PubMed · 14997737
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Nancy Ham. 2004. Eradicate enrollment?. https://pubmed.ncbi.nlm.nih.gov/14997737/
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The US health care system is struggling with a mismatch between the large, simple (low-information) financial flow and the complex (high-information) treatment of individual patients. Efforts to implement cost controls and industrial efficiency that are appropriate for repetitive tasks but not high-complexity tasks lead to poor quality of care. Multiscale complex systems analysis suggests that an important step toward relieving this structural problem is a separation of responsibility for 2 distinct types of tasks: medical care of individual patients and prevention/population health. These distinct tasks require qualitatively different organizational structures. The current use of care providers and organizations for both purposes leads to compromises in organizational process that adversely affect the ability of health care organizations to provide either individual or prevention/population services. Thus, the overall system can be dramatically improved by establishing 2 separate but linked systems with distinct organizational forms: (a) a high-efficiency system performing large-scale repetitive tasks such as screening tests, inoculations, and generic health care, and (b) a high-complexity system treating complex medical problems of individual patients.
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The main goal of health care units is patient care. During this process, water, energy, and different materials are used, generating liquid effluents and solid waste that require adequate treatment. Although medical waste management demands increasing attention by health care units, reduction in the generation of medical solid waste has still not been set as a priority. Using ecoefficiency techniques, it is possible to demonstrate whether a company is meeting it standards for quality, procedures, environmental control, and economic efficiency. Therefore, ecoefficient companies realize both economic and environmental benefits through progressive reduction in solid waste, liquid effluents, and air emissions. This new concept requires further dissemination among health care units, since many are making efforts to improve quality of services, but still overlook the issue of waste and generate an increasing amount of solid waste. This leads not only to waste of raw materials but also additional costs for proper waste management.