Our Aim Is At 100%. Other Than That, We Are At Zero

Paul Levy

Posted 3/21/12 on Not Running a Hospital

The power of transparency, as I have noted, is that it provides creative tension within hospitals so that they hold themselves accountable. This accountability is what will drive doctors, nurses, and administrators to seek constant improvements in the quality and safety of patient care.

MIT’s Peter Senge explains this more fully in his book The Fifth Discipline:

[T]he gap between vision and current reality is . . . a source of energy. If there was no gap, there would be no need for any action to move toward the vision. Indeed, the gap is the source of creative energy. We call this gap creative tension.

Continue reading “Our Aim Is At 100%. Other Than That, We Are At Zero”

Mr. Ness, Everyone Knows Where The Booze Is

Paul Levy

Posted 11/13/11 on Not Running a Hospital

A quality-driven physician colleague writes with frustration about two problems in his academic medical center.  I often hear similar comments from nurses and doctors, and so I present the examples for your consideration.

This hospital has a poor record with regard to hand hygiene (in the 30% range), and my colleague suggested at an infection control meeting suggested that the rates be publicly posted in the hospital to provide an impetus for improvement.  “I suggested that instead of being embarrassed, maybe we should OWN the data.” This, of course, is a standard and accepted approach in quality improvement.  S/he was told that the “the lawyers will not let us do this.”  S/he wonders, “Who, exactly, is our primary concern?”

Continue reading “Mr. Ness, Everyone Knows Where The Booze Is”

Now, Let’s Graduate to Lean 404

Paul Levy

First published 6/07/11 on Not Running a Hospital

I am borrowing some slides recently presented by James Womack, of the Lean Enterprise Institute, as a follow-up to my previous post about adoption of the Lean philosophy in an organization. If the description there was Lean 101, this is Lean 404.

It is one thing to talk about reducing waste in a process and to learn techniques for doing so. It is another thing altogether to create the management competencies that permit this kind of process improvement to take place on a sustained basis. As Womack notes in the first slide above, most organizations do not have the competencies in place to do that.

Continue reading “Now, Let’s Graduate to Lean 404”