Showing posts with label Seattle Children's. Show all posts
Showing posts with label Seattle Children's. Show all posts

Thursday, October 21, 2010

More wisdom from the NYT article

Let's take another look at some paragraphs from the NYT article on LEAN in Healthcare:
At Seattle Children’s Hospital, Dr. John Waldhausen, the division chief of pediatric general and thoracic surgery, acknowledges that he and other doctors weren’t initially very enthusiastic about C.P.I. (continuous performance improvement) because they thought it would take some decisions about patient care out of their hands.
Over time, he changed his mind, and he is now a vocal advocate of C.P.I. “When you look closely, C.P.I. is the same scientific method we learned in medical school, including hypotheses, data collection and analysis,” he says. “It is not opinion and conjecture — it is data-driven.”
TEN years ago, Seattle Children’s set a goal to become the top hospital of its type in the country, and hired Joan Wellman & Associates, a process improvement consulting firm in Seattle, to help it get there. Ms. Wellman, who had worked with Boeing on its lean-manufacturing processes, suggested that the hospital apply similar principles.
Mr. Hagan says he became enthusiastic about lean manufacturing and C.P.I. after doing research and visiting local manufacturers. He directed the hospital staff to examine the “flow” of medicines, patients and information in the same way that plant managers study the flow of parts through a factory.
Commentary from LI:
Seattle Children's set a goal to become the top hospital of its type in the country.   Similarly, our organization set a goal to become the top hospital of its type in the country.  A LEAN or process improvement healthcare consulting organization was hired.  Other hospitals that had made LEAN improvements were visited or targeted as having "must have" processes.
It didn't matter one bit if these processes fit our particular hospital, setting, population, staff, patients, etc.  The administrators simply saw cookie, and reached for the cookie cutter.  If Seattle Children's, or another top hospital of its type is doing this, then WE MUST DO THIS.  That's ??sane?? 
The issue:  Who states a goal that a hospital become the top hospital of its type in the country?  The patients?  The staff?  The administrators?  The Board of Directors?  The CEO?  If you detract from the goal or experience of providing top patient care, then who cares if you are a top hospital in the country?  If you take away from the experience of working in a hospital that cares about providing for the needs of it's patients, then who cares if you are a top hospital in the country?
The U.S. News BEST Hospitals have inspired this type of competition.  See http://health.usnews.com/best-hospitals/rankings.  Why?  Who is putting on the competition?  Read about who votes, how these ratings are created, how votes are bought.
Here they are - the honor roll hospitals and do you want to know who wants to get on this list?  And what they will do to get there?

 





Wednesday, October 13, 2010

NYT Factory Efficiency (LEAN) Comes to the Hospital

What do you see when you read the article from the NYT on LEAN in hospitals?

http://www.nytimes.com/2010/07/11/business/11seattle.html



Here is one paragraph:


"The system (refers to supply system for ICU) is just one example of how Seattle Children’s Hospital says it has improved patient care, and its bottom line, by using practices made famous by Toyota and others. The main goals of the approach, known as kaizen, are to reduce waste and to increase value for customers through continuous small improvements."


Note the following sentences from this paragraph:
1)  "Improved patient care, and its (Seattle Children's Hospital) bottom line."


2)  "Main goals...are to reduce waste and to increase value for customers through continuous small improvements."


What are the main goals of a hospital?


Reducing waste and increasing value for customers?  Does that mean cutting costs and what for customers?  Increasing value?  What does that mean in a health care setting?  "Improved patient care and its bottom line."  Which comes first - the improved patient care or the improved bottom line? 


 Was there any or check in place to catch the fact that the enthusiastic LEANsters in the hospital were convincing Hospital administration to do something that would degrade patient care?


If not, why not?


“It turns out the highest-quality care also is the most cost-effective because we make fewer mistakes and create better outcomes,” says Patrick Hagan, the hospital’s president."


Not true based on Seattle Children's second child death due to drug overdose in a year.  Sad,but a wake up call?