Is the tiny olive part of the solution to the problem of gargantuan health care costs?
William Parrish, a CAT-scan technician who dislikes olives, thought so. His suggestion to stop garnishing sandwich plates at the Johns Hopkins Hospital cafeteria with the obligatory green pimento-stuffed variety and dill pickle chips saved the institution about $10,000 annually and earned him a $1,000 bonus in the process.
It was one of more than $100,000 worth of ideas received last year from employes who joined in a Hopkins campaign called IdeaBank, part of an ongoing effort at the Baltimore hospital to keep rising hospital costs down.
Although the approach has been used in the past in private industry by tire, computer and hotel companies, Hopkins officials believe it is the only cost containment program of its kind adopted by a hospital.
In an updated version of the old employe suggestion box, the hospital used the incentive system, promising staff members a 10 percent share of the first-year savings, as calculated by the hospital accountants, up to a maximum of $1,000.
To Parrish's surprise, that turned out to be a "whole lot of olives." At two olives per sandwich, 750 sandwiches per day, 260 days a year, it amounted to savings of $8,500 on the purchase of 390,000 olives. An additional $1,500 was saved by giving out pickle chips only on request.
Other Hopkins employes declared a war on paper work. Sharon Tumminello suggested that one less copy be made of each in-patient bill--an estimated savings of $10,000. And, $2,000 came from compression of three hospital admitting forms into one.
Reducing the number of copies of the "census report"--how many patients in the hospital on which floors--from 14 to 4 amounted to $5,000.
Unnecessary equipment also came under attack, with nurse Lorraine Gordon suggesting elimination of items in the pediatric emergency room laceration trays that were not used regularly. She saved the hospital $4,000, earned $400 for herself and used the windfall to fly her mother-in-law from Montana when her first child was born.
The biggest savings--$35,000 annually--came from Burt Finkelstein's suggestion to use paper closures on intravenous equipment rather than plastic caps. His suggestion was free, since as a manager he was not eligible for a financial award.
About 600 of the hospital's 5,000 employes participated in the first IdeaBank last fall and it was so successful, says Hopkins cost containment director James Hedeman, that a similar intensive campaign is being repeated this month.
Although the effort is promotional, complete with buttons ("Good Money for Good Ideas"), mugs and IdeaBank logos depicting a light bulb bank, he insists that the effort is far more than a "gimmick." Instead, he says, "it is a focused attempt to increase the participation and interest of employes in cost containment in the hospital."
From a dollars-and-cents standpoint, he admits that the initial $100,000 savings was only a tiny portion of the hospital's $140 million annual budget. But "it's a nice chunk of money," says Hedeman, that allows the institution to fund other new programs. Even among employes that don't submit ideas, he believes there is a "heightened awareness of hospital costs."
With the national hospital cost increase running at about 18 percent each year, he says that Hopkins was able to keep its increase down to 9.4 percent in fiscal 1981. Hopkins spokesman Elaine Freeman says that the difference stems from a long-term effort by hospital director Robert Heyssel over the last five years.