Kathryn Golden Correia ’79, CEO of Legacy Health, a Portland-area health system, is obsessed with how hospitals work from a process standpoint. That might seem obvious given her 20-year career of leading large healthcare institutions, but here she offers some unique insight into where hospitals break down and how that impacts our nation’s health and well-being from a community perspective.
In your opinion, where do hospitals fall short from a patient perspective?
We discharge many people from the emergency room to the street, as I call it. We discharge knowing that they don’t have a bed to sleep in, knowing there’s no way that they’re going to get their prescription refilled—they can’t afford it. We know that they’ll be back in the hospital in a matter of hours or days. You can’t get well if you don’t have a bed to sleep in, if you don’t have a clean dressing for your wound.
Actual medical care is roughly 20 percent of the contribution to health and well-being of people, and other things, like genetics and social determinants that are often attributable to education, make up the other piece. And when we look at lifestyle, lack of shelter, or not having adequate food sources, all of that goes into the health and well-being of a community. So healthcare has to work in partnership with government, with nonprofits and for-profit entities to bear that responsibility and that burden.
How does Legacy Health fit into that larger context?
I see healthcare trying to do a lot, and rightly or wrongly getting blamed for a lot. Healthcare can’t solve the problem of homelessness, which is a huge health issue. But when we think about the experts that work for our health systems, we want to help them do the best job possible by having the processes in place that maximize their contribution at the highest level and create what we call “the least waste way” of helping someone get better. We increase the benefit we give to patients and decrease their burdens—costs, pain, time away from their families, waiting. That’s our job.
How much waste is there in hospital systems?
Roughly 30 percent of what we do in healthcare is non-value added, or “waste.” For instance, there’s a huge amount of time spent by highly trained professionals trying to find information, supplies, or equipment to do their jobs. When I was with ThedaCare in Wisconsin, we created a new, patented, inpatient care model to significantly improve quality and decrease cost. One part of that was reconfiguring the patient room. First we determined what was most often needed by doctors and nurses at the bedside in order to reduce their time looking for supplies and equipment. We wanted to find a way to make the items more accessible. We also knew that patients did not like getting disturbed—while they are sleeping, for example—by multiple people entering their room. To solve both of those problems, we used the concept of a “nurse server” (a pull-out storage cabinet) to create a way to exchange items outside of the room—from the hallway—with dual-access inside the room. We coupled that with a visual system of inventory. Most important, the room design helped the patient and the nurse by increasing the amount of time the nurse can be at the bedside. That’s where the nurse wants to be and that’s where the patient needs the nurse to be.