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Standardization isn't easy.
Tom Appleget learned that lesson when he tried to export the cost and quality innovations developed at a doctor-owned heart hospital in Nebraska to a group of general acute-care facilities providing the same services elsewhere in the state.
Appleget, director of invasive cardiology, ran the catheterization laboratory at the Nebraska Heart Hospital in Lincoln, a physician-owned hospital acquired by the national not-for-profit system Catholic Health Initiatives in 2011. The healthcare reform law's nationwide ban on building new doctor-owned hospitals or expanding existing ones paved the way for the acquisition.
Given the hospital's lower costs and better outcomes, CHI asked Appleget to teach his new colleagues at three other CHI hospitals in the state about techniques to control costs and boost care quality in cardiac catheterization. "I am responsible for four different campuses, and the cost is different at each campus," Appleget said. So was...