Value for Money

Chapter 12Make It Credible: Identify the 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 United Kingdom regarding changes in prep and aftercare 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 cost avoidance) to 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 represent minimal costs that could be absorbed by his particular hospital. With the assistance of ROI Institute and ROI Institute Canada, he set up the evaluation following the ROI Methodology. He had identified key impact measures that he wanted to influence: complications, infections, readmissions, and length of stay. This new approach should have improvements on all of these measures.

A group of 17 patients had the new procedures and their results compared with a control group of 17 other patients properly matched with the experimental group. The control group followed the routine procedure. To make this work with the experimental group, the staff had to be convinced that this procedure was good for patient ...