2 minutes reading time (415 words)

Making "big", SMALL


How do you make big, small when dealing with complex issues which may seem overwhelming and never achievable? As easy as it sounds, it is a major challenge to execute and ensure you are following a plan every day...making big into small. Essentially not "boiling the ocean" as the saying goes.

Some examples of complex issues include moving from volume to value payment models, patient flow, readmissions, hospital-acquired conditions and patient experience.

So how do you take any of these "big" and help make them "small"?

Start with understanding the position of "one," as this promotes the need for a more focused and disciplined approach. Let's take an example with a patient (n=1) at risk of readmission. She has congestive heart failure (n=1) which is one of the subset diagnoses with a higher risk of readmission.

Try this four-step approach to focus on the "n of 1" to see if you have a solid plan in place that can be managed every day:

Awareness: Ensure systems are in place to provide early identification that there is a patient you have to manage who has congestive heart failure. Do you know where all these patients are in your health system today? What tactics will ensure you do well and what obstacles get in your way to deliver consistent high performance?

Collaboration (Bridging Silos and Integrating: Who do you need to work with to coordinate the care of this patient while he or she is in your care and where will you transition this patient post-hospital stay? Do those post-acute locations know what they should be doing to continue the care you provided? How do you ensure you are all in sync with your efforts?

Intervention: How will you manage this patient while in the hospital? What are the patient risk factors and what is the plan of care and key care needs such as better nutrition, awareness of medications and potential side effects, and clear and understandable discharge plans?

Measured results and follow-up: Was this patient readmitted 30 days post hospital stay? If yes, why and how could it have been managed differently? If no, how was it managed so you could replicate with other similar patients and apply the same approach toward other "big" situations?

This approach will also help with the health and wellbeing of your team. With the rise in burnout along with the need to improve resiliency, these steps should help allow others to stay inspired and make a positive impact every day. 

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