Hospital, Heal Thyself

Proven solutions to transform a healthcare system in crisis

Part biography and part clear-eyed examination of a healthcare system in crisis, Hospital, Heal Thyself: One Brilliant Mathematician's Proven Plan for Saving Hospitals, Many Lives. and Billions of Dollars tells the story of enigmatic healthcare visionary Eugene Litvak, whose research and strategies have already been implemented at many top 12-ranked hospitals to save hundreds of millions of dollars and countless thousands of patient lives. While U.S. healthcare costs continue to skyrocket, Litvak's program described in this book offers tested, effective methods to trim those costs while simultaneously improving patient outcomes.

Written by veteran prize-winning healthcare journalist Mark Taylor, this book includes compelling discussion on:

• How hospital and emergency room overcrowding has harmful and potentially deadly effects on patients and staff
• How Litvak's algorithms and complex mathematical theories help hospitals staff appropriately to safely manage patient flow
• How applying Litvak's unique patient flow interventions improves nurse retention in an era of mass nurse exodus

Litvak's methods have been proven to work in the best hospitals in America and the world. Studies in the top medical journals confirm their success in reducing medical errors; hospital and emergency room overcrowding; nurse and physician burnout and stress and patient mortality rates. They've saved millions of dollars for each hospital adopting them, while improving patient satisfaction and outcomes, nurse retention, hospital efficiency and addressing healthcare disparities and inequities.

Distilling complex ideas into accessible language, Hospital, Heal Thyself: A Mathematician's Proven Plan for Saving American Hospitals Many Lives and Billions of Dollars is a timely, essential read for all medical practitioners and healthcare administrators and staff who want to play their part in transforming modern healthcare, and the world, for the better.

Preface xiii

1 How One Hospital Adopted Litvak’s Methods and Saved $100 Million 1

2 The Human Toll 13

3 A System in Chaos: US Healthcare at a Crossroad 21

4 The Soviet Years: Maybe I Wasn’t Supposed to Be Born 31

5 The Litvak Method: A Massachusetts Hospital Became His Test Lab 75

6 A New Research Center as Emergency Department Overcrowding Grows: Finally, the Media Notices 99

7 Physician Burnout and More Hospital Successes 129

8 The Rest of the Hospital and Healthcare 149

9 The Clinic Was Going to Fold 165

10 The Rest of the World Comes Knocking 177

11 Making Change Happen: How to Speed Hospital Adoption of Litvak’s Methods 191

Epilogue 203

What You Can Do Now 209

Notes 217

Acknowledgments 247

About the Author 249

Index 251

MARK TAYLOR is a veteran prize-winning healthcare journalist who has written for newspapers, healthcare business magazines, and online publications for 30+ years. He is a cofounder and past board member of the Association of Healthcare Journalists, a Kaiser Foundation Media Fellow, and a former steelworker, taxi driver, waiter, and lifeguard.

Eugene Litvak’s research has already saved many thousands of lives and hundreds of millions of dollars for client hospitals in the United States and around the world. He’s been called a genius and a visionary by some of the top healthcare leaders in the world. So why haven’t you heard of him? Because he’s been flying quietly beneath the radar in the rarefied, insular atmosphere of healthcare. Until now.

Hospital, Heal Thyself: One Brilliant Mathematician’s Proven Plan for Saving Hospitals, Many Lives, and Billions of Dollars chronicles Litvak’s colorful and accomplished life, both in the former U.S.S.R. and as an immigrant in the U.S., explaining how and why America’s healthcare system is failing patients and offering a tested blueprint for hospitals and other healthcare organizations to improve care and save lives and billions of dollars.

His not-so-secret superpower? Math. In this book, readers will learn about:

• How a Midwestern children’s hospital saved $100 million annually and avoided spending another $125 million to build a patient tower that was no longer needed after Litvak’s methods were implemented
• How Litvak’s algorithms and complex mathematical theories help hospitals staff appropriately to safely manage patient flow and avoid surgery postponements and cancellations, their money-draining effects, and the personal traumas they cause
• How applying Litvak’s unique patient flow interventions improves nurse retention in an era of mass nurse exodus

Telling Litvak’s compelling personal story and reviewing his quixotic quest to transform hospitals, protect patients, and improve the quality of care, Hospital, Heal Thyself: One Brilliant Mathematician’s Proven Plan for Saving Hospitals, Many Lives, and Billions of Dollars earns a well-deserved spot on the bookshelves of not only healthcare administrators and medical practitioners, but also all individuals wishing to join a national conversation about patient safety and hospital quality of care and costs.

Praise for HOSPITAL, HEAL THYSELF

“It would be hard to overstate the power of the scientifically grounded methods that Eugene Litvak offers for improving healthcare, protecting patient safety, and reducing costs. Yet, astonishingly, very few organizations appear to know them, much less master them. This book should be required reading for any healthcare executive or clinical leader who wants to achieve unprecedented performance in the service of patients, families, communities, and the organization they lead.”
— DONALD M. BERWICK, MD, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; former Administrator, Centers for Medicare and Medicaid Services; Lecturer, Department of Health Care Policy, Harvard Medical School

“Mark Taylor masterfully portrays a key solution to overcrowding and waste in hospitals and the story of its remarkable developer, Eugene Litvak. Hospital leaders, policymakers, and the public would be wise to heed the persuasive evidence of cost savings and health benefits from Litvak’s approach to smoothing the flow of patients.”
— HARVEY V. FINEBERG, MD, PhD, President, Gordon and Betty Moore Foundation; Past President, National Academy of Medicine; Past Provost, Harvard University

“Four words—‘demand exceeds mismanaged capacity’—neatly sum up Dr. Litvak’s serious assessment and engaging presentation of the imperative facing U.S. hospitals. Improving patient flow through a complex organization can seem impossible, but it is essential to patient safety and that’s all that counts. Litvak is unyielding in his quest to help providers simultaneously do the right thing for their patients and their own bottom line. Readers will enjoy his journey, diagnoses, successes, frustrations and humor!”
— RICHARD J. UMBDENSTOCK, Past President, now President Emeritus of the American Hospital Association

“Our hospitals and health systems are in crisis. Patients are endangered daily. This book is a reminder of the long-simmering underlying causes of that crisis and the fact that no system is safe if it is operated in an unsystematic way. It is also the compelling story of mathematician Eugene Litvak’s improbable life and career, from childhood in a multi-family Soviet apartment to managing patient flow in health systems around the world. Hospital, Health Thyself lifts the veil on hospital practices in a readable understandable way, and offers practical real-world solutions. If you are a healthcare professional or a patient, or plan on ever being one, this book is meant for you.”
— HELEN HASKELL, President, Mothers Against Medical Error and Consumers Advancing Patient Safety; Former Chair, World Health Organization, Patients for Patient Safety Advisory Group