How to survive without grants

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OK. You’ve landed here, maybe out of desperation for your organization. Maybe you are reaching the end of the proverbial rope and you believe that your funds are about to run out. If you are a non-profit healthcare organization, you likely survive only by means of generous donations/fund raising/foundations, and by finding grant sources. But, where to look?

But, how about approaching the problem from a different angle? If you’ve reached this page, you no doubt have already found some sort of funding, albeit sparse. But, what if you found more efficient ways of using those funds that you already have?

 

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If you still need some brainstorming, starter ideas on where to find funds, check out the notes section at the bottom of this post. If you want some suggestions on how to be more efficient with the money that you already have, keep reading.

Eliminate Paper, and Double-Data Entry

If you are collecting data as a grantee for reporting purposes, eliminate paper from the process. An economist from The World Bank found that switching to cell phone based surveys from their paper equivalents resulted in 71% average cost savings, and a 3.6% reduction in the time it takes to survey while still improving on the data collection quality from the prior year.

With an increasing number of smartphones out in the market, reasonable return on investment for enabling smartphone data collection is feasible, if you plan accordingly. And, If you only need some to collect some simple survey data that are not tied to other data within your organization, you might even be able to accomplish it for free over a weekend using a service like surveymonkey.com.

Streamline Workflow

While you are reducing paper, also reduce workflow bottlenecks. Identify key personnel and processes and determine if any of them are possible single points of failure. Think like McDonalds. Do you only have one person who understands the intake forms or systems required from the majority of your grantors? Make sure they have a competent backup. Do you know how long it takes for those intake processes to complete from start to finish? Maybe there are ways to do some pieces of that intake in parallel, like having the consumer complete some of the forms online or even at a kiosk at the intake station while your staff are recording other pertinent information related to the intake (like housing or income verification).

Automate Where Practical

That old axiom “a stitch in time saves nine” may seem quaint, or even incomprehensible to a modern culture, but putting in a little early effort can actually save you a lot of effort in the long run. Take a look back to your paper forms and your workflows. Are you duplicating collection or even reporting efforts with that information on those forms — are you having to retype that information from paper back into one or more electronic systems? If so, spending a little time and money implementing “re-heat/re-serve” of existing electronic data might save you a lot of staff man hours. Don’t retype anything, even if you think some translation has to take place between the source material (paper/electronic) and its final destination.

Say, for example, that you collect all of the Current Procedural Terminology (CPT) codes from your physicians, nurses, and physicians assistants, but your grantor only wants some aggregate rollup count of daily visits per consumer. Don’t spend the time retyping or calculating those CPT values — find a cost effective way to automate that aggregation.

Measure, Measure, Measure

Finally, remember another adage, “what doesn’t get measured, doesn’t get done”. You need to identify those key metrics for your organization just like a Harvard MBA might, even if you don’t really see a correlation between that analysis and the type of service you provide. The best  way to root out inefficiencies within your organization is to implement measurements around those high cost/expense areas of your organization in terms of time, payroll and full time employee resources.

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Need some outside help? Sometimes you can’t see the forest for the trees, and we can help you improve your outlook. Give us a call.

FUNDING SOURCES IDEAS:

  1. Federal Healthcare grants
  2. Grants.gov
  3. Good home health Federal grants overview post
  4. Check with your State Dept. of Health (e.g., Texas DSHS).
  5. National Institutes of Health
  6. Check with your county and city purchasing departments, especially local departments of health. (e.g., Houston’s Harris County Health Dept and Houston Dept of Health and Human Services)

Decision Support Systems: Silver Bullet or Lead?

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You might have seen the Jeopardy! episodes in 2011 where Watson, an IBM computer system, beat the biggest all-time human money winner, and also beat another record holder for the longest championship streak. Watson’s creators have aspirations of it eventually becoming your physician’s assistant, but are these type of computer assisted tools really ready for prime time?

Fans of Ray Kurzweil, the noted technology futurist and entrepreneur, would chalk this up as just one more inevitable notch on the progression towards real and practical artificial intelligence. Kurzweil has noted the exponential growth of computing power, which began, he says, with 1890 U.S. census, and has continued practically unabated since — leading up to the current wonder, Watson.

The folks at IBM’s DeepQA project have set even higher hopes for Watson than just uncanny gameshow trivia — they want to revolutionize the way healthcare providers make critical decisions by having Watson serve as a high-end clinical decision support (CDS) system.

There’s no doubt of the need for some sort of intelligent assistance when it comes to healthcare decisions. Dr. Herbert Chase, a Columbia University medical school professor, has said that for at least 30 years, doctors have been unable to keep up with the information overload . “Every day, doctors have questions they can’t find the answers to. Even if you sit down at a search engine, it’s so labor intensive and it takes so long to find answers.”

Futurists forecast that a mobile-accessible, cloud version of Watson is in the works, which would be a game changer. Think Siri + WebMD.com + MEDLINE.

Instead of waiting for Watson, many providers have turned to home-grown, or commercially available CDS solutions. But are these tools really viable for novice and experienced healthcare providers?

The medical research studies attempting to answer this question have returned with a mixed bag of results. We’ve dug through more than 40 studies conducted within the past ten years and have found that the answer is both yes and no — or a definite maybe.

All waffling aside, the majority of studies reporting positive impacts of current CDS seem to be for those systems that are very narrow and targeted in their application. Concerned about adverse drug events within a hospital or clinic setting? A couple of studies1 indicate a positive impact of utilizing these tools. Want automated real-time pneumonia and heart failure decision support? One study2 shows promise.

But, widen your net of what you want from decision support and the current crop of solutions don’t seem to be making much of an impact. One research project3 hypothesized that CDS functionality would result in higher-quality outpatient care compared with electronic health record (EHR) use without CDS. The results? Not even close. Neither EHRs nor CDS was associated with ambulatory care quality.

Many of the studies cautioned that CDS’s are not silver bullets, and urge decision makers to employ multiple factors before embarking on this path. Get buy-in from key, experienced staff. Try to envision unanticipated effects that the CDS introduction might cause — for example, one study referenced the ability for nurses to routinely override the CDS recommendations, which could lead to an increase rather than a decrease in variation or errors4.

Whatever your approach, wise counsel is always advisable. Need some help? Give us a call.

Research Study References:

  1. [Drug Saf] Drug Safety: An International Journal Of Medical Toxicology And Drug Experience 2011 Mar 1; Vol. 34 (3), pp. 233-42.;              [Am J Health Syst Pharm] American Journal Of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health-System Pharmacists 2012 Feb 1; Vol. 69 (3), pp. 221-7.
  2. [Am J Health Syst Pharm] American Journal Of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health-System Pharmacists 2009 Feb 15; Vol. 66 (4), pp. 389-97.
  3. [Arch Intern Med]. 2011;171(10):897-903. doi:10.1001/archinternmed.2010.527.
  4. [J Clin Nurs] Journal Of Clinical Nursing 2009 Apr; Vol. 18 (8), pp. 1159-67.