Monday, January 24, 2011

The Twinkie Factor

Around Christmas time, ironically, I began looking in the phenomenon of the “Twinkie Diet”.  For those of you unfamiliar with this unorthodox methodology of losing weight, it was the thought up by Mark Haub, a professor at K-State (there’s your sign) who wanted to prove a point that calories are important. Basically, for a condensed period of time he ate a strictly monitored caloric intake which included only Twinkies and protein. The result was he lost weight and improved his cholesterol.


What struck me about the diet was the intense focus on one factor – calories. It basically ignored every other health “rule” known to man. In the professor’s defense – he was not advocating for eating junk food consistently he was proving a point that calories are important. However, calories are just one factor in overall health. No, I am not a nutritionist but I, like Oprah and 90% of the US population, have had my battle share of weight gain/loss. The one major lesson I have learned is Calories/Weight Gain are just one factor in overall health.

Heart health, for example, is made up of multiple factors with different inidcations of whether you have good or bad heart health. Weight is one indicator, but it can be ultimately deceiving. You could be in good weight range, but you may have high blood pressure. Healthcare providers have learned to evaluate a number of Key Risk Indicators that look at multiple factors and lead to a decision.

The point is – make sure you are looking at multiple factors before assuming you are doing a “good” job based on one.

In a hospital – Response Time is like Calories. Response time alone can indicate efficiency to the taking care of the patient need but you really have to look at several factors to determine if the staff is being effective in responding to the request. I can eat 10 Twinkies a day and get enough calories to meet my 1500 calorie per day quota. Does that really meet the nutrition needs of a 29 year old woman? (Ok 31 year old but who’s counting) The patient may have their need noted in a prompt manner, but the need may not be met for a longer period of time. I would argue that the latter is actually just as important as the first, especially when it comes to the core measure of pain management. Specific design applications are needed to ensure that Caregivers are able to manage the flow of communications and responses to patients needs. Then the technology must be programmed appropriately to gain the information to provide accountability. Sphere3 has done this and collected the benchmarks.

I thought about renaming our Key Risk Indicator for Efficiency and Effectiveness the “Twinkie Factor” but my team thought that Efficiency and Effectiveness Indicator (EEI) may be a better name. Let me know what you think.

1 comment:

  1. I do think EEI is a good descriptor for measurement. But, “twinkie factor” would be a fun internal name to describe efficiency and effectiveness. But, you do bring up a very important concept here, which is that Response time is vital to delivering patient care. With certain types of applications and solutions out there that enable the uploading of vital signs data and other key patient indicators, these types of solutions can aid in more effective clinical decision making. And not only are certain types of applications effective in doing this, but it is more important like you said, that the response time is fast enough so that the process is effective as well. After all, what good is it to have a solution that has the ability, but cannot deliver the data fast enough? So the two measurements, effectiveness and efficiency are both crucial to the needs of a patient. If a solution can not only provide updated patient data, but then also quickly get that data to the EMR, the patient will be able to be cared for effectively- so it’s important that all of these processes go hand in hand.

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Kourtney Govro
kgovro@sphere3consulting.com