David Belson’s letter to the Wall Street Journal in response to last week’s front page article about hospitals cutting costs and laying off staff. WSJ erroneously stated that efficiency caused a lack of being prepared for an emergency such as Covid-19. Noting how misleading this is, David wrote the WSJ.
They published his letter on Monday, shown here:
My summary notes, link to article below
2001 startup Nurse Next Door (NND)
patient care demands zero tolerance for cracks "If you're a manufacturer and you mess up, you could lose money or even go out of business; but we take care of people's lives. We could seriously hurt someone if we mess up, so something has to change."
Most organizations tend to create practices and processes that increase over time in complexity, but have less and less importance to the customers.
NND identified these processes through a customer survey that asked two questions:
On a scale of one to 10, how would you rate our services?
What is your biggest reason for giving us this score?
feedback helped NND recognize
many of its practices were a waste of effort "We used to think customers wanted our caregivers to show up in uniform" The company provided home-care staff with a uniform allowance, paid for cleaning the uniforms, and was about to draft policies governing the wearing of uniforms, as well as an enforcement protocol. "Then we found out our customers didn't care"
A bigger concern proved to be that the company's invoices were too confusing - a 45-minute fix that improved its customer satisfaction score by 20%.
Here's an example
HOW TO REDUCE MRI TIMES:
https://pubs.rsna.org/doi/full/10.1148/rg.347140025
This was done at Department of Diagnostic Radiology, Henry Ford Hospital,
2799 W Grand Blvd, Detroit, MI.
It is more complex than most I would expect, and the team did not quit, they followed through their learning.
I've been implementing Lean for 10 years, part of that in healthcare, if you have questions or a hospital CEO interested in leading your facility to obtain these results.
It works.
The question is are you learning how to apply it Alberta Health Services?
I receive a call saying MRI appointment is for March 2019
- 1 year away.
Cannot straighten leg or bend it near 90 degrees.
*Would be 3 weeks post op in US and recovering; being told I have to wait a year now here.
Consider that other people have families, children or their elders to take care of; or may not be in a financial situation that allows a 1 year pause due to pending injury diagnosis - 1 year is unacceptable for MRI wait times.
It can impact their quality of life, #recovery potential & ability to economically contribute or support dependents.
This situation supports unnecessary ACL amputation & ACL reconstruction when diagnosis & #treatment is not achieved within the time frame for natural ACL regrowth - more explanation to follow.
Is MRI magnet time at 100% ?
If so, are we executing Lean Healthcare reducing costs in other areas to free up the available funding to purchase new equipment like so many other hospitals?
For example, Lean has been used to improve hospital utilization, improving patient outcomes while reducing the need to add entire proposed #hospital WINGS.
When properly applied the CEO frees up $$, space & resources which can be redeployed for additional healthcare services (or MRI suites).
One way to learn a solution Alberta Health Services
- in the same way emergency wait times are consistently reduced through 3-5 day Rapid Improvement events, MRI wait times are reduced the same way.
see how it's done in next post
last post was on ER, here's examples and explanation what's required for any emergency room learning Lean Healthcare including Alberta Health Services
Note the requirement for *commitment at the top senior level*
- & engaging front line employees.
HEALTH POLICY AND CLINICAL PRACTICE/ORIGINAL RESEARCH Use of Lean in the Emergency Department: A Case Series of 4 Hospitals https://createvalue.org/wp-content/uploads/2010/01/lean-ER-Annals.pdf
If you don't think it's your obligation to provide these healthcare services; consider one day you will be the patient relying on them.
(or waiting without)
Start now.
MRI wait time reduction example to follow.
Can make a pdf copy available & answer questions on how this is done.