Why clinical staff has been labeled resistant to change

This not so famous quote from Henry Ford illustrates why manufacturing operational proven methods don't work very well in a hospital.  For the past 15 years I've been watching hospitals struggle with improvement methodologies like Lean and Six Sigma and their application to ED wait times, medication administration, OR TAT, and even sepsis.

The weak results are not for lack of investment, training, or time.  The reason why these approaches seem to fail us is that we are forcing change.  It's always boiled down to a change management problem: "they are resistant to change".  After decades of trying we are just not getting the results from what I call manufacturing oriented operational improvement methodologies.  And the reason is simply that a hospital is not a factory.  

Patient flow makes hospitals safer

Sepsis a common cause of death in hospitals, killing more than 200,000 Americans each year.  Half of these patients could be saved by "early recognition and rapid treatment", via sepsis bundles.  But these bundles or protocols are just the beginning.  We'd like to add value to this conversation by introducing the concept of patient flow.  At Amplefi we see patient safety as a function of patient flow.  A hospital cannot be truly safe if patient movement or the supporting processes are riddled with delay.

Is your hospital ready for the impending care crisis?

The answer is no.  Your hospital can't handle the patients it has now.  Healthcare is an industry awash in demand with limited supply (doctors and nurses), and a price not directly paid by the consumer.  If you have a handle on basic economics, you know this means that there is a shortage of available healthcare in our nation, also known as rationing.  That's not a political statement -- its a factual one.  Rationing or shortage means that people have to wait in line for a resource, and man, do we have to wait in line at the emergency room.  The problem is so bad that hospitals use their ER wait time as a selling point.  This problem is about to get much, much worse. 

5 ways to fix your crowded ED (that you haven't tried yet)

Crowded emergency departments continue to plague the nation’s hospitals and the cost of poor service resulting from excessive delays can run into millions. Therefore, any attempts to ease ED crowding, reduce treatment delays and improve patient throughput can radically improve patient safety and a hospital’s bottom line — which makes the environment healthier for all concerned, including patients, staff, physicians and insurance companies. Because ED is the main entry point into these hundred million or even billion-dollar enterprises, it should always be important to improve access. 

Hospitals: Do you know who your customer is?

There are many hospitals out there pursing Six Sigma, in an attempt to provide rigorous discipline in order to boost hospital quality. And they sure do need it. Hospital insiders know one thing for certain, going to the hospital is no picnic, and it can even be dangerous.

Don’t take my word for it: watch how insiders behave when one of their loved ones needs to go to the hospital. The invoke all kinds of “insider” privileges to make sure the experience is routed with special handling. The ‘right’ people are contacted to make sure that their family doesn’t get the standard treatment. In fact, I have personally asked over 200 hospital middle-managers: “Would you take your father to this hospital?”, and over 65% respond with an emphatic NO!

So it is silly to argue against an operational excellence framework like Six Sigma or Lean; the rigor of which is a potent part of its own success formula. Unfortunately, the basic nature of the typical short-term care facility limits the potential of these tools. Why? Because a hospital cannot really define their customer.

Downsides of standardization in health care

We are approaching the tipping point in hospital provided care. Too many healthcare professionals have fallen in love with standardized medicine and standardized processes.

Don’t get me wrong – these are well intended, well educated, experienced and professional people. I believe they are some of the most intelligent people in the country. They have simply fallen in love with the wrong idea.

Standardization. Standardization is very efficient. Standardization is reliable. In a world where costs are spiraling out of control, standardization makes a lot of sense. I have no quarrel with standardization; when properly applied it has enormous benefits. But standardization has a downside. It stifles thinking. It treats labor (nurses/doctors) like commodities.

4 reasons why great clinicians cause medical error

Deaths caused by preventable medical errors are unnervingly commonplace in modern American healthcare, but our health system still hasn’t stumbled upon a solution. Addressing issues with staff communication is a superficial issue, and as much as it makes sense to us logically, patient-provider relationships aren’t at fault here either. It’s easy to blame the nurse’s disrespectful bedside manner or the doctor’s arrogant demeanor, but its essential to remember that the vast majority of healthcare providers aren’t denying patients the care they need for some arbitrary reason. Professionals just aren’t that catty in potentially fatal situations.

What we’ve just mentioned are just symptoms of the underlying issue — so let’s stop scratching at the surface and dig deeper. If we want to eliminate medical error fatalities for good we need to get to the core of the problem. Here’s where Amplefi comes in. We have been studying the inner workings of hospitals for 15 years and we’ve learned a lot along the way. We’re good at identifying true causes and bypassing superficial symptoms, and we’re about to share some of our discoveries with you in this post.