HC Content: Where’s the Beef?

Posted on October 3, 2013

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The 1980s made Clara Peller an unlikely television star when she posed the question “Where’s the beef?” in a Wendy’s commercial.

Lately, I have been so disappointed with the weak articles in some healthcare trade magazines, I have thought the same thing.

Publishers are really hurting for content, I know, and content is king. And for consultants, the drive for marketing material and national exposure is significant as well.  But when a desperate publisher and a desperate consultant get together…well, it’s like a desperate hospital and a desperate builder:  it is a disaster waiting to happen based on everyone’s expectations.  Reading time is scant (usually when I’m flying), and cannot be wasted on double-talk.

I read a really bad article in a summer issue of a publication (which I receive a subscription) that discussed “efficient facilities”.  The article was a utilities discussion (poorly disguised as an operations analysis), which is fine because utilities are a huge expense—especially for large healthcare systems.  And the life cycle cost implications are significant:  a couple percent savings year-over-year would be a nice coup.  Every provider wants to reduce costs while optimizing operations.  So, yes, let’s talk about it.

How can a hospital reduce utility costs?  Two ways:  reduce the cost of the input (price paid for energy) or reduce the demand (amount used).

The price paid for energy is not as immutable as most people think.  Hospitals can change or negotiate with providers, moving between co-ops and central utilities.  One community hospital I spoke with earlier this month is dying to leave their current provider in a couple of months so they can join a more progressive utility that is changing ownership.  The new vendor will allow demand shifting, off-peak pricing, and sell-back of surplus energy.  The hospital will be able to finally commit to on-site generated energy like photovoltaics and cogeneration—and save $0.02-.04 cents per kilowatt-hour right off the bat with the provider switch, which is a massive budget booster.

A larger system I met with two months ago is turning medical waste into energy.  Yes, reducing waste stream and energy supply costs at the same time:  red bag to burnable fuel; it can be done.  Hospitals can generate their own energy, and reduce reliance on grid-supplied energy.

The other opportunity to reduce utility costs is to use less energy.  Out of necessity, net zero investigations have taught us a lot about how any facility can accomplish this:  occupancy sensors in rooms, more accurately zoned heating and cooling, reduced plug loads, increasing daylight (especially in patient rooms) with smart bay spacing and room depth design.  Outside of these tactics, hospitals can execute more global revisions to usage by grouping disparate, non-clinical functions off-campus (centralized support services), and using intensive energy modeling on existing facilities and new projects.

Of course, none of these ideas were discussed in the article I read.  The article I read did mention demand reduction, but was obscured by vague blather about “an infrastructure plan concept”, “standardization”, “correcting bad habits”, and using “the latest technology and systems”.  And way too much reliance on “commissioning”—all within the context of new project design, and with no quantitative data.

Too many consultants want to drop buzzwords instead of provide real ideas.  As I wrote recently, too much ‘what’ and not enough ‘how’.  Where’s the beef?

Talk is still cheap.  In this Information Age, ideas are currency.  So if a company ‘manages’ and does not produce anything, all they have to offer is information, expertise—allegedly.  So break out the good stuff because the rest of us don’t have the luxury to stomach empty calories.

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