Budgeting for Results.

Budgeting is a mandatory yet misunderstood function in most organizations because of its current focus on estimating revenues and expenses. A budget should be a roadmap specifying in dollars and cents organizational goals and how management performance will be assessed. Like a roadmap, its value is entirely dependent on whether the plan is followed. Improving treatment and controlling costs require implementing budgets that focus managers' attention on the elements of production systems that they control and lead directly to better results. The choice between using an incremental, flexible, zero-base, program, or activity-based budget to chart the desired path of departments and organizations should be made in light of organizational goals and the role of the manager within the organization.

A second look at 100 000 lives campaign.

The Institute for Healthcare Improvement's (IHI's) 100 000 Lives Campaign provided a valuable service by focusing attention on quality improvement in health care. The recent release of Agency for Healthcare Research and Quality (AHRQ) statistics on 2006 hospital admissions provides an opportunity to reexamine the achievements of the 100 000 Lives Campaign. The AHRQ estimates of hospital deaths report a decrease of 23623 between 2004 and 2006, which casts considerable doubt on the IHI claim of 122300 lives saved. The article addresses the disparity in estimates of preventable deaths, recent trends in hospital mortality, ways of reconciling the AHRQ estimates with the IHI claim, and the lessons that should be learned from the campaign.

A statistical process control case study.

Statistical process control (SPC) charts can be applied to a wide number of health care applications, yet widespread use has not occurred. The greatest obstacle preventing wider use is the lack of quality management training that health care workers receive. The technical nature of the SPC guarantees that without explicit instruction this technique will not come into widespread use. Reviews of health care quality management texts inform the reader that SPC charts should be used to improve delivery processes and outcomes often without discussing how they are created. Conversely, medical research frequently reports the improved outcomes achieved after analyzing SPC charts. This article is targeted between these 2 positions: it reviews the SPC technique and presents a tool and data so readers can construct SPC charts. After tackling the case, it is hoped that the readers will collect their own data and apply the same technique to improve processes in their own organization.

Analyzing health care operations using ABC.

The evolution of health care created a climate in which cost was subordinate to medical treatment. Current reimbursement constraints have increased the need for providers to be cost conscious, but they have discovered that current accounting practices do not provide the appropriate information to determine the cost of service or make decisions. This article argues that activity-based costing (ABC) can bridge the gap between the medical and financial communities and provide a foundation for performance improvement.