Chapter 13Addressing Intangibles

A physician in a provincial health system in Canada was interested in making some changes in the procedures for colon cancer surgery. He had been reading about some successes with an innovative approach from the UK regarding changes in prep and after care with some important results and wanted to give this a try. However, he knew it would be a change for the system which would require time and resources to implement it. This change had to generate enough improvements (cost saving or avoidance) that will overcome the cost of the change. In essence, he needed to show a positive ROI.

Recognizing that it’s difficult to secure funds to make this change, he wanted to experiment with a trial first. A small sample would be minimal costs that could be absorbed by his particular hospital. With the help of the ROI Institute, he set up the evaluation following the ROI Methodology. He had identified impact measures that he wanted to influence: complications, infections, re-admissions, and length of stay. This new approach should have improvements on all of these measures.

A group of seventeen patients had the new procedures and their results compared with a control group of seventeen other patients properly matched with the experimental group. The control group followed the routine procedure. To make this work, the staff had to be convinced that this procedure was good for patient care and necessary to control the cost of healthcare in the providence. He ...

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