Healthcare Radicals Required, But Are They Welcome?

Mark Graban recently posted a piece taken from Tom Peters’ new book The Little Big Things: 163 Ways to Pursue EXCELLENCE about the need for Radicals in healthcare.  Peters is spot on!  But are they welcome?

Peters mentions an experience where at a dinner party, he brought up the issue of healthcare and the experiences of each person.  Every person at the table, or a member of their immediate family had a “serious unforced error” associated with their most recent hospital stay.  I realize this is not a statistically valid sample, but that’s a 100% error rate.  As a society, we do not tolerate that sort of failure rate from our common household appliances, but for healthcare, we think it’s acceptable because “that’s just the way it is.”  Peters also mentions his wife recently had to spend 5 hours waiting in an ER for a broken ankle, a pain she described as “second only to labor,” but she was not upset by this wait because a 5-hour wait is “what you expect” when you go to the ER.  Heck, even the DMV doesn’t make you wait this long – last time I went, I was in and out in 10 minutes.  Now they even let you renew your license tags on line!  The DMV provides better customer service than many hospitals – who would have thought that!

Healthcare and the delivery of healthcare has many problems.  But the main problem is not with the people or the technology being used.  The people who work in healthcare, for the most part, are some the hardest working most caring individuals you will ever meet, and most use the latest and greatest technology available to diagnose and treat their patients.  No, the problem in healthcare is with the systems, processes, structures and lack of integration that exist, which continually put barriers in the way of the people who are trying to care for patients.  The people want to be “successful,” but the “system” does not allow for success.

Many healthcare systems are “chipping away” at these issues and have created Performance Improvement type departments / groups using Lean and Six Sigma methodologies to identify problem areas and help them improve.  The problem is, “chipping away” is not good enough.  Most of these groups are assigned to relatively small projects and while improvements are being made, these are just baby steps.  We need quantum leaps.

The challenge is that quantum leaps in the systems and structures of an organization, especially a healthcare organization, are not welcome.  After all, it has just been in recent years that “outsiders” have been allowed to enter the healthcare room and sit at the table, though sometimes it’s the kid table, but at least it’s in the room.  Those outsiders to healthcare have been able to use their skills, which have proven successful in many other industries, to improve areas of healthcare and start to make a difference.  However, when the outsiders start talking about changing the systems and structure of the healthcare organization, they are rebuffed, and told to focus on their projects.  They are told they really “don’t understand” healthcare.

Maybe that’s a good thing.  Maybe the problem is there’s too much “understanding” of how healthcare works in the executive suite.  Too much “inbreeding” which leads to the same thinking being regurgitated year after year.  When was the last time you saw an opening for a senior level person in a healthcare organization that didn’t require 10 – 15 years of healthcare experience?  In this environment, “radical” thinking will never be welcome and the quantum leaps required will never happen.

It’s time we change.  It’s time for new thinking.  We cannot settle for the mediocrity that exists today in our healthcare systems.  Baby steps are progress, but they are not good enough.  We need to take quantum leaps – speaking of which:

“The significant problems we face today cannot be resolved at the same level of thinking we were at when we created them.”

–        Albert Einstein

What are your thoughts?


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