29 Sep Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere
Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere | At the intersection of health, health care, and policy.
This is a great and timely commentary on why change in healthcare is so hard. Other examples:
- Recent reports from the CDC reveal that hospitals still aren’t consistently lowering healthcare-associated infection rates, despite intensive education, guidelines, public reporting and regulatory requirements.
- Slow and variable implementation of strategies related to stemming antibiotic resistance and addressing outbreaks of emerging infections like Zika demonstrate the challenge of developing common public health responses.
- Despite common wisdom about the importance of treating the whole person, consistent integration of care, particularly for complex, chronically ill patients, remains elusive in many practices.
The Centers for Medicare and Medicaid Services (CMS) pours money into efforts to stimulate innovation in health care delivery, quality measurement and defining value to drive healthcare reimbursement. These are noble pursuits, but as this article rightly points out, such efforts cannot yield national-scale, universally relevant solutions. It can, however, identify and test new strategies, connect them with outcomes and highlight the issues of patient preference, culture, local health trends and workforce that must guide translation to other settings and inform similar activities in other areas of the country.
Innovation and implementation support must be present locally, with the ability to help stakeholders adapt their efforts to nuances in leadership, culture, health status, infrastructure and market dynamics. National policymakers must embrace the fact that local solutions may be most sustainable locally, rather than force a “scale up” mentality that cannot succeed everywhere.