Process flow in hospitals
A week ago, the Sunday Boston Globe carried a piece on Eugene Litvak's work on helping hospitals improve. A simple change could dramatically improve hospitals - and American health care.
The complexity of hospitals has long frustrated reformers. Hospital executives are adept at PowerPoint presentations that prove their 10 percent a year cost increases are justified, and they resist comparisons to other industries that have cut costs more effectively, saying it’s impossible to apply lessons from other industries to something as urgent and morally necessary as medicine.
I am not so interested in the ramifications on the national debate, though that is interesting. What's interesting is how Litvak recommends going about making these changes. His focus is on the flow of work (patients) through the system. With the focus on patient flow, he has helped a number of hospitals break many old ways of doing business that have hampered many other efforts at improvement and efficiency in hospitals.
One of the key elements to being able to improve a system are to articulate the how and why of improvements. Making changes just for the sake of change never takes you very far. People are making changes that will actually make sense in the context of their business. In this case: help patients move through the hospital. While this is the focus, there are many competing goals in hospitals (and any other system with that many moving parts), but the focus on this one primary goals helps everyone see the importance of an initiative of this sort.
And the fallout of focusing on one goal above all the others? The other goals are met if they serve the overall goal (quality improves, long hours reduced, surgery scheduling improves). And if the local goal doesn't make sense for the full system, they can be revised or scrapped in a logical fashion.
How about you? What is the goal of your organization? What does good look like for you? What is the first thing you would do to take you from what you have today to that vision of what should be?
Previous entry: What does a good plan look like