Episode #174 Saving Lives Through Hospital-based Operations Management with Eugene Litvak PhD, President & CEO of the Institute for Healthcare Optimization

Friends,

I think you’ll all understand this. Every once in a while an issue comes along which has such importance and urgency that you’re compelled to do something about it. In this case, I had a phone call with our expert guest a week ago, and ten minutes into the discussion, I stopped him and said ‘we have to do this podcast interview immediately and get it out there’.  

The compelling issue includes: (1) the severe and worsening nursing burnout and subsequent shortage; (2) the overcrowding of Emergency Departments with prolonged ED “boarding” and (3) morbidity and mortality in our hospital systems. 

These are indeed critically urgent issues. A recent Becker’s report noted that nursing and staff shortages is the #1 concern for hospital CEO’s. ED overcrowding is a worsening national crisis – well documented in the medical and lay press. In fact, 90% of hospitals report having to keep patients in the ED because of lack of hospital capacity; and this ED “boarding” is associated with significant increases in patient deaths and harm in the hospital. 

Our guest today has been studying and addressing this problem for over two decades. Eugene Litvak, PhD is an adjunct professor at the Harvard T.H. Chan School of Public Health who has published dozens of articles in peer-reviewed journals like the NEJM, JAMA, and Health Affairs. He’s also served as an advisor on patient safety and quality to the American Hospital Association as well as within the prestigious Institute of Medicine (now called the National Academy of Medicine). More to the point, Dr. Litvak developed a proven solution that he’s been deploying for years and which is now the focus of a recent book – Hospital Heal Thyself: One Brilliant Mathematician’s Proven Plan for Saving Hospitals, Many Lives, and Billions of Dollars – by Mark Taylor, a veteran healthcare reporter. 

So, we’ve had a proven, doable, financially viable solution to the problem of ED and hospital overcrowding, for years. But, for reasons that are unclear to me, most hospitals in the US are either unaware of or have not adopted his solution – which is the motivation for sharing this interview.

In this discussion we’ll discover:

1. The true cause of overcrowding in Emergency Departments and hospitals and how it is largely unrelated to the variability in the number of patients coming to the ED.
2. A detailed explanation of the ‘variability methodology’ that Dr. Litvak has developed which addresses the actual problem causing overcrowding. 
3. Published examples of hospital systems that have deployed Dr. Litvak’s method resulting in dramatic improvements in safety and quality, reductions in burnout and turnover amongst nurses, and increased hospital productivity and margin. 
4. Examples of how Dr. Litvak’s approach is being used in federally qualified health centers (FQHC’s) contributing to improved health equity.

In addition to improving quality and safety, the operational excellence that Eugene is