Geisinger - Public Television Lauds Geisinger

March 30, 2009 – This evening public television lauded the Geisinger Health System in northeastern and central Pennsylvania . The system, founded in 1915, has 600 physicians in 55 locations and three hospitals. It provides care for over 2 million in 31 Pennsylvania counties.

The PBS program focused on Geisigner’s “Proven Care” approach to coronary bypass surgery. Geisinger’s bypass surgery comes with a 90 day warranty – i.e., if complications develop with 90 days, Geisinger will fix the problem without any additional bill. The approach is now being extended to cover births and hip replacement.

PBS was not the first to praise the Geisinger warranty. Before PBS, an article in the New England Journal of Medicinehad praised the system’s work (Thomas Lee, "Pay for Performance: Version 2.0"? August 8, 2007) and the New York Times had also favorably weighed in (Reed Abelson, “In Bid for Better Care, Surgery with a Warranty,” May 17, 2007).

In bypass surgery, Geisinger doctors identify 40 essential steps in the bypass process, then develop a checklist with procedures to make sure every step is followed, from risk evaluation to a daily aspirin regimen after discharge. The doctors, in short, stick to a systematic process to make sure everything goes right.

Geisinger’s 90 day warranty is an example of “systems engineering” in health care. A number of large integrated multipspecialty groups - Kaiser, Virginia Mason, Intermountain Healthcare, Partners Health, and various academic centers – are following this approach. Systems engineering advocates say, in essence, if you get enough health care people within a health system working together in an organized and systematic way to achieve specific goals, you will reduce errors and improve performance. This requires data, commitment, infrastructure, computer monitoring, electronic records, and physicians in intergrated large multispecialty groups. In American medicine , systems engineering is not common since only 4% of doctors belong to groups of 50 or more.

Conclusion

Improving care sometimes take systems engineering,

and a critical mass of doctors for team pioneering.

When quality’s good enough you can issue a warranty

to show your level of confidence and certainty

and you can give your results a public hearing.