Measuring cost savings in the operating room: a matter of FOCUS (follow-through, obsolescence, control, utilization, standardization)

In summary, changes came slowly at first in the OR. The biggest inventory reduction came about a year after the effort had begun. It would seem that tackling obsolescence, standardizing products, etc. would give an initial "big chunk" savings, with small amounts coming later as inventories are lowered. What we expected did not occur, due to the inherent nature of practices and what was customarily being used. For example, previously, some equipment purchases were paid for by purchasing product, which resulted in long-term commitments and high supply costs. The OR at times seemed more like a process of managing change, not just supplies. FOCUS is a daily process. How many times can you afford to overlook this process? How often are the mistakes of the past repeated? In review, we suggest this simple outline: Follow-through (review each case from start to finish), Obsolescence (schedule inventories every six months), Control (achieve inventory management by adjusting PAR levels to needs), Utilization (utilize product/equipment with your control), and Standardization (standardize products and measure results).     

A vision for excellence

One hospital integrates employee relations, customer service and commitment to quality into one successful, award-winning program. Employees at AMI Palmetto General are motivated to constantly consider the hospital's goals and strive for excellence.     

Vying for time. Work and family

Time--there is never enough of it. There are never enough hours in the day to do everything at work and at home. Today's employees, forced to choose between work obligations and family responsibilities, often feel frazzled and guilty. Some employers recognize these conflicts and are finding ways to lighten the work/family load. They are offering a sophisticated combination of dependent-care options, flexible work hours and family-related benefits tailored to meet the needs of the employees within their specific industries. HRMagazine looks at leaders in six major industries--manufacturing, health, communications/technology, financial management, government and retail. No one can give employees that 25-hour day that everyone feels they need to juggle all their work and family obligations. But these industry leaders have provided a nurturing environment where employees can successfully balance those obligations.     

Identification and Measurement of Australian Consumer Sentiment

This article was prepared by Dr L. V. Defris and J. S. McDonnell of the Institute research staff. The authors wish to thank Professor R. F. Henderson and Dr P. J. Sheehan for their helpful comments.     

Money disillusion and stagflation

In the conventional income-expenditure model with rigid wages, the aggregate supply curve is upward sloping. Increases in demand therefore imply increases in real output and employment. We demonstrate here that this conclusion depends on the form of money illusion implied by the rigid wage assumption. If we assume instead that labor supply is more sensitive to price increases than to wage increases, the aggregate supply curve is negatively sloped, and the conventional policy multipliers are thereby reversed. In the second section, we show that this result also follows if labor supply depends on the expected real wage.     

PRICES AND PRICE ANALYSIS IN THE FRAMEWORK OF THE NATIONAL ACCOUNTS

The paper discusses the role of prices in the framework of the new System of National Accounts (SNA) in terms of three major uses: (1) deflation, (2) price indicators, and (3) price analysis. Following a brief review of the price and quantity measures required by the new SNA with its emphasis on deflation of commodity flows and input-output accounts, in addition to the more conventional deflation of final demand categories, the paper discusses some of the conceptual, methodological and data problems involved in implementing the various uses of prices in the new SNA. Implementing the use of prices as deflators depends, in part, on the concept of output selected (national versus domestic; gross versus net), and which of six concepts of valuation, ranging from purchasers'value to true factor cost, is used. Some of the difficulties in deflating nonmarket flows (e.g., interplant transfers) and industry value added, based on the double deflation method, are discussed. In concept price deflators, which have shifting weights, cannot be used as price indicators, which should have fixed weights. In practice, this is often disregarded and the deflators are used as price indicators. The paper support the SNA recommendation for the development of price indexes with fixed weights to be used as price indicators, in addition to the implicit price deflators. Research in the United States indicates that differences in weights can result in different price measures for various subperiods, components of demand and sector output. Periodic revisions in weights to provide more current fixed weights for price and quantity indexes in each subperiod may minimize the problem but it introduces a new problem—lack of comparability with the constant price tables in the SNA which have fixed weights for the entire period. The new SNA provides a comprehensive and integrated framework for price analysis including the analysis of the structure of aggregate price changes, the industrial origin of final demand prices, and the impact of price change in one sector of the economy on the rest of the economy. Some major gaps which need to be overcome in order to implement the use of the new SNA for price analysis include the development of industry capital stock estimates, separate estimates of proprietors’income, reconciliation of value added and distribution share estimates, and the development of a wide variety of information to supplement the conventional input-output tables in the SNA. Implementing the various objectives of price measures within the framework of the accounts will require a number of improvements in existing price measures and expanding the scope of coverage. “List” prices should be superseded by “transactions” prices and better techniques and data need to be developed to provide for quality adjustment of prices. Coverage will need to be expanded to include services, freight rates, trade margins, government expenditures, and also fill in gaps for many manufactured products. Finally, where possible, use of unit values as price indexes or deflators, e.g., imports and exports, should be replaced by direct price measures.     

A new approach to optimal selection of services in health care organizations.

A new reimbursement policy adopted by Medicare in 1983 caused financial difficulties for many hospitals and health care organizations. Several organizations responded to these difficulties by developing systems to carefully measure their costs of providing services. The purpose of such systems was to provide relevant information about the profitability of hospital services. This paper presents a new method of making hospital service selection decisions: it is based on an optimization model that avoids arbitrary cost allocations as a basis for computing the costs of offering a given service. The new method provides more reliable information about which services are profitable or unprofitable, and it provides an accurate measure of the degree to which a service is profitable or unprofitable. The new method also provides useful information about the sensitivity of the optimal decision to changes in costs and revenues. Specialized algorithms for the optimization model lead to very efficient implementation of the method, even for the largest health care organizations.     

Children's hospitals: specialty hospitals that treat children specially

Any reader who has children will agree that they make special patients, whether at home or in the hospital. These patients have unique requirements for love and compassionate care, and children's hospitals deliver on their promises. The well-run children's hospitals researched for this article have converted their material management operational challenges to opportunities. They have built thoughtful material management strategic plans, reorganized their support services to provide customer service to end users, and they have centered their materiel management efforts around service and quality improvement.