Hearings yesterday
Rep. Henry Waxman began hearings yesterday on “Healthcare-associated infections: A preventable epidemic.” Chief witness he first day was Peter Pronovost the Hopkins researcher who sparked some controversy when the HHS Office for Human Research Protection terminated his project after he had saved the state of MI $200 K per year. (see interview: Their reasoning was that this was “research” and he needed IRB approval. Makes interesting reading for those fascinated with bureaucracy. Widespread protests led OHRP to rescind their directive, but only partially. Stay tuned. A group from the ASQ will meet Monday with the acting director of OHRP (ivor.pritchard@hhs.gov )
There are several types of infections to be discussed, and most are included in a new book, “The Pittsburgh way to Efficient Healthcare” by Naida Grunden. (I bought my copy at Amazon.com.) Naida wrote the newsletters for PRHI ( www.prh.org ) and has compiled their experience into this book. The basic theme of PRHI was to use Toyota Production Systems to improve healthcare. When a production line worker has a problem, they push the red button and everything stops. A team assembles to analyze and fix the problem, not only for that worker but for the system, so no one else ever has the same problem. Same idea was used to stamp out central line infections. When anyone noticed an infection, phones rang, and a team assembled to analyze and strategize. One ICU reduced their infection rate to zero. For the year. That not only saved lives but also saved LOTS of money. Waxman quoted an IOM estimate that infections cost society $5 billion a year. That’s Billion, with a ‘B.’ Seems worth doing, regardless of what OHRP says.
And that, of course, is the justification for the subtitle of the book--efficient healthcare. Any infection adds time and money to the hospital stay, assuming survival. One study concluded that the hospital would lose money on every infection, even if insurance fully reimbursed for the care. Same care, less time, less money, that’s efficiency.
She talks about resistance to using Toyota methods in a hospital. “This is healthcare, and a patient is not a car.” I’ve often wondered what it is that closes peoples’ minds. Is there something in medical education? Graduates of the PRHI “Perfecting Patient Care” institute sometimes return to institutions “ill-equipped to accept change.” Large minds with small portholes. I once remarked to an anesthesia resident that the tests she had ordered were not of any benefit to the ambulatory surgery patient. “Oh, they must be useful. We order them every day.”
There are several types of infections to be discussed, and most are included in a new book, “The Pittsburgh way to Efficient Healthcare” by Naida Grunden. (I bought my copy at Amazon.com.) Naida wrote the newsletters for PRHI ( www.prh.org ) and has compiled their experience into this book. The basic theme of PRHI was to use Toyota Production Systems to improve healthcare. When a production line worker has a problem, they push the red button and everything stops. A team assembles to analyze and fix the problem, not only for that worker but for the system, so no one else ever has the same problem. Same idea was used to stamp out central line infections. When anyone noticed an infection, phones rang, and a team assembled to analyze and strategize. One ICU reduced their infection rate to zero. For the year. That not only saved lives but also saved LOTS of money. Waxman quoted an IOM estimate that infections cost society $5 billion a year. That’s Billion, with a ‘B.’ Seems worth doing, regardless of what OHRP says.
And that, of course, is the justification for the subtitle of the book--efficient healthcare. Any infection adds time and money to the hospital stay, assuming survival. One study concluded that the hospital would lose money on every infection, even if insurance fully reimbursed for the care. Same care, less time, less money, that’s efficiency.
She talks about resistance to using Toyota methods in a hospital. “This is healthcare, and a patient is not a car.” I’ve often wondered what it is that closes peoples’ minds. Is there something in medical education? Graduates of the PRHI “Perfecting Patient Care” institute sometimes return to institutions “ill-equipped to accept change.” Large minds with small portholes. I once remarked to an anesthesia resident that the tests she had ordered were not of any benefit to the ambulatory surgery patient. “Oh, they must be useful. We order them every day.”
