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Reducing Variations in Care Delivery

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For people outside of the healthcare industry, it seems to be an obvious conclusion that a surgery or medical procedure should be done in a specific way. However, this is not always the case. There are variations in techniques and materials used, and even something as standard as a gallbladder removal can be done in multiple ways, using multiple resources. If you’re planning or managing a budget, this can make your job much more complicated, especially if you’re using incremental budgeting and basing this year’s budget on the previous year.

Why do variations occur?

There are both negative and positive reasons for variations in treatment. In a situation where you have two people with the same diagnosis, but one has an additional chronic health condition, their treatment plans can be quite different even though the same issue is being addressed.


However, variations in care can be also be due to outside factors that cannot be controlled. An example of this is an unwarranted variation (or geographical variation). This is when variations occur from province/state to province/state or from city to city, in the following ways:

  • Overuse of treatments
  • Underuse of treatments, so that early intervention treatments (which might be more cost effective) are not applied
  • Inequality of care – when different ethnic or social groups receive different treatment than they might in another region of the country

What effect do these variations have?

In the first instance, when variations are required for unique patient needs, these variations are essential and appropriate for providing quality and customized healthcare to patients. But in many situations, clinical variations can have negative effects, including:

  • An increase in the chance of error, causing complications, and a potential increase in length of stay costs
  • An increase in customer dissatisfaction, due to delays
  • Difficulty in budgeting and estimating upcoming expenses

What can be done to prevent and manage variations in care delivery?

While oftentimes these variations cannot be controlled, finance and administrative teams can eliminate inefficiencies within the healthcare system by standardizing which resources are available, and which clinical procedures are adhered to. Standardized clinical pathways are one of the most effective tools in managing quality of care and allow you to correctly budget your organization’s needs going forward. Pathways have four main components:

  • A timeline
  • Categories of activities involved
  • Outcome criteria
  • Variance record

By making a plan, and by figuring out the best way to incorporate those unavoidable variations, you can ensure a high level of care, and better estimate your costs across all departments.


Questica Budget works in tandem with your clinical pathways and other techniques for reducing variations in healthcare delivery. Our budgeting system for preparing operating, salary an capital budgets includes staff planning, a statistical ledger, and unlimited what-if funding scenarios, which give you more flexibility and accuracy than working on spreadsheets. Our scenarios feature can help you decide what resources you will have if your budget is cut by a certain amount, or if there are staffing changes.


Questica Budget integrates with several financial and human resource systems used by hospitals and other healthcare facilities. Clients such as Providence Care in Kingston, Ontario, have found Questica Budget to be a solution that meets their existing business requirements and provides the flexibility to address their evolving needs and processes.