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Today’s fiscally constrained environment is challenging government contractors to find creative ways to provide more value to their agency customers. Sequestration, set to go into effect at the beginning of 2013, would trim 10 percent of federal discretionary funding across the board. This is in addition to the Office of Management and Budget’s (OMB) announced goal of reducing spending on management support service contracts by 15 percent ($6 billion) by the end of fiscal year 2012.
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At the same time the government health systems’ missions are expanding and, as such, face tremendous challenges. Veterans Affairs (VA) and the Military Health System (MHS) are up against an unprecedented influx of complex, and long-term medical and psychological conditions of wounded, ill and injured service members. It is difficult to forecast the next 60 years of care needs for a 19-year old double amputee with Traumatic Brain Injury and Post Traumatic Stress Disorder.
To truly deliver “more for less” government health agencies should look to organizational advancements made by another community fraught with complexity, trying to cut costs and improve quality simultaneously — the medical community.
Many healthcare organizations have cut costs by moving away from “doctor-centric” service to patient-centered, integrated care. This model deemphasizes the doctor as the central figure of care and communication, in addition to more actively involving patients and families in the care process. It also favors interdisciplinary teams of medical professionals, who deliver safe, effective and often novel approaches to diagnosis and treatment.
Treating the ills of an organization is in many respects similar to treating a patient. Just as interdisciplinary approaches to improving patient outcomes are successful, similar tactics can provide government health agencies cost-efficient and effective solutions, lasting process improvements and effective change management.
An example of this is the use of clinical consultants — clinicians with medical and business transformation expertise who consult — within the MHS. For example, in a government medical facility, an interdisciplinary team of clinical consultants decomposed the rounding process into its constituent parts, optimized them so that the processing of patients increased 40 percent, put in place a continuous process improvement facility to allow ongoing change and efficiencies, and extended the effective clinical reach to a larger patient population.
The highly integrated aspect of interdisciplinary teams is especially valuable considering a procurement process trending towards larger, more comprehensive projects and programs, with more wide-reaching and ambitious missions. These conditions risk, amongst other perils, misaligned expertise where resources may be misallocated or badly stretched. For example, software engineers designing clinical process flows or management analysts developing clinical models of care.
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Integrated approaches, like interdisciplinary teams can help identify these misalignments; breakdowns in coordination among agencies and individuals; and act as a “checks and balance” mechanism to ensure the patients interests are placed first and that the focus is on delivering safe and effective care.
These sorts of approaches make sense given the environmental pressures of the fiscally constrained federal agency environment, where contractors are called on to do more with less, to be resource-conscious, and demonstrate greater transparency
Dr. Ritcheson (@ASRitcheson) is a senior program manager and clinical consultant at DRC. He has an extensive background in clinical, communications, military, and government settings and provides subject matter and consulting expertise to support government agencies in meeting and overcoming their various challenges, and leaves processes performing better.