and money is being spent, and sometimes wasted, unnecessarily. There is no shortage of talented people in the industry, nurses are some of the most amazing people I have ever met, researchers trying to find ways to help people before they get sick, physicians helping them once they get sick...it is not a people problem, it is an institutional problem.

It seems like every initiative across the healthcare system takes too long and costs too much money. Hospitals have too many other organizations that are either providing them direction or trying to help them run more efficiently. Let's take Ontario for example. We all know the eHealth mess to try and get electronic medical health records and the rollout of a common IT platform has not even been discussed. A typical Ontario hospital has its own senior management team and board of directors to develop strategy and execute. There is also influence by major donors who want to help shape the direction of the organization. There is then, of course, the government who provides the majority of the funding to run the hospitals. Hospitals are also part of a LHIN (local health integration network) to whom they are accountable for certain things. Most hospitals are also members of a shared service centre that is responsible for providing supply chain support for backend activities and they are part of a GPO (group purchasing organization) to help them with tactical buying and managing contracts. I have not even mentioned all of the different associations, groups, organizations, etc. in which hospital employees participate. You can see why it is difficult to get anything done in the healthcare sector, there are too many cooks in the kitchen.

Hospitals should only have to focus on two objectives: helping patients get healthy and raising awareness for prevention. Stick-handling through bureaucracy and trying to figure out who holds the puppet strings are not productive uses of anyone's time. Especially those that are tasked with making society healthy.