Thanks for your comments on my post. A few thoughts on some of your points and questions, and some more food for thought 🙂
Caroline/Sam: Yes, based on my reading Trader Joe’s does invest a lot in their employees and tries to keep employee turnover to a minimum. They pay their employees well compared to their competitors which helps them retain talent. I find their customer service to be friendly while not being creepy and often have pleasant and interesting conversations when I’m checking out (which I really can’t say I have at any other grocery store). Sam I don’t know how this impacts what markets they go into.
Jane: Aldi does sell some of TJs products in their stores.
Young/Meghan: I agree I’d love to know how much their R and D spend is. They are a private company, so it’s hard to get at some of this info. They are definitely innovating all the time in terms of what products they offer, and they take the losers off the shelves and replace them with winners. As with other grocery chains, they also have a fair amount of seasonal products that aren’t available year-round. Meghan, I think they view the high-end stuff (at better prices than other stores) as a way draw people in and keep them coming back for a good deal. For example, I think their nuts, cheese and alcohol are very well priced compared to competitors, but agree that these are more high-end products.
Meghan, your post does a great job highlighting the way HSS has managed to achieve excellent results and stay ahead of the competition. As Adam points out, I wonder to what extent their processes can be rolled out to other hospitals. HSS certainly benefits from its narrow scope, which allows them to standardize more procedures since they have a high volume of fewer surgeries and services than a general hospital. Do see applications to other types of medical facilities or departments? Adam points out cancer centers, which is an interesting idea, but I would argue that there is actually more variability across cancers in terms of how they are diagnosed, treated and monitored with some requiring surgery, some requiring complex transfusions, than across orthopedic specialties and surgeries.
I was also really intrigued to see that HSS uses integrated care pathways to distinguish themselves, since this has become a hot topic in surgery departments across the country. While HSS isn’t the only hospital using pathways, I think that they are really ahead of the curve to combine pathways with a patient database so that they have access to a reliable set of patient outcomes. I hope other hospitals follow suit!
Will, great post! Having lived in Spain for a year in high school where the fast trains indeed were fast, I’m perplexed people pay so much more in the US to take the Acela, which hardly saves you 30 minutes on the Boston to New York routes. I used to take Amtrak a lot between Boston and New Haven to visit my husband, and there is one hidden gem about Amtrak which is that their customer service over the phone is (surprisingly) excellent. I often had to change train tickets, and it was always faster to call in than log in online because the customer service agents were so efficient. Not to mention they often gave me great tips for how to get better deals! Alas, that’s clearly not enough to make up for their poor results and slow service. Getting to New York in 1.5 hours instead of 4 on the train (without the security hassle) would be game-changing and if they could achieve these results through additional funding or savings from shutting down some of the less profitable routes. I remember in Spain, getting all the provinces on board for the first high speed trains took a lot of time and so I imagine the same issue applies in the US. Do you think we might be more successful at launching high-speed rail within one state, for example between San Francisco and Los Angeles, rather than across state lines?
Sojung, I really enjoyed reading your post. I had heard and read a little about PillPack but didn’t know much about their back end operations before reading your post. The use of robots makes a lot of sense to me in this industry, so that individuals are freed up from what is essentially bean-counting and can use their knowledge base for more complex questions. One potential issue I wonder about is what happens when individuals prescriptions change before they are done with a PillPack? I imagine that this could cause a lot of confusion for patients in terms of what to do with the medication they should no longer be taking and that there could be a substantial risk of patients taking the wrong dose.