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16 of our hospital CEOs have joined with the IHO in an added initiative to improve patient throughput. That effort shows promise in decreasing mortality risks, reducing length of stay, and decreasing emergency department boarding time. One of our CEOs said it best, when he said “consultants go away, but by working with the IHO, we now understand how to replicate this work throughout our organization.

Elizabeth A. Ryan, Esq

President & CEO
New Jersey Hospital Association

The overall theory in proper stewardship of resources and improvement is match supply to demand. We actually in healthcare have habits that don’t do that. For example we sometimes level staff when the demand is fluctuating. There will be periods of waste and periods of inadequacy to meet the needs. Professor Litvak has brought very modern theories and techniques into hospitals and medical settings and produced tremendous results, much better results for patients and a much better fit between what we are spending and what is needed.

Donald Berwick, MD

Former Administrator of the Centers for Medicare & Medicaid Services
Former President & CEO of IHI

James Anderson, adviser to the president at Cincinnati Children’s Hospital and former President and CEO, told Chicago Tribune that IHO helped that hospital improve revenue by 34 percent and avoid spending $100 million on a planned patient tower it no longer needed. Anderson, the hospital’s former president and CEO, said waiting times in the ER and OR also dropped.

We not only improved patient satisfaction levels, but instead of running around like crazy because of patient overcrowding or sitting doing nothing when few surgeries were planned, our nurses and physicians got home in time for dinner, they made their kids’ soccer games and life got a lot more orderly, he recalled.

He said significant quality improvements resulted after hiring IHO.

There are fewer mistakes and adverse incidents, and the surgeons are happier because fewer of their scheduled surgeries are canceled,” he said. “If his methods were applied to every hospital in America, we would see enormous increases in capacity, saving billions of dollars nationally.

James M. Anderson

Former President and CEO
Cincinnati Children’s Hospital Medical Center

Newark (NJ) Beth Israel Medical Center has adopted IHO practices in its telemetry department. Telemetry is something all doctors want their patients to have. Beth Israel Medical Center have saved $10 million annually by adopting IHO process improvement methodology, which decreased patient length of stay and improved flow.

Robert G. Lahita, MD, Ph.D.

Chairman of Medicine and Vice President
Newark Beth Israel Medical Center



Working with Dr. Eugene Litvak and his team from the Boston University Program for Management of Variability in Health Care Delivery, currently the Institute for Healthcare Optimization (IHO), has been a fascinating experience. They have already successfully implemented the methodology of variability and flow management in several hospitals in the US but we wanted to know whether it would work within a state-run service such as the NHS. Working with IHO to examine the data we collect highlighted several areas for improvement and re-design. It has also shown that we have much in common with US hospitals. It has been an interesting journey, adapting the IHO methodology to suit the way healthcare is organized and delivered in the UK. We have encountered some obstacles, but having completed the cardiac surgery prototype, we are now better placed to resolve future challenges.

Jane Collins

Great Ormond Street Hospital NHS Trust

The collaborative efforts between Palmetto Health Richland and Institute for Healthcare Optimization faculty continuing over the last few years have dramatically improved OR throughput at our hospital and will have a positive effect on patient flow throughout other areas within the facility including the ED. Dr. Litvak’s team has helped us identify and correct the root cause (variability in patient flow) of many problems (ED holds, diversions, medical errors, prolonged lengths of stay etc.) that plague hospitals like ours.

Ellis Knight, MD

Senior Vice President, Ambulatory Services
Palmetto Health System

The hospital is committed to using a more scientific approach to management. ‘Otherwise, we are squandering a huge, very expensive community resource,’… ‘We are saying, ‘This makes good business sense, and it make good sense for our patients.

John Chessare, MD

VP and CMO
Boston Medical Center
OR Manager, Vol. 19, No 11, November 2003

The power of flow management lies in making administrators think more analytically… The Alliance’s Cambridge Hospital used software developed by Litvak to predict patient numbers…to adjust employee schedules rather than scrambling to hire nurses on days when numbers jump, while cutting in half the number of patients transferred to other hospitals because of staff shortages… ‘Over time, you use fewer [temporary nurses] and overtime… so you achieve cost-savings that really do offset the higher levels of staffing.

Dennis Keefe

Cambridge Health Alliance

The learning process involved with understanding and managing variability was powerful but not overwhelming… solutions used by business were very transferable to the healthcare environment… Dr. Litvak’s commitment … [and] his understanding of issues affecting healthcare organizations … were extremely valuable. His recommendations enabled us to make a positive impact on daily operations very quickly.

Susan Leavitt Gullo

Elliot Hospital