Healthcare Efficiency

Dr, Burney:
Wanted to be sure you know about this documentary and book.

GOOD NEWS…HOW HOSPITALS HEAL THEMSELVES
A One-Hour Documentary Airing on PBS
Reported by Former NBC Anchor Lloyd Dobyns

This rare good news documentary broadcast on PBS this fall and winter reports on a surprising solution to escalating costs, unnecessary deaths and waste in America’s hospitals. Doctors and nurses tell how they did their best, working overtime, while hospital conditions worsened. They were delighted to learn a new way to improve patient care dramatically and reduce unnecessary deaths, suffering, errors, infections and costs without additional resources or government regulations.

A patient is not an automobile, but…
The unlikely solution was to use Toyota management principles called “systems thinking” to improve their hospitals. Systems thinking allows leaders and staff to see the complex, modern workplace with “new eyes” and turn problems into improvements. It has saved up to 50 percent in costs, thousands of lives, and avoided hundreds of thousands of medical errors. Significant improvements have already begun in hospitals in several major cities. The documentary also describes America’s deadly healthcare problem in detail for the first time on television:

The Problem
• Doctors, nurses and administrators reveal the dangerous conditions of American hospitals, and
• How the patient became lost in modern hospitals.

The Solution
• How staff put patient care and safety first and quickly began to reduce waste (by 50 percent) and improve clinical outcomes;
• How the reporting of errors and potential errors significantly increased and enabled better patient care when hospital administrators ceased focusing on blame; and
• An MD administrator predicts these new methods will solve the malpractice crisis.

The documentary reports on SSM Health Care system with 20 hospitals and 21,000 employees across the Midwest and a Pittsburgh initiative involving more than 40 hospitals. In 1989 SSM CEO Sister Mary Jean Ryan began to adopt methods developed by Americans in the l950s’s to help Japanese industry. She also used the Malcolm Baldrige National Quality Award criteria to teach systems ideas.

Former Treasury Secretary Paul O’Neill, who raised safety and profits dramatically at Alcoa, when he was that company’s CEO, using Toyota automobile manufacturing methods, introduced these ideas in l997 to the Pittsburgh hospitals with equally significant results.

No outside funds were required. Not incidentally, these hospitals leaders and staffs have done what the American automobile makers were not able to sustain as they tried such systems methods in the l980s. The automakers abandoned these ideas for short-term profits, and currently are suffering huge, possibly fatal, losses while Japanese car manufacturers prosper. Systems management can be used to make any organization from a hospital, school, government agency, manufacturing plant--even an entire nation--more effective, efficient, and competitive.


Lloyd Dobyns, former NBC News anchor, notes that everyone is a potential patient. Producer Clare Crawford-Mason was also the producer of If Japan Can…Why Can’t We? the NBC White Paper, also anchored by Dobyns, which introduced systems and quality ideas to the West in l980.

A companion how-to book, The Nun and the Bureaucrat—How They Found an Unlikely Cure for America's Sick Hospitals, is available.

comments from the experts about the companion book:

If you think that hospital care cannot be significantly improved in quality and cost, you have another think coming. Read this book.
Dr. Russell Ackoff, Professor Emeritus, The Wharton School, University of Pennsylvania. author Ackoff’s Best, Re-creating the Corporation, and Redesigning Society (with Sheldon Roven)

This book describes the kind of leadership that's essential for making our hospitals safe and patient friendly and at the same time cutting costs by driving out waste. And that is leadership that
employs systems thinking to realize an inspiring vision. Read this book to learn how two leaders educated and transformed their hospitals. They show the way that others can and should follow.
Dr, Michael Maccoby, anthropologist, psychoanalyst and consultant on leadership, strategy and organization. author, The Gamesman; Why Work? Motivating the New Work Force and Narcissistic Leaders, Who Succeeds and Who Fails

Most of us realize that living and doing daily work requires us to depend on other people and predictable work processes. Taking those understandings into health care and the work of improving it is a complex undertaking. These authors have created an inviting introduction to health care as a system. In the midst of widespread recognition that we must improve our health care, they offer a starting point for creating the changes we need. Their attention to the insightful people making these changes happen allows us to learn from what's working. They have seen what is hard to see at first: health care as a system. Their writing is clear and inviting. In short, this is a welcome addition to the public conversation. Read it, share it and tell your elected officials about what you now understand needs to be encouraged to make health care better.
Paul Batalden, M.D.
Professor, Dartmouth Medical School

This book gives me hope that we can make similar improvements at many hospitals around the country
Kenneth H. Cohn, MD, MBA, Cambridge Management Group, author:Better Communication for Better Care: Mastering Physician-Administrator Collaboration, and Collaborate for Success: Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital Executives
See www.ManagementWisdom.com for more information, a discussion guide and to download the foreword, introduction and chapter from the book.

Clare Crawford-Mason • CC-M Productions Inc.
cc-m@cc-m.com • 202 882-0974 • www.managementwisdom.com

Hospitals: Heal Thyselves
by Cal Thomas (syndicated columnist)
Is there anyone in America who doesn’t know that our hospitals are in trouble, along with the rest of the health care system?
Three reports released last week by the Institute of Medicine confirm that. As The Washington Post summarized it, “Emergency medical care in the United States is on the verge of collapse.” Dangerous overcrowding and an inability to provide necessary expertise to treat patients in a safe, timely and efficient manner are the main reasons.
The report recommends that Congress should create a new federal agency and spend billions of dollars to fix the problem.
That is the worst possible recommendation, because it is not a solution. Another federal agency is precisely what is not needed. “Systems thinking” is.
What is “systems thinking”? As described by veteran reporter Lloyd Dobyns in a new PBS documentary that has received some airings, but needs to be viewed more widely, “systems thinking” is “basically how you see things. Instead of seeing a huge mess with one problem piled on top of another, you see differently. You see with what people call ‘new eyes.’ You see how you and your work fit into the system, and how you and your work connect to the other people in the system.”
This is not theory. It is being tried at several hospitals throughout the country, reducing patient waiting time, dramatically cutting costs and delivering quality care to patients, making them happier and healthier. It has also resulted in doctors, nurses and other hospital workers enjoying their jobs more instead of worrying about other things. With systems thinking, the patient comes first and when that happens, other concerns take care of themselves.
This is what is known as the “Toyota model.” One focuses on the person or customer and his or her satisfaction. Profits and efficiency result.
The documentary for PBS, titled “Good News: How Hospitals Heal Themselves,” shows how St. Joseph’s hospital in St. Charles Missouri, adopted “systems thinking,” dramatically improving its emergency care. Simple things like moving the x-ray room closer to the emergency room, allowing doctors to get their x-rays faster; or coordinating with housekeeping so that a room is clean when a patient needs it, thus reducing waiting time, has substantially reduced costs, increased efficiency and contributed to patient satisfaction.
St. Joseph’s set a time limit of 30 seconds for an emergency room patient with life or limb threatening symptoms to be seen by a health care professional. All others would be under active care within 30 minutes of arrival. At the time of the filming, St. Joseph’s performance record for these goals was 90 percent. They even hired a “hospitality person” who keeps patients informed as to what is happening, again contributing to patient contentment.
Lloyd Dobyns says, “You have to see the whole hospital system. You have to see how blaming people does not help. You have to see how to practice continual improvement.” At St. Joseph’s and at 40 hospitals in the Pittsburgh area, which the producers also examined, everything is focused on the patients. “It is not focused on reducing staff, reducing costs, or improving profits,” says Dobyns. “ But as you focus on the patients, all the other things occur naturally. You want to help the hospital? Help the patients.” In hospitals where “systems thinking” is used, health care costs have been reduced by as much as half.
This proven system does not require more staff or expensive consultants and it certainly does not need another bureaucratic, costly and inefficient government agency which can only make things worse. Improvements can be made, says Dobyns, starting today and in every hospital in the country. Costs will decline. “So the question now becomes, can we afford not to heal our hospitals? We can, if we want, not do anything. But if we decide not to do anything, we have to accept that every day – every day – 500 people will die in hospitals in the United States who did not have to. You and I might be among them.”
Co-producer Clare Crawford-Mason (the late former NBC News president Reuven Frank was the other co-producer) tells me systems thinking also works with schools if students become the focus and not cost, buildings or even teachers. It works anywhere and can liberate us from big government. In fact, says Crawford-Mason, some government agencies that have adopted this Toyota model are already showing dramatic improvements. If ever there was an idea whose time has come, this is the idea and this is the time.
Local PBS stations can be contacted and encouraged to run this documentary. For more, visit www.managementwisdom.com

appeared in 600 newspapers nationwide in June, 2006