Seattle Children's and Hospital language for "the best"

Seattle Children's Mission from the website:

http://www.seattlechildrens.org/about/mission-vision/

Our Mission

We believe all children have unique needs and should grow up without illness or injury. With the support of the community and through our spirit of inquiry, we will prevent, treat and eliminate pediatric disease.

No arguments with that mission....

Our Vision

We will be the best children's hospital.

• We will provide patients and their families excellent care with compassion and respect
• We will provide superior, accessible, cost-effective service
• We will attract and retain the best talent at all levels of the organization
• We will be one of the top five pediatric research institutions
• We will be the nation's premier pediatric educators
• We will achieve worldwide prominence by integrating patient care, research, education and advocacy

BUT, the Vision?

We will be the best children's hospital.   Why?

We will be the nation's premier pediatric educators.  Why?

We will be one of the top five pediatric research institutions.  Why?  Does top 6 mean you stink?

We will achieve worldwide prominence by integrating patient care, research, education and advocacy?  Why?

WHY, WHY, WHY?

the best, premier, top five, and then worldwide prominence?   What for?  So that outside sources can signal that you are doing a good job while your patients and employees see deficits in patient care?  Does that make sense?  The LEAN and continuous improvement  Healthcare initiatives are like sparkling fool's gold.  Catching to the eye, boastful at first, but then when you pick it up and really examine it, it's worth nothing.  

The parade continues, people are impressed as they walk through, as they hear about the initiatives.  And yet, the people on the scene and in the trenches know the truth - it's just a show, fool's gold, the emperor has no clothes.  The real story is beneath but no one is listening - the sparkle has caught their eye.  LEAN Healthcare initiatives do not necessarily improve patient outcome and in fact can be detrimental.  Emperor, where are your clothes?  Oh, no one close to you will tell you that you are naked.

More wisdom from the NYT article

Let's take another look at some paragraphs from the NYT article on LEAN in Healthcare:

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

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?

http://health.usnews.com/health-news/best-childrens-hospitals/articles/2010/06/02/best-childrens-hospitals-2010-11-the-honor-roll.html

Best Children's Hospitals Honor Roll
Children's Hospital Boston
Childrens Hospital Los Angeles
Children's Hospital of Philadelphia
Children's Hospital of Pittsburgh of UPMC
Cincinnati Children's Hospital Medical Center
New York-Presbyterian Morgan Stanley-Komansky Children's Hospital
St. Louis Children's Hospital-Washington University
Texas Children's Hospital, Houston