Doing more with less?

Everyone is saying it, and many claim to do it -- with less. “Doing more-with-less” is one of the hottest buzzwords in business today. It makes the promise that anyone would seek, particularly in the current fiscal environment and with the inevitable tumble downwards into sequester cuts and their consequences. However, it is uncertain how this oxymoron actually delivers in reality. Looking more closely at three implementation scenarios in the government healthcare space helps shed a bit more light.

Innovation: For some, more-with-less describes a process for overcoming challenges by crafting game-changing solutions from existing resources that when combined in new ways are greater than the sum of their parts (like the Apollo 13 crew repurposing equipment to build a filter for CO2). A more contemporary example of this is the predictive data analysis used by health agencies to detect improper benefit payments before they actually happen. Approaches like this are clearly needed, as abuse of healthcare services in the United States is estimated at up to $175 billion annually. Although true innovation can bring more-with-less, it is extremely rare, and should not be relied on to counteract flawed processes that should not be in place to begin with.

Less Is More: Another way to achieve more with less is with “less-is-more.” This is achieved when all excess and waste is removed. Approaches like Lean Six Sigma (LSS) improve processes, enabling organizations to deliver more value efficiently and with fewer resources. For example, medical facilities can optimize intake procedures with LSS to safely increase patient throughput and access to quality care. However, a risk is that an overzealous and indiscriminate use of this approach can impact quality, which in the case of providing care to wounded warriors can have unconscionable consequences. Mitigating this risk is important to ensuring that the application of lean management strategies is not overpowering; going lean can easily be overdone.

Human Resourcing: Seen through the Human Resources lens, more-with-less focuses on employing personnel in small teams with integrated and complementary skill sets. For example, the Military Health System employs clinical consultants -- clinical professionals with management consulting expertise. Instead of costly clinical subject matter experts, clinical consultants leverage an integrated skill set to act both as subject matter expert and consultant. Staffing solutions that leverage cross-functional expertise are starting to gain support within government. The Defense Department CIO’s 10 Point Plan for IT Modernization calls for increased use of agile development concepts such as iterative project cycles with tight deadlines and small, integrated teams.

The most constructive use of “more-with-less” is perhaps a less literal approach, and instead taking it as a guidance or philosophy for all stakeholders. This includes using what we have (especially our people) more effectively, managing well, continuously improving, and cultivating a shared mission to provide the best value and the most durable solutions. It is the only approach that can meet and resolve agency challenges in an authentic, timely and durable way.